Transcript: Walking Isn't Optional — Dr. Courtney Conley #005

0:00

I don't even think people realize what a healthy foot looks like.

We certainly don't know what a healthy foot should function like.

How is this possible?

I know Nike and you know, these companies have not just engineers, but biomechanical engineers who who study elite runners.

0:18

Like how have they missed this?

You can imagine the conversations I have to have with my patients when I tell them that they have to exercise their big toe.

When I see people take their shoes off, I'm often like, oh, it's like you, you know, the troglodyte emerging from The Cave and it's all pale and shriveled and moist.

0:36

Regardless of age or anything, get your foot on the ground, even if it's for 5 minutes a day you know, And keep in mind that a 5 minute micro walk can be life changing.

Doctor Courtney Conley, welcome to the show.

0:52

Thank you so much for having me.

I'm so excited.

I love this topic.

I love what you talk about.

I want to start off by saying you look like a very fit person.

Well, thank you.

I try.

I'm 50 this year so.

You're turning 50.

I'm turning 50.

Yeah.

So you're a Gen.

Xer then?

1:07

Yeah, and I have to say, I do feel better now than I think I probably ever have.

It's an interesting thing, right?

I mean, also I'm turning 48 this year.

So we're from the same kind of generation, that forgotten generation, the the sort of Mad Max apocalyptic X Games generation.

1:27

And people always say that would I would always hear stuff like that while I feel better and in some ways I really genuinely do.

Do you?

What do you attribute that to?

You know, when I was younger, I was, I was a triathlete.

So I did a lot of, you know, swimming, biking and running.

1:44

I was like a cardio queen.

I loved all that long endurance, kind of the slow grind.

And then when I turned 40, things started to talk to me a little bit and I was introduced to more strength training.

2:04

And then I really switched gears and I still, you know, a lot of my training now has been converted to heavier lifting.

And that, you know, it's interesting, a lot of that goes into my strength training at my feet.

So it's been kind of this whole journey from not only getting stronger overall, but also from the ground up.

2:27

So yeah, my training looks looks much different than it did in my 30s and 40s.

I wish someone would have told me how important lifting heavy things is when I was younger because it really has taken.

I mean, I just had neck pain and back pain and you know, I'm riding my bike for five hours at a time.

2:46

And not that those things are bad by any means.

I just wasn't complimenting it with, you know, the strength work.

So I think that, you know, and now I'm doing more hit workouts, if you will, a lot of VO2 Max training and that's really can I swear kick.

3:04

I usually, I usually say it's kicking my ass.

I don't know if I can say that on here.

Please feel free my friend.

So, but yeah, so it's, it's, it's a little different these days.

It's a lot to balance everything I find, You know, I, I'm, I've gotten big into cardio in the last few years, Not as big as triathlon or Ironman cardio, but you know, I, I put several hours in a week, but I really like strength training as well.

3:29

But then it's like you get to where you're like, OK, well, cardio, like I want to do some zone 2 work.

I want to do some zone 5 work.

I strength training, I want to do power stuff, but I want to do muscular endurance stuff.

And it gets to her the laundry list of stuff.

And then you're like, how do I manage all this and have a life at the same time?

3:44

And you know, I want longevity.

I would like to look good now too.

It's like all that balancing, all that stuff and, and not many people.

It's like a narrow path.

Not many people get good at balancing it right.

People get kind of spun out into these weird extremes a lot, I find.

Well, so you can imagine the conversations I have to have with my patients when I tell them that they have to exercise their big toe.

4:05

They're like and now I have to do, I was like ways to do it so you don't have to make it an extra thing.

Let's start from the ground up then I I'd love to hear a little bit about your background, how you got here.

You know, I first saw you on Diary of the CEO, which seemed like that was such a huge interview.

4:23

I mean, it just it was talked about quite a bit and still is, but I'd love to hear about Gate happens all, you know, kind of catch me up.

So I understand the background and how you come to be here.

Yeah, I, I was a dancer as a child.

I spent a lot of time in point shoes.

4:40

I was a dancer for the Pittsburgh Ballet Theatre.

And I, you know, I always used to watch these ballerinas and they'd shove their feet into these point shoes.

And I just could never.

I'm like, this does not feel good.

It hurts.

And then I developed bunions at a very young age, and then I kind of jumped right into running in the triathlete world.

5:00

And really my Achilles heel, if you will, was always foot pain.

I had bunions and neuromas and stress fractures and Achilles tendonopathy and plantar fasciopathy and heel pain.

And it was just so frustrating because physically I felt like I could perform, but then when your foot hurts, you can't do anything.

5:21

So it became kind of my personal quest.

And I was like, how can I?

I really want to stay in the movement world, learn how to, you know, move better.

And so I ended up going to chiropractic school and we got maybe a half a semester on foot and ankle mechanics with the solution being if it hurts, cast them for foot orthoses, which was, you know, I didn't really think about it at the time, which we would never do anywhere else in the human body.

5:56

Like here's an extrinsic device to, you know, stabilize you or modify load that you're going to use forever.

But that's what we knew.

We knew.

So I got out of school and I was obsessed with foot and angle.

And so I did what I knew, which was I casted a lot of people for foot orthoses.

6:15

I worked in two orthotic labs.

I was constantly trying to tweak mine to like help my foot and help my heel.

And you know, and then I one day I was so like done.

And I was like, this is does not make sense.

And that's when I back pedaled and was like, we can my foot needs to get strong.

6:34

It looked at your feet, you know, like my foot just looked thin and weak.

I mean, you're using the word casted, right?

It's like an orthotic is a crutch of the foot, right?

So you end up of course not having to develop musculature when the foots being supported mechanically, right?

6:49

Yes.

And you know, we were getting, I was, you know, patients pain was getting better.

But now I look back and it wasn't not that it was getting better, it was changing.

Something might have improved, but then that load was going elsewhere.

7:05

So I just went down this very, very deep rabbit hole 20 years ago, 15 years ago and completely switched gears and that's when I started integrating it into my practice.

So I've gone very heavily kind of on the other end of the spectrum going, hey, we need to let our foot feel the ground.

7:23

And I'm not saying that there's not a time and a place for foot orthotic intervention or therapy, but the majority of us can really use strengthening from the ground up.

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So I this is actually a funny story.

I have a clinic in Colorado and I was teaching for a company and one of my friends said, you know, you really like this foot stuff, you should start just posting it on Instagram and use that as a marketing tool for your business.

9:01

I was like, really?

And she's like, yeah, So I got home from our trip and she's like, just do me a favor.

Be consistent.

So for seven days a week, probably for three or four years, I consistently posted on Instagram every single day about like something I thought was cool about the foot and hence gate happens.

9:25

So it's now has grown into this animal where it's no longer a a marketing agent for my brick and mortar.

It is now on its own animal and it is we have like online.

I'm just so grateful because that's how you know I'm able to spread this message on health and education and how important it is.

9:48

And I've seen some really amazing things happen in my clinic and I'm just want to continue to do it.

Have you ever had anybody come in and you look at their feet and you're, you say like, oh, you're, you're just good.

Or, you know, what percentage of modern humans need intervention.

10:07

You know, strength training, mobility, mobilization, some kind of work on their feet.

Yeah, it's a great question.

Prior to some of this education going more global, I was in a clinic.

So most people would come in with pain and they'd be like, you know, I had, I had a sprained ankle or my bunion hurts, or my foot hurts or my knee hurts or my back hurts.

10:32

And so then people start paying attention right when there's pain.

There's really no other musculoskeletal diagnosis, I believe, that will stop you in your tracks faster than foot pain.

Because even if you have chronic low back pain, the research will tell you, hey, go for a walk.

Go for a fast, brisk walk.

10:49

It's good for you.

When someone has foot pain, they don't want to go for a walk.

They don't even want to put their foot on the ground.

So it really alters movement when every step that you take hurts.

But now since I, I'm hoping that people are paying more attention, I'm getting a lot of people in the clinic now who are being more proactive.

11:11

Hey, can you test my toe strength?

Why?

You know, I want to know how strong my toes are, which I get very excited about.

You know, people are like paying attention.

We need to be proactive, not reactive.

