The quadruped scapular push up works the muscle that holds your shoulder blades against your ribs (serratus anterior), done on your hands and knees. With your elbows straight, you let your chest sink a little between your shoulders, then press the floor away so your upper back rises and the shoulder blades spread apart. It puts more body weight through the arms than the wall version, but less than a full plank.

How to do the quadruped scapular push up

Get onto your hands and knees on a mat, hands under your shoulders and knees under your hips. Kneel on a folded towel if your knees are sensitive.
Straighten your elbows without locking them hard, keep your back flat and look at the floor just ahead of your hands.
Let your chest sink slowly toward the floor between your arms, so the shoulder blades slide in toward your spine. The elbows stay straight.
Hold briefly, then press the heels of your hands into the floor and push your upper back up toward the ceiling, so the shoulder blades spread around your ribs.
Keep your lower back still, neither rounding nor arching, as you move between the two positions.

What you should feel

Effort along the sides of your ribs below the armpits, with some work at the front of the chest and in the stomach to keep your back still.

Common mistakes

Bending the elbows so the whole body dips, as in a push-up.
Rounding or arching the lower back to make the movement bigger.
Letting the head hang, or lifting it to look forward.
Sinking so far between the shoulders that they bunch up toward your ears.

How often

Many programs start with 2 to 3 sets of 8 to 12, with a brief pause at the bottom of each, once a day or a few days a week. Your physio will adjust this.

Stop and check with your physio if

A sharp pain or a catch in a shoulder or wrist as you push.
Numbness, tingling or pain spreading down an 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

This sits between the wall push up plus and the push-up plus held in a full plank. Only the shoulder blades move here, so keep the elbows straight and the back from humping up. If your wrists ache with the hands flat, push-up handles help keep them straighter.

If you have had a hip or knee replacement, get the go-ahead from your surgeon or physio before you try the quadruped scapular push up. Some operations limit this kind of work for the first months, so the timing depends on your surgery. Kneeling on a replaced knee often stays uncomfortable for a long time, so ask your physio about extra padding or a version done standing at a counter.

After shoulder surgery, including a rotator cuff repair, or after a shoulder fracture or dislocation, follow your surgeon's or physio's plan, and do only the movements and range they have cleared. Many plans allow only passive movement at first, where the arm is moved for you and its muscles stay relaxed. After a broken wrist, hand or forearm, or surgery on any of them such as a tendon repair, start only when your doctor, surgeon, physio or hand therapist says the bone or repair is ready for this, and follow their plan for how much to do. If you have high blood pressure, breathe steadily through every repetition and never hold your breath.

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.

Quadruped scapular push up