Pull-Up

The Pull-Up is a highly accessible Vertical Pull exercise that involves lifting the bodyweight through the sole use of the upper extremities. In addition to affording decompression of the Vertebral Column , this exercise may be relevant for the later stages of pathologies such as Subacromial Impingement , Adhesive Capsulitis , Scapular Dyskinesis and Glenohumeral Instability .

Muscles Involved

• Latissimus Dorsi

• Biceps Brachii

• Brachialis

• Brachioradialis

• Rhomboids

• Middle and Lower Trapezius

• Teres Major

• Posterior Deltoid

• Sternal Head of Pectoralis Major

• Rotator Cuff

• Core

Procedure

Starting Position:

• Patient grasps an overhead bar with both hands while upright posture of the upper body is maintained and excessive Lumbar - Extension is avoided

The Pull-Up is then performed by pulling the bodyweight from the ground till the hands fall either side of the chest, approaching end range GH Joint - Extension , Elbow - Flexion and Thoracic - Extension . Scapulothoracic Joint - Retraction / Scapulothoracic Joint - Downward Rotation may need to be queued as movement of the Scapula is often neglected for excessive movement at The Elbow .

Variations

Akin to the Lat Pulldown , the Pull-Up has many grip variations that each places emphasis on a particular Elbow - Flexion Muscle :

• Neutral Grip - Greater Pectoralis Major engagement when compared to Elbow - Pronation

• Pronated Grip - superior engagement of the Latissimus Dorsi , Lower Trapezius and Infraspinatus when compared to Elbow - Supination and better engagement of the Middle Trapezius when compared to Neutral Grip. Additionally, the Middle Deltoid was best recruited during the concentric phase of the pronated grip (SOURCE-1+2)

• Supinated Grip - also known as theChin-Upfeatures greater recruitment of the Pectoralis Major and Biceps Brachii (SOURCE-1)

• Freely-Rotating Grip - also known as theperfect pull-up, displayed greatest engagement of the Latissimus Dorsi (SOURCE-1)

• Width - in terms of maximal muscle activation, no differences are reported between close and wide grip. (SOURCE-1 + 3).

Cluster

Regression

The following exercises can be used as a regression if Pull-Ups exceed the capacity of the patient:

• Banded Unilateral Lat Activations - activate lat, posteroinferior drawer on Humerus

• Circumduction Row - isotonic exercise with variable load used to emphasise mid-to-lower Trapezius

• Band Pull-Apart - basic isotonic exercise for Scapular Retractors

• Lat Pulldown - rudimentary weighted isotonic vertical pull movement with a high range of motion

• Straight Arm Lat Pulldown - isotonic motion that emphasises Lats and straight arm strength

• Inverted Rows - rudimentary isotonic horizontal pull exercise that utilises bodyweight

Progression

The following exercises can be used as a progression to Pull-Ups once exercise proficiency is achieved:

• Medball Pullover Throw - plyometric Pullover variation

• Prone Lat Pulldown - Lat Pulldown variation that emphasises Thoracic - Extension

• Rope Climb - pull-up variation with entire load bestowed on alternating arm

References

1. Leslie, Kelly. L. M. BSc (Hons); Comfort, Paul MSc, CSCS*D. The Effect of Grip Width and Hand Orientation on Muscle Activity During Pull-ups and the Lat Pull-down. Strength and Conditioning Journal 35(1):p 75-78, February 2013. \| DOI: 10.1519/SSC.0b013e318282120e

2. Dickie, J. A., Faulkner, J. A., Barnes, M. J., & Lark, S. D. (2017). Electromyographic analysis of muscle activation during pull-up variations. Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology, 32, 30–36. https://doi.org/10.1016/j.jelekin.2016.11.004

3. Ortega-Rodríguez, R., Feriche, B., Almeida, F., Bonitch-Góngora, J., & Padial, P. (2021). Effect of the Pronated Pull-Up Grip Width on Performance and Power-Force-Velocity Profile. Research Quarterly for Exercise and Sport, 92(4), 651–658. https://doi.org/10.1080/02701367.2020.1762835