Mobility Exercise of the Week: Left-Stance Toe Touch
Written on June 19, 2013 at 6:23 am, by Eric Cressey
They say that nothing in the fitness industry is really "new" nowadays. Rather, new concepts usually originate with things that are already out there simply being "spun" in different ways. Maybe it's a different cue, or a new way to program an old exercise. Today's post is a great example.
Gray Cook has put out some outstanding stuff with respect to improving the toe touch pattern (and outlining why a toe touch is an essential movement skill in the first place). And, Ron Hruska of the Postural Restoration Institute(PRI) has brought to light how asymmetry is normal and somewhat predictable (based on our anatomy), but must be managed within acceptable limits. A central focus of both these approaches is that we have to get closer to neutral before we try to perform, especially if that performance includes strength training that will further solidify neural patterns.
Greg Robins gave a great introduction to some of the PRI postural distortions and corrections in a recent post here at EricCressey.com. As a Cliff's Notes version, we often get "stuck" in our right hip (adduction/internal rotation) like this:
When you look at these individuals from the front, you'll see an adducted right hip, low right shoulder, and anterior left rib flare:
However, this isn't just a frontal and transverse plane problem; rather, it also generally is accompanied by a sagittal plane concern: poor control of extension, meaning our weight is carried excessive forward via a number of different compensations: excessive plantarflexion (ankle), anterior pelvic tilt (hips), lordosis (lower back), scapular anterior tilt (shoulder blade), humeral extension past neutral (upper arms), or cervical hyperextension (neck/forward head posture). At the end of the day, virtually all of these folks – regardless of where they get their excessive extension – have a compromised toe touch pattern. They simply aren't able to posteriorly shift their weight sufficiently to make it happen. And, given their asymmetries from above, you'll often see a big side-to-side difference in the form of a posterior right rib humb when they demonstrate a toe touch for you. I have literally hundreds of photos exactly like this on my computer from working with clients, and I can honestly say that I've only seen three that have a posterior left rib hump! Effectively, they're in left thoracic rotation and right hip adduction.
As you can see, then, many folks may be better off performing their toe touch progressions with a bit of frontal and transverse bias, and that's where I started experimenting with the left-stance toe touch (with toe lift and med ball). Right handed individuals with the aberrant posture Greg demonstrates above tend to be "slam dunks" for improving a toe touch with this variation; the results are markedly better than if they do the drill with the feet side-by-side.
By learning to "get into" that left hip, we're actually activating the left hip adductors to help pull us back to neutral. And, when we're in neutral. We can pick up heavy stuff, throw 95mph, and sit in the car for more than 20 minutes without right-sided low back pain. All the villagers rejoice.
This is one exercise demonstration I include in my "Understanding and Managing the Hip Adductors for Health and Performance" presentation in our new resource, Functional Stability Training of the Lower Body. This collaborative effort with Mike Reinold has been a big hit already, and is on sale at a big introductory discount for this week only. You can check it out here.
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Very interesting. But if someone has a weak RiGHt side glute medias, and tight hip fleoxrs then you would want to switch sides on the toe touch progreasion right? Because the right side hip is rotated more forward right?
Great tip, but makes you wonder how the leaning tower of Pisa is feeling after all these years. The body is a dynamic work of architecture…always good to distribute the load evenly and make sure every brick is in place.
Great post! I definitely have some of the issues (left rib flare, adducted right hip) you name. I never had real issues with back pain, but always had the feeling not being balanced. Especially with squates and deadlifts the feeling not going straight up, but a little skew. Also my right leg is less muscular then my left leg. Is this also caused by postural issues? I give this exercise a try.
Hey Eric,
I’m assuming that someone with the opposite asymmetry (lowered left shoulder, left hip adduction, right rib flair, etc) would do a right-stance toe touch, yes? That’s the pattern I have… you said you’ve only seen it in a few people. Would those people happen to have FAI on the right side?
This whole post describes me to a T. Going through some similar stuff with Regan Wong, the PT you referred me to. Will add this to the rotation. Thank Eric
I have/had a chronic right ankle issue that has resulted with me regularly standing with my weight on my left leg, with my right leg/foot being the one toeing out. My questions are thus: Will the asymmetries mentioned in the article be the same for someone such as myself, just opposite? Does this left-shift stance make any difference in the execution of the drill demonstration you provided?
