Each week at the clinic I have a patient tell me something along the lines of, “I have never been able to touch my toes; I just have tight hamstrings and I’m not flexible,” which always makes me raise an eyebrow and skeptically reply, “Really…?” I readily believe that they have never been able to touch their toes and that they have some mobility problems, but I am not quick to assume what the source of their problem is. This same patient that tells me their hamstrings are inflexible has also been telling me they have been stretching and stretching their hamstrings for years and they have never changed.
The fact is, there are many reasons that people cannot touch their toes, including motor control problems, flexibility problems, joint stiffness, or neural tension to name a few. Knowing WHY you cannot touch your toes may be one of the most valuable pieces of information that you can learn. The WHY behind the movement pattern tells you how you can help yourself.
Let’s try to walk through a few of these possibilities…
Flexibility is the actual decrease is tissue extensibility. In this case, the hamstrings would be the tissue of concern and are most commonly blamed for the inability to touch one’s toes. True flexibility problems change over time with much dedication, and there has to be the appropriate amount of stress and strain over time to allow the structural changes to take place within the tissue.
Self Check: Lie on your back. Push your leg into the doorway for 5 seconds and then scoot closer to the doorframe. Repeat this until you can go no further. True flexibility issues will not make a great amount of change in this short period.
Treatment: If you do not notice a change, perform repeated stretching to the hamstrings frequently throughout the day at 30-second intervals.
The inability to touch your toes could also be due to joint stiffness, which could occur at the hips or the low back. Lack of lumbar flexion or pelvic rotation can inhibit one from obtaining the mobility needed to touch the toes.
Self Check: When you go forward to touch your toes, do you have a nice curvature throughout the spine, or does the low back look flat? If you get into a child’s pose position with your bottom sitting back on your heels, can you do it? How does your spine look?
Treatment: If you have a non-uniform spinal curvature or you have the inability to get your thighs to your chest, you may have a joint mobility problem at the spine and/or hips. A skilled physical therapist or chiropractor can assist in helping you gain the desired mobility at these joints. After you have gained mobility, you will need to perform exercises to be retrained on how to use this new movement.
Neural tension is tension throughout the entire neurological system that could be limiting movement. Tension through the sciatic nerve can often mimic what one may think of as hamstring pain or tightness that can extend down behind the knee.
Self Check: When you sit on the edge of the bed, put your hands behind your back and tuck your chin into your chest. Then, try to extend one leg out. Does this reproduce your symptoms? If you look up, do your symptoms go away?
Treatment: If the answers are yes, then you may have a neural tension component. Neural flossing may be a quick start to treating this problem. However, you will need someone skilled in movement analysis to dip deeper on why this is happening.
Motor control involves the ability of a person to control the movement they have from a neurophysiological perspective. This is the brain sending signals to coordinate movement patterns and allow for appropriate timing of the body’s structures to complete a task. A motor control problem can be disguised as some of the other problems above and takes careful consideration of the movement to determine the root cause of dysfunction.
Self Check: Did you have a change with the contract-relax exercise for flexibility testing above? Did you test negative for neural tension? Can you touch your toes when you are sitting with your legs out straight in front of you?
Treatment: If the answers are yes to these questions, then try the progression below and see if you can get yourself to touch your toes:
- Standing with your heels up on a 2” book, squeeze a towel in between your legs and curl down to touch your toes (keep your chin tucked into your chest). Repeat 10 times.
- Standing with your toes up on a 2” book, squeeze a towel in between your legs and curl down to touch your toes. Repeat 10 times.
- Standing flat on the floor, repeat the same movement 10 times.
Now, take a deep breath… simon says… “touch your toes.”
Through movement screening we can weed out some of the layers of movement problems and get to the root of the issue and the remedy for improvement. Try these at home, but you may, however, need a skilled practitioner to continue to break down these movement patterns.