Dispelling The Dysfunctional Kneeling Push Up

By Dr. John Rusin

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Here’s What You Need To Know…

1. The kneeling push up is NOT a safe and effective way to train the push up, period. By using this variation, you’ll not only make little to no progress in upper body strength, but may even get hurt in the process.

2. The kneeling push up alters the tension and connection of the full body kinetic chain, placing brutal stresses through the lower back, pelvis and anterior shoulders, and predisposing pain and injury in the process.

3. Faking a push up is one thing with poor spinal alignment, but continuing to place your body into injurious positions for the sake of adding reps to your totals is not an acceptable way to progress strength and functionality.

4. The quick fix to bulletproofing your body and making notable progress in strength, body composition and functionality, is by intelligently using and progressing the hand elevated push up. This variation will yield results, without dealing with the aches, pains and poor positions associated with the kneeling push up.

Time To Stop The Kneeling Push Up, Ladies!

The push up is one of the most important foundational movement patterns known to man, but many women, and truthfully men as well, struggle to progress and perfect this traditional exercise. You’ll be hard pressed to walk into any commercial gym or CrossFit box and not see the push up being absolutely butchered to the point of orthopedic concern.

When it comes to training and perfecting this horizontal push pattern, the addition of more and more poorly executed reps with shitty spinal and pelvic positions seem to take president over quality movement patterns that involve the tension and recruitment of muscles, movement chains and anatomical segments throughout the entire body.

While cheating push ups are ineffective at best, and injurious at worst, there’s also another side to this dysfunctional push up story that doesn’t involve being a ego driven meathead. For women that struggle to even compensate their way through a single traditional push up on level ground, the most common popular “regression” tends to be dropping down on the knees and starting to crank out kneeling push ups to make the exercise easier, while having the ability to string a higher number of reps together. Ladies, I commend you on the use of regressions if a limitation is obviously identified, but lets be clear… There are intelligent regressions and poorly thought out regressions. Sadly, the kneeling push up may be just as counterproductive as the ‘hump the floor’ push up you are trying to avoid.

Get Off Your Knees… And Push Up Properly!

The examples above of poorly executed traditional push ups and kneeling push ups are simply not an acceptable way to strengthen the push up pattern, and may even lead to pain and injuries to the spine, hips and shoulders down the road. When it comes to perfecting the push up, an emphasis must first be placed on proper full body alignment and tension through the pillar (hips/core/shoulders), then progressed from a dynamic standpoint with the pushing movement. That is, if you want to stay healthy and actually get stronger via your training instead of setting yourself up for a long and tedious bout of traditional physical therapy.

Here’s why we need to start ditching those ugly kneeling push ups and implementing the hands elevated push up instead in order to build foundational movement patterns at the hips, core and shoulders that transfer into strength, power and function, not lower back and shoulder pain.

Check out the video tutorial below that reviews the problem with the kneeling push up, and the correct way to start teaching the foundational hands elevated push up variation:

What Constitutes Poor Form And Why Is It Such a Big Deal?

Sure, cheating your way through a max set of 25 reps as a finisher, or breaking the century mark in reps on your knees during a Les Mills class, may stroke your ego a bit, but is it really worth it? The quick answer is no, but here are the four most blatantly clear disadvantages to continuing to push up with poor form, instead of biting the functional bullet and strengthening the movement pattern properly over time.

#1 Poor Spinal Alignment & Bracing

Dropping down to the knees may fool you into thinking you are in a better position to put in some sweaty work from, but in actuality you are likely throwing your lumbar spine into a hyperextended position and causing heavy anterior tilting at the pelvis.

While this position is awesome for Instagram booty shots, what this really does is disintegrates the rock solid pillar position that should be a requisite of any plank or push up variation before any movement is added to the setup. By essentially fulcruming at a lower lumbar segment, the pelvis is forced to rotate forward. While this is a rather shitty functional position to be maintaining, it gets worse as you go to press up with your upper body.

As this compensated lower spinal and pelvic position is quite shoddy by itself, the addition of a horizontal pushing force through the hands, arms and shoulders during the kneeling push up forces the thoracic cage to flare up, causing an even greater amount of extension at the lower spine. Making a bad position worse and continuing to crank reps in this range is usually not the best idea if you like walking, or any other normal activity of daily living. This is called the vicious circle of movement dysfunction and impairment, and most of you won’t even realize it’s happening until it’s too late.

#2 Increased Stress on the Anterior Shoulder

As we lose a neutral position at the hips and core, compensation patterns tend to kick in in order to keep the reps coming on cadence with the Justin Bieber song that’s playing during your muscle pump class every Tuesday and Thursday night.

