There are so many exercises I use every day with many clients in my training studio to correct postural problems and movement dysfunction causing weakness and pain. However, there is one exercise that stand above all others as my best stability exercise and that is the toe touch drill. One of the main reasons I rate it so highly is the fact it relates to people of all ages and abilities. For example, I regularly use this with clients in their 80’s for preventing falls and people with serious hip or knee injuries as it helps to restore optimal stability of the pelvis with the single leg stance used in walking. At the same time I also include this in training programs for elite athletes for improving sporting performance. In this article I will explain in great detail exactly what this exercise can do for your body and why you should include it in your training program.
What Is The Toe Touch Drill?
If you are not familiar with the toe touch drill below is a video showing you how it works.
Here is the instructions for completing the exercise.
Instructions
1.Standing upright with good posture on one leg. Imagine you are on the center of a clock face. (I use a functional testing grid which I will discuss shortly)
2.Drawing your belly button inwards, bend your knee ensuring that your knee tracks over your second toe whilst reaching forward with the other foot to touch 12 on the imaginary clock.
3.Repeat the movement touching each number on the clock from 1 through to 7 and back again maintaining a good posture and leg alignment.
4.Perform on the other side.
There are several versions of this exercise I use but this first one is my preferred version.
I use this as an assessment tool with all clients I meet on their first day and especially with people suffering lower limb injuries or walking impairments. The reason for this is it exposes mobility restrictions and weaknesses that are often hidden in other tests, helping me to design a corrective program that addresses these faults.
And the other reason is that it is so much more than just a simple core exercise. It is unique in that it has the ability to change the way a person walks for it shares the same relative timing used by all the joints of the body in the gait cycle. It is for this reason we use it extensively with older adults who are at risk of falling and with people suffering various injuries in their lower limbs.
With all these cases there will be a problem with how they stabilize their leg during the stance phase of walking.
Using The Functional Testing Grid
You may have noticed the colorful mat I am standing on in the picture below and this is called the Functional Testing Grid. This is separated into 12 sections with each section on a 30 degree angle and painted in a different color.
The colored sections are great for several reasons:
•It helps to teach neurologically impaired and elderly clients as the colored areas are more easily identified and can be verbally cued.
•Provides easily observable results for recording. I find this is essential in testing as I can easily see where the client is stepping or moving from or to and can even measure it.
•It helps the client gain more internal awareness and directional motor patterning.
•Assists in diagonal motor planning and control. Each color is repeated in the section that is 180º, with 360º being the top of the grid. Each consecutive circle is also numbered along the 90º, 180º, 270º and 360º lines for the ease of identifying where the client’s foot or hand lands during a movement pattern, test or exercise.
Now it is not essential for you to have a functional testing grid to do this exercise as you can still achieve great benefit from doing this on any stable surface. The grid just allows you to see how it works and how it can be a useful tool for assessments.
If you do want to get the Functional Testing Grid you can purchase this from AOK Health.
What Do I Look For When Using This As a Test?
All you have to do to appreciate how good this one exercise is as a test is to observe all the joints and muscles required to move in perfect harmony to maintain balance in order to move. All single leg exercises will also demand this but the problem many of these pose is they require a fair amount of strength to complete the movement.
For example, the single leg squat I regularly use as an exercise to assess people with knee pain for it is often the movement that demands the most control at the knee. If the person has too much pain or weakness present I will regress to the toe touch drill as it is much easier and requires very little strength.
To see more about this read the article how I use the single leg squat as an assessment tool
This is very important to remember when working with elderly clients, neurologically impaired people, or people with significant injury and pain. For any exercise that requires a fair degree of strength the result of the test can be compromised. As the toe touch drill does not require much strength to complete it correctly it is a better choice for these specific cases. And what it loses in strength it gains in coordination and reflex stability. And it is the lack of coordination and stability that is often the underlying cause of their problems.
When assessing this movement we start at the ground and work our way up, looking for clues as to where joints are not functioning correctly. We can use this exercise to assess several areas all at once as seen with the joint by joint approach.
Last but not least we cannot forget the brain.
This is always the most important factor to consider as the brain is the boss that drives all our movement. Sometimes we find that there is nothing wrong with any of the joints or muscles and it all comes down to poor coordination and an understanding of how to move.
There are 3 key things I look for.
1.Poor leg alignment – You should have a straight line from the ankle, knee and hip. Any deviation in this indicates there could be weak glutes and foot stability. It could also be a result of tight hips and ankles. Or it could be all of the above. With more testing and close observation you can begin to narrow the energy leak to where the real problem lies.
2.Poor postural position – This indicates there may be poor abdominal and pelvic stability and thoracic stiffness to explore with more tests.
