Push-ups: Understanding Upper Back Sensation, Form, and Prevention of Discomfort

Why do I feel pushups in my upper back?

Feeling pushups in your upper back can be a normal indication of stabilizing muscles at work, particularly the serratus anterior and trapezius, but it can also signal form issues or imbalances that require attention to prevent discomfort or injury.

The Anatomy of a Push-Up: Key Muscles Involved

The push-up is a fundamental compound exercise that engages a wide array of muscles across the upper body and core. While often perceived as primarily a chest exercise, its effectiveness hinges on the synergistic action of multiple muscle groups.

• Primary Movers:

  • Pectoralis Major: The primary muscle responsible for horizontal adduction and flexion of the shoulder joint, driving the "pushing" motion.
  • Anterior Deltoid: Assists the pectoralis major in shoulder flexion and contributes to the pushing force.
  • Triceps Brachii: Extends the elbow, straightening the arm at the top of the movement.

• Key Stabilizers: These are the muscles that work to maintain proper body alignment and joint stability throughout the exercise, often without being the primary drivers of movement.

  • Serratus Anterior: Crucial for protracting the scapula (moving the shoulder blade forward around the rib cage) and upwardly rotating it. This muscle helps prevent "winging" of the shoulder blades and allows for efficient shoulder movement.
  • Rhomboids (Major & Minor): Retract (pull together) and elevate the scapula. They work with the trapezius to stabilize the scapula against the pull of the push-up.
  • Trapezius (Upper, Middle, Lower): A large muscle spanning the upper back and neck. Its different fibers assist with scapular elevation (upper), retraction (middle), and depression (lower), all vital for shoulder stability and movement.
  • Rotator Cuff Muscles: Stabilize the shoulder joint itself.
  • Core Muscles (Rectus Abdominis, Obliques, Transverse Abdominis): Maintain a rigid plank position, preventing the hips from sagging or arching, which protects the spine and ensures efficient force transfer.
  • Erector Spinae: Along the spine, these muscles help maintain spinal extension and prevent excessive rounding.

Understanding Upper Back Sensation: Normal vs. Abnormal

Feeling your upper back during push-ups can be a normal and even desirable sensation, indicating proper engagement of crucial stabilizing muscles. However, it can also be a red flag for compensatory patterns or poor form.

• Normal Engagement:

  • Serratus Anterior Activation: A healthy push-up involves significant protraction of the scapulae at the top of the movement, effectively "pushing the floor away" and rounding the upper back slightly. This is the primary function of the serratus anterior, which lies beneath your shoulder blade and attaches to your ribs. Feeling this muscle activate can manifest as a sensation along the side of your rib cage or beneath your shoulder blade.
  • Scapular Stability: The rhomboids and all three parts of the trapezius work to stabilize the shoulder blades against the rib cage, ensuring they move correctly throughout the push-up. During the eccentric (lowering) phase, they control the scapular retraction, and during the concentric (pushing) phase, they stabilize as the serratus anterior protracts. A mild, generalized fatigue or warmth in this area is often normal.
  • Core Engagement: When your core is fully engaged, the entire torso becomes a rigid unit. This can lead to a feeling of overall muscular effort that extends into the upper back as it works to maintain spinal alignment.

• Potential Issues and Compensation Patterns (When "feeling it" becomes problematic):

  • Weak Serratus Anterior: If your serratus anterior is weak, other muscles, such as the upper trapezius or levator scapulae, might compensate by shrugging your shoulders towards your ears. This can lead to tension, discomfort, or pain in the upper trapezius, neck, or between the shoulder blades. You might also notice your shoulder blades "winging out" excessively.
  • Overactive Upper Trapezius: Often linked to poor posture or stress, an overactive upper trapezius can take over during movements where the mid/lower traps or serratus anterior should be more dominant. This can manifest as a burning or aching sensation at the base of the neck and top of the shoulders.
  • Poor Scapular Control (Scapular Dysrhythmia): If your shoulder blades aren't moving smoothly and synchronously with your arm movements, it can place undue stress on the surrounding muscles, including the rhomboids and mid-traps, causing them to become fatigued or strained.
  • Excessive Lumbar Sag or Arching: If your core is not adequately engaged, your lower back may hyperextend (sag), forcing your upper back and shoulders to compensate to maintain some semblance of stability. This puts significant strain on the spinal erectors and other upper back muscles.
  • Shoulders Shrugging Up: Allowing your shoulders to creep up towards your ears during the movement can over-engage the upper trapezius and levator scapulae, leading to neck and upper back tension.
  • Pre-existing Muscle Imbalances or Postural Issues: Chronic tightness or weakness in certain muscle groups (e.g., tight pectorals, weak deep neck flexors) can alter movement patterns and shift the load to the upper back.

