Pain guide · Back pain

Back pain when doing push-ups: the lower back sagging, between the shoulder blades, and swaps

Back pain when you do push-ups usually comes from ordinary back pain that dislikes one position: as your trunk tires late in a set, your hips sink and your lower back arches. In a push-up your tummy muscles hold your spine and your back muscles do very little, and no study links push-ups with back injury, so push-ups aren't shown to be bad for your back. A straight line from head to heels, a slight tuck of the pelvis, a brace rather than sucking in, ending each set as your hips sink, and incline or knee push-ups usually ease it. Pain between the shoulder blades is a different story: usually the muscles that hold them, sometimes the neck.

This guide starts with the signs that need help, from a 999 call for numbness around your genitals or bottom, new bladder or bowel trouble, weakness in both legs, or upper back pain with chest pain or breathlessness, to a same-day check through the National Health Service's 111 line (NHS 111) or a general practitioner (GP) for back pain with a fever or after a fall. It then maps the causes by where it hurts, explains what the studies of the trunk in push-ups and planks show, and don't, clears up the press-up name clash, shows how to change your push-up today, and gives a three-stage plan with a 3D demo of every move, from wall push-ups back to the floor.

3-stage exercise plan When to get help 40 sourcesUpdated 28 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.
Call 999 or go to A&E: back pain with chest pain, or back pain that started after a serious accident, such as a car crash.
Call 999: shoulder or arm pain with chest pain that feels tight or squeezing, or chest pain that spreads to your arms, neck or jaw, especially with shortness of breath, sweating or feeling sick. It could be a heart attack.
Call 999 or go to A&E if breathing suddenly becomes difficult, if pain in your chest or upper back comes on suddenly with breathlessness or a very fast heartbeat, or if someone passes out. Do not drive yourself. It can be a blood clot that has reached the lungs.
Call 999: sudden chest or back pain that can feel like something being torn inside, and causes shortness of breath, and problems with walking, vision and speaking (the NHS's wording, on its costochondritis page). It can be a tear in the wall of the body's main artery (an aortic dissection). Don't drive yourself to A&E.
Get help from NHS 111: pain or tightness in your chest, neck, shoulders, jaw or arms that comes and goes, often brought on by exercise, stress, emotion or cold and easing after a few minutes' rest. It can be angina, a sign of a heart problem. If you've been diagnosed with angina, get help from NHS 111 too if it feels worse than before, is happening more often, lasts longer or happens when you're resting.
Call 999: sudden, severe pain in the tummy or back, which can come with breathlessness, pale or grey skin, or collapse. It can be a burst abdominal aortic aneurysm, most common in men aged 65 or over and in people who smoke or used to smoke.
Same day (GP or NHS 111): back pain and you feel hot, cold, shivery or generally unwell, or severe pain that starts suddenly or is getting worse quickly.
Same day (NHS 111): back pain after a new, significant injury in the last 7 days, such as a fall from a height (off a box, a bar or rings) or a direct blow to the back.
Same day: leg weakness that is getting worse; new leg pain with a history of cancer, HIV, TB or inflammatory arthritis; or leg pain with a fever, feeling unwell, loss of appetite, unexplained weight loss or night sweats.
Same day (urgent GP appointment or NHS 111): new difficulty lifting the front of your foot or toes (foot drop), or a foot that slaps down or catches as you walk, especially if it is getting worse. Weakness in both legs, or with numbness around the genitals or bottom or bladder or bowel changes, is the 999 emergency above.
Same day: you have or have had cancer, and new back pain that is severe and doesn't let up, is getting steadily worse, is worse at night and disturbs your sleep, is worse when you cough, sneeze or strain, or comes with tenderness over the spine. Contact your cancer team or GP urgently. With cancer, new weakness, difficulty walking, numbness or bladder or bowel problems are an emergency.
Call 999 or go to A&E now if you have a femoral hernia (a small lump at the top of your thigh, in your groin) and very bad tummy pain, you feel sick or you're being sick, you cannot fart or poo, you have a high temperature or you feel hot, cold or shivery, or you've suddenly become confused. Do not drive to A&E. With any other hernia and pain in or around it, a bloated tummy, feeling or being sick, vomiting blood or vomit that looks like coffee grounds, constipation, a high temperature or feeling hot, cold or shivery, or sudden confusion, get help from NHS 111.
Same day (call NHS 111, or go to A&E if you feel very unwell): after a big or unusual session, such as hundreds of pull-ups, push-ups, dips or curls, a challenge or a new class, muscle pain, swelling or weakness far worse than the session explains, and dark pee (red, brown, tea or cola coloured), sometimes starting hours or days later. Dark pee isn't always there, so muscles far sorer, more swollen or weaker than the session explains still need the same-day check. It can be rhabdomyolysis, a breakdown of muscle that can harm the kidneys.
Same day (urgent GP appointment or NHS 111): severe neck pain that starts suddenly or gets worse quickly; heaviness or weakness in the arms or legs; pins and needles in an arm along with neck or arm pain; or pain between the shoulder blades.
Same day: clumsiness in your hands, or numbness, pins and needles or weakness in one or both arms, that is getting worse; problems with balance or walking since the neck pain started; or neck pain with a severe headache.