Side comment: The articles you and Gentilcore provide are fantastic! Keep up the great work!
Yes, it’s part of our mobility warm-up. “Less muscular” doesn’t really explain things, as certain muscles are tighter/bigger and others are longer/weaker.
Not that simple, unfortunately. As an example, anterior fibers of glute med are internal rotators, and posterior fibers externally rotate. Tight/weak doesn’t necessarily apply, either; we’re talking about an alignment issue that strength/ROM tests may or may not confirm.
Eric prescribed this exercise for me along with many others as part of my program.
I’ve gotta give it to him, after 11 years of an undiagnosed injury that saw countless experts misdiagnose me and even a cardothoracic surgeon cut me open, Eric’s program is the only thing that has helped and probided actual improvement.
I could not reccomend this product (and any of Eric’s resources) more highly.
EC, I’ve been reading lots of the PRI positioning and corrective exercises. I was trying a left side lying (over a swiss ball) apical expansion exercise and it called for adduction and IR of the left leg. Would IR help this particular toe touch progression?
Great exercise Eric,my wife has an assymetry problem I am going to show it to her.Eric I love your site man I a NASM CPT PES CES and I get great stuff from you one of my best clicks ever Thanks Alot Mayo
Hi Eric, great post. Love this stuff. Just thought I’d point out that your picture and description of “basically they’re in L rotation” should be R. Cheers!!
Yes, that’s another means of working toward the same end. If you can adduct to neutral on the left side, it’ll make a straight-ahead toe touch better (less hip shifting). If you can’t adduct, you can’t extend.
As always, phenomenal stuff. Quick question (and I think the same as Seth’s comment…): Due to R rib hump, wouldn’t it be relative Right thoracic rotation with the R hip adduction? Thanks for all of your info!
Wow, I need to study this more, but apparently I’m a right hander with everything the opposite of what is described here :/ Very good stability on my left foot, not so much on the right. Can’t internally rotate the right very well. The pic of the guy in the CP shirt — I’m opposite of that but still favor the right shoulder like he does. For me, putting the left foot biased in front of the right seems to work better. When I do, I hear all sort of snap crackle pop in my spine as it gets back to normal..
Also — when I went to PT a long time ago, for the longest time I thought my right (dominant) shoulder was lower than the right. From the front, it looks that way. But from the back, the left, anteriorly rotated shoulder looks lower.. confusing..
As an intrinsic biomech coach I see the type of problem all the time. The exercise shown is a great grooving pattern but wont resolve the underlying problems. It would be nice to know what leg/pelvis is rotated ie has the left rotated or the right, then start looking at the corrective stuff!!
Eric, I am a right handed pitcher so would this exercise be performed the opposite for me. My left collarbone is higher and thicker than my right collarbone. My left rib cage seems bigger and it bulges out more than my right and my whole left side in general is more muscular than my right side
It would be right lumbar/sacral orientation, but the thoracic rotation would be a compensation to the left (expect to see limited horizontal abduction on the left shoulder as a result, too).
Just wondering about the body weight, would you put more weight onto the back leg to try and ‘get into’ that hip or would the weight be evenly displaced?
thanks!
Adam
Am I correct in thinking this exercise will help with my right handed pitcher that has a HIRD issue?
Except for the ball between the legs and the plates on the floor, this looks pretty similar to a deadlift progression. Would this be an appropriate warm-up exercise just prior to performing our hex bar deadlifts?
Or, should I wait and watch my just purchased FST LB edition?
I do have the patterns described here. I also have been told that I have femoral anterior glide on my right side which gives me really bad pain in the front of my hip. So have been given LOADS of glute activation work, could this mobility exercise help with the femoral glide? In other words, do you think my tight right adductors could be part of the problem rather than just inhibited glutes? Do the two problems tend to occur simultaneously?
…also I sometimes get spasms in my right piriformis area and I’ve been told I have a ‘flat back’. With everything I’ve been told it’s hard for me to truly understand where the problem is!
Eric- I have fairly severe left hip arthritis ( am 38) with very limiting internal and external rotation. Years of poor postural alignment has resulted in right side compensation with accompanying issues including s4/s5 herniation, poor right side scap activation and so on.
It’s very hard to tell without seeing you in person. I’d encourage you to run it by your physical therapist to see if it’s a good fit. And, of course, never push through pain.
