The push up challenges scapula dynamic strength and stability. Done correctly, the scapula should perform abduction and upward rotation.
Observation:
- There should be no associated elevation.
- Forward head with protracted shoulders
- Gothic shoulder
- Levator notch
- Scapula winging / tipping
Domination of the Upper Trap (UT) and Levator Scapula (LS) need to be watched for. Serratus Anterior (SA) and the lower trapezius need to stabilise the scapula posteriorly. The lower trapezius helps upward rotation and prevention of anterior tipping. Scapula winging or excessive adduction can report weakness of the SA, with UT and LS causing a shrugging posture. Elbows should not wing outward to that the glenohumeral joint is in > 45′ abduction.
The most sensitive phase to screen in this movement is during decent/eccentric activation. Observe for any of the above deviations, and if the test is too challenging, the subject may perform this from a knees down position.
JC Physiotherapy 