It's much easier to address things and to get people stronger and more mobile when they don't have pain.

11:36

When I think about how this first got came into mind for me, it was when I was 16 years old, I started working out in a gym, you know, when I first started training and at that time the world was still really drunk on the wine of bodybuilding, I think, you know, and, and like Schwarzenegger and Ferrigno and all those guys.

11:57

And, and so you go into the gym and it would be like the poster of all the, you know, human and musculoskeletal anatomy, all labeled and everything.

And that was when I first started to learn anatomy.

And I remember that this chart was all color-coded.

Each muscle had a color code with exercises associated and then it just was blank white from like the mid shin down and I remember being like well that can't be right.

12:20

How that?

Happens too.

Yeah, so it was like, wait a second, somethings wrong here.

And so I always thought about this was like OK, well and I came across I would have had to have been 16 or 17.

I found this book called The Barefoot Hiker and it was by this guy Richard Frazine.

12:36

I just looked it up this morning to see if I could find it was on Amazon.

Now it's just a little booklet, but it was encouraging people to hike barefoot and so I got really lucky.

This sort of came into my mind early in and so I've always been doing things barefoot and, and training barefoot.

The results now that I'm in my late 40s, when I see people take their shoes off, I'm often like, oh, it's like you, you know, the troglodyte emerging from The Cave and it's all pale and shriveled and moist and the toes are all pressed together and you're like, oh, that looks bad.

13:08

So I feel really lucky that that's been and then I grew, you know, obviously now it's we've been in this era of like barefoot shoes and all this stuff for a little while.

So do you think my earlier question was like what percentage of people don't have foot problems or or emerging foot problems and then you've seen obviously a tremendous amount of change happening.

13:30

Is it trending right do you think?

Great questions.

I think that, well, let's put it objectively in my office, you can measure your toe strength.

OK, so we have, it's called a dynamometer and it's a, a device that measures how strong your toes are.

13:52

If most people don't have this device at home, but sometimes I'll tell people to use like a credit card or something.

So put your foot on the ground, put the credit card underneath your big toe, try to pull the card out and see if you can engage the muscle of your big toe.

14:08

And then you would do the same thing with your 4 toes.

At a minimum, we should see about 10% of your body weight producing 10% of your body weight out of your big toe and about 7 to 8% out of your lesser toes.

14:24

I have been doing this for 20 years and I can tell you I can probably count on both of my hands how many people have hit that number.

I need you to count on your toes, not your hands.

Fair.

14:40

So, OK, so it's, it's most everybody it's.

Really shocking because I don't think people pay attention to their feet.

They don't when I don't even think people realize what a healthy foot looks like.

You know, like when you look, I'm going to bring out Eddie here.

14:59

It's my foot bottle.

When you look at a foot, the widest part of the foot should be our toes.

Yeah.

So when you look down at your feet, it's what I love about the foot.

It's so cool because it's the only where in the the only place in the human body where you can start to see something and be like, hey, I should probably pay attention to this.

15:23

You'd have to get an X-ray at the knee or at the hip, right in order to see a barren loads.

But at the foot, all you got to do is look down.

So when you look at your foot, if your big toe in your pinky toe look like a tapered shoe?

15:39

Like a shoe.

Yes.

Then that's not what your anatomy of your foot should look like, right?

And I think because we have been putting our feet into footwear that does not respect the anatomy of our feet for many, many decades, we don't even know what a what a healthy foot should look like.

15:58

We certainly don't know what a healthy foot should function like.

And so that's why I think I see so many high numbers of people with foot pain.

One in three Americans over the age of 45 suffer from foot pain.

That's a.

That's a.

Lot of how many?

3.

16:15

Man, that's not right.

I I've been thinking about this one question for a really long time.

I wonder if you have any insights.

So I always think about the foot being shaped naturally like like a swim fin, you know, like a like you put on your foot like this and every shoe is shaped like that.

16:36

And is this like, OK, so I started asking myself why, you know, and then I started thinking about the foot binding that was going on in China and like the fetishism of it.

And when I look at high fashion, I mean, if you look at runway fashion, you're like, oh, this is fetishism.

16:52

This isn't these aren't clothes to wear out.

This is fetishism, right?

Like that's its own thing.

Is this like, what is this?

Is this fetishism?

Or is it just how is so many Cobblers had it?

How is this possible?

I know Nike and Root, you know, these companies have not just engineers, but biomechanical engineers who who study elite runners.

17:16

Like how have they missed this?

It makes no sense.

That can't be.

I want to be like, put my tinfoil hat on what's going on here.

Trust me when I say this, they know.

They know.

If you look at when all of this really, like when I was doing my research for the book, it was really in the 14th and 15th centuries where it was the introduction of Krakow and Poulain boots, you know, the medieval kind of pointy toed shoes.

17:46

And those were worn by men in a higher socio economic status.

And it was funny because when you look at the skeletal remains, well, not funny, but interesting of that period versus say the 12th and 13th centuries, you see more skeletal remains with people with bunions.

18:09

So we're starting to, we started to see this introduction of very narrow toe box shoes and then the sequela of changes in the structural positioning remains of the feet.

And then that started this whole fashion over function.

18:27

Why wouldn't we all want to dress like the higher socioeconomic people?

You know, we all want to strive to look like them, so thus started to change our footwear.

When you look at running shoes, Irene Davis talks a lot about this on running related injuries.

18:47

And there's not too much research prior to the 1970s.

And when you look at the 1970s and forward, that's when we start to have the shoe companies really starting to alter running shoes.

And if you see what's happening today, I just want to like shake my head.

19:06

It's like the alien invasion of footwear.

I'm like we don't need 3 pillows underneath our foot to run.

The hocus are like, what are we talking about here?

It's.

It's really pretty wild.

So I think.

My friend calls them maximalist shoes.

It is.

It's a maximalist environment.

19:25

So I think it really started decades ago and we were warned.

There's a lot of people and research saying, hey, this is not what's good for your foot.

But society kind of overruled and we have fashion over function.

And now most of the shoe brands out there, when you talk to the people developing the footwear, a lot of them don't have an anatomy or or foot function background.

19:47

They have a fashion background.

Yeah.

Dude, you see that?

Can I?

Just interject something I've noticed I've seen with so my wife's a CrossFit coach.

And so in that space, I'll watch a new company come in and they'll they'll have usually shorts and T-shirts.

20:03

And after they get rolling, they always roll out a shoe.

And every time I think who's behind this because you guys don't know about shoes, but now you have a full shoe line.

And I've seen this dozens of times where I think.

Are they do they go to some white label Shoemaker who just like?

20:20

How does that happen that they?

I don't know.

And it really it's like medical malpractice, especially in a CrossFit environment.

So if you, you know, there's always a, the right tool for the job, you know, so you know, you want to have certain footwear for certain activities.

20:39

If you want to talk about CrossFit where you are lifting heavy loads, right and heavyweight, your foot has to feel the ground because when you're barefoot or you have a shoe that has a very thin flexible sole, you can sense the ground.

20:55

You gather sensory information.

So if I was going to deadlift, for example, I want a wide foot, I want it to feel the ground and I want to feel stable so I can drive through my foot when I lift.

Now, if I lift on a shoe that has 55mm of cushion, you compromise sensory acuity and it's like you're standing on a pillow.

21:17

You know, what do you think the information you're going to get into your knee, into your hip, into your back?

It is, you know, I, I, I, I'm at the gym and I'm, it's very hard for me, you.

Probably want to go talk to everybody.

You know, and I just, I can't, I got to shut up sometimes.

21:34

Well, you know when you see like the sensory homunculus, are you familiar with that?

So that's something too that where feet if for for the listener, the sensory homunculus, imagine a human body that all the proportions are shaped around how much neurological sensitivity each body part has.

21:50

So the lips are obviously huge and the fingertips are huge and the genitals are huge.

The feet are obviously disproportionate because they have so much more sensory information.

So I, I used to say to people, this would be like cutting off another sense or like living with your hands and mittens all the time, right?

22:06

But, but obviously our feet give us a tremendous amount of information about I'm in such an outdoors person when I'm walking barefoot through the forest, man, I'm getting so much information about like sometimes I know what plant communities to expect by what I'm feeling under my feet.