June 19th, 2013 at 7:03 am
Very interesting corrective technique. I imagine it would be helpful to use after corrected SIJ dysfunction too.
June 19th, 2013 at 9:13 am
Your links do not work
June 19th, 2013 at 9:25 am
Very interesting. But if someone has a weak RiGHt side glute medias, and tight hip fleoxrs then you would want to switch sides on the toe touch progreasion right? Because the right side hip is rotated more forward right?
June 19th, 2013 at 9:42 am
Another great exercise Eric!
June 19th, 2013 at 12:57 pm
EC,
Great tip, but makes you wonder how the leaning tower of Pisa is feeling after all these years. The body is a dynamic work of architecture…always good to distribute the load evenly and make sure every brick is in place.
SG
June 19th, 2013 at 1:05 pm
Great post! I definitely have some of the issues (left rib flare, adducted right hip) you name. I never had real issues with back pain, but always had the feeling not being balanced. Especially with squates and deadlifts the feeling not going straight up, but a little skew. Also my right leg is less muscular then my left leg. Is this also caused by postural issues? I give this exercise a try.
June 19th, 2013 at 1:17 pm
Vikki,
Which links? You’re the only complaint I’ve received.
June 19th, 2013 at 1:34 pm
Forgot to ask: do you perform this excerise before strenght training as part of mobility drills or after?
June 19th, 2013 at 2:15 pm
Hey Eric,
I’m assuming that someone with the opposite asymmetry (lowered left shoulder, left hip adduction, right rib flair, etc) would do a right-stance toe touch, yes? That’s the pattern I have… you said you’ve only seen it in a few people. Would those people happen to have FAI on the right side?
Thanks!
June 19th, 2013 at 2:39 pm
This whole post describes me to a T. Going through some similar stuff with Regan Wong, the PT you referred me to. Will add this to the rotation. Thank Eric
June 19th, 2013 at 3:47 pm
Eric,
I have/had a chronic right ankle issue that has resulted with me regularly standing with my weight on my left leg, with my right leg/foot being the one toeing out. My questions are thus: Will the asymmetries mentioned in the article be the same for someone such as myself, just opposite? Does this left-shift stance make any difference in the execution of the drill demonstration you provided?
Side comment: The articles you and Gentilcore provide are fantastic! Keep up the great work!
Adam Noll
June 19th, 2013 at 4:20 pm
Another excellent article!
June 19th, 2013 at 4:23 pm
Adam,
It’s really difficult to say, unfortunately. There are some assessments we’d have to take you through to know.
June 19th, 2013 at 4:24 pm
Steve,
Hard to say. Self assessment is a tricky thing. FAI can really happen on either side in those who are stuck in extension.
June 19th, 2013 at 4:25 pm
Martos,
Yes, it’s part of our mobility warm-up. “Less muscular” doesn’t really explain things, as certain muscles are tighter/bigger and others are longer/weaker.
June 19th, 2013 at 4:29 pm
Matt,
Not that simple, unfortunately. As an example, anterior fibers of glute med are internal rotators, and posterior fibers externally rotate. Tight/weak doesn’t necessarily apply, either; we’re talking about an alignment issue that strength/ROM tests may or may not confirm.
June 19th, 2013 at 4:45 pm
Eric prescribed this exercise for me along with many others as part of my program.
I’ve gotta give it to him, after 11 years of an undiagnosed injury that saw countless experts misdiagnose me and even a cardothoracic surgeon cut me open, Eric’s program is the only thing that has helped and probided actual improvement.
I could not reccomend this product (and any of Eric’s resources) more highly.
June 19th, 2013 at 5:13 pm
How about the good old fashioned windmill calisthenic exercise, with a 3-1 emphasis on torquing the underactive hip? 🙂
June 19th, 2013 at 6:14 pm
EC, I’ve been reading lots of the PRI positioning and corrective exercises. I was trying a left side lying (over a swiss ball) apical expansion exercise and it called for adduction and IR of the left leg. Would IR help this particular toe touch progression?
June 19th, 2013 at 6:38 pm
Thanks, Christian!
June 19th, 2013 at 6:39 pm
Great exercise Eric,my wife has an assymetry problem I am going to show it to her.Eric I love your site man I a NASM CPT PES CES and I get great stuff from you one of my best clicks ever Thanks Alot Mayo
June 19th, 2013 at 7:51 pm
Hi Eric, great post. Love this stuff. Just thought I’d point out that your picture and description of “basically they’re in L rotation” should be R. Cheers!!
