How to touch your toes: why you can't yet, and what helps

Mostly hips, partly back

Bending forward, adults moved about 69 degrees at the hips and 42 at the lower back. Tight hamstrings are often the limit: men with short hamstrings tipped the pelvis less and rounded the upper back more.

Sources 1, 2

Nerves and proportions play a part

The sciatic nerve can add to the pull: with the spine and neck bent forward, hamstring range fell by 8 degrees with no change in muscle activity. Longer arms relative to your legs also help on the classic sit-and-reach test.

Sources 3, 4, 5

The test says little about your health

The sit-and-reach is a moderate measure of hamstring flexibility and a poor measure of back flexibility, and it didn't predict back pain in 2,747 adults followed for 6 years.

Sources 6, 7, 8

What helps

Hamstring stretches held for 30 to 60 seconds on most days; slow-lowering hamstring work such as Romanian deadlifts, which matched stretching in a trial; and a nerve slider if lifting your head eases the pull.

Sources 9, 10, 11

Rounded back: fine for most, not with osteoporosis

Low-quality evidence suggests bending the lower back while lifting isn't a risk factor for back pain. With osteoporosis, the UK consensus advises modifying or avoiding sustained, repeated or end-range forward bending: bend from the hips instead.

Sources 12, 13

Warning signs need a doctor, not a stretch

Numbness around your genitals or bottom, bladder or bowel changes, or symptoms in both legs: call 999 (911 in the US) or go to A&E.

Sources 14, 15

How the bend is sharedEmerging evidence

In 41 adults, a full forward bend averaged 111 degrees: about 42 degrees from the lower back and 69 from the hips. The lower back did more early in the bend and the hips more late. People with a history of back pain moved the same total amount, in a different pattern.

Source 1

Short hamstringsEmerging evidence

In 30 men, those with short hamstrings tipped the pelvis and bent the lower back less, and rounded the upper back more, to reach towards their toes. Standing, their posture was the same as men with longer hamstrings.

Source 2

NervesEmerging evidence

The sciatic nerve runs behind the hip and knee. In 8 people, adding nerve tension by bending the spine and neck forward cut hamstring range by 8 degrees and raised resistance by 14 to 15%, with no change in muscle activity. In another small study, lifting the head eased discomfort behind the thigh by 40% without changing hamstring activity.

Physiotherapists use the same idea in the slump test: the neck doesn't move the hamstrings, so if moving your head changes the pull, nerves are part of the limit.

Sources 3, 4

Body proportionsEmerging evidence

In 258 adolescents, those with long arms relative to their legs scored better on the classic sit-and-reach. A modified version that measures from where the fingertips start removed that bias.

Source 5

Calves, in the sitting test

Sitting with your feet flat against a box holds your ankles at a right angle, which adds some calf tension compared with letting your feet relax. This is anatomy rather than something the studies measured.

Bend your knees slightly

If your fingertips now reach, your hamstrings, and the nerves behind them, are the main limit.

Slump and lift your head

Sit slumped on a chair, straighten one knee until you feel the pull, then lift your head. If the pull behind your knee eases, nerves are part of the limit, and a nerve slider may help.

Sources 3, 4

Point your toes

Sitting with straight legs, reach forward with your feet pulled up, then with your toes pointed. If you reach further with your toes pointed, your calves, or the nerves that run down into them, are part of the limit.

Stop if it hurts down your leg

Back pain, or pain, tingling or numbness down a leg when you bend, is a reason to stop and read the warning signs below, not to stretch through it.

Sources 14, 15

A moderate test of the hamstrings, a poor test of the backStrong evidence

Across 34 studies, sit-and-reach scores matched hamstring flexibility moderately well and lower-back flexibility poorly, and the classic version tracked the hamstrings best. The modified version removes the advantage of long arms, though it tracked hamstring flexibility less closely. Angle tests, such as a straight-leg raise, measure the hamstrings more directly.

Sources 5, 6

It doesn't predict back painEmerging evidence

In 2,747 adults followed for an average of 6 years, sit-and-reach scores were essentially unrelated to later back pain. Across 12 cohort studies (5,459 people), fingertip-to-floor distance didn't predict new back pain, though restricted hamstring range had a small link.

Sources 7, 8

Health links are associationsMixed evidence

Lower overall flexibility has been linked with higher death rates in middle age, and poor trunk flexibility, measured with a sit-and-reach, with stiffer arteries. These are associations, not proof that stretching changes your health.

Sources 16, 17

Palms flat on the floorStrong evidence

Placing your palms flat on the floor with straight knees scores one of the 9 points on the Beighton score, the usual check for very flexible joints. Being able to do it isn't a problem in itself; our flexibility guide covers very flexible joints that come with pain or frequent sprains.

Sources 18, 19

Hamstring stretches

Static or contract-relax stretches, 30 to 60 seconds a hold, on most days. Hamstring and sit-and-reach measures both improved well with stretch training. Lying down with a strap keeps your back supported.

How much in a week is less settled. One meta-regression, an analysis of how results change with the dose, found gains peaked at about 10 minutes per muscle a week, about 2 minutes per leg a day on 5 days, but it conflicts with other reviews, so treat it as a rough target.

