Pike push up, also written pike pushup, pike push-ups or piegamenti a V in Italian, is one of the most used bodyweight exercises for training overhead pressing without equipment, and it is the step that many people place between classic push-ups and the wall handstand. In this guide you will find the execution, the mobility prerequisites that almost nobody checks, the progressions, the typical mistakes and the situations in which it is better not to do it. And if your shoulder hurts today, if it is unstable or if you have had a dislocation, the part to read first is the one on who should not do it: these are the situations in which overhead work is exactly what irritates the shoulder.
On the pike push up as a specific exercise, the scientific literature is essentially absent. There are no electromyographic studies, no efficacy studies, no comparisons with other pressing exercises. What can be said with evidence concerns overhead work in general: how to progress the load, how much range the shoulder needs to get there without compensating, and what happens when that range is missing. The rest is biomechanical reasoning and clinical practice, and in this guide you will find written each time which of the two it is.
⚠ Important: read this before continuing
The exercises and advice in this article are general indications and may not suit your situation. Every person has a unique clinical history: what works for others could be counterproductive for you.
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What it is, in practice
The exercise is performed in an inverted V position: hips high, legs straight, hands on the floor slightly wider than the shoulders, trunk tilted towards vertical. From there the head lowers towards the floor by bending the elbows, and you come back up by pushing with the arms. It is precisely the angle of the trunk that makes the difference compared with a classic push-up: the closer the trunk gets to vertical, the greater the share of body weight the arms have to push, and the more the movement resembles an overhead press rather than a horizontal push.
The name comes from the "pike" position of artistic gymnastics; in Italian you also find it as "piegamenti a V". No equipment is needed, and difficulty is adjusted by changing the angle of the body, not by adding weight.
What it really trains: the muscles involved
From the mechanics of the movement, the drivers are the deltoids (especially the anterior and middle heads) and the triceps, which extend the elbow on the way up. Around them, the muscles that orient the scapula and those of the trunk work to hold the position while the arms push. It is a coherent biomechanical description, and it is what you will find written everywhere: reasonable, but never measured on this exercise.
Here it is worth being precise, because it is the point where most articles on the pike push up slip. A 2022 scoping review gathered shoulder electromyographic activity during push-up variations: 30 included studies, six types of push-up and five muscles analysed. The pike push up is not among the six. The variants studied are the standard push-up, the one on an unstable surface, the one on suspension straps, the one with the hands on a ball, the "plus" push-up and the incline push-up with raised hands. For the last one, which interests us because it is the easier progression of the exercise, the review reports that the serratus anterior reaches its highest values together with the "plus" push-up.
A second study explains why "harder" does not automatically mean "more shoulder activation". Comparing the standard push-up with three versions performed on suspended or unstable supports, activation of the abdominal muscles was significantly greater in the unstable variants, while the anterior deltoid, the pectoralis major and the serratus anterior did not show greater recruitment than the classic push-up. Changing the support changed the work of the trunk, not that of the shoulder's prime movers.
Put plainly: the logic that tilting the trunk shifts the load towards the deltoids is solid and consistent with the mechanics, but the measured data on this exercise simply does not exist. Anyone who tells you how many percentage points of activation the pike push up produces compared with lateral raises is making it up. And it is worth adding something that is often forgotten: a measured muscle activation is not a benefit. It says how much a muscle works at that instant, not that the exercise makes you stronger, protects you from anything or reduces pain.
The mobility prerequisites: the piece nobody checks
To bring the arms overhead with the trunk aligned you need good shoulder flexion range. If that range is not there, the movement does not stop: it moves elsewhere. In the pike push up the "elsewhere" is almost always the same: the lumbar area arches and the neck extends to bring the head to the floor.
On this, research says something, even if not about our exercise. A study on 12 young men measured maximal arm elevation in standing and in a slouched posture, with 3D motion analysis and electromyography. In the slouched posture maximal elevation fell by about 15 degrees, the speed of the movement dropped, and the muscular cost increased in all three muscles measured: peak activity rose by 32% in the upper trapezius, 49% in the lower trapezius and 21% in the serratus anterior, with even larger increases in total work. It is a small study, on healthy subjects, and it measures arm elevation, not a push-up. But the principle is clear: if the trunk does not allow the range, the shoulder pays for it in fatigue.
A 2026 systematic review looked at the same relationship from the other side, pooling five studies and 887 shoulders: greater thoracic kyphosis was associated with reduced shoulder flexion and abduction, and with greater internal rotation of the scapula. The reported correlations are weak and the level of evidence is low, so no clinical threshold can be derived from it. What can be derived is that the shoulder and the trunk are not two separate chapters, and that is a good reason not to insist on an inverted V you cannot manage.
But the counterpoint is also needed, because the opposite idea has spread around: that there is a "correct" movement of the scapula and that every deviation must be corrected. A 2025 systematic review with meta-analysis of twenty studies dismantled two cornerstones of that narrative: the so-called initial setting phase of the scapula and the constant 3-to-1 ratio between arm elevation and scapular rotation. The variability between people is such, the authors write, that it is hard to establish what an abnormal pattern is, and the differences between people with rotator cuff-related shoulder pain and those without had very low certainty of evidence. The moral: worry about how far you can move and how you feel while doing it, not about resembling a diagram.