See a doctor or physiotherapist if

Back pain that hasn't improved after a few weeks of looking after it at home, stops you doing day-to-day activities, worries you, or you're struggling to cope.
Pain at the top of the back, between the shoulders, rather than in the lower back.
Unexplained weight loss, or a lump, swelling or change in the shape of your back.
Pain that doesn't improve with rest or is worse at night, or pain that is worse when you sneeze, cough or poo.
Pain, tingling or numbness spreading below the knee that isn't settling after a few weeks, is getting worse or stops your normal activities: see a GP.
Pain that is not improving after a few weeks, is getting worse, or is stopping your normal activities.
Back pain that started before 45 and has lasted more than 3 months, especially if it started before 35, wakes you in the second half of the night, comes with buttock pain, gets better with movement or within 48 hours of anti-inflammatory painkillers, or you have or have had arthritis, pain where a tendon attaches to bone (enthesitis) or psoriasis, or a parent, brother, sister or child with spondyloarthritis. These can point to inflammatory back pain (axial spondyloarthritis, such as ankylosing spondylitis). The National Institute for Health and Care Excellence (NICE) asks GPs to refer people with 4 or more of these 9 features to a rheumatologist, and to do a blood test for the HLA-B27 gene marker if exactly 3 are present, referring if it is positive.
Sudden new back pain after a minor fall, lift, cough or sneeze, from 50 or past the menopause, or if you take long-term steroid tablets; or height loss, a curved spine or a change in posture: see a GP. It can be a spinal fracture.
A teenager or young adult whose low back pain is worse arching backwards and hasn't settled after a couple of weeks: stop the lifts that arch the back and get it checked by a GP or a sports medicine doctor or physiotherapist. It can be a stress fracture of the spine (spondylolysis), which usually does well without surgery when it's found.
A lump in the groin, upper thigh or tummy, especially one that appears when you cough or strain and goes when you lie down: see a GP, as it may be a true hernia. A femoral hernia (a small lump at the top of the thigh, mainly in women over 50, though it can happen to anyone) needs treating in hospital.
A ridge or doming down the middle of your tummy when you strain, during or after pregnancy: see our diastasis recti guide, and ask about a pelvic health physiotherapist.
Pins and needles or a cold arm alongside neck pain, or a new loss of strength or feeling in the arm that you cannot explain (a possible nerve problem).
A shoulder blade that suddenly sticks out, or new weakness lifting, pushing or carrying: see a GP. Nerve tests may be needed to find which nerve is affected and how badly.
A strain that is getting worse, or isn't feeling better after looking after it yourself: see a GP or physiotherapist. In many areas you can refer yourself to physiotherapy.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

Upper back pain with chest pain, breathlessness, sweating or feeling faint, or a sudden tearing pain

Call 999: it could be the heart, a clot in the lung or the main artery. See the warning signs.

An ache across the lower back that builds through a set, worse as your hips sink and your back arches, easing when you rest or drop to your knees

Usually ordinary low back pain, brought on by the arch late in a set. It is by far the commonest kind and usually settles within weeks.

Read: Back pain →A sudden catch or sharp pain on one side as you drop into or push out of a push-up, sometimes with the muscles locking up

Usually a pulled back muscle or a back spasm, which settles over days to weeks.

Read: Back spasm and pulled back muscle →A dull, even ache across the back, chest or tummy the day after a new or bigger session or a challenge

Muscle soreness, which fades within about a week.

Read: Back pain after a workout →An ache or burn between the shoulder blades or along their inner edges, through the set or the next day

Usually the muscles that hold the shoulder blades, or the small joints of the upper back (our reading).

Read: Upper back pain →Under or around one shoulder blade

Our shoulder blade guide maps the causes, including the organs that can be felt there.

Read: Pain under the shoulder blade →Under one shoulder blade with a stiff neck, then pain, pins and needles or numbness down the arm

A trapped nerve in the neck, where the shoulder blade pain often comes first.