22:26

You know, how much moisture, what's the texture of the soil?

Is it silty?

Is it soft?

Is it muddy?

Is it clay?

There's just so much information.

People are obviously, maybe it's not top of mind for people on how much information they're missing from their environment already because this is just one thing.

22:43

But wow, there's a lot there.

It's so, it's so cool to me to hear that because that's what our foot was designed to do.

Is it to feel?

If you were going to walk on stone or grass or sand, you would adjust your stride.

23:03

You would adjust how heavy you're stepping based on what you feel because you're gathering information when you can't feel anything, you're just, you know, striking away and over striding or whatever other gate adaptation or compensation pattern that you've acquired.

23:22

But that foot was designed to feel and it will make the appropriate adjustments.

Stiffening it's it's a neurological adaptation that occurs, but will adapt, it will pronate, it will lengthen, it will supinate based on the central nervous system.

23:41

And when we compromise that, you're setting yourself up for problems.

Yeah, when I think of like the two, if I try to, if you said give me a list of worlds where people not only ignore their feet, but go even further and just like tape them together because they don't want to think about it.

I would think ballet and triathlon are two that come to mind.

24:00

Like ballet obviously just notorious for this, you know, and, and the amount of tape and splinting that has to go on in order for some of those positions to be held or whatever.

And I can't even imagine what happens to your toenails and stuff a little.

Yeah, but.

24:15

And then in triathlon, especially because you're transitioning from like wet to dry and all of that.

And then.

But I just see people relying on a lot of like external stuff to hold themselves together almost like this attitude like, well, you know, we die tomorrow.

24:30

So I just got to make it through today kind of a thing where it's like almost no thought about, you know, And if you get up to, like, Iron Man, it's like, crazy how much people harm themselves in order to accomplish these feats.

So I think, like, people from outside see it and go like, oh, so cool, so noble like that.

24:46

People do that.

And it's like, yeah, but they're sacrificing, right?

Really big, that's like 1 extreme but you must have just saw people constantly like having to tape themselves together or somehow hold themselves together.

Yeah, it's, it's treating symptoms, you know, rather than going after why.

25:05

You know, a perfect example is, you know, 4 foot pain bunions, for example, very common.

They when you talk about a bunion surgery or bunionectomy, you know, and you start doing it, performing a surgery based on a symptom, have to figure out why it got there in the 1st place or else you're going to fix the bunion.

25:31

And then you're going to have what's called transfer metatarsada.

You're going to have loads going into different parts of the foot.

So you really have to be able to assess the why between why all this stuff is happening.

You know, I've worked with a lot of people across the board, right from kids to your grandmother to professional athletes.

25:52

And the professional athlete world is really interesting because athletes are getting bigger and stronger.

Like we're getting all this information, like we got a strengths train.

We need protein, and people are getting bigger and they're getting stronger.

Especially the pros.

26:07

Like I stayed at a hotel recently with a football team and it was these didn't even look like regular humans to me.

You know, fine, great, bigger, stronger, I'm all I'm here for it.

But you can't train, you can't build this jet engine of a body on a paper airplane of feet.

26:31

Hey, we put two to three times our body weight through our foot when we're walking.

When we're running, there's certain places in our foot where that number jumps up to 8 to 11 times our body weight.

So when I get these calls from these teams and they're like, hey, a lot of our athletes are having foot pain and Achilles issues.

26:49

And I'm and I go and assess these guys, these professional athletes, the best of the best.

And I'm doing some of these foot and ankle assessments and I'm like, goodness, like if you would just use the powerhouse of your body, which is from your knee down, you're already running faster, right?

27:10

But what if you got stronger and you were actually able to propel through your foot?

You would look at injury decreasing injury risk.

I mean, it just, it's really interesting to me when I talked to these guys because I asked them about their training and there's minimal, if any, that occurs below the knee.

27:30

OK, Now if somebody wants to start, I well, when you were just talking about those loads on the feet when we walk and when we run, I don't want to get too far away from the average listener here, but obviously our skeleton is a piezoelectric structure, right?

It's a crystalline piezoelectric structure.

27:47

So when forces travel through our bones, they leave an electrical charge that tells our body where to lay down new bone, right?

So if we do a little thing that changes our gait or changes the position of the pelvis or changes how we step on our foot, if we do that consistently, does not our skeleton remodel around those compensatory patterns?

28:12

And then, so if I want to then drop my shoes, it's not like just like, oh, now I just go back to normal.

It's like now I need to go through months of skeletal reconstruction, right?

Yes, it's a this is where I think, you know, the conversation of walking barefoot and minimal footwear is not new by any means.

28:34

I mean this is I think 2007 was when the Vibram 5 finger shoe came out.

And I think what happened and I think why this time around people are understanding it more as the education behind it.

If you wore a shoe that restricted its function and your foot has never felt the ground, and you said this makes sense to me, it makes sense that my foot should be allowed to feel the ground.

29:04

I'm going to go from zero to 100 overnight.

I promise you that you more than likely you will be in my office because you wouldn't tell someone who's squatting 100 lbs one week to squat 200 lbs the next week.

It's the same concept at the foot.

29:22

There has to be graded exposure, and sometimes that graded exposure is very slow because when I put my foot on the ground, I have more load going through my muscles, through my tendons, through my bones, which is good because that creates a strong foot.

29:42

It's a good environment, but just like with anything else, if I go too hot and heavy too soon, that load becomes too much.

So our demand is greater than our capacity.

29:59

So instead of to answer your question, having good bone remodeling, which is, you know, we're building new bone and the bone is remodeling now we have too much and that edema in the bone turns into stress reactions, for example.

So that is where I'm educating all the time.

30:19

You're starting at 5 minutes a day.

Of exercises or barefoot walking.

Barefoot walking, if your if your foot has not seen, if your bottom of your foot doesn't have a callus on it, you're starting at 5 minutes a day, Yeah.

Yeah.

That's like, I was just reading some research on that this morning of, you know, calluses on our feet and everybody wants to run to the, you know, get a pedicure and get all the calluses cut off.

30:45

I'm like, please don't do that.

Yeah.

OK, There's a reason those are there, you know, because when you're walking barefoot, you develop these calluses.

It's a protection mechanism, you know, it's.

Like cutting the pads off your dog's foot or something.

You know, and then it's like, oh, my foot hurts.

31:02

I need more cushion.

Right, Yeah.

You know, having had the opportunity to travel to some places and see Indigenous people in the forest and you see their feet, it's like a completely different organ than what we have.

31:17

I mean the you know, and we talk about having your toes played there sometimes have like a big toe that's doing its own thing, like a thumb, you know, like pointed almost like to the side and the way they're gripping things and moving around get.

Me excited.

It's a beautiful thing because I love seeing like a strong foot, you know?

31:33

It's like, man, they got some resiliency.

They're gritty, you know?

Yeah, same.

Same.

But you know, I've been watching my wife slowly.

You know, she was always about doing everything in her shoes.

And so I've been like slowly coaxing her out of her shoes.

31:49

But I mean, she started with a foot that was sort of shaped like a shoe.

Oh, yeah.

And I've watched too with the, you know, and now obviously, like it's, it's changed tremendously.

But watching also.

In fact, it was funny.

We were just, we just got back from the West Indies and she was every day wanting to walk barefoot in the sand.

32:08

And it, I was a lifeguard on the beach growing up for many years.

And so I got a lot I, it drives me crazy.

So I want to actually ask about that ground reaction force, because if you're like, hey, do you wanna go for a walk?

I'm always down.

But like sometimes it's nicer to walk on a stable surface because you have that sense of every step propels the next step.

32:29

And then if I, if I'm walking on like soft sand where you don't have that, it's like every step or right now it's melty snow.

So it's no longer snowshoe weather up here in Maine.

But it's not fun to walk in this snow.

It's every step is like your feet are now.

32:45

I'm sure that's strengthening my feet, but it for walking, it's not very enjoyable.

You know what I mean?

So I would love to get your thoughts on that too because I love to walk a trail or a a dirt Rd.

I used to be a Vibram 5 finger guy.

33:01

I remember when to your point remember getting a letter in the mail for the class action lawsuit against them and I was like Oh my who are these people who want to suit this so ridiculous to me.