Since the reason for regressing yourself down to a kneeling push up obviously stemmed from the inability to execute a traditional push up, there was obviously something faulty with either your positioning, bracing, or upper body strength in general.

But for most people who cannot execute a single push up, I’ve seen a majority of people’s “strength” get blamed, when in actuality it is poor alignment at the core and hips, and even worse, bracing and tensional capabilities throughout the pillar that does not allow strength to be displayed. This is something that should be evaluated and tested for, especially if pain is present.

Without the ability to utilize the upper body strength that you do have, even a kneeling push up becomes more stressful on the shoulder joints when compared to a properly positioned and braced push up pattern. As overextension happens at the lower back, the compensation usually throws people forward, causing elevation, internal rotation and protraction at the shoulder blade during the push up. Not only is this the polar opposite position one wants to be maintaining during a push up pattern for optimal strength vectors, but also if you want to protect the shoulders from chronic and traumatic injuries.

#3 Poor Functional Carryover to Strength

I’d argue that the single most important “skill” that an athlete, fitness fanatic or living, breathing, human being should be able to display in order to move through life without putting their orthopedic health behind the eight ball, is the ability to create tension through the pillar and brace properly during movements of all kinds.

That’s the reason why spinal, shoulder and pelvic alignment is the first thing that is reviewed with every single client that walks through my door, no matter if they have goals of performance or rehabilitation.

The ability to brace properly using optimal positions through the pillar, and even incorporating a breathing component, will allow people to function freely no matter what the activity. If the positioning and bracing strategy is absent, due to alignment issues at the knees and hips because of being in a kneeling position in a push up, there is little chance that the pillar can synergistically work as a unit to maintain tension and alignment, while also acting as a means of force transference into the extremities.

Poor positioning and bracing carries over and leads to poor strength, hypertrophy, functional and aesthetics goals, plain and simple. So that being said, if you are doing kneeling push ups with the goal of chiseling out your arms, you’re better off doing nothing instead and saving your back and shoulders in the process.

#4 Limited Upper Body Targeted Training Effect

Like I mentioned in the previous point, with no core stability or recruitment of tension, the last thing that is going to be trained is the pressing motion off the floor. As segments lose stability and deviate away from neutral, compensation patterns sneak in and tend to mitigate the force of any movement, taking the force away from the targeted movement at hand.

A simple example of this is, as you push up with flexed hips, knees bent and a hyper lordodic lumbar position, the “horizontal” pressing turns into a pseudo push back instead of being locked into the plane of motion that should directly target the pecs, triceps and other key players. This press back causes shoulder flexion to happen instead of a locked in horizontal press. Think of pressing from a plank position to a downward dog in yoga and you can picture the movement I’m speaking to.

The strength and force curves are simply altered, and leakage of tension and torque through the upper body and shoulders causes less emphasis to be placed on the muscular recruitment requisite of the motion, and more on compensation at the spine, hips and lower body. This is the reason brittle and frail yogis can seemingly press up forever. It’s all compensation.

Here’s another video that looks deeper into the poor positions of lumbar spine, hips, pelvis and shoulders from the kneeling push up compensation patterns below:

Strengthen The Movement Pattern with Hands Elevated Push Ups

With so much that can go wrong with the kneeling push up, it’s pretty awesome that so many problems can be avoided by using one simple variation. This variation will yield strength development and bulletproof your back and shoulders, while progressively improving a foundational movement pattern that will translate into other lifts and exercises along with daily life.

Enter the hands elevated push up, the superior “regression” off the traditional level ground push up. By providing all the benefits of the foundational push up pattern that we know and love, we are able to simply shift the force plane and use physics to our advantage to deload this movement.

Take a look at the video tutorial below to master your perfect setup for the hands elevated push up and start making gains without all the pains:

Progression of The Hands Elevated Push Up

By using the hands elevated push up variation, you will start to see some marked improvement not only in your execution and injury prevention, but also in your strength and aesthetics. It’s quite common for my clients to start off focusing on the hands elevated push up as their key indicator lift for upper body horizontal pushing, and progress the height of the box all the way down to level ground once again like bosses.

It’s important to remember that the push up is indeed a loaded movement, meaning that rep ranges that focus on strength, hypertrophy and muscular endurance are absolutely still pertinent to making notable progress. Just because the push up starts out as a bodyweight movement doesn’t mean we can’t eventually progress it to be loaded. First thing first though, making sure you can knock out bodyweight reps on level ground with pristine form.