Read: Pinched nerve in the neck →A sharp spot beside the spine in the middle of the back, worse on a deep breath, a twist or a cough

Possibly a rib joint, a joint of the spine or a strained muscle between the ribs.

Read: Rib pain →The middle of the back, from the bottom of the shoulder blades to the bottom of the ribs

Our middle back pain guide covers it.

Read: Middle back pain →A shoulder blade that sticks out as you lower or push

Winging, rarely from a nerve problem: see a GP, as the warning signs say.

Read: Winged scapula →The front of the hip or groin during the set, or a cramp there

The hip flexors, the muscles at the front of the hip, working to hold your hips up.

Read: Hip flexor pain →Down one leg past the knee, with tingling, numbness or weakness

Sciatica, often from a disc; the leg usually hurts more than the back.

Read: Sciatica →A teenager or young adult whose low back hurts arching backwards, building over weeks

Possibly a stress fracture of the spine (spondylolysis): get it checked if it lasts more than a couple of weeks.

Read: Spondylolisthesis →From mid-life, an ache worse leaning back or standing, eased by bending forward

Often put down to the facet joints, the small joints at the back of the spine.

Read: Facet joint pain →A lump in the groin, at the top of the thigh or near the belly button, bigger when you strain and smaller lying down

A possible hernia: see a GP, and read the warning signs for when it is urgent.

Read: Groin pain →

A ridge or doming down the middle of the tummy during a push-up, during or after pregnancy

A separation of the six-pack muscle (diastasis recti), common after a birth. Ease off push-ups and planks for now, and ask about a pelvic health physiotherapist.

Only in a still hold: a plank or side plank

Our plank back guide covers holds, side planks and hold length.

Read: Back pain in planks →The lower back in burpees, circuits or a class

Our burpee back guide covers the drop, the jump and a plan back.

Read: Back pain in burpees →The shoulders, wrists, elbows or neck in push-ups

Not the back: our push-up guides for the shoulder, wrist, elbow and neck cover them.

Read: Shoulder pain in push-ups →

Muscles far sorer, more swollen or weaker than the session explains, after hundreds of push-ups or a contest

Rarely muscle breakdown, which needs a same-day check, as the warning signs say.

Understand it

What a push-up asks of the back, and what no study has measuredEmerging evidence

A push-up is a moving plank: hands just outside the shoulders, one straight line from head to heels, the chest lowered and pressed back up. Gravity tries to sag the middle of your body towards the floor, and the tummy muscles hold it up. In 11 men doing push-ups, the abdominal muscles provided 64% to 87% of the lower spine's stiffness, depending on the direction, while the deep tummy muscle, the multifidus and the back muscles contributed very little.

In 18 adults holding a plank on their toes (the top of a push-up), the back muscles worked at about 5% of their maximum, the six-pack and obliques at 29% to 40% and the rectus femoris, a hip flexor, at about 20%; on the knees, the six-pack and outer obliques worked less. Push-ups also worked the deep hip flexor (the psoas) at up to 25% of its maximum in fine-wire recordings.

In a lab model of 12 push-up styles in 10 people, clap and hand-moving push-ups needed more muscle activity and loaded the spine more, balls under the hands added only a little, and the one-arm push-up gave the highest spine compression. The abstract gives no figure for an ordinary push-up, and no study has counted back pain from push-ups, measured how far the lower back arches as a set goes on, or tested a change to the push-up for back pain. So this page's map comes from these lab studies, plank studies, back pain trials and NHS pages.

Sources 1, 2, 3, 4

The usual cause: ordinary back pain that dislikes the archStrong evidence

For nearly all people with low back pain, no single cause can be found, and only a small proportion have a well understood cause such as a broken bone, cancer or an infection. The NHS says back pain is very common and usually improves within a few weeks. An ache across the lower back that builds late in a set and eases when you drop to your knees is usually this kind of pain, showing up in a position it dislikes (our reading). Change the push-up rather than stop moving: advice to stay active did slightly better than bed rest (2 trials, 401 people).

Sources 5, 6, 7

Between the shoulder blades: muscles, small joints and the neckEmerging evidence

Upper back pain affects 15% to 27.5% of people over a year, more often young people and women. In push-ups, the serratus anterior holds the shoulder blades to the ribs and works hardest in the extra push at the top (the push-up plus), so an ache between or along the shoulder blades is usually these muscles or the small joints of the upper back (our reading); injected rib joints next to the spine gave a deep, dull, local ache.

