How to Do a Pushup? Causes, Explanations, and Next Steps

How to do a pushup correctly is usually straightforward: start in a strong plank, lower the chest with control, and press back up while keeping the body aligned. For most people, learning proper form and gradual progressions is enough, but pain, weakness, or repeated difficulty may need medical review.

Overview: how to do a pushup

How to do a pushup correctly can often be answered simply: place the hands slightly wider than shoulder-width apart, brace the core, keep the body in one straight line, lower the chest toward the floor, and then press back up without letting the hips drop or the elbows flare too far out. For many healthy adults, pushups are a safe bodyweight exercise when done with good technique and appropriate progression.

Pushups are not only an arm exercise. They train the chest, shoulders, triceps, abdominal muscles, back stabilizers, and gluteal muscles together. Because so many areas work at once, small errors in posture can lead to poor performance or discomfort, especially in the wrists, shoulders, neck, or lower back.

Most problems with pushups are mechanical rather than serious. Tight tissues, weak core control, limited shoulder mobility, or starting with a level that is too advanced are common reasons a person may struggle. However, if pushups cause sharp pain, chest discomfort, repeated joint instability, numbness, or sudden weakness, medical evaluation is important before continuing exercise.

Step-by-step pushup technique

To begin, place both hands on the floor just wider than the shoulders, with the fingers spread for support. Extend the legs behind the body so the weight is balanced on the hands and toes. The head should stay in a neutral position, with the eyes looking slightly ahead of the hands rather than straight up or tucked too far down.

Before lowering, gently tighten the abdominal muscles and gluteal muscles. This helps keep the body in one line from the shoulders through the hips to the heels. As the elbows bend, the chest lowers in a controlled way toward the floor. Many people do best when the elbows angle back at roughly 30 to 45 degrees from the torso, rather than pointing straight out to the sides.

At the bottom of the movement, the chest comes close to the floor while the shoulders remain controlled and the lower back does not collapse. Then the hands press firmly into the ground to straighten the elbows and return to the starting position. Breathing can be natural and steady: inhale on the way down and exhale while pressing up.

• Hands under or slightly wider than shoulder width
• Neck neutral, not craned upward
• Core braced and hips level
• Lower with control, not by dropping
• Press up evenly through both arms

Common mistakes and what they may mean

One of the most common errors is letting the hips sag. This often reflects weak core control, fatigue, or trying a full pushup before being ready. Another common issue is raising the hips too high, which turns the movement into more of a pike position and reduces the intended chest and trunk work.

Elbows that flare far out to the sides can increase strain at the shoulder in some people. Shrugging the shoulders toward the ears may suggest poor upper-back control or tension through the neck. A very short range of motion, such as only bending the elbows slightly, may indicate weakness, stiffness, fear of pain, or incomplete technique learning.

Wrist discomfort can happen if the hands are placed awkwardly, the load is introduced too quickly, or there is underlying irritation in the joint or tendons. Shoulder pain may relate to mobility limits, rotator cuff irritation, or poor control of the shoulder blade. If pain continues, a clinician may assess for issues such as shoulder impingement syndrome or other musculoskeletal causes.

Why some people find pushups difficult

Pushups require a combination of strength, mobility, coordination, and endurance. A person may have strong arms but still struggle because the trunk is not stable enough to support the body as one unit. In other cases, limited flexibility at the wrist, chest, or shoulder can make the position uncomfortable even before the movement starts.

Body proportions can also affect how difficult pushups feel. People with a longer torso or longer arms may experience a different leverage demand than others. This does not mean the exercise is unsuitable, only that modifications and gradual progression may be helpful.

Previous injuries are another important factor. Wrist sprains, shoulder irritation, neck tension, or low back pain can all interfere with form. If persistent joint pain or weakness is present, a doctor may recommend evaluation and, when appropriate, physical therapy and rehabilitation to improve movement patterns and reduce strain.

Beginner progressions and safer modifications

A full floor pushup is not the only starting point. For many beginners, wall pushups are an excellent first step because they reduce bodyweight load while teaching alignment. Standing arm’s length from a wall, the same principles apply: hands stable, body straight, lower with control, and press away evenly.

Once wall pushups feel manageable, incline pushups using a bench, countertop, or sturdy elevated surface can increase the challenge gradually. Knee pushups are another option, although some people find incline versions easier for learning body alignment. The goal is to choose a variation that allows smooth, pain-free movement with consistent technique.

Progression should be gradual. A person may begin with small sets, rest adequately, and focus on quality rather than high repetition. If symptoms such as wrist pain or shoulder pain limit exercise, medical assessment may be useful before advancing. In selected cases, rehabilitation specialists may also review neighboring areas such as the spine, especially if poor trunk control or pain patterns suggest involvement of the back or posture-related mechanics. When needed, doctors may coordinate with services such as orthopedic rehabilitation.