I felt so bad.

I thought they produced such a cool product and that really sucked but but I found like running in those on pavement makes no sense to me.

33:19

It really hurt over time.

I wanted to get your opinion on that.

So surfaces, because it's not like we all just like inside our house, we have natural surfaces, right?

So it's unnatural surfaces.

So if I try to take my natural foot and put it on a natural surface, how is that different than if I want to walk outside?

33:37

That's a great question, and I think it's one that does need to be addressed because some of us don't have the luxury of, you know, walking around in the woods or on dirt, those environments, the foot is adaptable.

So when we are stepping on dirt or a softer terrain, the foot can kind of adapt.

33:55

It can feel there's less force, you know, and that was really, you know, original footwear was used for protection.

There was a lot less concrete around, you know, so the foot was able to adapt to the terrain, to the variable terrain.

34:14

I have a lot of patients like I also am in New York City a lot.

That's, you know, you're a concrete jungle.

And you walk there, man.

It's.

Not going.

To log 6 miles a day or something and.

I've been doing, like I said, I have been working on my feet for years and when I go there I have different footwear.

34:36

So if I'm going to be walking around for maybe half a day, I have my minimal footwear, which is defined, I define this in the book as white toe box, not a wide shoe.

So a wide shoe is wide at the metatarsals, right?

34:56

Or at the ball.

Like you mean like if you buy like the D wide shoes that we're talking about?

My patients would be like, I got a New Balance.

It's a triple E I'm like it still tapers at the toe.

Oh man, they just can't get it right, huh?

You know, so wide toe box.

You can take out the factory insert of the shoe and put your foot on it, and if your toes extend beyond the factory insert, the shoe is probably too narrow.

35:20

But keep this in mind, most people's feet look like a shoe, not a foot.

So you have to, you know, minimal shoe, 0 drops.

So that basically means that the heel and the toe sit in the same plane.

There's no elevated heel and a thin and flexible sole.

35:37

So most shoes that kind of fall into that minimal category or anywhere from 20mm of stack height or less.

Typically I like you know, 1415 is more minimal. 1415mm basically under the foot.

35:55

Correct.

So if you're walking on concrete all day long or you're walking through an airport, your foot might not like the thin and flexible part.

It's going to love the wide toe box, which is my non negotiable.

36:13

It probably will like the zero heel to toe drop depending, right?

Some people still need that low drop if they have weak feet, weak calves, that's a different conversation.

But it's that stack height.

So that's where I think with you're going to be on concrete or standing in one place or I call museum walking or grocery shopping or you don't have that faster paced gate where you can roll through your foot that's stack height is an important conversation.

36:46

OK, I want to talk about that.

So just to clarify, museum walking, sometimes people who work in an office building will be like, oh, I've got 8000 steps today.

And you're like, I'm always, I never feel like that's really 8000 steps because there's such a difference between unimpeded walking versus like shuffling around from place to place.

37:06

Like I don't feel like I'm getting the same thing from those different types of steps.

So if I walk from, you know, this gate in the airport to that gate in the airport, that is really different than if I'm like moseying around in the shops or something, right?

Or that's my experience.

37:22

Can you help disambiguate all that?

So I kind of define it as ambient walking versus intentional walking.

Yeah.

Something is better than nothing.

Of course.

Yeah, of.

Course, you know, if you're taking less than 5000 steps, you're really considered a sedentary individual.

37:39

So that is like where I start with some people and some people that have been in chronic pain.

I mean, I've had patients that have had 2000 steps a day, OK, that is that is not really moving at all, so.

You get that like going to the bathroom every day and like going to the refrigerator.

37:58

It's not a lot of steps can to can to put it into, you know something a little more objective about a 5 minute walk.

Intentional walk will get you about 500 steps.

OK. 5 minutes.

So with those people, that's what I'm saying.

38:14

I know you're kind of moving around your house, but if you can give me 5 minutes three times a day of an intentional walk, that means you're going outside and your pace is a little bit faster or you're on a treadmill.

If you can't get outside, you're going to grab yourself another 1500 steps.

38:30

Now, for some people that is a very big deal.

For people who suffer from depression, getting to that 5000 step mark can reduce the symptoms of depression by quite a bit.

38:48

So it's like a no brainer to me.

I'm like, this is the conversation we need to be having it.

It's like on every doctor's prescription pad.

It should be people.

Take drugs.

But they do.

They're taking drugs because they're not walking.

That's so sad.

Like, I'm not judging it.

39:04

I'm my heart hurts that this is the scenario we're in.

Oh my goodness.

It's why I do what I do, Daniel, because on the other side of it, it's like the most rewarding.

Like, it's like what I was meant, like put on this planet to do.

39:20

And it's so I had a recent patient who was from out of the country, and she came in in a wheelchair and she stayed in the US for five weeks.

And we worked together.

And she had had a foot injury three years ago.

39:39

Now tissues heal.

This no longer was a conversation of a musculoskeletal injury.

This was now a complicated conversation of a whole biopsychosocial issue.

39:56

It was an emotional thing.

It was a mental thing.

So we worked not only on, you know, improving her strength, right, because things had atrophied, but more importantly, building her confidence and movement and, you know.

40:12

She I told her you're made me cry.

I was like, when you leave here in five weeks, you're leaving that wheelchair here.

You know, you're going to walk on that plane.

And I spent a lot of time I would like text her pictures of like the mountains when I'm hiking in Colorado and like all those little things that like I think were so important to retrain her brain outside of just she's identified with this foot pain.

40:39

She was there was a person behind that diagnosis and you just can't treat that foot.

So I know I went that was a little, that's OK.

You you said we were talking about steps and number of steps, and I'm wondering about two tools in particular.

41:01

Do you recommend people have a pedometer and do you recommend people have a dog because people it's like who's walking who here?

I would not.

My dog walks me a mile a day.

You know, my dogs like Take Me Out every day.

I can't say no to them.

41:16

I have to do that walk every day.

So I often tell people like take the dog of your body for a walk, like, you know, get a dog and you'll find yourself walking.

I'm just curious both of those things, How important?

Do you think that people need to have some way to monitor what they're doing?

41:32

You know, I have a Garmin, A lot of my patients have some type of like, you know, Fitbit or some way to monitor that.

I think it's also nice if you know, when I'm at my office and I'm like, did we talk about that ambient walking?

You're like, well, I'm, I got 5000 steps, but I was just like walking around my office.

41:49

That is different than going for an intentional walk.

All right, So at the end of my work day, I'll look down at my step count and I'll be like, huh, I could probably use another 1000 steps here.

So I get outside, I go for 10 minutes, brisk pace.

42:09

I grab some more steps, I'm outside.

It's like a good, I'll usually go after dinner.

You know, that's a nice way to kind of monitor where you are.

And as far as the dog, I have a little mini goldendoodle and we moved to the mountains in August and I'm always like, come on, you know, like he just, he just, he's not a mountain dog.

42:34

Just yeah, OK.

He's not walking you.

So, you know, it depends, it depends on what kind of dog you have.

But I will tell you this, dogs will get you outside walking.

Yeah.

So you know, the some of the things we'll talk about with my patients is if they are going to be with their dogs for a while, I'll recommend they get one of those belts.

42:51

So they're not just like arm swing is very important.

Yeah.

Oh, great.

I want to talk about that.

So walking is all about rotation, same with running.

It's how it's basically this like Corkscrew, that's what gives us kind of free energy.

That's why humans are such good endurance walkers, because really, it's a.

43:10

Spinal engine.

We've we've been designed to walk for long, long periods of time, but that comes with being efficient and being able to rotate.

So when people are walking and they like, they're holding their dog on a leash, they're kind of impeding.

43:26

Yeah, sure.

What, what do you think about man?

I don't want to lose hold on.

I got 2 two things going on.

The 1st is just quick step count question and then I want to come back to this question about weightlifting.

But I my kind of optimal running distance is I like 5 KS.

43:43

I think.

I think it's like moderate enough that I'm not going to beat myself up too bad, but it's long enough that I, I feel like I get some good work in.

So I run a few a week and we were just on vacation.

You know, I did 10 in a row.

