I have been training calisthenics for many years never encountered any issues with wrist pain until a combination of high reps of push ups and time spent practising handstands lead me to develop pain and discomfort in my right wrist.

The reason for the pain was that I was over-training whilst my wrist was in an unfavourable position.

Extending your wrist so that your forearm is at a 90° from your palm can put significant strain on your wrist joint. Especially when you consider that during push ups you are supporting 70% of your body weight (30% is supported with the feet) through the wrist and 100% of your body weight when training handstand push ups.

The best thing you can do when you notice any wrist pain or discomfort from push ups is to rest the joint to give it time to repair and recover. Do not adopt the same wrist position and try to train through the pain as this will only exacerbate the injury.

Proactively avoiding injury by taking time off training can seem frustrating, but fortunately there are other ways to train push ups without putting strain on your wrists.

The Correct way to do Push ups

The first thing to address is to make sure you have the optimal form whilst executing your push ups as poor joint alignment will inevitably lead to discomfort and potentially injury.

The two most important factors when it comes to avoiding wrist pain from push ups are…

1. Making sure your hands are aligned correctly with your shoulders

2. Don’t flare your elbows out wide from your body, keep you elbows within 45° of the body or less.

When your arms are locked out at the top of the push up, you need to make sure your hands and wrists are placed in a near vertical alignment to the shoulder. This is the position that will minimise the stress on your wrist joint.

If your hand placement is below that of the shoulder then this will put the wrist in an unfavourable position. The wrist joint will not only be hyper-extended from its range of motion, but also your have your body weight bearing down on it whilst its compromised hence why shoulder alignment is so important.

Mistake number two is to flare you elbows out too wide whilst you do your push ups.

People often flare out their elbows because they think it targets the chest more then if your elbows were tucked in close to your body. This in fact not the case and it will only lead to pain in your shoulders, elbows and wrist joints as it is out of their optimal alignment.

You can put more of the emphasis of the exercise on the chest by placing your hands wider then shoulder width but only if the elbow is at 45° or less from the body. If your elbows are more then 45° away from the body then you are risking joint impingement and tissue damage in your shoulders, elbows and wrists.

If you are unsure what a push up with the perfect form looks like then check out this short YouTube video:

Avoid Wrist Pain with Neutral Grip Push ups

Rather then let your hard earned gains fall by the way side your can still perform push ups by changing the angle of the wrist.

A neutral grip put the wrist in a far safer and more natural alignment with far less flexion at the joint, throughout the range of motion, therefore negating unnecessary stress on joint.

There are a few ways to do this…

1. Push ups on the knuckles

2. Using push up bars/ dumbbells

3. By doing push ups on gymnastic rings

4. Using the ‘Perfect Push up V2’ which is a product developed by a US navy seal

Push ups on your knuckles is the easiest way of maintaining a neutral wrist joint whilst doing your push ups because it doesn’t require any additional equipment. This is also a popular way to condition your hands for martial arts.

However, because the weight is concentrated on your fist, they can be a little uncomfortable on your hands, particularly for a high number of reps on a harder, unforgiving surface.

To avoid this simply place a towel on the ground or use a yoga mat to rest your fists on.

Push up bars

The second option is to use a set of push up bars or perhaps dumbbells. This is a deceivingly more challenging variation as there is element of grip strength required and the forearms are recruited more for maintaining stability then they are with a conventional push up.

With a conventional push up, your forearms and grip strength take a more passive role as the weight is supported by your flat palms and on the bent wrist so its easier to maintain stability. With push up bars the tension is not on the wrist joint but on the muscles of the forearm to maintain a stable position. The increased forearm recruit makes the exercise more challenging.

The body’s adaptive response to this new stimulus is to strengthen your grip and the muscles and tendons that support the wrist. This improved grip strength is directly transferable to other exercise such as pull ups, rowing, bench press or any other exercise which requires you to hold a bar whilst under tension.

The next variation is push ups using gymnastic rings…

Gymnastic Rings Push ups

Personally I favour ring push ups as the best variation for avoiding wrist pain. This is for two reasons:

1. The neutral hand positioning

2. The fact that rings are able to rotate to the optimal position for your wrists, elbows and shoulders

As with the other variations you can practice your push ups on rings whilst maintaining a neutral wrist position so there is far less stress on the joint.