How to Differentiate Normal Engagement from Problematic Pain

Understanding the difference is crucial for safe and effective training.

• Normal Engagement:

  • Sensation: A feeling of muscular fatigue, warmth, or a general "work" sensation.
  • Location: Often broad, encompassing the area beneath the shoulder blades, along the side of the ribs, or across the middle of the upper back.
  • Nature: Generally a dull ache or burn that subsides quickly after the set.
  • Symmetry: Usually felt symmetrically on both sides.

• Problematic Pain:

  • Sensation: Sharp, localized pain, pinching, burning, or a deep ache that doesn't subside.
  • Location: Often specific, such as directly between the shoulder blades, at the base of the neck, or along the top of the shoulders.
  • Nature: Worsens with repetition, persists after the exercise, or affects daily activities.
  • Symmetry: May be unilateral (one-sided), indicating an imbalance.
  • Associated Symptoms: Clicking, popping, grinding, or a feeling of instability in the shoulder.

Correcting Your Push-Up Form for Optimal Engagement

To ensure your push-ups effectively target the intended muscles and minimize upper back strain, focus on these form cues:

• Master Scapular Control:
  • At the Top (Protraction): Actively push the floor away, allowing your upper back to round slightly as your shoulder blades spread apart. This is the serratus anterior at work. Avoid locking out your elbows and letting your shoulders collapse.
  • During Descent (Controlled Retraction): As you lower, allow your shoulder blades to come together slightly, but maintain control. Do not let them "wing out" or excessively retract.
  • Shoulder Depression: Keep your shoulders "down and back," away from your ears, throughout the entire movement.
• Engage the Core: Brace your abdominal muscles as if preparing for a punch. Your body should form a straight line from head to heels, like a rigid plank. Avoid sagging hips or arching your lower back.
• Elbow Position: Your elbows should point backward and slightly out, forming approximately a 45-60 degree angle with your torso. Avoid flaring them out to 90 degrees, as this puts excessive stress on the shoulder joint.
• Head and Neck Alignment: Keep your head in a neutral position, in line with your spine. Avoid craning your neck forward or letting it drop. Look slightly ahead of your hands.
• Controlled Movement: Perform the exercise with control, especially during the eccentric (lowering) phase. Avoid rushing or relying on momentum.

Exercises to Strengthen Key Stabilizers

Incorporating specific exercises to strengthen the muscles that stabilize your shoulder blades and core can significantly improve your push-up performance and reduce upper back discomfort.

• For Serratus Anterior:
  • Scapular Push-Ups: Start in a high plank. Keeping your arms straight, depress your chest towards the floor by allowing your shoulder blades to come together, then push back up by protracting your shoulder blades, rounding your upper back slightly.
  • Plank Protractions: Similar to scapular push-ups but often performed with hands on the floor or forearms on a stability ball for added challenge.
• For Mid/Lower Trapezius and Rhomboids:
  • Band Pull-Aparts: Hold a resistance band with both hands, arms extended in front of you. Pull the band apart by retracting your shoulder blades, squeezing them together.
  • Face Pulls: Using a cable machine or resistance band, pull the rope/band towards your face, externally rotating your shoulders and squeezing your shoulder blades.
  • Prone Y-Raises/T-Raises: Lie face down on a bench or the floor. Raise your arms in a "Y" or "T" shape, squeezing your shoulder blades together.
• For Core Stability:
  • Plank Variations: Standard plank, side plank, plank with hip dips.
  • Bird-Dog: On hands and knees, simultaneously extend one arm forward and the opposite leg backward, maintaining a neutral spine.

When to Seek Professional Guidance

While minor aches can often be resolved with form adjustments and targeted strengthening, it's important to know when to consult a professional.

Seek advice from a physical therapist, sports medicine doctor, or certified strength and conditioning specialist if you experience:

• Persistent or worsening pain in your upper back, shoulders, or neck during or after push-ups.
• Sharp, shooting, or radiating pain.
• Numbness, tingling, or weakness in your arms or hands.
• Significant asymmetry in your movement or pain.
• Pain that interferes with daily activities or sleep.
• A feeling of instability or clicking/popping in your shoulder joint.

By understanding the complex interplay of muscles in a push-up and diligently practicing proper form, you can transform this foundational exercise into a highly effective tool for building strength and stability, without unnecessary upper back discomfort.