So every day I would look down at my pedometer and I would feel like do am I counting these steps or not?

44:01

Because like let's say I do a 5K and I get 7500 steps out of that.

And then I hit my 8000 step goal like 5 minutes later and it's 9:00 in the morning and I'm like do I still need my steps or are those my steps?

You know, that's a great question.

44:18

There is when you're looking at just step count, there's a law of diminishing return.

So I'll have patients that'll say I'm getting 15,000 steps a day.

I did my run and then I was done and I wanted to get my walking steps in.

44:34

And so they're coming in at 15,000 steps, for example.

And then my next question to them is, are you strength training?

And they say, well, no, I don't have time to strength training because I'm, I'm getting 15,000 steps.

This is when we have the conversation of at after about 9 to 10,000 steps, we kind of plateau.

44:57

OK, That's good to hear.

That's good to hear.

That takes pressure off because some days I'll be like 24,000.

I need more days like this, you know.

And so that's when you can, you know, be able to free some time up for yourself, you know, maybe don't go on, you know, try to hit 20,000 steps and free up some of your time to do other things.

45:20

Right, That makes some, that makes perfect sense to me.

I always say to people, it's like, you know, you can tell the difference between a $5 bottle of wine and a $50 bottle of wine, but it's hard to tell a $50 bottle from a $5000 bottle.

That's right.

You just OK on a weightlifting question coming back to the rotational conversation, you know, I've really switched up a lot of my weight training now for rotational movement.

45:43

So I've been doing club bell, Mace, Bulgarian bag, all these things that are rotational because what I was finding doing a lot of CrossFit type movements, everything being in this sagittal plane, it's like, wow, all actual activities are rotational, all sports are rotational.

46:01

And then weightlifting.

And it's not just a CrossFit thing, but it's so single plane.

And then what I've noticed and have been guilty of all my life and watched this all my life, is how everybody starts to get walk all stiffened.

And I used to think we were just doing that because you, you know, you get that pump and you're like, yeah, I'm huge.

46:21

But then I started realizing, no, it's because I'm constantly bracing my spine in one plane.

And so I've got friends who do not know how to rotate, and they walk in ways that look kind of ridiculous, but also like they're missing.

They, there was a famous thing that happened to CrossFit Games many years ago where they decided to throw in this different activity and they had them throw a softball.

46:44

And these are the most incredible athletes I've ever seen.

And they can no rotation.

It's like embarrassing.

So yeah, that I'm curious how you're managing that.

So you brought up dead lifting.

It sounds like you're doing some heavier weight lifting.

47:00

You know that feeling, you put the weights down and there's that couple of moments where your body's like all stiffened together like a unit.

But obviously that's not how we want to move.

So any thoughts on mitigating that or or the effects of that?

You know, I think it's interesting when you look across different sports because you can always pick out a CrossFit athlete.

47:18

Yeah, OK.

There's in that.

There's nothing wrong with that.

They're just a lot of their movements that they do is just what you said.

So the first thing I'll usually ask them is what do you like better, front squat or back squat?

OK.

47:34

And the majority will always tell me I like the back swat right because I can hang out on my low back.

Having to front squat in load the front of your body is more difficult.

It requires different stability.

47:53

I will tell my patients all the time.

It is so much harder to turn tissues down or off than to turn things on.

We need.

Quiet, right?

You mentioned this kind of like, you know, chest out, rib cage flared.

48:12

You know, standing in this position, I am constantly queuing my patients.

Drop your sternum.

Just relax.

Breathe.

So like a parrot, they're like in a sympathetic posture, sympathetic nervous system posture all the time evoking that kind of adrenal response essentially versus you're talking about things that signal the body that it's OK to down regulate.

48:38

That's right.

And you know what you see something is really cool, and if I had time, I'd go back to school and research this.

I think that when people have bilateral foot pain, bilateral heel pain, even chronic plantar fasciitis, I don't necessarily think it is a problem being driven from the foot.

48:59

When someone is unstable or they're in this state of fight or flight, their nervous systems are jacked up, right?

Everything becomes a grip, right?

And that means my respiration rates are changing and I can't relax my pelvic floor when I inhale, right.

49:16

So everything in the pelvic floor, everything is gripping.

Gripping is not strength.

So that's when you'll start to see pelvic floor issues.

And this is with like heavy lifters.

You know, you start to people are like, oh, women don't heavy lift because you'll have it get incontinence.

49:32

I'm like, that is the biggest bunch of horseshit I've ever heard.

We just have to work on how we can control these tissues and when you can get the tissues to relax and then load, then my foot is also not gripping because my foot's like, hey, this person is unstable.

49:51

I'm going to grip to high heaven because I got to try to stabilize them.

Well, what do you think you're going to get?

You're going to get foot tension.

Right.

So the foot has to be able to relax, it has to be able to absorb shock and so does the pelvic floor.

So I think all of that comes.

There's a lot to there.

50:07

Gosh, you know, I'm sure you're familiar with Tom Meyer's work and, you know, anatomy trains and he connects that deep frontal line.

I think it's like the arches of the foot, the pelvic floor and the diaphragm are all sort of part of one line.

And I agree with you that if you can, you know, Andy Galpin talks about 5 minutes of meditating after heavy lifting and stuff.

50:27

And one thing that I've noticed again, I'll pick on my CrossFit friends who I love and I love my gym and the community is amazing.

A lot of the people are training very hard, but they have a hard time staying lean and they're always injured.

50:42

And I believe it's because their cortisol levels are jacked all the time because every workout is running from absolute peril.

Like the, the timer goes and there's something so good about getting to that zone 5 heart rate and hitting those VO2 Max workouts.

50:58

But you got to tell your body after that you're safe again.

And if you just carry that into your life day after day, the chronic stress seems to eat away people's connective tissues so that they're, they're never recovering.

And then they, they all kind of get fat because I think because their body's like, hold on everything.

51:16

We're in total stress.

And I'm seeing that very often.

And most people don't have any kind of meditation practice in their life or prayer practice or something or sauna even that down regulates their sympathetic nervous.

System so important.

If that's like the one thing I think people are missing, it is not more and more and more.

51:34

I used to be that person mostly.

And I was like, you know, always, always injured.

And it wasn't even until, you know, recently where I, you know, you practice what you preach.

And I'm like, man, there is something to this rest and recovery.

51:50

There is something now down regulating your nervous system.

And then what you find is you can actually lift more and you cannot get injured chasing injuries all the time.

Yeah.

Wow, there's so OK, I know only have you for limited time here.

52:07

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Yeah, you have the toes that are not inhibited.

They're going to be able to splay.

They're going to have a thin and flexible sole in that type of shoe.

53:53

I always say you got to earn your right.

You got to earn your right to wear that thing all the time because it's an environment where you need to be stronger.

OK, the I remember, so if you're just listening to this, this is a vapor 5 finger, the five toe shoes and there's some other brands now, but I I remember when this came out thinking like, finally we're using all this technology for something useful because what a cool.

54:16

I think back to how many indigenous people have thought about doing it and it just wasn't worth the time when they were making moccasins or whatever.

But such a cool idea.

OK, cool.

I want to this is pretty close.

So this is a vivo, you know, fairly wide, basically a modern moccasin is what I would say that is.

54:36

Yeah, so Vivo Barefoot's one.

I like the Ogs of the minimal footwear world.

They create a great shoe.

That Vivo Barefoot Motor Strength is one of my favorite shoes to strength train in because it's what you just did.

You can roll it up in a ball, you can twist it, and it's thin and flexible so you can feel the ground.

54:56

Yeah, that's a great shoe.

One thing I just side note about shoes like that I love is that they're so easy to keep an extra pair like in your carry on bag or something because they just don't take any space and they're.

Like when you travel you're like, oh, I have 4 pairs of shoes in here.

Exactly.

55:11

Face of one like Hoka.

OK, another question.

I didn't bring my any of my boots here, but of course, you know, I do a lot of outdoor activities, a lot of hunting and fishing and, and things that would be very difficult to do barefoot and, and, or just would really slow things down.

55:27

You know, so often what I'm wearing is a rubber boot.

You know, it could be, I usually wear lacrosse's.

They could be mucks, they could be bogs.

