The push-up plus is a small shoulder blade movement done in a plank on straight arms. Up on your hands and toes, you push the floor away so your upper back rises a little and the shoulder blades spread around your ribs, then let them settle back. It works the muscle that holds the shoulder blade against the ribs (serratus anterior) and is common in shoulder programs. In the video the elbows stay straight the whole time, so there is no push-up before the plus.

How to do the push-up plus

Start on your hands and knees on a mat, with your hands under your shoulders and your knees under your hips.
Straighten one leg back, then the other, to come into a plank on straight arms with your feet about hip width apart. Your body makes one straight line from your head to your heels.
Keeping the elbows straight, press the heels of your hands into the floor. Your upper back lifts slightly as the shoulder blades slide apart and flatten against your ribs.
Hold for a moment, then relax so your chest sinks a little between your shoulder blades. The elbows stay straight.
Repeat the push and relax for the set, keeping your hips level. To finish, bring your knees back down onto the mat.

What you should feel

Work along the sides of your ribs just below the armpits. Your stomach works to keep your body straight.

Common mistakes

Bending the elbows, which turns it into a push-up.
Hunching the whole back or lifting the hips to make the movement look bigger.
Letting the hips sag as the shoulder blades relax.
Dropping the head toward the floor.

How often

Many programs start with 2 to 3 sets of 8 to 12, holding each push for 2 to 5 seconds, a few days a week. Your physio will adjust this, including whether you start on your knees.

Stop and check with your physio if

Chest pain or pressure, dizziness or feeling faint, a racing or irregular heartbeat, or being far more out of breath than the effort should cause.
Sharp pain or catching in the shoulder or wrist.
A sense that the shoulder is slipping or about to pop out.
Pain, numbness or tingling travels down your arm or into your hand.
Pins and needles in your arm or hand that do not go away after you stop, or part of your arm or hand goes numb. Get medical advice the same day. If one side of your face or body suddenly goes numb or weak, or your speech becomes slurred or muddled, call emergency services, even if it goes away.
A sudden pop or tearing feeling in the shoulder that brings sharp pain, new weakness or trouble lifting the arm. Stop and contact your surgical team the same day, or get medical advice the same day if you have not had surgery.
The shoulder feels as if it has slipped out of place, looks a different shape or suddenly locks so you cannot move the arm, or your hand turns cold, pale or blue. Go to an emergency department straight away, without driving yourself, and do not try to put the shoulder back in yourself.

From the clinic

The movement is small, and people often make it bigger by bending the elbows or rounding the whole back. Keep it to the shoulder blades. If the full plank is too much, do the same push with your knees on the mat, or standing with your hands on a wall as in wall push-ups. The serratus punch trains the same muscle lying on your back, with no body weight on the arms. If your wrists hurt with the hands flat, push-up handles or two solid, flat-sided dumbbells that cannot roll keep them straighter.

Holding a plank loads the stomach wall heavily. If you are pregnant, have recently given birth, have had abdominal surgery or have a hernia, ask your physio or doctor before you plank. With high blood pressure, breathe steadily all the way through each hold and never hold your breath. If it is not well controlled, get your doctor's go-ahead before you start.

If chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked. If you faint while exercising, call emergency services, even if you feel fine again quickly. Your full weight goes through your hands here, so after a shoulder dislocation, an operation on the shoulder or a broken arm, check with your physio before you try it.

Written and checked by the PocketPhysio editorial team. Last updated 2026-09-28.

This page is general education, not a diagnosis or a personal treatment plan. If you have pain, an injury or a health condition, see a physiotherapist or doctor before starting new exercises.

Push-up plus