Best of The Body Pod: Why Foot Strength Is Key to Balance, Power & Aging Well for Women with Dr. Courtney Conley

32:21Typically people that have weak feet, they're very good at curling their toes because that's how they're trying to stabilize themselves. So when I give people a short foot exercise, right, engaging the arch, or if they were doing this, it's like they were just in a boot. They just had surgery. It's a very initial foot rehabilitation phase, if you will. but you got to move away from things that aren't functional and those things aren't functional. Hey guys, it is Ryan for years. Chum has been setting the bar for online social casino fun, and it just keeps getting better with new games released every week and daily bonuses to collect.

33:02The fun never stops. So claim your welcome bonus now at ChumBacasino.com. No purchase necessary. BGW room. Voidware prohibited by law. See terms and conditions. 21 plus. Okay. So there was a, a PT in Boulder. I won't say the name. you may have known it when you were there. Every person that goes in gets an orthotic. Every person, like any person I've ever known that's ever gone to him, orthotic. I've heard you mention that that should not be a lifelong fix. Why? My favorite question is, well, doesn't my arch need support? does anywhere else in your body need support all the time no and in fact this foot was designed to handle many times our body weight when we're walking two three times our body weight going through this foot when you're running there's parts of the foot that take on 11 times your body weight.

34:06It was designed to handle many, many times our body weight in loads and forces. Therefore, when you have a strong foot, it should be able to do those things. The problem is, is that if I take my foot and do this to it, so let's say I'm in a narrow toe box shoe, for example, I've now changed the structure of my foot. So it's not, you don't have toe splay. You don't have force distribution across the forefoot. So feet will get weaker. And then the solution is, well, here's a foot orthotic. I'm not anti-foot orthosis by any means. There is a time and a place when you want to modify load. So for example, if I have someone with acute heel pain, acute plantar fasciitis, fine, put a foot orthosis under there.

35:03Let's deload things, get things to settle down a little bit, but then there's an exit strategy because we're not going to deload your foot forever. It doesn't make any sense. So it's wear this foot orthosis for X amount of time, But while you're doing that, we're going to have the and conversation, which is you're going to be wearing this and you're going to be strengthening your foot and you're going to be loading your hips and you're going to be getting stronger so that we can remove the foot orthosis. Because if not, you keep wearing those things and you will see weakness. What if someone's been wearing them for 20 years without strengthening, strengthening their foot?

35:53What's the exit strategy? What is it? Slow. It's very, very slow. Because the other thing that happens too, is that I think these devices bring some type of comfort, like a comfort, a safety. They're like, I can't, you're telling me I can actually get out of my bed and put my foot on the ground. And I'm like, that's exactly what I'm telling you, but you're going to do it for like five minutes and that's it. And then you build their system and you also build their confidence and their safety because you could give a patient the best exercise on the planet. But if they don't feel safe doing it or they don't trust the process, it's game over.

36:41So I'm just assuming this is the case for other people listening. So I'm going to ask the question, but I have been wearing orthotics just in my workout shoes for running because I used to run marathons and I, it helped some sort of pain in the beginning and my arch would get some pain in there. so now when you're saying all of this part of it I'm thinking okay I can't get out of it when I'm doing it the wrong way because I would just try to go cold turkey and just not have an orthotic in there and then my arches would be killing my foot my ankles so for anyone else listening that's been wearing them for years you just can't go cold turkey and there's nothing wrong with my foot it's just, it's not, it doesn't have the strength that needs.

37:36Is that what your guess would be? That's what, you know, if you were a patient of mine and you said this to me, which I hear all the time, we're not going to go zero to a hundred. So I would ask you, what are the things you like to do? So if you were, if you said to me, I like to strength train that I'm going to say, when you go into the gym, I want five to 10 minutes, take the shoes off. You're going to start doing a couple of exercises with your foot on the ground. If you were a walker and you said, I wear this foot orthosis all the time when I'm walking, I would say the same thing. Take out the orthotic, you're going to get a different pair of shoes and you're going to go walk for five to 10 minutes and you're going to see how your foot feels that night and the next morning.

