{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T23:56:52Z","timestamp":1781135812541,"version":"3.54.1"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Push-ups are performed ubiquitously as a means of strengthening\/training and\n                        evaluating the upper extremity. However, push-ups performed on the hands\n                        with the wrist extended can cause wrist, elbow and shoulder injuries, which\n                        may result in disability. Conversely, individuals with a prior wrist or\n                        elbow injury are unable to perform push-ups. Our purpose was to evaluate\n                        movement patterns in two push-up styles (neutral and extended wrist) at the\n                        elbow and shoulder joints. We hypothesized that force-transfer will differ\n                        between the two styles, allowing the adjustment of training protocols\n                        according to athletic and physiologic needs.<\/jats:p>\n                  <jats:p>Fourteen healthy right-handed male volunteers performed push-ups on a neutral\n                        wrist and a hyperextended wrist in the gait analysis laboratory. Skin\n                        markers were applied over fixed points in the upper extremity. A Vicon\n                        motion capture system was used to follow the kinematics. Force vectors were\n                        measured using force plates.<\/jats:p>\n                  <jats:p>The movement and transfer of forces through the shoulder and elbow differ\n                        between the push-up styles. The shoulder moves more, in general, in a\n                        circular direction, when a push-up is performed on a neutral wrist compared\n                        to a push-up performed on an extended wrist. The shoulder is exposed to more\n                        load when the push-up is performed on a neutral wrist. The elbow moves less\n                        in general, and less in the medial and lateral planes, when the push-up is\n                        performed on a neutral wrist. The elbow is exposed to less load when the\n                        push-up is performed on a neutral wrist. The direction of forces through the\n                        joints differs between the two styles and the amount of force traversing the\n                        joints is inverse between the two styles.<\/jats:p>\n                  <jats:p>The movement through the elbow and shoulder is distributed differently during\n                        different styles of push-ups. The wrist and elbow can be relatively\n                        protected from ligament injury when push-ups are performed on a neutral\n                        wrist.<\/jats:p>\n                  <jats:p>Understanding the kinematics during different patterns of loading of the\n                        upper extremity can enable a tailored approach to strengthening training,\n                        treatment, and rehabilitation of the upper extremity. Specifically,\n                        differential strengthening and loading certain areas may be used for\n                        training protocols for a specific athletic task (such as throwing).<\/jats:p>","DOI":"10.1055\/a-2862-1658","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T23:04:18Z","timestamp":1781132658000},"page":"243-251","source":"Crossref","is-referenced-by-count":0,"title":["Push-Up Techniques Affect Elbows and Shoulders: How Should They Be\n                    Used?"],"prefix":"10.1055","volume":"58","author":[{"given":"Olga","family":"Polovinets","sequence":"additional","affiliation":[{"name":"Mechanical Engineering, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Wolf","sequence":"additional","affiliation":[{"name":"Mechanical Engineering, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Friedlander","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronit","family":"Wollstein","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/S0306-9877(02)00203-7","article-title":"Are the \u2018hard\u2019 martial arts, such as the Korean martial art, TaeKwon-Do, of\n                    benefit to senior citizens?","volume":"59","author":"M A Brudnak","year":"2002","journal-title":"Med Hypotheses"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"106","DOI":"10.3810\/psm.2014.11.2097","article-title":"Muscle activity levels in upper-body push exercises with different loads and\n                    stability conditions","volume":"42","author":"J Calatayud","year":"2014","journal-title":"Phys Sportsmed"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1016\/j.ptsp.2014.12.004","article-title":"Shoulder muscle activation during stable and suspended push-ups at different\n                    heights in healthy subjects","volume":"16","author":"S Borreani","year":"2015","journal-title":"Phys Ther