Should I perform all the different hand positions? Inclines or declines? Should I put my hands close together or far apart? Should I have one hand high and one low? Is it better to start with pushups off the wall and graduate to your feet on a bench or ball? If the goals of the pushup are for strengthening the arms (triceps), shoulders (anterior deltoid), core stabilizers (transverse abdominus, multifidi, obliques),and chest (pectoralis major), then there is one version that will accomplish this as well or better than any other way of performing the pushup. The challenge is not how to make the pushup harder or easier, the challenge is meeting the strengthening needs while minimizing wasted efforts and avoiding unnecessary stress on joints.
So, the questions become, by moving my hands or body into different positions, am I just increasing stress to make the exercise harder to do, or am I adding benefit? Making an exercise harder to do can add strength, but this should never be performed if the stress on joints or tissues offsets the strength benefits. Who makes this decision? You do. Let’s see if we can help.
The pushup is certainly more of a triceps dominant exercise simply due to the fact that the fixed hands position will only allow so much shoulder horizontal adduction (there is only so much movement that occurs across in front of the body, where the shoulder and chest derive most of their benefit). The elbow is essentially able to get pretty much full extension (maximizing benefit to triceps), but the shoulder cannot (decreasing some benefit to the chest and shoulder).
If joint stresses increase while also losing some benefits to the muscles, then we don’t need to perform that version.
If you put your hands wider apart you will put increased torque and shearing stresses on the shoulder (not necessarily bad to increase joint stress as long as the benefits offset the risks). There will be less range of motion of the shoulder in horizontal shoulder adduction (less benefit to pectoralis major and anterior deltoid because there is very little overall movement across the body), and add stress to the wrist due to greater radial deviation (the wrist is turned inward more).
If you put your hands closer together the pectoralis major will become actively insufficient due to the beginning position of near complete horizontal shoulder adduction, so you’ll have little to no chest involvement (if you shorten the pectoralis major before performing the exercise by bringing the arms fully across in front of you, the chest muscles cannot be assisting with the work in the exercise). If the hands are placed more down toward the rib case, as opposed to just bringing them together in front of the chest, the plane of motion changes, which decreases pectoralis major involvement almost completely. The shoulder internal rotation stress will increase (once again, not necessarily bad, but we’re struggling to find increased benefits on this one). The wrist will now be ulnarly deviated (pinky turns outward toward wrist) adding significant stress to the wrist.
If you put one hand high and the other low, there will be significantly increased stress on each shoulder (in different ways, obviously), and the benefits to pectoralis major will be minimal.
If you choose to do a pushup on a ball (medicine ball or stability ball), the effect is similar to the close-grip pushup (also known as triangle or diamond pushups) mentioned above, with the stress to the wrists and shoulders now significantly increased over the basic close-grip pushup.
If you perform a pushup on using straps hanging from the ceiling or from a cable machine, the core stability requirement increases, as does ulnar deviation pull on the wrists.
The basic pushup, with the hands directly out from the chest such that the forearms are parallel at the bottom of the pushup (the “the bottom” or “end position” should be when the elbow barely passes behind the shoulder, the exercise has nothing to do with trying to get the chest to the ground unless you are 5’2″ with a 55″ chest). Taller people will have their chest farther from the ground at the end position, and those with shorter limbs will be much closer. This basic, ordinary version of the pushup will give you all the benefits of strengthening the core and arms without adding significant, and possibly unnecessary stresses. What may surprise you, and surprises most people, is that performing the regular pushup with impeccable form, is likely to make you capable of performing any other of the mentioned pushup versions, without having to do them at all. This provides some food for thought.
Use these ideas and overview as information to determine the best choice for you. You must decide not whether or not the pushup is for you, and what version to perform, you must decide what your goals and capabilities are, and then determine whether the pushup is right for you!