When pushup discomfort may need medical review

Mild muscle fatigue after exercise is common, especially when someone is new to pushups or returning after a break. Temporary soreness in the chest, arms, or upper trunk that improves over a day or two is usually not concerning. What matters more is whether there is true pain, repeated loss of control, or symptoms that interfere with daily activity.

Medical review is sensible if pushups cause sharp or worsening pain in the wrist, shoulder, elbow, neck, or lower back; if one side feels much weaker than the other; or if the shoulder seems unstable, catches, or slips. A person should also stop and seek urgent care for chest pressure, shortness of breath, dizziness, or pain spreading to the arm or jaw, because these symptoms are not typical exercise-form problems.

Numbness, tingling, swelling, joint locking, or symptoms after a recent injury also deserve assessment. Depending on the pattern of symptoms, a clinician may consider tendon irritation, joint strain, nerve compression, or a broader musculoskeletal issue such as a herniated disc when neck or back symptoms accompany upper-limb weakness or pain.

How a doctor evaluates pushup-related pain or difficulty

When a person seeks care, the first step is usually a clinical history. The doctor may ask where the discomfort occurs, when it started, whether there was a specific injury, and which movements make symptoms worse. They may also ask about exercise habits, prior joint problems, work posture, and whether the symptoms affect sleep or daily tasks.

A physical examination often looks at posture, shoulder motion, elbow and wrist function, core control, and any tenderness or weakness. In some cases, the doctor may ask the patient to demonstrate part of the pushup movement or a similar loaded position. This can reveal alignment patterns that are difficult to identify from symptoms alone.

Imaging is not always necessary, especially if the problem appears to be a straightforward overuse or technique issue. However, persistent pain, suspected structural injury, nerve symptoms, or failure to improve may lead to further testing. Depending on the clinical concern, this may include X-ray, ultrasound, or MRI to assess soft tissues, joints, or the spine.

Treatment, self-care, and next steps

Treatment depends on the cause. For simple overuse or technique-related discomfort, short-term rest from provoking movements, gradual return to exercise, correction of form, and mobility or strengthening work may be enough. A clinician or physiotherapist may recommend exercises for the wrist, shoulder blade muscles, rotator cuff, chest, core, or hips based on the person’s specific movement pattern.

When a more defined injury is present, treatment may include structured rehabilitation, temporary activity modification, supportive taping or bracing, or other targeted care. Recovery is often best when exercises are progressed step by step instead of returning immediately to full floor pushups. Good sleep, appropriate warm-up, and balanced training can also support recovery.

To reduce future problems, it helps to warm up the shoulders and wrists, start with a level that matches current strength, and stop when form breaks down. People who are unsure about pain or repeated difficulty should consult a qualified healthcare professional rather than pushing through symptoms. Near the end of the care pathway, some patients benefit from multidisciplinary assessment; Acibadem International’s specialists in JCI-accredited hospitals diagnose and treat musculoskeletal and rehabilitation concerns for international patients.

Frequently asked questions

How should a beginner do a pushup?

A beginner can start with a wall or incline pushup instead of a full floor pushup. The main goal is to keep the body aligned, lower with control, and press back up without pain or loss of posture.

Where should the hands go during a pushup?

The hands are usually placed under or slightly wider than shoulder width. A comfortable hand position allows the wrists to stay supported and the elbows to track slightly back rather than flaring straight out.

Why do pushups hurt the wrists?

Wrist pain during pushups can result from limited mobility, excess load too soon, poor hand placement, or irritation in the joint or surrounding tendons. If pain persists or worsens, a doctor or physiotherapist should assess it.

How low should the chest go in a pushup?

In a standard pushup, the chest lowers close to the floor while the body stays in one straight line. The ideal depth depends on control, comfort, and shoulder mobility, but the movement should remain smooth and pain-free.

Is it normal to shake during pushups?

Mild shaking can happen when muscles are working hard, especially in beginners or during fatigue. However, marked shaking with pain, weakness on one side, or repeated loss of control may need evaluation.

When should someone stop doing pushups and seek care?

A person should stop if pushups cause sharp pain, joint instability, numbness, swelling, or symptoms that do not settle with rest. Urgent medical care is needed for chest pain, shortness of breath, dizziness, or pain spreading to the arm or jaw.

References

• American Academy of Orthopaedic Surgeons
• American College of Sports Medicine
• National Institute of Arthritis and Musculoskeletal and Skin Diseases
• MedlinePlus
• National Health Service

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.