The neck can send pain there too: in 50 people with a trapped nerve in the neck, neck or shoulder blade pain came before the arm symptoms in 70%, and a review found shoulder blade pain described in 72% of studies. So pain under one shoulder blade with a stiff neck, or arm symptoms that follow, belongs to our trapped nerve guide.

Sources 8, 9, 10, 11, 12

Press-ups for back pain: two different exercisesMixed evidence

In the UK a press-up is a push-up. The McKenzie prone press-up, lying face down and pushing your chest up with your hips on the floor, is a different exercise: our back pain guide uses it when arching back eases pain. As a whole method, McKenzie exercise didn't beat no treatment in one network analysis of 89 studies. This page is about the push-up.

Source 13

When a scan or test helps, and what it can't tell youStrong evidence

Not for a lower back ache in push-ups. The National Institute for Health and Care Excellence (NICE) says don't routinely offer imaging for low back pain outside specialist care. Scans of people with no back pain show worn discs in 37% at 20 and 96% at 80, and disc bulges in 30% and 84%.

The NHS asks you to see a GP for back pain coming from the top of your back, between your shoulders, rather than your lower back. Tests matter for the warning signs (heart tests for chest pain), after a fall or a blow, for a young athlete's suspected stress fracture, and for worsening nerve signs.

Sources 14, 15, 6

How it usually goesStrong evidence

No study follows back pain from push-ups. Across 33 groups of people with new back pain (11,166 people), average pain fell from 52 out of 100 to 23 at 6 weeks, 12 at 26 weeks and 6 at a year; pain that had already lasted a while improved less. The NHS says back pain usually improves within a few weeks but can sometimes last longer or keep coming back. Soreness fades within a week. No one can promise a date.

Sources 16, 6

What helps, and how strong the evidence is

Exercise helps back pain, but no type is clearly bestStrong evidence

Across 249 trials, exercise eased long-lasting back pain by about 15 points out of 100 against no treatment, usual care or a placebo (moderate certainty). Motor control ("core") exercise beat minimal treatment but was no better than other exercise (29 trials, 2,431 people). A network analysis ranked Pilates, motor control, resistance and aerobic training highly, with low-quality evidence, and NICE suggests a group exercise programme of any type. So this plan uses push-ups as one part of a mix, not as the cure.

Sources 17, 18, 13, 14

Push-ups in back pain treatment: barely testedEmerging evidence

In the only trial we found with push-ups for back pain, 30 adults (10 per group) had general physiotherapy, sling exercise, or sling exercise with push-ups for 6 weeks; disability fell in all three groups and more in the two sling groups, and the abstract reports no extra benefit for disability from adding push-ups. The only plank trial for back pain had 38 people. In 8 healthy men, 8 weeks of suspended push-ups thickened the six-pack by 27% and the outer obliques by 14%. These are tiny studies.

Sources 19, 20, 21

A weak core doesn't predict back pain, and a push-up test isn't a back testMixed evidence

Across 12 cohorts (5,459 people), back muscle endurance and tummy strength didn't predict back pain. People with back pain scored lower on a movement screen's push-up test in a meta-analysis of 3 studies (144 people), but in 79 volleyball players the screen's scores were the same with or without back pain, and a snapshot can't show which came first. A poor push-up isn't a diagnosis, and a good one isn't a guarantee.

Sources 22, 23, 24

Easier versions take load off the hands and the trunkEmerging evidence

About 66% of body weight was on the hands at the start of a floor push-up and 53% from the knees in 8 men, and in 23 adults, hands-raised and knee push-ups put the least force through the hands, while feet-raised push-ups put the most. In a knee plank, the six-pack and outer obliques worked less than on the toes. That a knee or incline push-up eases a sore back is our reading of these studies.

Sources 25, 26, 2

Plank cues: tuck, brace, and don't suck inEmerging evidence

In 15 adults, a plank with a slight backward tuck of the pelvis and the shoulder blades drawn together drew the most trunk muscle activity and felt hardest; in 19 adults, a pelvic tuck drew more side tummy work. In 8 men, bracing (tightening all round) improved modelled spine stability by 32% for a 15% rise in compression, and the authors saw no mechanical reason to hollow (suck in). In 8 adults, hands placed far forward or far back drew the most tummy and back muscle activity, and the authors advise care with these in low back pain. None of these studies measured pain.

Sources 27, 28, 29, 30

The push-up plus works the serratus anterior hardestEmerging evidence

In 30 people, the standard push-up plus drove the serratus anterior up to 123% of a maximal contraction with little upper trapezius, and a review of 19 studies (356 people) and a scoping review of 30 studies agree that the push-up plus targets it. Pushing the floor away at the top is the usual cue for the shoulder blades; whether it eases pain between the shoulder blades hasn't been tested.

