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Push ups and Stress fractures | Boddicker Performance

Filed under: corrective exercise, injuries

Push ups and Stress fractures

by on Mar 17th, 2010

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I got this comment on yesterday’s post, and thought that it would make an outstanding blog for today.

What I do know that might interest you involves stress fractures with military recruits in the Army. Stress fractures are one type of injury that has a huge impact on recruits in the Army. To be able to predict stress fracture would be a very good thing. A physical therapist I know who did some work on attempting to predict stress fractures found something quite interesting. (His work is not published because he was trying to create a prediction rule for stress fracture occurrence and the statistical aspect of the prediction rule had problems.) What he did find that was that push up performance was a definite factor in what predicted a stress fracture. He said the way the Army does the push up performance test requires both strong tricep and core strength. (I don’t remember the cutoff for the number of repetitions in a defined amount of time, but if the recruit didn’t meet the cutoff the probability for a stress fracture was greater.)
Interesting, huh?~Snippets

Think about that.  He who cannot do a certain number of good push ups is more likely to pick up a stress fracture over the course of training.  To me, this says that strength definitely matters and that upper body strength is important in running athletes, but probably more powerfully, it demonstrates the power of core stability.

The push up, as noted in an earlier post, places high demand on the anterior chain of the body leading to reflexive activity of the core.  Now exactly why or how it is the push up that predicts stress fracturces, I cannot say.  What I do know, however, is that those people capable of producing the greatest torque at the hips and who have the most stable “cores” are much less likely to be injured over the course of an NCAA season in a broad range of sport.  Additionally, there is evidence showing that those who fall one standard deviation below “mean” strength on a leg press (both absolute and relative) were at a five times greater risk of stress fracture.  In the same study, it was shown that aerobic fitness (the ability to run) had no association with health or injury.

Strength training is important, and running is by no means a panacea.

Best regards,

Carson Boddicker

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Leave a Comment »6 Comments
  • Jeff Cubos March 17, 2010

    As I was reading the comment from yesterday’s post, I KNEW it was snips….

    Anyway…great topic

  • SnippetPhysTher March 17, 2010

    The findings were surprising for the physical therapist conducting the study. I don’t think there was an actual substantiated conclusion as to why. The goal of the physical therapist’s study was to create a prediction rule to identify those who would have a higher probability of a stress fracture. Those identified would be put into more of a strength and conditioning program for however many weeks and then put through basic training (or whatever they call it). Stress fractures were the target injury because of both the cost and the loss of a recruit. The military can’t afford to lose recruits.

    The other aspect of the study also had to do with the timing of when the stress fractures occurred. My memory doesn’t serve me very well (I heard my colleague present and I WAS listening), but I can’t remember all the details. My recollection is that the stress fractures actually happened sooner in training versus later. It wasn’t like what you’d think with say a seasoned athlete who after what seems as a long period of time has a stress fracture. So, the other area being looked at was the actual training itself and changing up the activities performed especially at say the 2 or 3 week point in training. That type of a solution met resistance from the higher ranks due to “tradition.”


  • Bret Contreras March 17, 2010

    I had a lifting partner who took all summer off of weight training and instead did four sets of fifty push ups around five days per week. When he returned to weight training after the four month layoff, despite losing around ten pounds, his deadlift increased around fifty pounds. This was around five years ago before I knew as much about the benefits of core stabilization, but it made me realize how great of a core exercise the push up is. Who woulda thunk it…push ups to build your deadlift?

  • Frank Neuman March 17, 2010

    I think another highly underrated aspect of push-ups is the ability to really add the lats into the picture by focusing on actively trying to pull yourself down during the negative. Standard planks are a nice start, but that aspect of the push-up adds in another crucial piece. Plus, let’s face it, controlling our bodies in space seems like it should be second nature, but these days so many of us want to skip past the basic, foundational stuff and move right on to the bells and whistles (that is if we add resistance training to the mix at all).

    I think I recall reading in Pavel Tsatsouline’s “Beyond Bodybuilding” that even bodybuilders in the old Soviet Union were generally made to be able to perform a certain number of bodyweight push-ups (in addition to a few other benchmarks) before being allowed to progress on to other forms of training.

  • Carson Boddicker March 18, 2010


    That is some really good stuff. Interesting to see injuries happened so early. I very much appreciate your thoughts and ideas on the matter. I’d love to look into the subject further.


  • Carson Boddicker March 18, 2010


    Interesting story. I’ve heard similar things with gymnastics oriented training. I think a lot of it may have to do with developing effective pressure and stabilization mechanisms.

    Perhaps, as Frank suggests, the body control aspect helped augment the nervous system.

    Best regards,

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