As I have problems with my wrists, I do my push-ups from a closed fist 'stance'. This isn't a problem for me, as the Dojo has nice soft (right!) mats - soft enough for my purposes, at least - and the carpet at home does just as well. Because I start up a little higher, I don't go quite to "nose down" position when doing push-ups, but stop just a little bit short of that.
Once I have completed the program, I intend to start working on other hand positions, including traditional wrist position, inverted wrist (weight on the back of the hand, instead of on the palm), finger tips and whatever else Sensei Rudy can come up with (he suggested, and demonstrated these and a few others).