Push-Up Plus: Serratus Anterior Exercise and Technique

The push-up plus adds a deliberate shoulder-blade movement to a push-up. At the top, you continue pushing the support away so that your shoulder blades move around your rib cage. This movement is called protraction, and the serratus anterior contributes to it.

The name is also sometimes used for a shorter exercise performed with straight elbows throughout. It helps to distinguish the two versions before deciding how to practice them.

Scapular push-up versus push-up plus

In a scapular push-up, your elbows remain straight and the movement comes primarily from your shoulder blades moving on your rib cage. Your chest travels only a short distance.

In a full push-up plus, you first complete an ordinary push-up. You then add a controlled push away from the floor at the top without bending your elbows again.

Both can be useful. A small scapular movement is not a failed full push-up, and a normal push-up is not automatically wrong because it does not exaggerate the final protraction.

How to perform the straight-arm version

1. Place your hands on a stable wall, bench or floor. Choose a height that lets you support yourself comfortably.
2. Keep your elbows straight without forcefully jamming them into the end of their range.
3. Allow your chest to move slightly toward the support as your shoulder blades move toward each other. Do not deliberately collapse deeply between your shoulders.
4. Push the support away so that your shoulder blades move outward around your rib cage.
5. Return slowly and repeat while keeping your trunk reasonably steady.

Think of moving your shoulder blades rather than repeatedly bending your elbows or rounding and straightening your whole spine. The visible movement may be small.

How to add the plus to a full push-up

Complete a controlled push-up first. Once your elbows are straight, continue pressing the floor away without letting your hips drop or your head reach forward.

Pause briefly if that helps you distinguish the final movement, then begin the next repetition. You do not need to produce the largest possible upper-back curve.

Easier variations

Start against a wall or with your hands on a stable raised support. A higher incline reduces the load. You can also practice on your hands and knees before using a full plank position.

The most useful starting point is the version in which you can recognize and control the shoulder-blade movement. Starting on the floor is not a requirement.

A supine serratus punch is another way to practice reaching with the shoulder blade: lying on your back with an arm pointing upward, reach the hand slightly toward the ceiling without turning the movement into repeated elbow bending. Use little or no external load while learning.

Common mistakes

Bending the elbows during the scapular-only version: reduce the load and separate this drill from a full push-up.

Moving mainly through the lower back: choose an easier incline or shorten the set. A plank can provide a separate way to practice trunk support.

Forcing the shoulders into an uncomfortable position: adjust the hand placement and range. More protraction is not automatically better.

Treating fatigue as proof that the exercise is working therapeutically: muscular effort alone does not establish that a movement is addressing the cause of shoulder symptoms.

Does this fix winged shoulder blades?

Not necessarily. A prominent or winged shoulder blade can have several causes, including muscle problems, nerve injury or other shoulder conditions. It should not automatically be attributed to a serratus anterior that has switched off.¹

New or persistent asymmetry accompanied by weakness, pain or difficulty raising the arm warrants assessment. A generic exercise guide cannot determine the cause or replace an individualized rehabilitation plan.

Programming

Begin with a small amount of controlled practice and finish before fatigue changes the movement substantially. Several short sets may be more useful for learning than one long set of increasingly uncontrolled repetitions.

Progress by lowering the support, improving your control or integrating the plus into a full push-up. Change one feature at a time so that you can tell what has improved.

Sources

1. American Academy of Orthopaedic Surgeons. Scapular (Shoulder Blade) Disorders. Causes, assessment and individualized treatment of altered scapular movement. https://www.orthoinfo.org/diseases—conditions/scapular-shoulder-blade-disorders ↩