Push-Up Plus (Serratus)
Talk to your doctor first. General education, not medical advice.This content is general education, not medical advice, diagnosis or treatment. Get approval from your physician or another qualified healthcare provider before starting any exercise program, especially if you have a medical condition, a recent injury or surgery, are pregnant, or take medication. Stop and seek medical advice if an exercise causes pain, dizziness, chest discomfort or shortness of breath. You choose to exercise at your own risk. Read the full medical disclaimer.
Build a full routine
This exercise isn’t on one of our printable sheets yet. These free routines cover similar ground:
Physical therapist or assistant? Add this exercise to a patient’s home program →
Why it helps
The serratus anterior keeps the shoulder blade flat on the rib cage and helps it rotate upward when you raise your arm. When it is weak, the shoulder blade can stick out (winging) and the shoulder may pinch with overhead reaching.
The “plus” is the extra push at the top, which is what targets the serratus. Start at the wall, as in wall push-ups, and work down to the floor. The serratus wall slide trains the same muscle with less load.
Step-by-Step Instructions
- Start with your hands on a wall at shoulder height, slightly wider than your shoulders, and step your feet back.
- Keep your body in a straight line from head to heels and your stomach muscles gently tight.
- Bend your elbows to bring your chest toward the wall, then push back to straight arms.
- At the top, push a little further so your shoulder blades slide apart and your upper back rounds slightly. Hold for 1 to 2 seconds.
- Relax the shoulder blades back to neutral and repeat. Progress from wall to counter, then knees, then full floor version.
What you’ll need Paid links
What this exercise uses, with household swaps where they work.
- Exercise mat · Non-slip, about 6 mm (1/4 in) thick, for floor exercises. A rug or folded blanket works.
Links go to Amazon search results, so you choose the product and price. We don’t recommend specific brands. As an Amazon Associate we earn from qualifying purchases, at no extra cost to you. How we make money
Key Form Cues
- Push away: At the top, push the floor or wall away to spread the shoulder blades.
- Straight line: Do not let the hips sag or pike up.
- Elbows angled: Keep elbows at about 45 degrees from the body, not flared wide.
How much to do
2 to 3 sets of 8 to 12 slow reps, 3 times a week. Move to a lower surface only when the current one feels easy with good form.
Progression & Regression
Regression (Make It Easier)
- Do the “plus” only, with straight arms against the wall
- Do wall push-ups without the plus first
- Start with the serratus wall slide
Progression (Make It Harder)
- Move from wall to kitchen counter to knees
- Do the full push-up plus on the floor
- Hold the plus position for 3 to 5 seconds
Who it suits, and who should check first
Good fit for: shoulder blade winging or weakness, shoulder impingement, shoulder instability programs, and posture work.
Check with your clinician first if: you have had recent shoulder, elbow or wrist surgery, a shoulder dislocation, or pain when putting weight through your arms.
Precautions
Pick the level you can control.
- Choose the height (wall, counter, knees or floor) where you can keep good form for every rep.
- Mild muscle effort around the shoulder blade is normal; pinching pain in the front of the shoulder is not.
- If your wrists hurt, try it against the wall or on your fists or push-up handles.
- Stop and consult your provider if: you feel sharp shoulder or wrist pain, the shoulder feels unstable, or you have numbness or tingling in the arm.
Frequently asked questions
What is the “plus” in a push-up plus?
It is the extra push at the top of the push-up, where the shoulder blades move apart around the rib cage. This is what works the serratus anterior.
Can a push-up plus help a winging shoulder blade?
It is one of the main exercises used for shoulder blade winging from muscle weakness. Winging after an injury or with sudden weakness should be checked by a clinician first.
Is the wall version enough?
For many people starting out, yes. Progress to the counter or floor only when the wall version is easy, and see the shoulder impingement guide for related exercises.
Video: HPT Physical Therapy on YouTube. We link to it because it shows the movement clearly; the written instructions and dosing on this page are our own general guidance.
Try next
Back to Exercise Library
Explore more exercises for every body region, each with a video and step-by-step instructions.