How Many Pushups Should You Be Able to Do? A Physio's Guide to Strength & Heart Health
Pushups have been a cornerstone of fitness programs for generations, and for good reason. As a Physiotherapist, I value them as a fantastic bodyweight exercise for building upper body strength, core stability, and functional mobility - all without any equipment or cost.
But beyond building muscle, the humble push-up might be a powerful crystal ball for your long-term health. Research suggests that the number of pushups you can do is strongly linked to your risk of cardiovascular disease, the leading cause of death worldwide.
Key Clinical Insight
A landmark study published in JAMA Network Open found that middle-aged men able to complete more than 40 pushups had a 96% reduced risk of cardiovascular events compared to those who could not do 10. Pushup capacity was a more powerful predictor of heart health than submaximal treadmill tests.
The Pushup Study: What They Found
The influential 2019 study followed 1,104 active male firefighters with a mean age of 39.6 for 10 years. Researchers measured each participant's pushup capacity and exercise tolerance, tracking all cardiovascular disease events throughout the decade.
The results were striking. The study established a clear dose-response relationship:
- 11+ pushups: Significantly reduced risk of cardiovascular disease compared to those doing fewer than 10.
- 40+ pushups: A dramatic 96% reduction in cardiovascular event risk compared to the sub-10 group.
Notably, pushup capacity was a better indicator of future cardiovascular risk than submaximal treadmill exercise testing, suggesting it could be a simple, no-cost screening tool for functional strength and heart health.
Pushup Performance Standards: How Do You Compare?
While the study focused on cardiovascular risk, it's helpful to understand how your pushup capacity compares to general fitness standards. The following table, based on data from a large fitness community, shows average pushup reps for men by age and fitness level.
| Fitness Level | Age 20 | Age 30 | Age 40 | Age 50 |
|---|---|---|---|---|
| Beginner | < 16 reps | < 18 reps | < 18 reps | < 12 reps |
| Intermediate | 39 reps | 41 reps | 41 reps | 33 reps |
| Advanced | 66 reps | 68 reps | 68 reps | 57 reps |
| Elite | 95 reps | 99 reps | 99 reps | 85 reps |
A Physiotherapist's Perspective on the Numbers
As the table shows, "good" is relative to your age and training background. From a clinical standpoint, fitness director Ebenezer Samuel, C.S.C.S., suggests that everyone should aim to achieve 20-25 consecutive pushups with proper form as a foundation of functional strength. This aligns well with the study's finding that even moderate pushup capacity (11+) offers significant health benefits.
The Critical Element: What Counts as a "Proper" Pushup?
One limitation of the JAMA study was that it didn't specify the standard for a counted repetition. As a Physiotherapist, I can confirm that form dramatically impacts both the effectiveness of the exercise and what your capacity truly represents.
Many people perform partial repetitions or compromise their form to increase their numbers. For a pushup to genuinely reflect your functional strength, it must be performed correctly.
How to Perform a Perfect Pushup
- Starting Position: Begin in a high plank with hands placed slightly wider than your shoulders, palms flat. Your body should form a straight line from your head to your heels.
- Engagement: Squeeze your glutes, engage your core, and keep your neck neutral. Rotate your elbows outward (without moving your hands) to engage your rotator cuff.
- The Descent: Bend your elbows and lower your body until your chest touches the floor. If you have maintained your rotator cuff engagement, your elbow will travel close to your trunk.
- The Ascent: Press back up to the starting position by fully extending your elbows.
Common Form Pitfalls to Avoid:
- Sagging Hips: Maintain a rigid torso throughout; don't let your hips dip toward the floor.
- Partial Range of Motion: Going only halfway down significantly reduces the exercise's effectiveness.
- Flared Elbows: Keeping elbows out at a 90-degree angle to the body places unnecessary stress on the shoulder joints.
Study Limitations and Considerations
While the findings are compelling, it's important to view them through a scientific lens. As with any study, we must consider its limitations before broadly applying the results.
- All-Male Cohort: The study included only male firefighters. We cannot automatically generalise these specific risk percentages to women, though the underlying principle that strength correlates with health likely holds.
- Occupational Bias: Firefighters are generally more active than the average population. The risk thresholds might differ for those in sedentary occupations.
- Form Standardization: As mentioned, the lack of a standardised pushup form means the exact "dose" (number of reps) needed for benefit might vary based on depth and quality.
A Physiotherapist's Action Plan: Improving Your Pushup Capacity Safely
If your push-up test reveals room for improvement, here's a safe and effective way to build your strength and, potentially, support your long-term health.
1. Start Where You Are
If you can't yet do a full pushup, begin with an incline pushup. Place your hands on a sturdy elevated surface like a table or bench. This reduces the amount of bodyweight you're lifting while maintaining proper core engagement. Avoid dropping to your knees, as this shortens the lever and reduces core activation.
2. Focus on Quality Over Quantity
It's better to do five perfect pushups than 15 sloppy ones. Change the incline to make things easier if you struggle to do many classic ones.
3. Implement Smart Programming
You don't need to do pushups every day. A balanced approach is key. Aim for three sets of as many clean reps as you can, resting as needed between sets. A common and effective goal is to work toward three sets of 20-25 reps.
4. Balance Your Training
You should not train for pushups in a vacuum every day. Balance pushing exercises like pushups with pulling exercises like rows or pull-ups.
Conclusion: Pushups as a Vital Sign
The evidence is clear: pushup capacity is more than just a measure of upper body strength—it's a powerful biomarker for overall health and resilience. While the specific risk reduction percentages from the study may not translate directly to every individual, the overarching message is undeniable.
Being able to control and move your own bodyweight is a fundamental indicator of functional fitness. Whether your goal is to hit 10, 40, or more pushups, focusing on proper form and consistent progression is one of the simplest and most effective investments you can make in your long-term health.
How many pushups can you do with proper form? Have you noticed a connection between your strength and your overall well-being? Share your experiences in the comments below!
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