38:19And then as things start, which they always do, they're like, yeah, it wasn't that bad. Then it's add a little bit more time, add a little bit more time. And eventually what my patients say to me and they always do yeah this does feel better you're right i didn't need this you're right i feel more stable it's just getting over that initial kind of this has been my safety net for so long um i i can't tell you how many patients i have pulled off of their foot orthoses with plantar heel pain because they've been in orthotics for 20 years and i'm not saying they didn't need it initially. But you cannot deload tissue for long periods of time without expecting some type of consequence.

39:07Courtney, you're going to change my life right now. This is so exciting. I know it's life changing. So really to bring it round circle here, it is no different than loading muscles for tissue tolerance for clearing up tendinopathies anywhere else in the body you would start slow with you know an acute phase and then go into loading tissue at the amount that you can handle and building from there no difference i love that like you wouldn't tell someone who's never squatted before to go squat 200 pounds oh but people are trying it that's a good point and so it is it's you know muscle hypertrophy strength takes weeks months that's what i will tell people right in the beginning i'm like this is not gonna happen overnight no you gotta put the time in and i'm talking three months six months a year but if you put the work in and it doesn't have to be a lot it's like just wear this footwear a little bit just start letting your foot feel the ground, the results that you will have on the long end, because I see it from my younger patients to my older patients, when they can put their foot on the ground, the benefits that you get from that outweigh so much.

40:34It is, I want to like scream it from the mountaintops how important this stuff is. So this is like, again, to bring it back to the the strength training of, of what I see. It's so often that, um, looking for a little Hollywood style fun, check out Ryan Seacrest 10 K ways exclusively at Chumba casino. There's 10 ,000 ways to play get spinning for free at Chumba casino.com. No purchase necessary. VGW group void where prohibited by law, CTS and C's 21 plus sponsored by Chumba casino. You know, no one, you're right. No one's looking at the foot and it's like, oh, this is a hip problem. And I'm like, but, but is it, Is it a knee problem truly?

41:13Or is the knee just sandwiched in there because the foot collapses and the hip's not strong enough? So then it's all this like breakdown of the whole kinetic chain down or up of what that looks like. But for someone like I've had clients with halus valgus and halus rigidus. yeah um but the valgus like the toe in there i i don't even know how you can balance but these clients will live in orthotics and just i'm like well if we never build up the foot this isn't you're never getting there if you look at hallux valgus so bunion there's like so much to talk about here it's why i started this because i have two i had a bunion it was very painful But if I have my big toe that's straight, it helps stabilize the arch of my foot.

42:11Yeah. So even if I were to, if I can't splay it actively and I were to put a toe spacer in here, for example, it's going to align the foot better so that I can push off. Now, if I don't do that and I do this, when I go to push off, I have an instability in the foot. So that's when people are like, well, I have to have this orthotic there. Yeah. But if the foot can splay and propel off this position wide and strong, then even with bunions that are flexible, A lot of the times I'll see people come in and the bunions will be rigid. So in other words, it'll start to crop, go under the second toe and it's stiff.

43:01You can't move it. That's a different conversation. Yeah. So that's why early intervention with this stuff is so important. And, you know, here's my, one of my favorite things I hear. Well, my mom has a bunion and my grandma has a bunion. So they're hereditary. I don't care what camp you live in. If you think that they're hereditary or you think that you don't, my question is always think about it from another perspective. If your mom had heart disease, it's the first thing they ask you when they go to the doctor, right? What's your family history? You say, well, my mom has heart disease. And the first thing they tell you is, well, pay attention to your diet, exercise, take preventative measures because you have a genetic predisposition.

43:48It doesn't mean you're not, you have to have it. You just have a predisposition. If you have a predisposition to getting a bunion, then do something about it. Yeah. Take preventative action, right? Wear the right footwear, wear a toe spacer, get strong, strengthen your foot. I feel I'm okay. Now I feel like I have to, I hiked Mont Blanc this year. so I did that in in nine days and I went to REI and I got these shoes and I was like these are the ugliest shoes in the world but they were so wide like my toes could I mean it was almost it took me a while to get used to because there there felt like there was so much space but at the end of that and I was so mad I was like I look like a platypus foot like it's this and like platypus shoes yeah I was like, I'm never wearing the shoes outside of this hike when nobody can see me.

44:45But now I feel like that lady sold me the right shoe. I tell my daughter, smart is sexy, smart and strong is sexy. So when you see women that are, they are aware of what their foot is doing. That to me is sexy because they know it's, they're going to age well. They're going to be able to walk and strength train and move. And that to me is sexy. And I get it. Like we have a battle. Our biggest, my biggest battle is the function over fashion conversation. I cannot even imagine. Because it is, you know, I'll split my, I split my time between here and New York city in Colorado. It's an easier conversation to have in Colorado.