3.Poor range of motion – This indicates lack of strength with the stance leg and possibly lack of mobility in the moving limb with the hip.
What about the core I hear you ask?
This exercise demands an incredible amount of core stability and abdominal control to keep the trunk aligned and well balanced. There is a real misunderstanding as to how the core really works and it is not from isolating abdominal muscles with planks and sit-ups that make a difference, but challenging movements like this that require reflex stability.
“Core control is reflex driven, not conscious driven”
For more detailed information on this concept make sure you read our article – What is stability training?
The beauty of the toe touch drill is that the test will become a great corrective exercise. Once you have mastered the basic version it is time to complete the more difficult progressions.
Toe Touch Progression #1 – Ball Rolling
When I first attempted this version I thought it was going to be easier. After a few seconds I quickly realized it is much more difficult as it requires a considerable greater amount of strength and control. To do this you need to use of some type of ball such as a small medicine ball or soccer ball.
What you need to do is stand on one leg in the and then roll a ball around in a circle as far away as possible without losing stability or constant flow of the ball. You can progress this by performing consecutively larger circles, then by rolling the ball forwards, backwards or by changing direction on command with a partner.
With the functional testing grid we sometimes roll the ball along the lines dividing the sectors. We ask the client to start as far out as possible and roll the ball towards the center, timing the number of complete trips out and back from the center and comparing the control and accuracy between each leg. You could easily do this by placing tape on the floor in a grid like fashion.
Toe Touch Progression #2 – Sensa Mat
This version of the toe touch drill adds another unique training tool to the mix with the purpose of improving foot stability. The sensa mat is something I have used for several years now and it is an incredible tool for targeting people with weak feet.
Our feet and ankles are meant to withstand incredibly high forces and should provide more in terms of shock absorption than perhaps any other body part. Unfortunately, we begin to gradually lose this ability once we start wearing shoes. Over time, the feet, ankles, and toes become inhibited leading to lazy and weak feet muscles.
Besides minimizing the ability to withstand intense ground reactive forces, the body gradually begins sending fewer and fewer signals to the feet, leading to distortions in pro-prioception and loss of innervation all the way up the kinetic chain that compromise your ability to stand on one leg.
The sensa mat helps to overcome this problem by stimulating the numerous mechanoreceptors under the sole of your feet to work as they were designed. An incredible tool to assist the person with stability problems caused by weak feet.
You can read more about how the sensa mat works in this article – How to improve your foot stability with the sensa mat
Toe Touch Progression #3 – 360 Degree Movement
This first progression shows me completing the toe touch drill in a full 360 degree motion.
This significantly challenges the stability of the stance leg and in particular the glutes due to the positional stress on the hip joint. This is one of the best exercises to use for developing glute strength once the person has demonstrated they have good single leg stability with the basic version.
This exercise is perfect for the sporting athlete looking to drive more strength and power through the posterior chain to improve running and jumping skills. The glutes are the powerhouse of sporting performance and this one beats many of the isolated exercises for the same reason as it improves walking, which is – it shares the same timing used in these advanced movement patterns.
Do You Need More Help?
If you are suffering with a hip or knee injury I highly suggest to download our advanced online programs from the ONLINE SHOP that provide you with all of the assessments of these joints and the step by step programs to follow for correcting your injury once and for all.
Below I have the image of the knee pain program but there are programs for back pain, hip pain and shoulder pain available.
Summary
I hope you have enjoyed this detailed look at how this very unique and often under-rated exercise and is a fantastic way to help someone improve the stance phase for gait. As I mentioned in the beginning this exercise can be used with people in their 80’s to maintain function for daily activities but at the same time be used with an elite athlete to improve sporting performance. It may take some time to master but once you have you will find it will be the cornerstone of your training program for years to come and keep your body in great condition.
About The Author
Nick Jack is owner of No Regrets Personal Training and has over 20 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specializes in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.
References
•Functional Anatomy of the Pelvis and the Sacroiliac Joint – By John Gibbons
•The Vital Glutes – By John Gibbons
•Movement – By Gray Cook
•Corrective Exercise Solutions – by Evan Osar
•Back Pain Mechanic – by Dr Stuart McGill
•Diagnosis & Treatment Of Movement Impairment Syndromes – By Shirley Sahrman
•Anatomy Trains – by Thomas Meyers
•Motor Learning and Performance – By Richard A Schmidt and Timothy D Lee
•Assessment & Treatment Of Muscle Imbalance – By Vladimir Janda
•How To Eat, Move & Be Healthy by Paul Chek
•Scientific Core Conditioning Correspondence Course – By Paul Chek
•Advanced Program Design – By Paul Chek