Force transmission through the wrist during performance of push‐ups on a hyperextended and a neutral wrist

Study Design: Cross‐sectional cohort. Introduction: Push‐ups are used ubiquitously to evaluate and strengthen the upper body. They are usually performed in 1 of 2 main ways: with the wrist in hyperextension and with the wrist in a neutral position. Purpose of the Study: The purpose of our study was to compare the dynamic forces in the wrist during the 2 push‐up styles. Methods: Fourteen volunteers performed push‐ups in 2 different patterns: on a hyperextended wrist and a neutral wrist (NW). Two force plates and a motion capture system were used to measure the ground reaction forces (GRFs) and the kinematics of the upper extremity during push‐ups. Kinematic and kinetic analyses were performed using Matlab software (Mathworks, Natick, MA). Results: The GRF vector was distributed differently during the different types of push‐ups. For both methods, the total GRF carried by the upper dominant extremity was larger than those of the nondominant extremity. In the NW configuration, the GRF vector was more uniform throughout the push‐up in the vertical direction. The horizontal distance between the capitate bone location and the GRF origin was smaller in hyperextension. The forces traveled more dorsally over a wider area and more ulnarly in the hyperextended wrist. Discussion: Forces are transmitted differently through the wrist in the 2 methods. Push‐ups on an NW are likely safer because ligaments may be preferentially loaded in hyperextension. Further study may delineate the differences in the anatomic location of force transmission and the long‐term clinical effect on the wrist. Conclusions: This study supports the performance of push‐ups on a wrist in neutral flexion extension; both to enable patients after surgery or injury to strengthen the upper body and prevent injury and long‐term wear in the wrist. The knowledge gained from this study may assist in outlining guidelines for push‐up performance. Level of Evidence: Diagnostic level 2a.

[1]  David M Frost,et al.  Evidence of a Double Peak in Muscle Activation to Enhance Strike Speed and Force: An Example With Elite Mixed Martial Arts Fighters , 2010, Journal of strength and conditioning research.

[2]  R. Waters,et al.  Late complications of the weight-bearing upper extremity in the paraplegic patient. , 1988, Clinical orthopaedics and related research.

[3]  G. Giakas,et al.  The Load-Bearing Characteristics of the Forearm: Pattern of Axial and Bending Force Transmitted Through Ulna and Radius , 2006, Journal of hand surgery.

[4]  S F Viegas,et al.  Load transfer characteristics of the wrist. Part I. The normal joint. , 1987, The Journal of hand surgery.

[5]  Min-Seong Ha,et al.  Effect of the push-up exercise at different palmar width on muscle activities , 2016, Journal of physical therapy science.

[6]  F J Bejjani,et al.  Analysis of upper-extremity performance in athletes and musicians. , 1990, Hand clinics.

[7]  Sebastien Borreani,et al.  Muscle Activity Levels in Upper-Body Push Exercises With Different Loads and Stability Conditions , 2014, The Physician and sportsmedicine.

[8]  Giannis Giakas,et al.  The distal radioulnar joint as a load-bearing mechanism--a biomechanical study. , 2004, The Journal of hand surgery.

[9]  M A Brudnak,et al.  Are the 'hard' martial arts, such as the Korean martial art, TaeKwon-Do, of benefit to senior citizens? , 2002, Medical hypotheses.

[10]  R. Mattar,et al.  Mechanoreceptors and nerve endings of the triangular fibrocartilage in the human wrist. , 2004, The Journal of hand surgery.

[11]  Rajiv Arora,et al.  The effects of residency on physical fitness among military physicians. , 2004, Military medicine.

[12]  馬島 雅高,et al.  Load transmission through the wrist in the extended position , 2008 .

[13]  Jin Bo Tang,et al.  Changes in contact site of the radiocarpal joint and lengths of the carpal ligaments in forearm rotation: an in vivo study. , 2013, The Journal of hand surgery.