45:27Oh yeah. And I'm like, and these women will come in and they're like, I'm not going to give up my heel. And I'm like, why are you here? Right. And eventually, eventually they do. I have a lot of, you know, 50 and 60 year old women and what I hear all the time, I wish I didn't wear the heels as much as I did when I was younger. Cause when we're in our twenties and thirties, we're like, this is fine. Who cares? You have more time on this planet. You will start to see changes in that foot. And then I will tell you when you have foot pain, It is the one diagnosis in the entire human body that will literally stop you in your tracks.

46:08You can walk with low back pain. You can walk with shoulder pain. You will not walk or move when your foot hurts. And that's when people are like panic. Yeah. Oh, no. What am I going to do? And it's like we have to have these conversations before the panic sets in. So you do do some work for the ankle mobility of really trying to work with that tissue. But that tissue too, I mean, I would say by far more women than not. I would even say, dare I say 90 % that come in, most women that I see just in their 50s just can't squat well. um but again they can if they're like holding on to trx straps and they can offload it but it's that like there's just no move of that forward you know the knee can't drive forward over the over the toes but then we've also been taught that knees shouldn't travel over the toes so there's that whole conversation yeah which drive i'm like sit in a chair walk down a step your knee goes over your foot.

47:21Yeah. You know, I, there are, there's very few, if any, movement patterns that I will tell people, don't do that. It's, we want movement variability, train all the ranges and ankle mobility is so important. It's, you know, when you're walking, for example, it should be this beautiful, like people should be able to walk forever. the foot's a rocker it's literally like you know your heel comes hits the ground your ankle comes over your foot and you roll through your toes and it's this kind of beautiful efficient motion people walk like they're you know it's like a frankenstein gait they're like picking up their foot and dropping it down because they don't have control over their ankle mobility and that's weakness.

48:10That's poor footwear. I mean, wearing a, even an athletic shoe that has an eight millimeter heel to toe drop, which is most running shoes, you know, a lot of running shoes out there. It's not the functional position for the foot, but it sure feels good when you put it on. Cause it makes things easier. Yeah. And you know, nobody gets a free lunch. So you want to wear these shoes that help propel you forward and feel all nice and easy I would certainly challenge the conversation that Drew McIntyre here from WWE wielding the claymore can be a life of chaos when I'm not dominating in the ring Chumba casino is how this warrior takes a wee break with hundreds of online social games and new weekly releases there's always something fresh to try and those daily boosts next level even my free time feels like Valhalla so when life feels like a battle.

49:03Kick up your feet, have some fun, and less Chumba. No purchase necessary. VGW Group, void where prohibited by law, CTs and Cs. 21 Plus, sponsored by Chumba Casino. Too easy is not good. Okay, so for women, again, these midlife women, we know, and maybe this is because of the foot, I'm curious, but we know that plantar fasciitis kind of kicks up in this perimenopausal space. is that only because of the foot or do you feel like the loss of estrogen i mean there's like the musculoskeletal syndrome of menopause that we have you know information on now and there's all of these other like what could it be but that is definitely it's like rotator cuff is one of them um plantar fasciitis do you see it as much in men as women or is it pretty similar that's a good question.

49:58I would love to like do research on the etiology of plantar fasciitis. Like where does it, we know that there's a correlation between foot weakness. So having certain muscles in the foot that get weak, they share loads of the plantar fascia. So if the foot is weak, it can be a predictor of having plantar fascial pain. Increased BMI. So increased weight puts more pressure on the foot, we know that that can be a factor. But I would argue, I think that a lot of this comes from above the foot. I think a lot of it is what the hips are doing, what the pelvis is doing, the control that we have when the foot hits the ground.

50:41So I do see it in both men and women. I always take note of when people say they have it on both sides. So if someone will have heel pain on one side, I kind of put my more biomechanical hat on and say, you know, have they sprained their ankle? Is there weakness? Have they had an, you know, ACL tear? And I go kind of that direction. But if they tell me that they've had heel pain on both sides, you don't have the same injuries on both sides. So you have to start thinking elsewhere. Is this more systemic? Is it hormonal? Is it they have four kids and they were living in a position of changes in their pelvic mechanics that increases loads into their feet?

