Hand Pain During Push-ups: Causes, Prevention, and Solutions

How do you stop your hands from hurting when doing push-ups?

To stop hand pain during push-ups, focus on optimizing wrist alignment through proper hand placement and form, strengthening the supporting muscles of the forearms and wrists, and utilizing equipment like push-up handles to maintain a neutral wrist position.

Understanding Hand Pain During Push-Ups

Hand pain during push-ups often stems from biomechanical inefficiencies or underlying issues rather than the exercise itself being inherently problematic. The most common culprit is excessive wrist hyperextension, where the wrist bends too far backward, placing undue stress on the carpal bones, ligaments, and tendons of the wrist joint. Other contributing factors include:

• Pressure Distribution: Concentrating too much weight on the heel of the hand or base of the fingers.
• Weakness in Supporting Muscles: Insufficient strength in the forearm flexors and extensors, or the intrinsic hand muscles, which are crucial for wrist stability.
• Limited Wrist Mobility: Stiff or inflexible wrists may not tolerate the required range of motion, leading to pain.
• Surface: Hard, unforgiving surfaces can exacerbate pressure points.
• Pre-existing Conditions: Conditions like carpal tunnel syndrome, arthritis, or previous wrist injuries can be aggravated by the exercise.
• Improper Progression: Attempting push-ups without adequate foundational strength or gradual progression can overload the hands and wrists.

Optimizing Hand Placement and Form

Correct technique is paramount for pain-free push-ups. Focus on these adjustments:

• Neutral Wrist Position: This is the golden rule. Aim for your wrist to be as straight as possible, minimizing the angle between your hand and forearm.
  • Spread Fingers Wide: Spreading your fingers wide and pressing down through your entire hand, including the fingertips, helps distribute your body weight more evenly across a larger surface area, reducing localized pressure on the wrist.
  • "Screw the Floor" Action: Imagine you're trying to rotate your hands externally, screwing them into the floor. This external rotation cues the engagement of your lats and helps stabilize the shoulder, indirectly reducing stress on the wrists by improving overall upper body mechanics.
• Hand Position: Place your hands slightly wider than shoulder-width apart, with your fingers pointing straight forward or angled slightly outward (approximately 11 and 1 o'clock positions). Avoid turning your fingers inward, which can create awkward wrist angles.
• Elbow Tuck: As you lower your body, keep your elbows tucked relatively close to your sides, forming about a 45-degree angle with your torso. Flaring your elbows out wide can place more stress on the wrists and shoulders.
• Full Body Tension: Engage your core, glutes, and quadriceps to maintain a rigid plank position throughout the movement. A strong, stable body reduces compensatory movements that could strain the wrists.

Strengthening Supporting Structures

Targeted strength and mobility work can significantly improve your hands' resilience during push-ups.

• Forearm Strength:
  • Wrist Curls (Palms Up & Down): Using a light dumbbell, perform wrist flexion (palms up) and wrist extension (palms down) to strengthen the forearm muscles that stabilize the wrist.
  • Reverse Curls: Using an underhand grip, curl a light barbell or dumbbells, focusing on the brachioradialis and forearm extensors.
  • Grip Strength Exercises: Squeeze a tennis ball or use a hand gripper.
• Wrist Mobility:
  • Gentle Wrist Circles: Slowly rotate your wrists in both directions.
  • Wrist Flexor Stretch: Extend one arm forward, palm up. With your other hand, gently pull your fingers down towards your body. Hold for 20-30 seconds.
  • Wrist Extensor Stretch: Extend one arm forward, palm down. With your other hand, gently pull your fingers down towards your body. Hold for 20-30 seconds.
• Finger Strength:
  • Finger Extensions: Use a rubber band around your fingers and thumb, then spread them apart against the resistance.
  • Tabletop Finger Presses: Press your fingertips into a table, lifting your palm slightly.

Equipment Solutions for Hand Comfort

Certain equipment can modify the push-up to be more wrist-friendly.

• Push-up Bars/Handles: These are highly recommended. They elevate your hands off the floor, allowing you to maintain a neutral, straight wrist position throughout the exercise. This significantly reduces the hyperextension that often causes pain.
• Fist Push-ups: If wrist hyperextension is a severe issue, performing push-ups on your fists can be an alternative. This keeps the wrist straight but shifts the pressure to your knuckles. Ensure you have strong, conditioned knuckles and a soft surface (like a yoga mat) to perform these to avoid injury to the knuckles themselves.
• Soft Surfaces: Performing push-ups on a yoga mat, carpet, or other slightly cushioned surface can reduce direct pressure on the palms and wrists compared to a hard floor.
• Weightlifting Gloves with Wrist Support: While not a primary solution for joint pain, gloves can provide a small amount of cushioning and, if they include wrist wraps, offer some external support to limit excessive extension.

Progressive Overload and Smart Training

Avoid jumping into advanced push-up variations or high volumes too quickly.

• Start with Incline Push-ups: Begin by performing push-ups with your hands elevated on a wall, counter, or sturdy bench. The higher the elevation, the less body weight you're pressing, reducing stress on the hands and wrists. Gradually lower the incline as your strength and comfort improve.
• Knee Push-ups: If standard push-ups are too challenging or painful, performing them on your knees can reduce the load, allowing you to focus on form and build foundational strength before progressing to full push-ups.
• Gradual Increase: Incrementally increase your repetitions, sets, or the difficulty of the push-up variation as your hands and wrists adapt. Listen to your body and avoid pushing through sharp pain.

When to Seek Professional Advice

While these strategies can effectively alleviate most push-up related hand pain, it's crucial to know when to consult a healthcare professional. Seek medical attention if you experience:

• Persistent or Worsening Pain: Pain that doesn't improve with rest, modifications, or strengthening exercises.
• Sharp, Shooting Pain: Especially if accompanied by tingling, numbness, or weakness in the hand or fingers.
• Swelling, Redness, or Bruising: These could indicate a more serious injury.
• Loss of Range of Motion: In your wrist or hand.
• Suspected Injury: Such as a sprain, fracture, or flare-up of conditions like carpal tunnel syndrome or tendinitis.

By systematically addressing form, strengthening supporting structures, utilizing appropriate equipment, and progressing intelligently, you can significantly reduce or eliminate hand pain during push-ups, allowing you to safely enjoy the benefits of this fundamental exercise.