Sources 9, 31, 32

Strength work helps neck and shoulder muscle painEmerging evidence

In 48 women with long-lasting neck and shoulder muscle pain in repetitive jobs, 10 weeks of specific strength training cut their pain by about 79%. These weren't push-ups or lifters, so the plan borrows the idea for the upper back, not the dose. In 7 trials of long-lasting pain (385 people), exercise that allowed some pain did no worse than pain-free exercise.

Sources 33, 34

How much pain is OK while you exercise?

Up to about 5 out of 10, no worse the next morning, never down a leg or an armEmerging evidence

This guide uses the back hub's rule, as our other back movement guides do. Some discomfort during exercise is fine, and it does not mean you are doing damage: the WHO counts "hurt does not necessarily mean harm" among the messages people with back pain need. Aim for pain you would call mild to moderate, no more than about 5 out of 10. It should settle within an hour or so, and your back should be no worse the next morning. If it is worse, do less next time (fewer reps, a smaller range, a lighter load), not nothing.

Leg symptoms are the exception: stop or shrink any movement that sends pain, pins and needles or numbness further down your leg. If leg symptoms move back towards your spine, that is a good sign, even if your back aches a little more for a while.

If pain climbs day after day, or you notice any warning sign, stop and get it checked. The 5 out of 10 figure matches this site's other pain guides and has not been tested in a back pain trial; in trials of long-lasting muscle and joint pain, exercise that allowed some pain did no harm.

The 5 out of 10 figure matches NHS inform's back exercise bands (0 to 3 minimal, 4 to 5 acceptable, 6 to 10 excessive, and your pain no worse the morning after you've exercised); the NHS back pain page says stop if your pain gets worse and see a GP.

For push-ups (our suggestion, built on the same rule): judge each set by its last reps, and use the version (wall, worktop, bench, knees, toes) and the number of reps at which those last reps stay at 5 out of 10 or less and your back is no worse the next morning. End the set when your hips sink or your back arches, whatever the target. Pain or tingling spreading down a leg or an arm, chest pain or breathlessness, and a new bulge in the tummy wall aren't pain-rule questions: see the warning signs.

Sources 35, 6, 34

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Keep moving, take the sag out

About the first 2 weeks: daily walking, trunk work with the back supported or the lever short, and the push-up pattern against a wall. With a diagnosed condition (sciatica or a disc, a stress fracture of the spine, a hernia or a repair, a separation after pregnancy), that guide's plan comes first. Doses are editorial unless a source is named.

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

5 to 10 min, several times a day · As in our back pain and plank back guides (editorial); outdoors is just as good. The NHS says stay active

Harder: Treadmill jogging

3D demoCat-cowBeginner · No equipment

8 waves, slower than feels natural · The move page's dose

Harder: Half lord of the fishes (Ardha Matsyendrasana)

Dead bug heel taps demonstrated on the 3D figure

3D demoDead bug heel tapsBeginner · No equipment

2 sets of 6 to 8 each side · As in our back pain guide (editorial). Lower each foot only as far as your back stays still

Easier: Bent-knee fall-out · Harder: Forearm plank

Knee plank demonstrated on the 3D figure

3D demoKnee plankBeginner · No equipment

5, then 3, then 1 holds of about 10 s, resting a breath or two between · Our McGill big 3 routine's falling sets, as our plank and burpee back guides use them (editorial). Pelvis slightly tucked; end each hold as your hips sink

Harder: Forearm plank

Wall push-up demonstrated on the 3D figure

3D demoWall push-upBeginner · A wall

2 to 3 sets of 8 to 12, body straight from head to heels · As in our push-up neck guide (editorial)

Harder: Push-up

Thoracic rotation demonstrated on the 3D figure

3D demoThoracic rotationBeginner · No equipment

6 rotations per side, moving with the breath · The move page's dose. For pain between the shoulder blades

Easier: Side-lying open book · Harder: World's greatest stretch

Move on when: You can walk for 15 to 20 minutes and get through normal daily tasks, knee planks and wall push-ups pass the pain rule, and your back is no worse the next morning (as in our back pain guide's first stage).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Incline and knee push-ups, with the shoulder blades

About weeks 2 to 6, 2 or 3 days a week, plus walking: the push-up position again on a shorter lever, the push-up plus for the shoulder blades, and the trunk's other jobs.