51:33You know, is it more of a nervous system fight or flight response? But when I see symptoms on both sides, I start thinking much bigger picture. So interesting. So what do you do for someone with like Hallux Rigidus? is that something that you can cure or you just have to work around it so there's kind of different phases of that diagnosis so the big toe should be able to extend you know 65 degrees a little you know some sources would say more in a walking gait cycle you need about 40 to 45 degrees Nice. And it's important. Yeah. Because that's push off. So if you start cheating the system here, so you start to have decreased range of motion here, you're going to still be able to walk forward.

52:29You're just going to find another joint to steal it from. So hallux limitus is when you start to see decreases in ranges. There's a diagnosis called functional hallux limitus, which if you start strengthening certain muscles of the foot, like peroneus longus, for example, that's the guy on this side, right, that stabilizes the big toe, you can really start to stabilize that joint. But if you continue to not use this joint, you will start to creep into hallux rigidus diagnosis, which is this thing's not moving, five to 10 degrees. You have arthritis on the top of the joint. It's literally a joint block.

53:19And those conversations that I have with my patients are very different because you cannot force range out of a joint that you're not going to get it from. So it's now we have shoes that have rockers on them. But I always like to be very hopeful with people when it comes to this stuff. Because I see panic all the time. And I think education calms panic. And the more people know, we can start to think about this. Okay. So even if you have a diagnosis of hallux rigidus and you can't bend your toe, you still have an ankle, you still got a knee, and we still have a hip that we can pay attention to.

54:07if I can't roll through my big toe, people's gait starts looking like this. They start picking up their foot. So now they start to lose range of motion at the ankle. So we start working heavy on ankle mobility, for example. I'll pay attention to hip extension. So I just pay very close attention to the joints we still have access to because we just lost one of our friends. We didn't lose the rest of the kinetic chain. so there's always ways but those are the conversations that need to be had is just because this has happened have hope because if we do the right things we can still you know keep you going here so for the shoes you mentioned like that do you have names of shoes or is that like a no no that you can't say the names of some that that are i mean everyone will be like well what shoe do I wear now if I have to wear a shoe and I can't go, you know, in socks in the gym, which I actually got in trouble for at a Marriott once.

55:09I was like, who's looking at the hotel? There's two people in here. Why are you using the security cameras to zoom in if I have shoes on? But anyhow, what would the shoes be? Yeah. So, you know, that's such a great question of every podcast I ever do. That's always like the number one topic. What shoe should I wear? In my book, I've defined kind of two different types of footwear. So we have functional footwear and we have minimal footwear. All minimal footwear is functional. All functional footwear is not minimal. So I'll define the two for you. Functional footwear allows your foot to be in its functional position.

55:53So wide toe box is my non-negotiable. So, companies like Ultra Running, they're one of my favorites. Topo Athletic, Notice, those guys live in the functional shoe kind of conversation because they still have a low to zero drop, six millimeters or below. And if you look at research, that's where they'll say functional footwear lives, six millimeters or below. But they'll still have some pretty decent cushion on them. So for people who are new to this conversation, I always say, start over here. Get yourself in a wide toe box shoe. If you have poor ankle mobility, put yourself in a four millimeter drop.

56:42put yourself match the cushion that you have on your shoe and start wearing the shoe as your foot gets stronger now we have the conversation of spending time in minimal footwear which is wide toe box zero drop in very thin and flexible sole if you are wearing minimal footwear this is a hard environment for your foot and ankle you have to work a lot harder the muscles are working harder you have to have better range of motion will you get stronger in minimal footwear yes if you jump the gun and go i'm going to wear this minimal footwear 100 % of the time and i have weak feet will you run into problems probably okay so topo designs that was the shoe that was my shoe that i wore on your hike so that one gets and then ultra is um Is that Stuart McMillan's company?

57:41Or is he one of them? Golden Harper and Brian Beck said started Ultra. Ultra. Okay. And they like, they're some of my favorites for my patients because I see people that have had foot pain, their feet are not very strong. So, you know, we have a shoe spectrum. So I'll say, when you're going on your longer walks, you're going to wear this ultra, for example, that has a wide toe box, maybe a four millimeter drop so that they can still keep their cardiovascular. I still want them moving. Yeah. And then I'll say, here's a minimal shoe like Vivo Barefoot, for example, or Zero. And I'll say, wear the shoe for like five to ten minutes a day.