Typically that's the typical boot up here in Maine.

55:43

We got a long mud season.

It's just starting now, and I wear them in the winter, ice fishing and all of that.

But I typically wear them in such a way that they're fairly roomy inside and my foot just floats inside of it and I can fully splay and move.

But the shoes often have a bit of a heel to keep you out of the mud and stuff.

56:01

So I'm curious about your thoughts on that.

And, you know, because when I look at the companies like Vivo attempting to make winter boots, it's like I live in a legit winter.

It's like, guys, you have to be up a little bit because the cold, you know, for insulation.

So yeah, just curious with the winter boot thing.

56:20

Yes, it's like that.

Don't ever say always, never.

You know, I think where I really want to educate people is just that exact topic.

People in the barefoot shoe world or the minimal shoe world, they'll be like, I have to wear these shoes all the time.

56:38

And that is not true for exactly the same reasons that you just said.

There is a time and a place that you are going to want to wear.

You're going to be on rocky terrain.

It's technology.

It's OK, you know, if your foot's cold, if you're going to be on rocky terrain, if you're going to be on your feet for longer distances, it is OK to have a stiffer shoe.

57:03

It's OK to have that heel to keep you out of mud.

You know, it's this conversation of in the book I call it a 24 hour shoe clock.

Yeah, OK.

So if you're going to be out in the woods for three hours in X shoe that is going to be not as functional as a minimal shoe, that's OK.

57:20

Enjoy yourself.

When you get home, take the shoe off and go wear something that's more functional.

Just balance out your time a little bit.

Thank you that makes.

Sense that's all you have to do.

That makes sense.

I got one more shoe I want to show you and I'm nervous what you're going to say.

57:36

OK, so this is my this has become my favorite running on pavement shoe.

I've got a a true form treadmill upstairs.

So, you know, like a curved self.

Propelled curve now.

And I run that barefoot and it's funny, my wife will run it with shoes and it builds up a static charge and her hair stands straight up.

57:54

And if she doesn't off, if she doesn't touch the sides every couple minutes, you build up such a charge that, I mean, it hurts when you actually discharge it.

But so I'll run on that barefoot.

But when I'm running outside, I've been running in these.

Those are the fluxes.

So those are 0 drop the toes box has been fairly wide and I just these have been my airport shoe.

58:15

I've been running high rocks races in them.

I do a lot in them.

So, but they're fairly tall.

Like when I first got used to it was like, Oh, I could roll my ankle in that.

It's like if I just wore 1, you know, I'm standing up fairly high over the other foot.

So, thoughts on that shoe?

58:33

Is it comfortable?

Yeah, it's all knitted.

I don't have to lace it.

I just slit my foot in it.

If you look at all the research on what is the best shoe, Ben or Nick did a lot of this.

It boils down to are you comfortable in that shoe?

58:49

Now there's kind of a caveat to that because there's always a trade off, right?

When people put on a super cushy shoe that has a big toe spring on it and you see them running and it basically, which is not that shoe by the way, it basically looks like it's, it's rolling them forward like the shoe is doing the work, right.

59:16

I always say nobody gets a free lunch that it's not, you know, we our goal in life should not be to be the most comfortable all the time.

It's OK to be uncomfortable, you know, that's when growth happens.

So I always preface that conversation of discomfort is OK, we want to live there.

59:37

But with that shoe that you have, it is allowing your toe splay.

It has some stack height on it.

You're running, but that's in that like that's in that functional footwear, that footwear world, you know, and you're running on it.

So yes, that's OK for me.

59:54

You know, well, you mentioned the stack height with, you know, spraining your ankle.

Keep that in mind.

The further the foot is off the ground, you have a, you know, a better chance of stepping on something and then you're going to go into excessive inversion.

1:00:13

Now I will say my wife's a little taller than me, so that's a slight incentive I have.

And on that note, I wanted to ask you about shoes that.

OK, like, I agree with you about that, that clock analogy that you gave.

So if we're going out to dinner, I've got a pair of cowboy boots I might wear or, you know, another pair of, like, dress boots.

1:00:35

They're so uncomfortable.

Like I want nothing more than to get them off at the end.

But I think, you know, it's like wearing a belt out at a wedding, like, or a tie.

It's like, I don't also want to do that all the time, but I'll do it for a few hours.

Yeah.

But but as shoes get more and more aberrant from the human, you know, like, obviously the obvious one is high heels.

1:00:53

I'm kind of curious your thoughts on that because now you're getting into changing the position of your pelvis obviously and gait dynamics dramatically, right?

So as, and, and I guess I'm going to add one more piece of this.

Sorry, the guy who wrote you know Shane Benzie, who wrote The Lost Art of Running?

1:01:13

No.

So he's a running coach and he spent some time in Kenya looking at, you know, the, the, the elite runners there and he wrote a really great book about it.

He's really into using your fascia to run basically.

And he said something to me, which I've been thinking about for a while, something about that.

1:01:29

And, and you just echoed it.

Something about in some cases, a little bit of drop can be appropriate.

Now obviously if drop is the same thing that's going on, correct me if I'm wrong, but but a high heel is just very extreme drop, right?

Like if somebody's like, well, what's drop mean in a shoe?

1:01:45

And what's 0 drop like?

Well, a high heel would be 1 extreme and then a shoe with totally flat plane would be the other extreme, right?

So how much is, when is it beneficial?

Why do they even do it?

And then what happens when you get to those extremes?

So to answer the first question about high heels and those types of things, as little time as possible, you know, I'm not, I'm not going to win the conversation of saying, hey, when you go on a date, you need to wear your functional footwear.

1:02:11

No feel good.

You know, like if get, if wearing a high heel to go out to dinner makes you feel good, go for it, you know, but as little time as possible.

I have had many patients in my office because of I wore high heels to this wedding or I've worn high heels to work all the time and there will be problems.

1:02:30

If that is your favorite footwear, if you have your shoe clock and you're wearing that high heel all day long, you will have problems.

So limit that time.

In the book we have like a high heel rehab section where like if you were high heels, do these things right to accommodate for that.

1:02:48

So you know, that's one way to be aware of that.

As far as the heel to toe drop, if you look at the research of low to no drop, it's 6mm or below, so a few.

1:03:04

Millimeters between the heel and the toe differential will be considered zero drop.

Correct.

That is considered to be functional.

All right.

If you think of brands like Ultra running, Topo Athletic, they have shoes that sit along the zero drop with the wide toe box, but also 4mm drop, 5mm drop.

1:03:31

So those are also nice transition shoes for people versus other companies that are 8 millimeters, 10mm, that's a high heel to toe drop.

Now if you have someone who has heel pain or Achilles issues sometimes that's nice right?

1:03:49

It's easier it run up the mountain in a zero drop shoe versus a shoe that has an 8mm heel to toe drop.

You will feel a difference.

It's a lot easier even when I run with the higher drop.

Because you have more surface contact and you're not working the gastroc and.

1:04:07

The If I'm running up a mountain and my heel and toe are in the same plane, you better have a real strong foot and calf to be able to push you up.

OK, Yep.

But if you have that heel that's elevated, you're getting a little assist.

1:04:25

Well, how do you feel about a lifter then?

Like for somebody who's squatting.

You have to ask yourself why I.

Love that answer, you just got me good with that one.

You know, if I want to squat and I can't deep squat without a lift underneath my heels, I should be asking why can I not do this?

1:04:48

Is it because I don't have good proximal stability?

Is it because I have poor ankle dorsiflexion?

Is it because XY or Z?

And then figure that out and work on it.

But in the meantime.

That's in a different category for you than the running uphill with some drop.

1:05:04

You have those as different those.

Are different, no, because I think in both scenarios you are, you know, getting a job.

Done.

Compensating to get a job Done.

You know, there's some days where I'm tired and I'm like, man, I'm going to throw on my, you know, ultra experience, which is a 4mm drop.

1:05:25

It's a little, it's a little easier run for me, but I'm still going to go run.

I'm still going to, you know, I don't want to compromise movement or steps or activity because I'm a little tired.

I'm going to be like, all right, I'm just going to wear my formal drop today.

But there's other days where I'm like, you know what, I want to go after my foot and calf strength.

