Push-up Palmar Palsy

To the Editor. —Despite their occasional use as punishment, push-ups are widely and voluntarily practiced by our fitness-conscious population. We would like to report a previously undescribed but preventable complication of this activity. Report of a Case. —Following several weeks of a program of persistent push-ups on a hard floor, an otherwise healthy, 38-year-old man developed progressive weakness and atrophy of the left hand. Initially he had noted a brief bout of pain in the base of his palm, but when weakness developed he discontinued the push-ups. In the first four weeks he had only partial return of strength. Examination revealed atrophy and weakness of his first dorsal and other interosseous muscles, with preserved hypothenar bulk, fifth digit abduction, and sensation. Electrodiagnostic studies showed an absent ulnar motor-evoked response, marked spontaneous resting activity, and absent motor unit potentials in the left first dorsal interosseous muscles. However, results of ulnar sensory,