Incline push-up demonstrated on the 3D figure

3D demoIncline push-upBeginner · A bench or box

2 to 3 sets of 8 to 12, hands on a worktop, then a bench; a notch lower when every set reaches 15 · As in our push-up neck and burpee back guides (editorial); a notch lower at 15 is our push-up guide's ladder rule

Easier: Wall push-up · Harder: Push-up

Knee push-up demonstrated on the 3D figure

3D demoKnee push-upBeginner · No equipment

3 sets of 8 to 15, once incline push-ups at bench height pass the rule · Our push-up progression workout's dose (editorial). Pad your knees, as the move page says

Easier: Incline push-up · Harder: Push-up

Scapular push-up (push-up plus) demonstrated on the 3D figure

3D demoScapular push-up (push-up plus)Beginner · No equipment

2 sets of 10, on a bench or from the knees · Our push-up progression workout's dose (editorial). Push the floor away at the top

Easier: Dumbbell shoulder-blade punch · Harder: Push-up

3D demoBird dogBeginner · No equipment

2 to 3 sets of 6 to 8 each side, 3 to 5 s holds · As in our back pain guide (editorial)

Easier: Bird dog, one limb at a time · Harder: Bear crawl

Knee side plank demonstrated on the 3D figure

3D demoKnee side plankBeginner · No equipment

3 holds of 15 to 20 s each side · As in our back pain guide (editorial)

Harder: Side plank

3D demoBand rowBeginner · A band + An anchor point

3 sets of 10 to 15, stopping 2 to 3 reps short of failure, with 60 to 90 seconds' rest · The move page's dose (an editorial starting point). For the upper back

Harder: Supported single-arm dumbbell row

Move on when: 3 sets of 10 knee push-ups pass the pain rule with your hips level, and your back is no worse the next morning, for a week (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Back to full push-ups: cleaner, then harder

From about week 6, often later, 2 or 3 sessions a week: floor push-ups and planks back in your training, one change at a time by the written steps below. No study has tested a return to push-ups after back pain, so the order is editorial.

3D demoPush-upIntermediate · No equipment

3 sets of 8 to 15, stopping about 2 reps short of failure · The sets and reps are our push-up progression workout's; stopping short is editorial, as in our push-up neck guide

Easier: Wall push-up · Harder: Close-grip push-up (close triceps position)

Straight-arm plank (high plank) demonstrated on the 3D figure

3D demoStraight-arm plank (high plank)Intermediate · No equipment

3 holds of 15 to 30 seconds · The move page's dose (a suggested starting point). Fists or the forearm plank if your wrists ache, as the move page says

Easier: Knee hover (Pilates tabletop hover) · Harder: Leg pull front (Pilates leg pull down)

Forearm plank demonstrated on the 3D figure

3D demoForearm plankIntermediate · No equipment

3 holds of 20 to 45 s, ending each when your hips start to sink · Our plank back guide's dose (editorial)

Easier: Stomach vacuum (drawing-in) · Harder: Plank walk-up

Side plank demonstrated on the 3D figure

3D demoSide plankIntermediate · No equipment

3 holds of 20 to 30 s each side · As in our back pain guide (editorial)

Easier: Knee side plank · Harder: Side plank with leg lift

Bear crawl demonstrated on the 3D figure

3D demoBear crawlIntermediate · No equipment

4 crawls of 8 to 10 metres, forwards and back, resting as needed · The move page's dose (an editorial starting point). Keep your hips level with your shoulders

Easier: Knee hover (Pilates tabletop hover) · Harder: Spider crawl (low push-up knee drive)

Feet-elevated push-up demonstrated on the 3D figure

3D demoFeet-elevated push-upAdvanced · A bench or box

3 sets of 6 to 10, last and optional · As in our push-up shoulder guide (editorial). Raising the feet puts more of your weight on your hands

Easier: Push-up · Harder: One-arm push-up

Move on when: Your usual push-up sessions pass the pain rule for 2 weeks: then add one harder version at a time (diamond, decline, archer, clap), and build any push-up challenge up over weeks rather than starting at its top number. If a session flares it, go back a stage for a few days, not to nothing (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Your push-up for now (written steps)

Our 3D figure can't show the tuck, the brace or your breathing. These steps come from lab studies in healthy people and the site's push-up guide; no trial has tested a change to the push-up for back pain, and each step names its source or says it is our suggestion.