Sources 9, 20, 21, 22, 23

Strength in the stretched position

In 69 teenage boys with tight hamstrings, 6 weeks of slow-lowering (eccentric) hamstring exercise gained 12.8 degrees, the same as static stretching (12.1). Slow Romanian deadlifts, lowering for about 3 seconds, are a good place to start (our suggestion).

Sources 10, 24, 25

Nerve sliders

If lifting your head eases the pull, add a nerve slider: 10 slow repetitions, 2 to 3 times a day (an NHS service dose), and it should never be painful. In trials of people with tight hamstrings, sliders improved range a little more than static stretching, by about 3.5 degrees, though the evidence is of low certainty.

Sources 11, 26, 27, 28

Calves

A wall calf stretch, if your heels or calves pull in the sitting test (our suggestion).

Practise the movement

After stretching, practise the toe touch or a slow roll-down a few times (our suggestion). The Jefferson curl, a slow roll-down holding a light weight, is an advanced option for experienced lifters with no trials behind it, and not for anyone with osteoporosis.

How long it takes: our estimate

If your fingertips are within a few centimetres of your toes, a few weeks of practice on most days is often enough; from mid-shin, expect 1 to 3 months or more. This is our estimate from trials that gained roughly 10 to 20 degrees of hamstring range in 4 to 6 weeks; no trial has timed the toe touch itself.

Sources 10, 29, 30

Rounding your back is fine for most peopleMixed evidence

Low-quality evidence from 11 studies suggests that bending the lower back more while lifting isn't a risk factor for back pain. Our back pain guide lists "always lift with a straight back" as a myth.

Source 12

With osteoporosis, bend from the hipsStrong evidence

The UK consensus on osteoporosis says movements involving sustained, repeated or end-range forward bending should be modified or avoided, because spinal fractures have been reported with them, especially with a load. Skip the standing toe touch, seated forward folds and the Jefferson curl, and practise the hip hinge with a long back instead.

Source 13

The Jefferson curl is unproven

It is a slow roll-down holding a light weight. No trials have tested it. If you try it, start very light, build over months, and only once bending without a weight is pain-free (our suggestion, from the move's page).

Call 999 (911 in the US) or go to A&E

If you have back pain or sciatica with any of these:

• pain, tingling, weakness or numbness in both legs, or sciatica on both sides
• numbness or loss of feeling around your genitals or bottom (anus)
• difficulty starting to pee, being unable to pee or to control when you pee, or not noticing when you need to poo or being unable to control it
• changes in how your penis or vagina feels during sex, or not being able to get or keep an erection or to orgasm
• chest pain
• pain that started after a serious accident, such as a car accident

Sources 14, 15

Urgent GP appointment or NHS 111

Back pain with feeling hot, cold, shivery or generally unwell, or severe pain that starts suddenly or gets worse quickly.

Source 14

See a GP

The NHS says exercises and stretches can help back pain, but to stop if your pain gets worse and see a GP for advice. See a GP for back pain:

• that hasn't improved after a few weeks of looking after it at home
• that stops you doing your day-to-day activities
• with weight loss you weren't trying for
• with a lump or swelling in your back, or a change in its shape
• that doesn't improve with rest or is worse at night
• that's worse when you sneeze, cough or poo
• at the top of your back, between your shoulders

Sources 14, 15

A young athlete with back pain that won't settle

Low back pain, stiffness or tight hamstrings that keep going in a young athlete, especially in gymnastics or weightlifting, can be spondylolysis, a stress fracture in the spine. See a GP: early stress injuries may not show on an X-ray.

Source 31

Osteoporosis or a past spinal fracture

Don't practise sustained, repeated, end-range or loaded forward bending; use the hip hinge. Our osteoporosis guide has safer alternatives.

Source 13

Pain or tingling down a leg when you stretch

Stop stretching into it: it can mean an irritated nerve rather than a tight muscle (our suggestion, in line with our back pain guide). Our sciatica guide covers what helps.

"If you can't touch your toes, your hamstrings are tight"Emerging evidence

Often, but your lower back, the nerves in the back of your legs and your arm-to-leg proportions count too. Tight hamstrings are often the limit, not the only one.

Sources 1, 2, 3, 4, 5

"If you can't touch your toes, you'll get back pain"Emerging evidence

Sit-and-reach scores didn't predict back pain over 6 years in 2,747 adults, and fingertip-to-floor distance didn't predict it across cohort studies.

Sources 7, 8

"Bending with a rounded back is dangerous"Mixed evidence

Low-quality evidence suggests more lower-back bending when lifting isn't a risk factor for back pain. The exception is osteoporosis, where sustained, repeated, end-range or loaded forward bending should be modified or avoided.

Sources 12, 13

"Hold a stretch for 6 seconds to switch off the stretch reflex"Emerging evidence

Gains from contract-relax and static stretching are explained by a change in how much stretch you tolerate, not by reflexes switching off, and 30-second holds beat 15-second holds in a trial.

Sources 20, 32, 33

"Bounce to reach further"Strong evidence

Bouncing (ballistic) stretching built about half the lasting range of static or contract-relax stretching.

Source 9

"The sit-and-reach test measures your back flexibility"Strong evidence

It is a poor measure of lower-back flexibility and a moderate one of hamstring flexibility.

Source 6