Here’s how to perfectly execute the foundational push up movement pattern:

Once you get yourself back down to hands on the ground, without kneeling of course, here are some rep ranges you want to think about progressing through based on your goals for this pushing movement. Before you start to add external loads with a weighted vest or plate on your back, ensure that you can rock out 10 perfect reps.

At that point, feel free to work into your “strength” set/rep schemes that are practiced between 3-8 repetitions. Hell, even use banded accommodating resistance for overloading the push up pattern like we do in FHT to make some gainz! Make sure that you are damn near failure on the last rep on these to make overloading the movement pattern effective and reproducible.

Once you have your hands back on the ground, remember, there is no shame in elevating the hands back up to hit some higher rep sets in the hypertrophy and muscular endurance set/rep schemes. For instance, if you can only complete 10 good push ups on level ground and want to hit a set of push ups to challenge your muscular endurance, elevating your hands and hitting failure near rep 15 would be perfect!

This just goes to show that yes, we want to focus on hands elevated push ups to eventually progress to the strict off the floor push up, but once you are there, don’t forget what got you there and use the knowledge to your training advantage. Enjoy the gains everyone, this is going to be a game changer for many of you who have been struggling with push ups on your knees for far too long!

About The Author

Dr. John Rusin

Meet Dr. John Rusin | The Strength Doc

Dr. John Rusin is an internationally recognized coach, physical therapist, speaker, and writer, whose published over 200 articles in some of the most widely regarded media outlets in the industry like Men’s FitnessTestosterone NationMountain Dog DietBodybuilding.com, and Muscle and Strength, to name a few.

Along with an impressive laundry list of publications, Dr. John works with some of the world’s most elite athletes, including Gold Medalist Olympians, NFL All-Pro Quarterbacks, MLB All-Star Pitchers, Professional Bodybuilders and World Class IronMan Triathletes.

He takes pride in offering uniquely customized programming to clients of all walks of life in the exact same detail and passion as the Pros! Dr. John’s 12-Week Functional Hypertrophy Training Program is now available to you.

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  1. Leighton Wells April 22, 2016 at 10:49 am - Reply

    I’ve been doing push ups wrong my whole life…but I’m glad to know how to do them the right way now! Thanks for the helpful videos!

  2. Michelle April 22, 2016 at 1:46 pm - Reply

    Thanks for the regression variation! What do you recommend doing in a bootcamp type session where an elevation option might not be available

  3. robin April 25, 2016 at 10:20 am - Reply

    wow. What an eye opener. How do you feel about wall pushups? I use these with clients with a little plyometric move when they cannot get a good floor push up in

  4. Adrian July 16, 2016 at 9:54 pm - Reply

    Nice article! Thanks for getting me thinking scientifically about this. Definitely moving forward leaving kneeling push-ups behind when absolutely possible.

  5. Stephanie Taylor October 9, 2016 at 8:11 am - Reply

    It’s “precedent” not president.

  6. Peter swallow November 6, 2017 at 10:45 am - Reply

    Whilst I agree with the points raised in the poor form kneeling push up, I disagree that a kneeling press-up with good form is useless or dangerous.
    Using elevated press ups is a fantastic way to increase press up strength.
    If you keep a straight line from the floor to your shoulder, not raising the backside as is demonstrated, kneeling press-ups can be useful.
    I have had ladies go from doing no press ups to full press ups, utilising kneeling press ups on the way.
    Any exercise performed with poor form is a bad exercise, kneeling or otherwise. Very good article though

  7. Carmena November 18, 2017 at 12:04 am - Reply

    Very interesting and thoughtful article, as usual, John. As a yogi who strength trains, I think you probably mean Plank Pose to Upface, not Downface Dog when illustrating the point you’re making. That is the sequence of poses when doing vinyasa. And I have to admit after many years of doing vinyasa yoga, my pushups weren’t great – only after I started getting stronger overall from lifting and learning how to create full body tension, did these start making sense.

  8. Randy Weeks May 6, 2018 at 7:09 pm - Reply

    I disagree. I suffer from spinal stenosis and the pain doing regular pushups is unbearable. However I get a very good workout doing knee pushups. I’ve being lifting and weight training for over 45 years, so just saying that for some people with back pain this is a great exercise .

  9. Cara September 25, 2018 at 6:19 am - Reply

    Love it and the effort you put into writing an article! I couldn’t agree more.

  10. Jen July 16, 2019 at 7:41 pm - Reply

    Are there benefits to the kneeling push up if one is mindful to keep shoulders – hips – knees aligned?

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