Crush Your Push up Limits

Bodyweight movements are oftentimes an equalizer for many, and can result in red lining early in a workout or skyrocketing time splits during rounds. This is often due to a limited base of strength, efficiency, and endurance for these movements. When the skill is progressed prematurely without prerequisite strength for the strict movement this is where injury occurs.

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A lot of crossfit athletes are fit and strong humans, but when asked to perform bodyweight skills under high volumes or with higher level skill injuries tend to occur. Specifically with regards to the push up and it's progression the handstand push up. While the handstand push up may seem more closely related to strict overhead press strength, it is actually a progression of the common pushup. It would be recommended that you be able to perform 15 strict push ups with no faults before attempting handstand push ups. 

STRICT PUSH UP POINTS OF PERFORMANCE: A MOVING PLANK

1. Hands just outside shoulder width (simply bend your elbows with your palms facing away from you this should put you in roughly the correct position.)

   * Wider reduces the activation of your pecs and triceps while narrower widths increase this (get more bang for your buck!)

2. Fingers pointed forward (middle finger at 12p) or slightly outward. Fingers should never point inward as this is likely to cause elbow and wrist pain

3. Entire hand contacts the floor, not cupping the floor. 

4. Straight line from shoulders to feet with eyes looking 12” in front of you to keep a comfortable neck posture.

5. Glutes and quads engaged.

6. Descend without change in starting position

7. Elbows stay over the wrists so forearm is vertical to the ground in the bottom

   * More inclined forward increases pec activity while elbows behind the wrist resulted in increased tricep activation

8. Elbows stay close to the body with ≤ 45 degree angle from torso (think forming an arrow not a T) 

9. Return to the starting position with the straight line still intact. 
   

WHY “SAGGING” OR SNAKE PUSH UPS SHOULD BE AVOIDED

Simple: low back and shoulder injury prevention. 

The push up is challenging because of it's demands on the entire body. Your abdominals are working at >50% of the max to keep your spine stable during the push up. Allowing your hips to sag is placing undue stress on the joints of your lower back and cheating you out of stronger abs for more challenging skills….handstand push ups, pull ups, etc. Also allowing your hips to sag changes the pressure at the shoulder joint, as its point of stability (shoulder blade to rib cage) is altered. 

What does this mean: if your sagging your solution is core work including exercises like:

• Hollow holds

• Planks

• Planks on rings

• Planks with your feet elevated on a bench or box

*using a stability/exercise ball under your arms does not increase the demands on your abdominal muscles, but will increase the activity of your upper body.

HOW DO I ELIMINATE THE FAULTS FROM MY PUSH UP

Push up Progressions: Match your current level and perform during the workout. Work on the next progression during open gym or at home as an accessory program. Or shoot us an e-mail with more specific programming questions.

Why are knee push ups not on this list?

Knee push ups should be avoided. Unfortunately, this common modified “girl push up” is both insulting and ineffective. The knee push up significantly alters the form from that “moving plank” increasing the stress on the shoulder, and eliminates the activity of many of the muscles required for a push up, especially the core musculature. This means you’ll never be training the appropriate muscles and never progress from the knee push up to a push up. You will see faster progression and strength utilizing inclined surfaces which you progressively lower to the floor.  

How to increase push up volume

I feel awesome for rounds of 10 push ups….for about 2-3 rounds then my endurance and strength plummet. How do I address this problem? With drop sets of push ups. 

1. Pick a variation of push up: traditional, narrow, hands on parallettes/KBs

2. Perform 3 sets of max repetitions in each of the following variations of the push up variation you choose: 

Declined (feet above hands)

Floor (feet and hands on floor)

Inclined (feet below hands)

3. Allow 20-30 seconds of rest between transitions.

**When performing on parallettes or KBs for increased range when you move to inclined surfaces, place your hands on two benches or boxes to allow your chest to go between your hands to maintain the range of motion. 

Other Accessory Exercises

As discussed in the “sagging” section the strength of the abdominal muscles can be a limiting factor in the push up and is best addressed with the provided exercises in that section. 

In the upper body, the pecs or the triceps could be a limiting factor. Unsure of which? First make sure your hands are no more than shoulder width apart. Second, add a weighted vest or band to your push ups. 

If your pecs are the limiter: 

Try push ups with shoulders inclined further past the hands

If your triceps are the limiter: 

Add in accessory work with diamond push ups, skull crushers, banded pressdowns.

When should I move up or down in the progression?

Regression is often required when pain is present whether its neck, shoulder, or lower back pain. Simply move up or down the scale until you can perform with minimal pain. If you have wrist pain variations can be performed with on your knuckles or your hands on DBs, KBs, or parallettes to minimize the wrist extension required. 

Progress on the variation when you’ve achieved 10-15 repetitions without breaks in form or pain. 

Elbow Pain

Tennis elbow or lateral epicondylalgia, is an irritation of the common wrist extensor tendon, and more specifically the extensor carpi radials brevis portion. While, historically, associated with tennis players due to both the amount and intensity of gripping and wrist extension/snapping required, this conditioning can affect anybody performing repetitive gripping activities, including weight lifting. 

The true pathology of tennis elbow is a hotly debated topic and often there is no traumatic injury.  To boil this down quickly, tennis elbow can be either a tendinitis, which is a more acute form of pain, or a tendinosis which has been present off and on for months or even years. What’s the difference? 

Tendinitis is an acute inflammatory response to micro-damage with swelling present. Whereas in tendinosis there is pain, but no acute swelling. When tendinitis isn’t managed properly often times it transforms into a tendinosis as improper healing occurs and continued repetitive breakdown of tissue results. Ultimately, tennis elbow is often the result of an acute increase in gripping or repetitive wrist extension. Often times there is a large contribution of faulty mechanics at the shoulder and thoracic spine. 