Sport"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1089\/biores.2019.0035","article-title":"Movement analysis with inertial measurement unit sensor after surgical treatment\n                    for distal radius fractures","volume":"9","author":"B Zucchi","year":"2020","journal-title":"Biores Open Access"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1007\/s00421-009-0996-7","article-title":"Effects of aquatic resistance training on health and fitness in postmenopausal\n                    women","volume":"106","author":"J C Colado","year":"2009","journal-title":"Eur J Appl Physiol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1016\/j.jsams.2012.08.012","article-title":"Improving muscular endurance with the MVe Fitness Chair in breast cancer\n                    survivors: A feasibility and efficacy study","volume":"16","author":"E Martin","year":"2013","journal-title":"J Sci Med Sport\/Sports Med Aust"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1080\/02640414.2015.1069383","article-title":"Mediating effects of resistance training skill competency on health-related\n                    fitness and physical activity: The ATLAS cluster randomised controlled\n                    trial","volume":"34","author":"J J Smith","year":"2015","journal-title":"J Sports Sci"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1007\/s00167-008-0634-7","article-title":"Stress fracture of the hamate body and fourth metacarpal base following military\n                    style push-ups: An unusual trauma mechanism","volume":"16","author":"M N Busche","year":"2008","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.jhsa.2017.10.019","article-title":"Effect of push-up position on wrist joint pressures in the intact wrist and\n                    following scapholunate interosseous ligament sectioning","volume":"43","author":"B T Daly","year":"2018","journal-title":"J Hand Surg Am"},{"issue":"116","key":"ref10","doi-asserted-by":"publisher","first-page":"e113","DOI":"10.1016\/j.ajem.2007.07.019","article-title":"Push-ups may be hazardous to your health: An atraumatic etiology for bilateral\n                    shoulder dislocation","volume":"26","author":"F A de la Fuente","year":"2008","journal-title":"Am J Emerg Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/S0363-5023(05)80178-9","article-title":"The effects of exercise on ligamentous stiffness in the wrist","volume":"22","author":"J J Crisco","year":"1997","journal-title":"J Hand Surg Am"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/00003086-198509000-00021","article-title":"Athletic injuries of the wrist","author":"R L Linscheid","year":"1985","journal-title":"Clin Orthop Relat Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.jemermed.2025.10.003","article-title":"Epidemiology of boxing-related upper extremity injuries presenting to emergency\n                    departments in the United States from 2014 to 2023","volume":"80","author":"M N Megafu","year":"2025","journal-title":"J Emerg Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.jhsa.2007.10.018","article-title":"Load transmission through the wrist in the extended position","volume":"33","author":"M Majima","year":"2008","journal-title":"J Hand Surg Am"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1016\/j.jht.2017.04.005","article-title":"Force transmission through the wrist during performance of push-ups on a\n                    hyperextended and a neutral wrist","volume":"31","author":"O Polovinets","year":"2018","journal-title":"J Hand Ther"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/S0268-0033(01)00008-0","article-title":"Elbow load during pushup at various forearm rotations","volume":"16","author":"S Lou","year":"2001","journal-title":"Clin Biomech"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1055\/s-2002-33745","article-title":"Elbow load with various forearm positions during one-handed pushup exercise","volume":"23","author":"P H Chou","year":"2002","journal-title":"Int J Sports Med"},{"key":"ref18","first-page":"69","article-title":"Intersegmental elbow joint load during pushup","volume":"28","author":"K N An","year":"1992","journal-title":"Biomed Sci Instrum"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"5021","DOI":"10.1007\/s00431-024-05736-8","article-title":"Reference data for body composition parameters in normal-weight Polish\n                    adolescents: Results from the population-based ADOPOLNOR study","volume":"183","author":"M Kaczmarek","year":"2024","journal-title":"Eur J Pediatr"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2473","DOI":"10.1249\/MSS.0000000000000664","article-title":"Updating ACSM\u2019s Recommendations for exercise preparticipation health\n                    screening","volume":"47","author":"D Riebe","year":"2015","journal-title":"Med Sci Sports Exerc"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1007\/s10439-015-1384-6","article-title":"Bone