1:05:42

I feel good.

I go into my zero drop and run up the same trail.

But if I'm strapping on lifters every time I want to go squat or clean or snatch, that might be leaning on a crutch a little too hard.

Most of us are not Olympic lifters.

Right.

1:05:58

Where we're like, we're squatting 700 pounds.

Yeah, that is a different conversation.

Yeah, yeah, right, right.

Yes, of course there needs to be, you know, some stability and other factors underneath the foot, but the majority of us don't live in that category, right, Right.

1:06:14

Good.

Which means we should be asking ourselves, hey, why do I need this?

Yeah.

And then do both.

Training variability is great.

Yeah, I love that.

Well.

Movement variability.

The more movement options we have, the less oh shit moments we have.

1:06:32

Right.

Well, on that, like, how do you feel about?

Do you have time for?

Can we go any further?

Yeah, how do you feel about?

I was talking before about unstable surfaces like walking in soft sand or something I really like doing is box step UPS off of a stable Sir unstable surface.

1:06:50

So I'll have like a balance board that I'll step down and try to do a controlled step onto that balance board.

You know, unstable surfaces I assume are working peroneals, tibial, tibialis anterior, you know, all the muscles of the calves.

1:07:07

Like, how important is that kind of stuff to walk in in?

Yeah, in surfaces that don't necessarily react the way a firm surface does.

So the first part of that question with the training piece, if you can't control it and you don't own it, then you have no business putting yourself on an unstable surface.

1:07:28

That's when I train people.

I'm like, if you can't do it on the ground, you have no business putting your foot on a Bosu ball, right?

Get control first.

But then I love training the foot into inversion and E version.

1:07:45

Like I'm designing us as a board right now where you can actually put your foot on it at different degrees of slants so that you can like calf raise off of a foot that's inverted.

You know, some people that had an ankle sprain, they'll look at that and be like, no way.

And I'm like, Oh yes, oh, we're definitely doing this because your foot is going to do this at some point in your life, you're going to go outside and step on a curb and your foot is going to go into inversion again and you better be prepared for it, right?

1:08:15

Same with E version.

So we want to train all of those different positions to do.

Do you like something like this?

These foot boards are getting pretty popular.

Yeah, those are great.

It's like a sidekick or the blackboard.

Yeah, mine's some knock off from Amazon, but anything in particular do you think just do everything that it does or is there anything you're like, oh, prescriptively you should be doing this with it or?

1:08:38

I think those boards are nice because it brings awareness to the fact that the foot needs to dissociate our foot.

You know how you mentioned earlier about the fin, right?

It's, it's wide at the top and then narrows.

But if you think of a fin, it's like a paddle, OK?

1:08:56

Our foot has, you know, a rear foot, a mid foot and a forefoot.

This foot was designed to dissociate and move.

And that's what I think those, you know, boards and training people to kind of roll through their foot is important because I see a lot of people that, you know, their foot literally functions like a paddle.

1:09:18

It's like their heel strikes and they slap their foot on the ground and there's none of this, you know, beautiful role that happens.

And that's shock absorption.

So yeah, I, I appreciate you saying that because I never, I don't think embarrassingly I never really thought about my heel moving independently from my 4 foot before.

1:09:36

And if you set it so that the four foot of the board is stable and you can kind of roll the heel back and forth, I've never actually felt that until recently.

It's the coolest part of the foot.

I think the calcaneus is like the coolest bone in the foot.

It is a better shock absorber than any type of synthetic material.

1:09:55

There's a calcaneal fat pad that sits along the heel that is filled with receptors that give us information.

So when that heel strikes the ground, if we can feel it right, it initiates an unlocking of the foot.

1:10:12

The the calcaneus starts to open up KR what we call aversion, and that starts this unlocking of the foot, which is pronation, which is a very, very necessary movement.

So that's why that heel has to move.

OK.

1:10:28

That's so helpful for me.

Couple injury questions I want to ask about 1 was OK here's a big picture 1 so I was doing some stupid young guy stuff in the mountains when I was a teenager and I got a pretty bad rotational tib fib break just above the ankle.

1:10:50

I was alone while my friends were quite far away.

I had to be like basically hauled out of these mountains and it was winter times.

I mean, I could have died up there.

And, and so then I get out and I'm so dumb that I, well, I knew better than to let them do surgery on me.

1:11:06

They wanted a pin and rods and all the stuff and, and I basically said, just can you just push the bones back and cast it?

And they did, but it wasn't the probably the best that they could have worked that could have been done.

Then when I got the cast, which was over the knee, I walked on it the whole time I was hiking on it.

1:11:25

I mean, just doing stupid things.

Hindsight's 2020 at this point, the way that it's healed, I, my foot is tilted outward just a little bit on that side.

And what I noticed when I squat is that my talus bone is not sitting quite where it should be.

1:11:43

So it, it impinges in dorsiflexion.

So, so that if I took a like a band and put it on my rig and set it low and then like walked into that band so that band was pulling back against my talus bone, it's like I can go into like full dorsiflexion.

1:11:59

Just curious if you have any thoughts on like anything there.

Am I like stuck this way forever?

I mean I'm functional of course and I can run and squat everything, but I mean my squat I'm better off doing staggered stepped or or single leg squats.

And I am squatting bilaterally because I've got it causes my whole pelvis to rotate.

1:12:19

I weight my left leg a little bit more and so if I squat heavy I'm at risk of back pain.

Yeah, I love all the single leg stuff anyway.

I'm a big fan of that single leg work, but that Taylor.

So the interesting thing about the Taylor's is that there's no muscular attachments to that bone.

1:12:35

Oh, it just floats in there.

The only bone in the foot there where there's no muscular attachment.

So those Posterior Taylor mobilizations that you're Speaking of there, sometimes those have to be done consistently to kind of work on centration, if you will.

1:12:53

OK.

But there's a lot of parts of the foot that can be trained to help control some of that.

I think when we talk about dorsiflexion, you know, we're always thinking about I have to stretch my calves.

1:13:10

You know, I have to like, you know, mobilizing my calf.

We have another option there, which is strengthening the anterior compartment of the lower leg.

If you strengthen the anterior compartment, you will lengthen the.

1:13:27

Post like reciprocal inhibition.

So with those patients, I'll do a lot of, you know, anterior shin work, if you will get certain gait drills, tibial raises if there's no pinching, working on pronation and supination, how to control the arch of the foot.

1:13:48

Cause a lot of people are really, really calf focused.

I, I actually have a lot of friends who live in fear of an Achilles injury.

And my coach has had both, it snapped both Achilles tendons.

And then his wife actually a couple years ago, jump roping hadn't warmed up.

1:14:09

I mean, it's so awful to watch somebody go through that.

I wanted to ask you if you had any like for my buddy who every time I talk, if you even talk about this, I don't know why he gets so nervous and he's never experienced it.

What do I tell him to do?

Because like, I don't even think about it.

1:14:25

I feel like my feet and ankles are really healthy and I don't think about this, but he's thinking about it all the time.

You load it, you have to load the foot and ankle like you load the rest of the body.

If you look at research on Achilles tendinopathy, Peter Mallieres, his work, it's actually he did a study and he looked at runners with Achilles issues.

1:14:49

Some of the statistics are baseline measures for calf raises.

A single leg calf raise OK holding half of your body weight 6 times.

Half of your body weight is like a farmer's carry, like in one hand.

1:15:06

So like I'm 140 lbs.

I would hold a 70 LB kettlebell.

I should be able to do 6 single leg calf raises and they better be pretty.

Yeah, OK.

OK, pretty means not this little half, you know, my my heels coming halfway off the ground.

1:15:23

My heels up off the ground.

It's.

Lock it up at the top.

And, and I think this research is telling us, hey, not all of us have to get to these numbers, but it tells you the capacity that we can.

If you are seated now, a seated single leg calf raise 1.5 times your body weight.

1:15:47

These were the numbers in the study.

Now that's a lot of weight.

So when people are talking about their Achilles and they're, you know, I'm afraid of ruptures.

Tendons need load when people feel and when you wake up with an Achilles tendon issue, you're like, man, it's all sore.

1:16:09

You have difficult time going downstairs.

