Push-ups plus exercise are often used by people with shoulder dysfunction or conditions. Its use is due to activation of the serratus anterior and improvement of scapular kinematics . Typically if a participant increases upper trapezius activity and decreases serratus anterior There is more anteversion and medial rotation of the scapula during activity and less upward rotation with elevation . Increasing activation of the serratus anterior has been found to improve this upward rotation of the scapula. Using push-ups has been found to improve pain Symptoms in people with impingement symptoms  and winged scapula .
Unlike regular pushups, in which you brace your hands and toes on the floor, then lower your body to the floor and back. The push-up starts in the same position as a push-up with arms extended, but the participant is not lowered to the floor Stretch their shoulder blades.
Push up plus start position
Push up plus end position
Participants stand against a wall, stretch their arms and lean forward against the wall. This position limits the loading of the upper body and is usually the participant’s starting point
Participants are in a reclined position on a table or firm surface. This increases the weight bearing through the upper body
Participants kneel on the ground with their arms extended for added upper body resistance.
- Push up position
Participants are in a push-up position with arms extended and toes on the floor.
Participants assume any desired position, but wrap the hands around the torso to increase strength in the upper body.
- Ludewig, P. M., Hoff, M. S., Osowski, E. E., Meschke, S. A., & Rundquist, P. J. (2004). Relative balance of serratus anterior and upper trapezius muscle activity during push-up exercises. The American journal of sports medicine, 32(2), 484–493.
- Hardwick, D. H., Beebe, J. A., McDonnell, M. K., & Lang, C. E. (2006). A comparison of serratus anterior muscle activation during a wall slide exercise and other traditional exercises. The Journal of orthopaedic and sports physical therapy, 36(12), 903–910.
- Ludewig, P. M., & Cook, T. M. (2000). Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Physical therapy, 80(3), 276–291.
- Park, K. M., Cynn, H. S., Kwon, O. Y., Yi, C. H., Yoon, T. L., & Lee, J. H. (2014). Comparison of pectoralis major and serratus anterior muscle activities during different push-up plus exercises in subjects with and without scapular winging. Journal of strength and conditioning research, 28(9), 2546–2551.