58:25And so then we can kind of play along the spectrum. but you don't have to be a hundred percent in minimal shoes all the time. And you certainly don't want to be a hundred percent in, you know, traditional footwear all the time. You have to dance. You have to know when to wear what. Yeah. Okay. So if we were to create or you were to create what you have, you have the little toe box, the toe, the toe box that has, so let's talk about what's in there and then what would your what do you do um every day if you if someone doesn't have any outstanding issues that they know of i'm just curious what does your routine look like one of the reasons i we designed that foot health kit was because i know it's another thing you know it's like we have one more thing we have to do so i wanted it to be easy for people so toe spacers are a huge thing i wear those every single day all day long they're in my slippers right now um it's just an easy thing you can do like around your house um there's toe strengtheners so my the reason i designed those my daughter was a rock climber when she was younger and she was up in her room one day and she had the rubber bands around her fingers and she was like sitting there as she was reading doing her like and i was like man i'm like there needs to be one of those for the foot.

59:48So that's all I did. I just designed one for the foot. So when you're sitting at your desk, you can wear them around your toes and you just sit there and spread your toes. You're engaging the muscles of your foot. Easy. There's a ball in there. Remember all those receptors. You just want to wake them up. You're not trying to, you know, dig into the heel. Don't do that if you have heel pain, by the way. My patients do that. They're like it hurts right here. So they'll take the ball and try to stay on the meaty part of the foot. Cause there's a bunch of nerves. Okay. Um, but you can sit there and roll your foot, um, a band, you can like do banded toe exercises.

1:00:25So like, I'll be sitting here on a zoom call. I have a four hour zoom call tomorrow. I'm in a moment to do anxiety. My room schedules these things. Um, but I'll sit there on that call and I will be exercising my big toe on that call. And those are all like little things that you can do that I do daily. And then I'm in the gym two to three times a week, strength training. My shoes are off. When I do things like deadlifts, I'm always loading, you know, I'm loading my midfoot. I'm pushing through the ground. I'm doing some type of calf work. And then plyo, you got to train the spring of the foot.

1:01:08And I think we forget that power piece. I think that's important. But, you know, for those, you know, listeners who are already in the gym, just add in a little bit of this stuff. It will go so far. Well, like you said at the very beginning of this podcast, just changing your shoe and doing that for, what did you say, six months will change your foot 50 %? Yes. You can increase your foot strength. It's like a no-brainer to me. It really is. And it takes time. And I tell my patients, you're going to have days like these, like, you know, good and bad days. But as long as that trajectory keeps going up, there is nothing more powerful and or sexy when your foot hits the ground and you have strength and power because your feet will literally carry you well into your, you know, later decades.

1:02:06But If you do not have that power from the ground up, you just pick a diagnosis. Well, I'm starting today. Me too. I'm ordering the foot box. As soon as I get off this, I'm getting the foot box. I think it will be a great giveaway for my current group. I need some giveaways. So I'll be purchasing some. Um, so, okay. In closing, Courtney, um, where can people buy any of your products, the foot box, um, anything and how, and where do they find you? Um, gate happens G A I T. Um, so that is our kind of platform. So that's on Instagram and Facebook and YouTube. We have a lot of free resources, by the way, on YouTube, we have exercises, um, how the, we've talked about the pelvic floor exercises on the relationship between pelvic floor and the feet our entire instagram account are like exercises and ways to help people on our website we have kind of two platforms so for the layperson who just wants to get their feet stronger there's 12-week programs for you there's foot health kits and then for people that are more movement professionals they want to like work with their clients there's other resources to get certified in gait assessment and things like that.

1:03:28But, you know, I wanted it to be easy and accessible and I wanted people to, you know, have, have fun with this stuff. Like it's, it really is, um, a part of our bodies that is so often overlooked and it doesn't have to be. Yeah. Wow. Okay. Well, Laura and I are both we're going to do it on our next podcast that's going to be our mission that we're doing it while we're on our next podcast i look forward to seeing that thank you so much courtney for your time and your education and just i we're totally vibing with your personality you are really fun to interview and to to have on so thank you for your time thank you both so much Thanks for listening, everyone.

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