Picture: 123RF / KANTVER
Picture: 123RF / KANTVER

Some call the push-up “the world’s greatest exercise”. Others say it’s a “body-altering, core-strengthening move” without equal. Now, new US research by Harvard Medical School scientists adds to that fulsome praise and raises the push-up’s reputation to brave new heights.

The push-up’s power could make it a fast, cheap and objective way for doctors to assess patients’ heart disease risk, the Harvard researchers say in the Journal of the American Medical Association (JAMA).

All doctors need to do, they say, is ask patients to drop to the floor and do some push-ups. Compared to patients who can do fewer than 10 push-ups, those who can do 40 or more are likely to have significantly reduced “incident cardiovascular disease (CVD) event risk”, they say. (That’s medical jargon for reduced risk of heart attack or stroke.)

While the researchers don’t explicitly say it, their study also strongly suggests the push-up could be a good way to reduce your risk of premature death from heart attack or stroke.

If you can’t make it past 10 push-ups, don’t despair. Fitness experts say you should increase your push-up capacity sooner rather than later and it’s not difficult to do.

Science backs up benefits as CVD remains a leading cause of death worldwide, including in SA. Along with well-recognised risk factors, such as smoking, hypertension (high blood pressure) and diabetes, unfavourable health consequences of physical inactivity on heart health are well-established, the Harvard scientists note.

They refer to evidence showing that physical activity provides cardiovascular benefits independent of other modifiable risk factors associated with a lower incidence of diseases, and not just of CVD but diabetes, cancer and Alzheimer’s as well. They also refer to US research showing that moderate to vigorous physical activity may significantly reduce premature death and prolong life expectancy.

For the JAMA study, the researchers conducted a longitudinal, retrospective group study of 1,104 “occupationally active adult men” — all firefighters aged 18 and upwards from 10 Indiana-based fire departments — who they followed for a decade.

When the firefighters had routine medical check-ups, doctors also checked how many push-ups they could do. Over the 10-year period, the researchers reported significantly fewer symptoms of CVD-related conditions among firefighters who could do 40 or more push-ups.

Data pointed to a whopping 96% reduction in CVD incidents compared with those who could finish fewer than 10 push-ups. The researchers rightly interpreted that as a strong association between a higher baseline push-up capacity with a lower incidence of CVD events. They concluded that push-up capacity may be a simple, “no-cost measure to estimate functional status”.

They have acknowledged study limitations with the caveat that “larger studies in more diverse cohorts [groups] are needed”. Their study is observational and therefore, by definition, can only show association, not causation.

And while technique and practice can influence push-up capacity, the researchers said that use of a standardised protocol for push-up performance by clinic staff would minimise the effect of technique on capacity.

All told, the study is good news for push-up fans.

One big fan is SA fitness trainer and sports nutrition consultant Julian Naidoo. He has helped elite athletes, celebrities and more ordinary mortals of all ages achieve peak fitness and health.

Push-ups have been mainstays of school and military physical training programmes for good reason, he says.

Push-ups are a form of calisthenics — exercise that works not just your pectoral muscles but also triceps and “delts” (slang for thick deltoid muscles covering shoulder joints), Naidoo says.

Benefits don’t stop there. Push-ups also work secondary muscles, such as your abdominal stabilisers, forearms and biceps.

Whichever method of push-up you choose, Naidoo says you should ensure your posture is correct and your “core” (abdominal) muscles are tightened throughout the movement.

That allows for optimum stimulation of your rectus abdominis muscles (popularly known as “abs”) and transverse (core) muscles.

When you do push-ups properly and with aerobic intensity, you’ll tone muscles and tax your cardiovascular system sufficiently to reduce CVD risk, Naidoo says.

Push-ups are also a helpful addition to strength and conditioning workouts as “a finisher for a chest pump for the guys”.

If you are a push-up novice or lack physical strength, Naidoo gives tips on starting safely.

Beginners can start with their knees on the floor and feet crossed, instead of in the full push-up “plank” position — resting the full body on the tips of the toes with elbows resting on the floor. An easier variation is to go halfway down and back up, starting with three sets of 10 repetitions — if possible — and building up slowly.

A narrow stance with palms on the floor, a shoulder width apart, provides more stimulation and assistance from the triceps and shoulders.

And if, or more likely when, motivation dips, remember Mahatma Gandhi’s famous saying: “Strength does not come from physical capacity. It comes from an indomitable will.”