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Background and Hypothesis The push-up plus exercise is a common therapeutic exercise for improving shoulder function and treating shoulder pathology. To date, the kinematics of the push-up plus exercise have not been studied. Our hypothesis was that the push-up plus exercise would demonstrate increased scapular internal rotation and increased humeral anterior translation during the plus phase of the exercise, potentially impacting the subacromial space. Methods Bone pins were inserted in the humerus and scapula in 12 healthy volunteers with no history of shoulder pathology. In vivo motion during the wall push-up plus exercise was tracked using an electromagnetic tracking system. Results During the wall push-up plus exercise, from a starting position to the push-up plus position, there was a significant increase in scapular downward rotation (p<0.05) and internal rotation (p<0.05). The pattern of glenohumeral motion was humeral elevation (p<0.05) and movement anterior to the scapular plane (p<0.05) with humeral external rotation remaining relatively constant. Conclusions We found that during a wall push-up plus exercise in healthy volunteers, the scapula was placed in a position potentially associated with shoulder impingement. Due to the shoulder kinematics of the wall push-up plus exercise, utilization of this exercise without modification early on in shoulder rehabilitation, especially in patients with subacromial impingement, may not be advised. Level of evidence Laboratory Study

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