However gymnastic rings have the edge over the other variations as the rings are not in contact with the ground but rather suspended from an anchor point above with straps.

This means that the rings and therefore your hands are able to rotate to the angle that is most comfortable for your wrist, elbow and shoulder joints rather then staying static as with conventional push ups.

This is far kinder to the joints and respects the body’s natural movement throughout the course of the rep.

When your palms are flat on the ground as with a regular push ups the hands are static and the plane of motion remains the same, and there is a straight up and down motion with no rotation or adjustment to the angle of the arm. This can be unfavourable to the joints and connective tissue.

Now think of how you throw a punch or pressing a dumbbell. The arm doesn’t move in up and down or laterally in a perfect line because the arm is no longer restricted. The arm is free to move more naturally in a way that is optimal for the comfort of your joints.

Think of the difference between a smith machine bench press and a dumbbell press. The smith machine removes any stability training and forces your body to work along a specific plane of motion. Whereas with the dumbbell press the onus is on you to stabilise the equipment and you can move the weight in a way that is optimal for joint health.

This is like the difference between a push up and a ring push up, both in terms of stability and a respect for the body’s natural way of moving.

Gymnastic ring push ups also more challenging because of the instability aspect. Gymnastic rings by their nature are characteristically unstable which is a great stimulus for the body to adapt to. Instability may seem at first like a dubious attribute but it has profound benefits for the shoulder and wrist joints.

The instability of the rings acts as another form of tension and triggers a response from the body to strengthen the surround muscles that support these joints so that they can become accustomed to the new stimulus.

This results in stronger and more stable joints that form a solid foundation for pressing exercises and therefore reduces the risk of injury. All the muscles of the chest and triceps also have to contribute to the stability of the exercise which increases the overall tension of the exercises so there is greater potential for muscle and strength gains.

Ring push ups can be a great way to progress your calisthenics chest workout and can be scaled in difficulty. The increase muscle activation required for the exercise, increases your coordination, balance and proprioceptive strength (the sense of the relative position of one's own parts of the body and strength of effort being employed in movement). If your progress with regular push ups has begun to stall, introducing ring push ups is a great way to bust through the plateau.

For a full guide on how to introduce gymnastic training for shoulder stability into your training with the correct sequence of exercises, check out my post on how to develop shoulder stability with gymnastic rings.

The Perfect Push up V2

Another option is the ‘perfect push up’ which is a product developed by US Navy Seal Alden Mills. Consider this a halfway house between static push up bars and gymnastic rings.

The perfect push up keeps the same neutral wrist position but the handles also rotate, so you naturally adjust to the most comfortable position throughout the movement. The rubberised treads on the bottom of the ensures the product sticks to the surface your training on.

These are a little bit more expensive then regular push up handles but they do definitely feel very comfortable on the wrists thanks to their ability to rotate and they are also very portable.

I personally do prefer gymnastic rings push ups myself because you can scale the intensity (for beginner to advanced) by adjusting the length of the straps and because of the instability there is more muscle engagement and more of a proprioceptive component which is better for athletic performance. Also gymnastic rings are extremely versatile with a huge range of exercises.

Conclusion

Push ups can often cause wrist pain because of:

• Improper technique

• Over-training

• The angle of the wrist is not comfortable

The problem is often made worst by people trying to push through the pain and not the wrist sufficient time to rest for any exercise induced soreness to alleviate.

To avoid developing or exacerbating wrist pain from push ups you have several options that all put the wrist at a more favourable neutral angle.

Push up bars are a good choice as they are relatively inexpensive and you can use the for handstand push ups too. They also offer a greater challenge then regular push ups thanks to the increase demand for grip strength.

The perfect push up product is also a worthy contender as it has the added advantage of being able to rotate which puts less stress on your joints and connective tissue.

My personal favourite is ring push ups as the free rotation of the rings allows you to find the most comfortable angle and position for your joints. Rings respect the body’s natural desire to move, rotate and adjust as you go through the range of motion. Gymnastic rings are also great for other exercises such as pull ups, dips and muscle ups.

Thanks to the challenging instability element of gymnastic rings, my wrist is now pain free and having adapted to the instability, my shoulders and wrists are now far more stable and form a solid foundation for other pushing exercises.

If does not alleviate after sufficient rest period (6 weeks) without taxing the joint under stress then you should consult a doctor or physiotherapist in case there are any underlying causes which may be causing long term discomfort.