[14]  Yukihiro Hara.  Dorsal wrist joint pain in tetraplegic patients during and after rehabilitation. , 2003, Journal of rehabilitation medicine.

[15]  J B Tang,et al.  Contact areas of the scaphoid and lunate with the distal radius in neutral and extension: correlation of falling strategies and distal radial anatomy , 2014, The Journal of hand surgery, European volume.

[16]  T Harnroongroj,et al.  Palmar pressure distribution during push-up exercise. , 2009, Singapore medical journal.

[17]  M. Gouvali,et al.  DYNAMIC AND ELECTROMYOGRAPHICAL ANALYSIS IN VARIANTS OF PUSH‐UP EXERCISE , 2005, Journal of strength and conditioning research.

[18]  A. Cappozzo,et al.  Human movement analysis using stereophotogrammetry. Part 3. Soft tissue artifact assessment and compensation. , 2005, Gait & posture.

[19]  K. An,et al.  Functional ranges of motion of the wrist joint. , 1991, The Journal of hand surgery.

[20]  Daniel F Battafarano,et al.  The effect and safety of short-term creatine supplementation on performance of push-ups. , 2007, Military medicine.

[21]  Scott W Wolfe,et al.  In vivo kinematics of the scaphoid, lunate, capitate, and third metacarpal in extreme wrist flexion and extension. , 2013, The Journal of hand surgery.

[22]  G. Giakas,et al.  Contact area inside the distal radioulnar joint: effect of axial loading and position of the forearm. , 2007, Clinical biomechanics.

[23]  T. Takken,et al.  Ii: Cardiorespiratory Fitness and Physical Activity in Children with Cancer Physical Exercise Training Interventions for Children and Young Adults during and after Treatment for Childhood Cancer Plain Language Summary Physical Exercise Training Interventions for Children and Young Adults during and , 2022 .

[24]  E Y Chao,et al.  Intersegmental elbow joint load during pushup. , 1992, Biomedical sciences instrumentation.

[25]  Jesús Dapena,et al.  A comparison of the reverse and power punches in oriental martial arts , 2008 .

[26]  Peter M. Vogt,et al.  Stress fracture of the hamate body and fourth metacarpal base following military style push-ups: an unusual trauma mechanism , 2008, Knee Surgery, Sports Traumatology, Arthroscopy.

[27]  Jack P Callaghan,et al.  Muscular contribution to low-back loading and stiffness during standard and suspended push-ups. , 2008, Human movement science.

[28]  Harold White,et al.  Physical training of combat diving candidates: implications for the prevention of musculoskeletal injuries. , 2008, Work.

[29]  A E Flatt,et al.  Kinematics of the wrist. , 1980, Clinical orthopaedics and related research.

[30]  R. Mugnai,et al.  Scapholunate interosseous ligament injury in professional volleyball players. , 2016, Hand surgery & rehabilitation.

[31]  A Khan Nasr Esfahan,et al.  USING MULTIVARIABLE STATISTICAL METHODS TO SEPARATION AND DETECTION OF LITHOLOGIC UNITS IN ETM+ SATELLITE IMAGES, CASE STUDY: OUTCROPS IN THE SOUTH OF AB-PONEH VILLAGE, TIRAN (WEST ISFAHAN) , 2007 .

[32]  David F Stodden,et al.  Mediating effects of resistance training skill competency on health-related fitness and physical activity: the ATLAS cluster randomised controlled trial , 2016, Journal of sports sciences.

[33]  Osmar Pinto Neto,et al.  The effect of hand dominance on martial arts strikes. , 2012, Human movement science.

[34]  Scott M Tintle,et al.  Outcomes of Open Dorsal Wrist Ganglion Excision in Active-Duty Military Personnel. , 2015, The Journal of hand surgery.

[35]  Shruti Mahajan,et al.  An electromyographic analysis of shoulder muscle activation during push-up variations on stable and labile surfaces , 2008, International journal of shoulder surgery.