June 20th, 2013 at 6:25 am
Seth,
Which quote are you referring to? I don’t see it. Thanks!
June 20th, 2013 at 6:27 am
Drew,
Yes, that’s another means of working toward the same end. If you can adduct to neutral on the left side, it’ll make a straight-ahead toe touch better (less hip shifting). If you can’t adduct, you can’t extend.
June 20th, 2013 at 6:29 am
Eric,
As always, phenomenal stuff. Quick question (and I think the same as Seth’s comment…): Due to R rib hump, wouldn’t it be relative Right thoracic rotation with the R hip adduction? Thanks for all of your info!
June 20th, 2013 at 1:26 pm
Wow, I need to study this more, but apparently I’m a right hander with everything the opposite of what is described here :/ Very good stability on my left foot, not so much on the right. Can’t internally rotate the right very well. The pic of the guy in the CP shirt — I’m opposite of that but still favor the right shoulder like he does. For me, putting the left foot biased in front of the right seems to work better. When I do, I hear all sort of snap crackle pop in my spine as it gets back to normal..
June 20th, 2013 at 1:34 pm
Also — when I went to PT a long time ago, for the longest time I thought my right (dominant) shoulder was lower than the right. From the front, it looks that way. But from the back, the left, anteriorly rotated shoulder looks lower.. confusing..
June 21st, 2013 at 10:03 am
As an intrinsic biomech coach I see the type of problem all the time. The exercise shown is a great grooving pattern but wont resolve the underlying problems. It would be nice to know what leg/pelvis is rotated ie has the left rotated or the right, then start looking at the corrective stuff!!
many thanks for the exercise
June 21st, 2013 at 5:02 pm
Eric, I am a right handed pitcher so would this exercise be performed the opposite for me. My left collarbone is higher and thicker than my right collarbone. My left rib cage seems bigger and it bulges out more than my right and my whole left side in general is more muscular than my right side
June 21st, 2013 at 7:08 pm
Jake,
It would be right lumbar/sacral orientation, but the thoracic rotation would be a compensation to the left (expect to see limited horizontal abduction on the left shoulder as a result, too).
June 21st, 2013 at 7:08 pm
Ron,
You’re mis-reading. It sounds lik eyou need this exercise the exact way it’s performed in the video.
June 23rd, 2013 at 7:07 am
Mr. Cressey,
Just wondering about the body weight, would you put more weight onto the back leg to try and ‘get into’ that hip or would the weight be evenly displaced?
thanks!
Adam
June 23rd, 2013 at 1:24 pm
Am I correct in thinking this exercise will help with my right handed pitcher that has a HIRD issue?
Except for the ball between the legs and the plates on the floor, this looks pretty similar to a deadlift progression. Would this be an appropriate warm-up exercise just prior to performing our hex bar deadlifts?
Or, should I wait and watch my just purchased FST LB edition?
June 24th, 2013 at 5:10 am
Jeff,
It’ll all be explained in that presentation, but it’s definitely a slam dunk for RHPs with poor left hip IR. Enjoy!
June 25th, 2013 at 5:12 am
I do have the patterns described here. I also have been told that I have femoral anterior glide on my right side which gives me really bad pain in the front of my hip. So have been given LOADS of glute activation work, could this mobility exercise help with the femoral glide? In other words, do you think my tight right adductors could be part of the problem rather than just inhibited glutes? Do the two problems tend to occur simultaneously?
June 25th, 2013 at 5:35 am
…also I sometimes get spasms in my right piriformis area and I’ve been told I have a ‘flat back’. With everything I’ve been told it’s hard for me to truly understand where the problem is!
July 6th, 2013 at 7:01 pm
Eric- I have fairly severe left hip arthritis ( am 38) with very limiting internal and external rotation. Years of poor postural alignment has resulted in right side compensation with accompanying issues including s4/s5 herniation, poor right side scap activation and so on.
Would you recommend giving this a try.
(Btw great website)
July 7th, 2013 at 5:05 am
David,
It’s very hard to tell without seeing you in person. I’d encourage you to run it by your physical therapist to see if it’s a good fit. And, of course, never push through pain.