That will stop people in their tracks and be like, I better rest this thing more rest is not the answer for tendons.

I'm not saying you won't feel better because you're not doing anything, but when you try to return to sport of a rested tendon you it will most certainly come back.

1:16:30

So just like bone, the the body's remodeling or a removing tissue, if you're not getting the, the tension and strain that you need to put on, if that's not being loaded, then your body goes, oh, we can take some resources away from this tendon.

Is it like that?

Tendons, in order to stay healthy as we age, tendons need load and that becomes a very important conversation as we age.

1:16:53

We need to train for strength and we need to train for power.

So like your friend who is jump roping, you have to train the spring.

You know, I mean, there's a lot of people that as they age, you say the word jump and they're like, no way.

1:17:11

You know, there's ways that we'll like we'll start with little bounces, right?

If you're scared to jump, you just start with a little bounce.

Then you can start with pogos.

Then you can even do assisted on the wall.

You can do a TRX assisted.

But you we are going to train the spring of your foot and ankle because that is walking, That is reaction time.

1:17:31

That is power, and that is all needed as you age.

Thank you.

Got two more injuries I want to ask about.

I'll clump them together.

Last two years ago I'm walking out of the woods.

Just finished a shoot.

We're just walking out of the woods, nothing going on, no stress.

I step on an acorn.

1:17:49

The number of acorns I've stepped on in my life incalculable.

I step on this one right where my first metatarsal and phalangie meet, you know, like at the base of the big toe and get a pop sound that was not the acorn breaking.

1:18:06

And for nine months maybe it's just so painful and I've wondered if I like detonated A sesamoid bone or something.

Is that?

Could that have been what it was?

You know, the big toe to me is the most important joint in the human body.

1:18:27

You do not want to mess with the big toe.

When you have an injury to the big toe, you have to make sure that you restore its range of motion.

So I'm not sure what the actual, you know, diagnosis was with your injury, but following any injury to the big toe, you have got to try to restore its range.

1:18:51

You know, if we were sprinting, for example, we would need an average about 60 to 65° of range of motion out of that big toe.

A walking gait is a mid range range of motion activity.

That's why it's so safe for people.

1:19:08

You need about 40 to 45°.

A lot of people don't have that even, especially if there's been an injury.

So if you don't have 4045° out of your big toe or it's pinching at the top, you have to either get that thing assessed, figure out why, try to restore it.

1:19:29

But this is important.

People will be like, man, my big toe is so stiff, I'm just going to keep jamming this thing into extension.

If you have arthritic change to that joint and you keep trying to drive it into extension, you're going to piss it off and make it worse.

1:19:46

So that is an important joint that needs to be assessed.

How about traction and extension?

Yeah, so you can attraction it and then try to go above, but you want to avoid pinching there of.

Course, so no one don't force impingement in that joint.

1:20:03

That's right.

That's the the other injury I'd wanted to ask.

My wife has also dealt with that particular spot and she I said, did you want me to to ask Doctor Conley any questions?

And she said, yeah, why?

Why does that injury so it's that same spot at the mound of the big toe.

1:20:20

It goes away, it comes back, it goes away, it comes back and seems like kind of hard to heal, obviously because I'm assuming because we're walking on all the time, but.

There's a lot that goes into the stability of the first ray.

So for example, when I'm walking, the first metatarsal has to drop down first.

1:20:41

It's about timing and so that my big toe can extend if I have perennial weakness, if I've ever had ankle sprains, if I have a weakness of an extensor.

Extensor hallucis breath is the big toe.

1:20:58

These muscles help drop the head of the first, so if there's some type of dysfunction there, if there's a tightness or weakness, you can have pinching pain at the toe.

You can also have pinching pain there if your foot is an excessive pronation for example.

1:21:20

So these are causes of limited big toe range of motion.

So cut like what we would call a collapsed arch.

That's pronation, right?

Yes, well, pronation is a necessary movement.

It's when you have this excessive pronation in and out.

1:21:35

Returning to like anatomical neutral or whatever.

Correct.

So when you're standing, if you're driving too much load into the big toe, it's hard to extend that guy.

OK.

And most of those muscles, you're talking about them, it's like they're not in the foot, right?

1:21:51

They're in.

Their.

Their tendons run through the foot, but they're up in the lower leg or.

To your ponials flexor houses longest that can also be a cause of big toe pain so you I would want to I can send you some information for her.

That'd be great.

1:22:06

Yeah.

I was wondering, you know, obviously this isn't the the place for this type of an interview, but I, I'm assuming you must have a, a catalog of stuff you can point people to exercises or things like that.

Where would people get all that?

Yeah.

So Gate happens is I've wanted to kind of develop a resource for people for all of this stuff.

1:22:26

We have on our Instagram page and on our YouTube channel there are for literally 8 years there's exercises and information on all this stuff.

The YouTube obviously is more long format, so I do a lot more education speaking on there.

1:22:45

We have on the website there are courses for both the individual.

If you're there's a bunion course, there's a fit feet program which is 12 weeks of like getting your feet stronger.

And it's not only focused at the foot, but it's everything above it.

1:23:03

I mean, your foot is only as stable as the hip that drives it.

So shame on me if I don't train people above just the foot.

So that program I think has been really awesome and we got that translated in like 3 different languages.

That's cool.

1:23:20

And then I just wanted to close out talking about your book launch and and tell us about the book.

I'm really excited about it.

I was saying to you off air, I mean, I there's only so many books that have been even written close to this topic, but this one, I think is that the first really in its genre that's that's dedicated to this topic.

1:23:37

And that's crazy, because this is the fundamental thing humans do.

It's really wild.

Well, the book is called Walk Very simple and I want.

That that title is available is crazy.

You know what I mean?

Really, I wanted, I want people to kind of rediscover a lost art of what it is.

1:24:01

I also kind of the basis of it is that walking is a, it should be viewed as a physiological necessity like breathing and sleeping.

If you were thinking of like a Venn diagram, we have breathing, sleeping, walking and food, right?

1:24:17

You want to add food in there.

But when those things are functionally optimally, then we have this Wellness, you know, if we're not sleeping and we're under high stress, you're not going to want to walk.

So that's what I wanted to kind of to educate people on, is this physiological necessity rather than exercise?

1:24:38

Exercise, I think to some people is considered optional.

Walking is not.

It is something that is a core biological skeletal system.

But our nervous system, every single system in your body depends on this low to moderate intensity, repetitive rotational movement.

1:24:59

And that's what we talk about.

And there's a lot of information on feet.

There's foot assessments and foot exercises and footwear.

And it was really fun to write.

It was a labor of love for sure.

I want to let you go, but I don't.

1:25:14

I there's just so many things.

Like I assume when you're walking, it's, for instance, the soleliest pump being the second heart, as they sometimes say, like moving fluids out of your lower body or the that rotation for the, I imagine your diaphragm is very impacted by walking and your organ systems are in.

1:25:32

So I just want to reiterate what you're saying.

It's not like just because you need exercise, it's actually that the human animal needs this in order for it to, like function optimally, right?

Yeah.

When's the book coming out?

May 5th it's presale pre sale is now, but the the launch is May 5th.

1:25:48

Cool, where do people go for that?

The presale.

Anywhere Amazon, it's all over Amazon now.

Any anywhere where you'd buy your like local books.

It's on our website so.

I'm so excited for you.

I hope I see it at the airport.

That's always like my favorite thing.

Well, it's funny.

We were picking like the colors they were.

We were like, what's the cover going to be?

1:26:05

And I'm from Pittsburgh originally.

So when they came to me with a bright yellow color with black lettering, I was like, that's the one, that's you.

Well, congratulations.

I know how much work it takes and I just, I'm really excited for you and I, I'm excited for how that is going to take your message even further obviously into the mainstream.

1:26:24

So really exciting and thanks for your generous time today.

I really appreciate it.

Yeah, of course.

Any final concluding thoughts?

No just you know, if I had to like recommend anything I would tell people regardless of age or anything, get your foot on the ground even if it's for 5 minutes a day you know?

1:26:41

And keep in mind that a 5 minute micro walk can be life changing so doesn't take much.

Thank you so much, Courtney.

Appreciate you today.