Well Being: Pushing back on push-up warning

My recent column on push-ups, in which orthopedic surgeon John Fenlin of the Rothman Institute tossed a hand grenade by recommending that people over 40 stop doing body-weight exercises such as push-ups, pull-ups, and dips, generated a huge response from readers.

Many were alarmed by his warning and wanted guidance about sensible ways to adapt push-ups so they're less perilous, as well as advice about suitable substitutes. But others objected to Fenlin's counsel, claiming that body-weight exercises are an important and valuable part of their fitness regimen that pose little danger if executed carefully and properly.

Among the latter was D.C. Maxwell, who has been at the forefront of fitness trends in the Philadelphia area for the last 20 years, which is about as long as I've known her. Today, she is a consultant to club managers and training educators and is a persuasive advertisement for fitness herself, with a trim and shapely figure. Passionate about martial arts, she has won seven gold medals in Brazilian jujitsu international competitions. She asked me not to divulge her age, but I will say that she appears anywhere from 10 to 20 years younger than the score kept by Father Time.

In her e-mail response, Maxwell wrote:

"Of course, doctors are going to see the problems, the results of bad form, lack of tension, overuse, and the like. They don't encounter all the other folks who are doing the movements properly and reaping the benefits."

The other day, Maxwell and I met at the Optimal Sport Health Club just off Walnut Street in Center City. The purpose of our meeting was to give her a chance to vent some more and also to demonstrate proper push-up technique, explain muscle tension and why it matters, and show me some lead-up movements and modifications that can make body-weight exercises safer for beginners and the weak and less experienced.

Maxwell's attitude toward the potential injury caused by body-weight exercises such as push-ups can be summarized in a sentence: "It's not what you're doing that's wrong; it's how you're doing it that's wrong."

She proceeded to demonstrate by dropping to the floor and doing several push-ups. Proper form requires that you position your hands directly under your shoulders. As you lower your body, your elbows should bend toward the back rather than out to the side. Your chest or chin should touch the floor.

(For an exhibition of how not to do push-ups, go to YouTube and call up the appearance of Paula Broadwell on Jon Stewart's The Daily Show, when she was peddling her book, All In. On the show, David Petraeus' honey engaged in a push-up contest with Stewart and her husband. While Broadwell has, in the parlance of the gym, "great guns," she does her push-ups with her arms set wide apart, and she bends her elbows out and to the side. Even worse, she lowers herself only halfway, and doesn't touch her chest or nose to the floor, a gross violation in the eyes of purists like me.)

One of the knocks against push-ups and other body-weight exercises is that you can't change the load or resistance, because your body weight is set and static. Maxwell begs to differ. To illustrate, she performed push-ups with her knees on the floor and her lower legs crossed. These so-called girl push-ups reduce resistance considerably. I resorted to them myself a few years back after injuring my shoulder when I fell off a bike in Maine.

Maxwell also demonstrated how resistance can be varied by using a Smith machine, a steel structure that has brackets set at different heights so bodybuilders can perform weightlifting exercises from different starting positions. By doing push-ups with your hands gripping a bar set at four feet, the exercise is relatively easy because the upright angle of your body shifts the center of gravity, lessening the load. Lower the bar and your body becomes more horizontal, and the load on your arms and shoulders rises.

Another way to reduce the stress of push-ups is to reduce the range of motion. Maxwell accomplished this by placing a small medicine ball and, later, a couple of foam blocks, beneath her chest. She lowered herself only as far these supports permitted. As you become stronger and more proficient, you can decrease the height of the supports or eliminate them altogether.

Next, Maxwell addressed the matter of tension - not the nervous tension that causes anxiety, but muscular tension. The idea, she said, is to "fully engage all the muscles you'll use in the course of an exercise, and to maintain the tension of all the involved muscles through its entirety." Equally important is to generate muscle tension before undertaking an exercise or, in her words, "before you load up with weight." That way, "you're not jammin' and slammin' " - subjecting parts of your body to the shock of a sudden load.

As an example, in the negative phase of a push-up, when you're lowering your weight to the floor, you shouldn't just drop but rather lower yourself slowly, tensing all your muscles in the shoulders, arms, back, and abs, just as you would during the positive or concentric phase of the push-up, when you raise your body from the floor.

Maxwell has no beef with machines. She says they're an effective way to introduce tyros to resistance exercise in a controlled manner that will develop proper form and good habits. But in the end, she heartily endorses body-weight exercises "because they develop neural patterns." She compares them to a "neural upgrade, like upgrading the software" that controls your physical self and coordinates movement.

"Body-weight exercise connects body parts and also establishes neural patterns so that when we're moving through life, we don't get hurt," Maxwell said. "As we get older, what do we care about really? It's being able to move our bodies through the tasks of daily living."

John Fenlin doesn't disagree with Maxwell, he told me. What he called her "cheater" pushups are a legitimate way to reduce resistance, which is beneficial for beginners, the deconditioned, and the aged. Where he and Maxwell differ, he said, is that Maxwell is dealing with people who are getting proper instruction about correct form and preparation and, in many cases, are, like her, elite athletes. There are some who are so genetically gifted that they can do pushups with impunity to age 100, he said. By contrast, in his original warning about the perils of body-weight exercise, he was addressing "the average Joe"-someone who is middle-aged, overweight, and out of shape and begins doing pushups with poor form and little or no preparation, sometimes on a barroom floor to win a bet or show off.

His bottom-line advice: "Don't try to behave like you're 20 when you're 70."

"Well Being" appears every other week, alternating with Sandy Bauers' "GreenSpace" column. Contact Art Carey at art.carey@gmail.com. Read his recent columns at www.philly.com/wellbeing.