[36]  F W Werner,et al.  A dynamic biomechanical study of scapholunate ligament sectioning. , 1995, The Journal of hand surgery.

[37]  R. Glisson,et al.  Functional wrist motion: a biomechanical study. , 1985, The Journal of hand surgery.

[38]  M Fischer,et al.  [Post-traumatic pain in the wrist, a diagnostic challenge]. , 1993, Zeitschrift fur Unfallchirurgie und Versicherungsmedizin : offizielles Organ der Schweizerischen Gesellschaft fur Unfallmedizin und Berufskrankheiten = Revue de traumatologie et d'assicurologie : organe officiel de la Societe suisse de ....

[39]  Alon Wolf,et al.  Bone Pose Estimation in the Presence of Soft Tissue Artifact Using Triangular Cosserat Point Elements , 2015, Annals of Biomedical Engineering.

[40]  Claudio Battaglini,et al.  Improving muscular endurance with the MVe Fitness Chair™ in breast cancer survivors: a feasibility and efficacy study. , 2011, Journal of science and medicine in sport.

[41]  E. Karaharju,et al.  Innervation of synovial membrane and meniscus. , 1985, Acta orthopaedica Scandinavica.

[42]  Pedro Saucedo,et al.  Effects of aquatic resistance training on health and fitness in postmenopausal women , 2009, European Journal of Applied Physiology.

[43]  Jo Salmon,et al.  Rationale and study protocol for the 'active teen leaders avoiding screen-time' (ATLAS) group randomized controlled trial: an obesity prevention intervention for adolescent boys from schools in low-income communities. , 2014, Contemporary clinical trials.

[44]  T. Spalding,et al.  Effect of short-term upper-body resistance training on muscular strength, bone metabolic markers, and BMD in premenopausal women , 2012, Open access journal of sports medicine.

[45]  J Knapik,et al.  The Army Physical Fitness Test (APFT): a review of the literature. , 1989, Military medicine.

[46]  K N An,et al.  Kinematic and kinetic analysis of push-up exercise. , 1990, Biomedical sciences instrumentation.

[47]  A Arndt,et al.  Exercise-induced strain and strain rate in the distal radius. , 2005, The Journal of bone and joint surgery. British volume.

[48]  F W Werner,et al.  Force transmission through the distal ulna: effect of ulnar variance, lunate fossa angulation, and radial and palmar tilt of the distal radius. , 1992, The Journal of hand surgery.

[49]  Bryan L Riemann,et al.  Ground Reaction Force Patterns in Plyometric Push-Ups , 2012, Journal of strength and conditioning research.

[50]  Steve Doucette,et al.  Effects of aerobic training, resistance training, or both on cardiorespiratory and musculoskeletal fitness in adolescents with obesity: the HEARTY trial. , 2016, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[51]  J. Chong,et al.  Chronic sprains of the carpometacarpal joints , 1982 .

[52]  Brian G. Webb,et al.  Gymnastic Wrist Injuries , 2008, Current sports medicine reports.

[53]  K A Croteau,et al.  Effectiveness of a Navy remedial exercise intervention. , 2000, Military medicine.

[54]  Jill A. Bush,et al.  Benefits of Strength and Skill-based Training During Primary School Physical Education , 2015, Journal of strength and conditioning research.

[55]  Peter Zapalo,et al.  Difference in Agility, Strength, and Flexibility in Competitive Figure Skaters Based on Level of Expertise and Skating Discipline , 2016, Journal of strength and conditioning research.

[56]  Y Liu,et al.  Lunate and perilunate dislocation. , 1996, Zhonghua yi xue za zhi = Chinese medical journal; Free China ed.

[57]  S. Bryant,et al.  Push-ups may be hazardous to your health: an atraumatic etiology for bilateral shoulder dislocation. , 2008, American Journal of Emergency Medicine.

[58]  S F Viegas,et al.  Pressure distribution in the wrist joint , 1988, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.