1. Choose the version you can do for 8 clean reps with your hips level: a wall, a worktop, a bench, your knees, then your toes (our push-up guide's ladder).
2. Hands just outside your shoulders, fingers forward, and elbows angled back about 45 degrees (our push-up guide). Hands far forward or far back worked the trunk hardest in a lab study, so keep them under your chest for now.
3. Make one straight line from head to heels, tuck your pelvis slightly, squeeze your glutes lightly and brace all round rather than sucking in (our suggestion, from lab studies of planks).
4. Lower under control until your chest nearly touches, or as low as you can keep the line, then push the floor away to straight arms and a little beyond at the top (our push-up guide).
5. Breathe in on the way down and out on the way up, and don't hold your breath (our push-up guide).
6. End the set when your hips start to sink or your back starts to arch, 2 reps short of failure (our suggestion).
7. No push-up challenges, daily maximums, clap or one-arm push-ups until the last stage, because the dynamic versions load the spine more (our suggestion, from a lab study).

Sources 25, 27, 29, 30, 4

Today, in pregnancy and after a birth, and everyday life (written steps)

These come from the NHS unless they say our suggestion.

1. Keep active and carry on with your daily activities, and don't stay in bed for long periods; advice to stay active did slightly better than bed rest.
2. The NHS suggests an anti-inflammatory such as ibuprofen if it suits you (paracetamol on its own isn't recommended for back pain), and an ice pack or a heat pack wrapped in a tea towel.
3. After a birth: the NHS says avoid sit-ups and planks to start with, and begin with gentle tummy exercises; bring push-ups back once a move no longer makes the middle of your tummy dome (our suggestion).
4. Classes, burpees and fitness tests: step back rather than jump into the plank, leave the push-up part out until the last stage, and build test numbers over weeks (our suggestion, as our burpee back guide does).

Sources 6, 7, 36

Positions to swap, and why

Habit or position	Why it matters	Instead
Letting your hips sag into an arch	The arch is what a sore back usually dislikes (our reading); the push-up move page says go back to an incline rather than push through.	Knees down or hands raised, with a slight pelvic tuck.Try: Incline push-up
Sets to failure, challenges and daily maximums	The hips sink as the trunk tires (our reading).	Stop 2 reps short, or as soon as your hips sink.Try: Knee push-up
Sucking your belly button in hard	In a lab model there was no mechanical reason for it; bracing gave more stability.	Brace all round.Try: Dead bug heel taps
Clap, hand-moving and one-arm push-ups early on	They needed more muscle activity and loaded the spine more in a lab study.	Standard push-ups first.Try: Push-up
Hands far forward or far back	These drew the most trunk muscle activity, and the study's authors advise care with them in low back pain.	Hands just outside your shoulders, under your chest.Try: Knee push-up
Craning your head up to look forward	It's the neck, not the back, that complains; our push-up neck guide covers it.	Head in line, eyes just ahead of your hands.Try: Wall push-up
Letting your chest sag between your shoulder blades at the top	The serratus anterior does its work in the push at the top (our reading of lab studies).	Push the floor away at the top.Try: Scapular push-up (push-up plus)
Pushing through pain spreading down a leg or an arm	It points to a nerve: see the warning signs.	Stop, and keep to moves that don't bring it on.Try: Bird dog
Push-ups or planks that make the middle of your tummy dome after a baby	The NHS says avoid planks to start with after a birth.	The NHS side-lying draw-in.Try: Side-lying tummy draw-in
Bed rest until it stops hurting	Staying active did slightly better than bed rest, and the NHS says don't stay in bed for long periods.	Walking and the first-stage moves.Try: Treadmill walking

Routines to follow

Push-up progression workout

Work up to full push-ups: wall, incline and knee push-ups, then the floor push-up and harder variations.

15 minBeginner8 movesA wall, A bench or box

Beginner core workout

A 15-minute beginner core workout on the floor: dead bugs, bird dogs, knee planks, side planks and curl-ups.

15 minBeginner6 movesNo equipment

McGill big 3 core routine

The McGill big three for the core: curl-ups, side planks and bird dogs, each held for 10 seconds at a time in falling sets of 5, 3 and 1 reps.

12 minBeginner3 movesNo equipment

Plank challenge workout

A 12-minute plank session for the 30-day plank challenge: front planks that get harder, not longer, plus side planks and bird dogs for the whole trunk.

12 minBeginner12 movesNo equipment

Pilates for back pain (gentle routine)

A gentle 15-minute Pilates-based routine for ongoing low back pain, built from neutral-spine moves with options for backs that dislike bending or arching.

15 minBeginner10 movesNo equipment

Upper back mobility routine

A 12-minute routine for a stiff upper back and rounded shoulders: chin tucks, wall angels, Y-T-W raises and open books.

12 minBeginner8 movesA foam roller, A wall

More moves for this area

Questions people ask

Why does my lower back hurt when I do push-ups?