pose estimation in the presence of soft tissue artifact using triangular\n                    cosserat point elements","volume":"44","author":"D Solav","year":"2016","journal-title":"Ann Biomed Eng"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1589\/jpts.25.833","article-title":"Surface EMG during the push-up plus exercise on a stable support or swiss ball:\n                    Scapular stabilizer muscle exercise","volume":"25","author":"S H Seo","year":"2013","journal-title":"J Phys Ther Sci"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1080\/00140130902919113","article-title":"Constrained handgrip force decreases upper extremity muscle activation and arm\n                    strength","volume":"52","author":"M P Smets","year":"2009","journal-title":"Ergonomics"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1186\/s12984-019-0637-2","article-title":"The nature and extent of upper limb associated reactions during walking in\n                    people with acquired brain injury","volume":"16","author":"M B Kahn","year":"2019","journal-title":"J Neuroeng Rehabil"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1249\/JSR.0000000000000606","article-title":"Rehabilitation and prehabilitation for upper extremity in throwing sports:\n                    Emphasis on lacrosse","volume":"18","author":"H K Vincent","year":"2019","journal-title":"Curr Sports Med Rep"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1055\/a-0927-6818","article-title":"Weightlifting shoulder injuries presenting to U.S. Emergency departments:\n                    2000\u20132030","volume":"40","author":"K Pirruccio","year":"2019","journal-title":"Int J Sports Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1016\/j.jbiomech.2010.09.011","article-title":"Pressure distribution over the palm region during forward falls on the\n                    outstretched hands","volume":"44","author":"W J Choi","year":"2011","journal-title":"J Biomech"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1016\/j.clinbiomech.2013.02.005","article-title":"Biomechanical study of the efficacy of a new design of wrist guard","volume":"28","author":"M L Maurel","year":"2013","journal-title":"Clin Biomech (Bristol, Avon)"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.1007\/s00296-022-05184-3","article-title":"Strain sonoelastography in asymptomatic individuals and individuals with knee\n                    osteoarthritis: An evaluation of quadriceps and patellar tendon","volume":"42","author":"D M Dickson","year":"2022","journal-title":"Rheumatol Int"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.jbiomech.2017.01.026","article-title":"Bone orientation and position estimation errors using Cosserat point elements\n                    and least squares methods: Application to gait","volume":"62","author":"D Solav","year":"2017","journal-title":"J Biomech"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1123\/jab.2017-0063","article-title":"Muscle activity patterns do not differ between push-up and bench press\n                    exercises","volume":"34","author":"J S Gottschall","year":"2018","journal-title":"J Appl Biomech"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1123\/jsr.2019-0381","article-title":"Recruitment of shoulder prime movers and torso stabilizers during push-up\n                    exercises using a suspension training system","volume":"29","author":"J W Youdas","year":"2020","journal-title":"J Sport Rehabil"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.jelekin.2018.12.008","article-title":"Examining upper extremity muscle demand during selected push-up variants","volume":"44","author":"A J Ho","year":"2019","journal-title":"J Electromyogr Kinesiol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1589\/jpts.29.35","article-title":"A comparison of the shoulder and trunk muscle activity according to the various\n                    resistance condition during push up plus in four point kneeling","volume":"29","author":"J B Kim","year":"2017","journal-title":"J Phys Ther Sci"}],"container-title":["Handchirurgie \u00b7 Mikrochirurgie \u00b7 Plastische Chirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2862-1658.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T23:04:27Z","timestamp":1781132667000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2862-1658"}},"subtitle":["Liegest\u00fctzstil wirkt sich auf Ellenbogen und Schulter aus \u2013 Wie sollten\n                    sie angewendet werden?"],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":34,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,6,10]]},"published-print":{"date-parts":[[2026,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2862-1658","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0722-1819","1439-3980"],"issn-type":[{"value":"0722-1819","type":"print"},{"value":"1439-3980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}