On a practical level, and this is clinical practice, not a validated test, a simple way to get an idea before trying the exercise is to raise your arms overhead from standing with your back against a wall, keeping the lower back in contact with it. If to reach the wall with your hands you have to lift the lumbar area away from it, the range you need for the pike push up is probably being borrowed from your back. This is not a rejection: it is the indication to start from an easier variant.
How to perform it well
- Start in plank and lift your hips until the body forms an inverted V, with the legs straight or slightly bent if the hamstrings pull.
- Hands slightly wider than the shoulders, fingers spread, weight distributed across the whole hand and not only the palm.
- Bend the elbows, bringing your head towards the floor between your hands, with the elbows at about 45 degrees to the trunk, not flared out to the sides.
- Keep the neck neutral: the head goes down with the whole body, it does not poke forward to arrive first.
- Push to come back up by fully extending the arms, without bouncing at the bottom.
Two details decide the quality of everything else. The first is range: a shorter but controlled descent is better than a full descent reached by arching the back. The second is the position of the head. In the handstand, flexing the neck worsens performance, and in the pike push up a neck that stretches forward is the sign that the movement is escaping from the shoulder.
Common mistakes
- Hips too low. If the inverted V is not pronounced, what you are doing is a push-up with a few extra degrees, and the load stays on the chest.
- Neck collapsing. Extending the cervical spine to reach the floor with your head adds discomfort and adds no training.
- Elbows flared wide. Opening them beyond the mark puts the shoulder in a poor position: 45 degrees remains the practical reference.
- Jerky movements. Bouncing at the bottom skips exactly the part of the movement that generates the adaptation.
- Progressing too fast. Going from a high support to the floor in one week is the most common way to end up with an irritated shoulder and no gain.
Progressions: from easiest to hardest
With bodyweight you cannot add plates, so difficulty is adjusted in only one way: by changing how much of your body weight ends up on your arms. Here is the scale, from easiest to hardest.
- Hands on a high support (a table, a stable windowsill): the trunk stays almost horizontal and the load on the shoulders is minimal. It is the starting point if arms overhead already feel demanding.
- Hands on a medium or low support (a sturdy chair, a step, the edge of the sofa): lowering the support a few centimetres at a time is the real progression, and it is continuous rather than stepped.
- Hands and feet on the floor: the standard version.
- Feet elevated on a bench or chair: the trunk gets closer to vertical and the load on the shoulders increases clearly. The range required of the shoulder also grows here, so it is the point where compensations start to show again.
- Wall handstand: almost all body weight on the arms, with in addition a balance component that the pike push up does not train.
A simple criterion for deciding when to move up a level, and this too is clinical practice: move to the next step when you can do three sets of 10-12 clean repetitions, with the same range from the first to the last, without pain appearing in the following 24-48 hours.
How to dose it
On dosage there are no studies that have tested the pike push up. There is, however, solid data on resistance training in general, and it is useful for understanding which direction to move in.
The first concerns load. A systematic review with meta-analysis compared low-load and high-load training, across 21 studies in which all sets were taken to muscular failure: changes in muscle mass were similar between the two approaches, while gains in maximal strength were greater with high loads. For those who train at home this is a half-good piece of news: for building shoulders bodyweight holds up in comparison, but if the goal is a maximum overhead, sooner or later you need overload.
The second concerns how close to failure to go. A series of meta-regressions published in 2024 analysed the distance from failure expressed in repetitions in reserve: strength gains were similar across a wide range, while hypertrophy increased as sets were taken closer to failure. The authors themselves describe the analysis as exploratory and urge caution, because the repetitions in reserve were estimated after the fact from the descriptions in the studies. But the direction is useful: you do not need to reach exhaustion to get stronger.
From here, the practical reference I use in the clinic, which remains clinical practice and not a validated protocol: 3-4 sets of 6-12 repetitions, twice a week, stopping with 1-3 repetitions still in reserve, on the hardest variant you can perform while keeping good technique. If the technique worsens before the sixth repetition, the variant is wrong, not you.
The link with the handstand: a goal, not a benefit
The pike push up is almost always presented as "preparation for the handstand". It is a sensible training goal, not a demonstrated benefit: no study has verified that training pike push-ups gets you to a handstand push-up faster or more safely.
It is also worth scaling back the idea that it is only a matter of strength. A 2025 systematic review on the biomechanics of the handstand, across 21 studies, describes balance as a control strategy that starts from the wrists and involves the shoulders, hips and elbows only when that strategy is not enough; head position and visual conditions also influence performance. The strongest gymnasts have better control, but the handstand remains a balance skill, and that is trained in the handstand.
Who should not do it, or should do it only after an assessment
The pike push up is an overhead exercise with a good share of body weight on the arms and the head down. These are exactly the two features that make it unsuitable for some situations.
- Painful or unstable shoulder. Overhead work is often precisely what provokes the symptoms. If the shoulder hurts when you lift your arm, the right sequence is to understand what is behind it, not to look for the right exercise by trial and error.