Management of tennis elbow begins with a couple of techniques to address the pain. This includes direct pin and stretch techniques to the muscles and an exercise we call “nerve gliding”. Nerves exit the spinal cord and travel through other tissues throughout the body to allow you to do everything you need. A nerve is a sensitive, high maintenance structure meaning it likes it space and respect from the other tissues. If inflammation or mobility restrictions are present this will impact the nervous tissue and can result in a nerve entrapment. When this happens a nerve becomes sensitized and it will take less pressure, force production, or movement to provoke your pain. In the elbow, this nerve is called your radial nerve. By performing the nerve glide you are essentially improving the relationship of the nerve to its surrounding tissue and reducing it’s sensitivity. 

Once you managed the pain with the above techniques we can talk about addressing the actual cause of your elbow pain, which is often weakness. There are many causes to tennis elbow symptoms, including your neck, but the most common cause of isolated elbow pain I see is weakness in the shoulder. Overuse of the wrist extensors occurs because the muscles around the shoulder are ineffective at doing their job. Below you will find a few exercises to begin addressing these muscles. 

Again, these type of symptoms can have many causes so give these strategies a try, and if you still can’t get back to your favorite activities give us a shout for more personalized care strategies! 

Own your movement. Build your resilience. 

Warrior Rx 

Best Recovery Drill

The Best Recovery Posture and Drill You’re Not Using. 

I get all sorts of questions as a physical therapist about stretching and mobility drills to help with a variety of aches and pains. While each area of the body has its various drills that are useful, one of the best all around drills is 90-90 diaphragmatic breathing. 

The 90-90 with diaphragmatic breathing drill is a go to at the end of training or day because it helps shift me from a place of stress to a place of rest and recovery. It restores not only my squatting depth, helps with my overhead movements, but prepares me to get the most out of my sleep.

Why is this drill so simple yet so effective? 

The position itself allows you to reset your low back and pelvis posture. Resetting this region will also allow your femurs to drop back into the hip socket and reduce anterior hip tightness. It also puts you in a great posture to practice diaphragmatic breathing. Diaphragmatic breathing aids in rib and thoracic spine mobility, appropriate core activation, as well as, quieting your sympathetic nervous system allowing built in physiological recovery systems to operate and prime you for whatever happens tomorrow. 

How to do it? 

1. Lie on your back with your knees and hips each bent to 90 degrees. You can either have your feet on the wall or supported on a box/couch (foam roller between the knees optional)

2. Curl your pelvis so that your hips are slightly off the floor

3. Place one hand on your belly and one hand on your chest

4. Inhale fully with your belly hand moving first, then your chest hand second. 

5. Hold your inhale for 2-3 seconds 

6. Fully exhale over 6-8 seconds imagining pulling your rib cage towards your pelvis

Hang out in the position for a few minutes after your training session to prepare you for the rest of your day. Or spend 5-10 minutes here at the end of the day before bed time to optimize your sleep habit. 

As always, 

Own your movement, build your resilience. 

Warrior Rx

Questions about your specific injury? We’re happy to talk to you about it! Contact us by e-mail to set up a phone call abigailbird@warriorrxtucson.com

Plantar Fasciitis Self-Management

Plantar fasciitis seems to plague everyone at some point in their active life. You know the symptoms: 

1. pain in the heel or arch 

2. pain upon standing first thing in the morning or after prolonged sitting 

3. pain when walking for a long period of time. 

What do all these symptoms have in common; PAIN. Plantar fasciitis is a real pain and for most people, a real challenge to eliminate permanently. I hear it all the time, “Oh my plantar fasciitis is acting up again, I’ve had this about 3 times.” So why is this such a pain and why is it so hard to get rid of? Let’s start with the basics….

What is your plantar fascia? 

The plantar fascia is part of the medial arch of your foot. Your medial arch is the primary load bearing structure of your foot. Your plantar fascia within this arch is the primary shock absorbing structure, and ultimately acts like a spring to help you receive load when your foot hits the ground then quickly return it when your foot pushes to leave the ground. The plantar fascia receives assistance from the muscles of the foot to propel you efficiently with walking, running, jumping, etc. When any part of this system doesn’t function plantar fasciitis is likely to show it’s ugly mug. Now, while rolling your foot on a frozen water bottle or tennis ball along your arch will help with the pain, it won’t solve the problem completely, or at least not forever. 

WHAT TO DO ABOUT IT

One of the common causes of plantar fasciitis….poor shoe choices. In shoes there is a feature called heel drop. The greater the heel drop, the higher the heel, causing stiff ankles. However excessively cushioned shoes result in reduced muscle activation. Make better choices to start with then implement a few of the following strategies to get you started.

1. Toe yoga and basic foot exercise, if you have flat feet that would be the best place to start to help rebuild some of the muscular supports for your plantar fascia. 

2. Get some big toe extension. Lacking big toe extension reduces what’s called the “windlass mechanism”. This mechanism uses great toe extension to help tighten the plantar fascia and keep the arch lifted. Why is a lifted arch important? It makes the foot rigid for more effective force transfer. This means less energy to perform box jumps, running, or whatever horrible torture you signed up for in class. 

3. Get and maintain some ankle dorsiflexion with either calf stretching or banded ankle mobilizations. 

4. Heel raises with a twist. 

These strategies will put you leaps and bounds in front of the people just rolling a frozen water bottle on their foot. Ultimately you’ll need a progression back to your activity to address any other deficits in your movement. 

Own Your Movement. Build your resiliency.

Warrior Rx