Usually because your hips are sinking and your lower back is arching as your trunk tires late in a set, and a sore back dislikes that position. End the set earlier, tuck your pelvis a little, or put your hands on a bench or your knees on the floor. Pain down a leg is different: see the warning signs.

Are push-ups bad for your back?

No study shows that. In a push-up your tummy muscles hold your spine and your back muscles do very little, and no study links push-ups with back injury. Clap, hand-moving and one-arm push-ups load the spine more, so leave those until your back has settled.

Why does my upper back hurt after push-ups?

An ache between the shoulder blades is usually the muscles that hold them, or the small joints of the upper back, and it fades within days. Push the floor away at the top and use an incline for a while. Pain under one shoulder blade with a stiff neck or arm symptoms can come from the neck, and upper back pain with chest pain or breathlessness needs 999.

Can I do push-ups with lower back pain?

Usually, yes, changed: hands on a worktop or bench, or knees down, a straight body line, and sets ended before your hips sink. Keep the pain to 5 out of 10 or less and no worse the next morning.

Are knee push-ups easier on the back?

From your knees, about half your body weight is on your hands against about two thirds on your toes, and the tummy muscles work less in a knee plank. Raising your hands on a bench does a similar job.

Do push-ups help back pain?

About as much as other exercise, not more: many kinds of exercise ease back pain, and core exercise isn't special. Push-ups have barely been tested as a back treatment. Pick exercise you'll keep doing; push-ups can be part of it.

Should I suck my stomach in during push-ups?

No: brace all round instead, as if for a light poke in the stomach. Bracing gave more spine stability in a lab model, and there was no mechanical reason to suck in.

What's the difference between a press-up and a McKenzie press-up?

In the UK, a press-up is a push-up. A McKenzie press-up is done lying face down, pushing your chest up while your hips stay on the floor; it's a back exercise for people whose pain eases when they arch back, and our back pain guide covers it.

Why does my back hurt the day after push-ups?

A dull, even ache across both sides after a new or bigger session is usually muscle soreness, which fades within about a week. NHS inform says pain from new exercises should ease quickly and be no worse the morning after, so if your back is worse after an ordinary session, go back a step.

Do I need a scan?

Not usually: NICE doesn't routinely offer imaging for back pain, and disc bulges are common in people without pain. The warning signs, or a young athlete whose back hurts arching backwards for more than a couple of weeks, need checking instead.

How long will it take, and when should I see a doctor?

New back pain usually eases a lot within 6 weeks, though no one can promise a date. Call 999 for numbness around your genitals or bottom, new bladder or bowel trouble, weakness in both legs, or upper back pain with chest pain or breathlessness; get a same-day check for back pain with a fever or after a fall. See a GP if it isn't better after a few weeks, or for pain between your shoulders; in the US, call 911 where this page says 999.

Related exercise guides

Push-ups guide

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.

When to get help first

Get urgent medical help if

See a doctor or physiotherapist if

Where does it hurt?

Understand it

What a push-up asks of the back, and what no study has measuredEmerging evidence

The usual cause: ordinary back pain that dislikes the archStrong evidence

Between the shoulder blades: muscles, small joints and the neckEmerging evidence

Press-ups for back pain: two different exercisesMixed evidence

When a scan or test helps, and what it can't tell youStrong evidence

How it usually goesStrong evidence

What helps, and how strong the evidence is

Exercise helps back pain, but no type is clearly bestStrong evidence

Push-ups in back pain treatment: barely testedEmerging evidence

A weak core doesn't predict back pain, and a push-up test isn't a back testMixed evidence

Easier versions take load off the hands and the trunkEmerging evidence

Plank cues: tuck, brace, and don't suck inEmerging evidence

The push-up plus works the serratus anterior hardestEmerging evidence

Strength work helps neck and shoulder muscle painEmerging evidence

How much pain is OK while you exercise?

Up to about 5 out of 10, no worse the next morning, never down a leg or an armEmerging evidence

The exercise plan: 3 stages

Keep moving, take the sag out

Incline and knee push-ups, with the shoulder blades

Back to full push-ups: cleaner, then harder

What to change for now

Your push-up for now (written steps)

Today, in pregnancy and after a birth, and everyday life (written steps)

Positions to swap, and why

Routines to follow

Push-up progression workout

Beginner core workout

McGill big 3 core routine

Plank challenge workout

Pilates for back pain (gentle routine)

Upper back mobility routine

More moves for this area

Questions people ask

Related exercise guides

Other pain guides

Sources