- Sequelae of dislocation. The guidelines on traumatic anterior shoulder dislocation indicate that, after the acute phase, physiotherapy aims at recovering function, coordination and proprioception, and that among the risk factors for recurrence are young age and male sex.
- Rotator cuff pain. The guideline on rotator cuff disorders recommends an active, task-oriented programme, but after an assessment based on clinical history and physical examination, with imaging only in selected cases. Assessment first, then load.
- Neck disorders with tingling. If tingling or numbness running down the arm appears, putting the neck in an extreme position under load is not a good idea until you understand what is causing them.
- Uncontrolled hypertension. Here honesty requires a clarification: I have found no studies on the blood-pressure effect of the inverted V position. Caution about the head-down position is practical prudence, not a measured finding.
Two notes. The recommendations on dislocation are largely based on low-quality evidence, which is one more reason not to improvise on your own. And on hypertension, the European consensus document confirms that physical activity, including resistance training, is part of the treatment, and that the prescription must be personalised to baseline values: if your blood pressure is not under control, the question should be put to whoever follows you, not to an article.
Signs that call for an assessment, not training
Some conditions are not managed by changing the exercise. If you recognise one of these signs, the useful thing is to get checked.
- Loss of arm strength that appeared after a trauma, for example being unable to lift or hold the arm up.
- A hot, swollen and red shoulder, especially if accompanied by fever or general malaise.
- Night pain that progressively worsens, particularly in someone with a history of cancer.
- Tingling, numbness or weakness running down the arm towards the hand.
Shoulders, pain and prevention: what we really know
That gradually training overhead pressing is a good idea is reasonable. That a single exercise "prevents impingement" is not: the evidence does not authorise that leap.
What research does show is something else, and still relevant. In subacromial pain, often labelled shoulder impingement, therapeutic exercise is the pillar of conservative treatment, and a meta-analysis of eight controlled studies found that scapular stabilisation exercises improve pain and function compared with conventional physiotherapy, without however a gain in joint range. On rotator cuff-related pain, a 2025 meta-analysis found that specific exercise programmes reduce symptoms to a moderate extent compared with generic exercises, with effects that vary according to the type of exercise: hence the recommendation for individualised prescriptions rather than one protocol for everyone. On optimal doses, the same reviews are explicit that type, quantity and duration remain to be clarified.
Put differently: progressions serve to adapt the load, not to skip the assessment.
In summary
The pike push up asks only for the floor and can be adjusted in both directions. It has no studies of its own, and anyone who sells you precise figures on its muscle activation is filling a gap. It is worth doing for what it is: a simple, scalable way to train overhead pressing, provided you choose the variant that lets you move well rather than the one that forces you to compensate. If you have had shoulder problems in the past, or if you do not know where the pain that appears when you raise your arm comes from, Ri-Hub's physiotherapists can assess you online before you try it.
This exercise is part of the exercise library: eighty-three guides like this one, with execution, common mistakes and variants, written by our physiotherapists.
Sources
- Shoulder electromyography activity during push-up variations: a scoping review, Shoulder & Elbow, 2022
- Recruitment of Shoulder Prime Movers and Torso Stabilizers During Push-Up Exercises Using a Suspension Training System, Journal of Sport Rehabilitation, 2020
- A slouched body posture decreases arm mobility and changes muscle recruitment in the neck and shoulder region, European Journal of Applied Physiology, 2015
- Spine alignment influences shoulder range of motion and scapular orientation: A systematic review, Journal of Experimental Orthopaedics, 2026
- Scapular kinematics variability in individuals with and without rotator cuff-related shoulder pain: A systematic review with multilevel meta-regression, Brazilian Journal of Physical Therapy, 2025
- Strength and Hypertrophy Adaptations Between Low- vs. High-Load Resistance Training: A Systematic Review and Meta-analysis, Journal of Strength and Conditioning Research, 2017
- Exploring the Dose-Response Relationship Between Estimated Resistance Training Proximity to Failure, Strength Gain, and Muscle Hypertrophy: A Series of Meta-Regressions, Sports Medicine, 2024
- Biomechanical analyses of the handstand: a systematic review, Frontiers in Sports and Active Living, 2025
- Diagnosing, Managing, and Supporting Return to Work of Adults With Rotator Cuff Disorders: A Clinical Practice Guideline, Journal of Orthopaedic & Sports Physical Therapy, 2022
- Clinical practice on treatment of primary traumatic anterior shoulder dislocation: a multidisciplinary guideline, Acta Orthopaedica, 2026
- Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the EAPC and the ESC Council on Hypertension, European Journal of Preventive Cardiology, 2022
- An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain, Journal of Orthopaedic & Sports Physical Therapy, 2020
- Effect of scapular stabilization exercises on subacromial pain (impingement) syndrome: a systematic review and meta-analysis of randomized controlled trials, Frontiers in Neurology, 2024
- Specific modes of exercise to improve rotator cuff-related shoulder pain: systematic review and meta-analysis, Frontiers in Bioengineering and Biotechnology, 2025
Last source check: August 2026.
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