I Want to do Pushups, but it Hurts My Wrists...

Pushups are great--one of the most accessible upper body exercises known to man! No special equipment required, several levels of progression or regression to challenge almost any athlete--but what do you do when pushups hurt your wrists?

Short answer, you don't do 'em--at least not the usual way. But, there are ways you can take some pressure off your wrists that may allow you to do a version of pushups while avoiding joint pain and inflammation.

Wrists feel best when they're in a "neutral alignment." A previous post of mine described in detail what neutral alignment looks like for the spine; but neutral wrist position is something different.

The simplest way I've come across to explain it is, if you see minimal wrinkles in the skin around the wrist, that's good, more neutral. To get a better understanding of how this plays out with movement, look at your wrist as you move your hand through all of its possible motions. If you pull the palm of your hand towards the ventral side of the forearm, skin wrinkles up on underside of the wrist. Conversely, if you extend your wrist, like you're riding a motorcycle and increasing the throttle, the top side of the wrist will wrinkle up. The extremes of the range of motion of the wrist pull your wrist farther out of neutral alignment.

So, let's examine the pushup and apply this principle: in a traditional, flat-palm pushup the dorsal side of wrist compresses and lots of wrinkles show up. This is why many people can't do them comfortably. Their wrists don't tolerate hyperextension along with weight-bearing. But what can you do to keep your wrists neutral while still doing horizontal pushing for the upper body?

1. substitute a fist pushup (you'll probably want some padding for your knuckles) or use pushup handles.

2. dumbbells or a barbell for a chest press on a flat bench (pushing weights away from yourself rather than yourself away from the ground). Keep the bar(s) over the base of your palm(s) to minimize wrist extension/strain

3. put something under the base of your palms while you do your pushups (e.g. a book, a plank of lumber, or a yoga block); the idea is to make it so the base of your palm rests higher from the ground than your fingers or knuckles, and your fingers can flex forward over the object. Less extension almost always = more comfortable wrists.

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Don't ignore wrist pain with pushups. Make smart modifications to take strain off your wrists. Or, if you're dead set on doing flat-palm pushups, work with a physical therapist to address the pain first, then come back to pushups when it doesn't hurt anymore. Take care of your wrists; in today's tech-heavy work environments, they're super important!