In short
Foot health as the foundation for strength, balance, ankle mobility, and fall prevention in midlife women; how footwear, toe alignment, and calf/soleus training affect power and longevity.
Guest background
Dr. Courtney Conley is a foot-focused clinician and movement specialist. She was a ballet dancer and triathlete, with a personal history of foot pain (bunions, neuromas), and built her practice around strengthening and resilience rather than “orthotic then surgery” escalation.
Key claims
Weak feet/ankles limit power and reduce load tolerance (“house on sand”). Cushioning under the foot interferes with sensory receptors needed for balance; thin, flexible, wide toe-box footwear improves foot strength. Toe deformities (bunions/hammer toes) increase fall risk. After ~50, foot sensory sensitivity drops; exercise increases nerve fiber branching. Orthotics should be time-limited with an “exit strategy,” not lifelong.
Notable examples
Back squat depth improves when ankle mobility improves; toe spacers help restore toe width; seated calf raises target soleus; short-foot “marble/towel gripping” is discouraged as nonfunctional; hallux rigidus requires working remaining joints (ankle/hip) rather than forcing toe range.
Written by AI. May contain mistakes. Listen to the episode to check what was said.
Chapters
Tap a time to open that second in VODr. Conley's Journey to Foot Health
0:00 to 0:19
Dr. Courtney Conley shares her background and passion for foot health.
“What's going on everyone, it's Bluff here and you know what's more American than America's 250th birthday?”
Dr. Conley's Journey to Foot Health
1:15 to 2:15
Dr. Courtney Conley shares her background and passion for foot health.
“Courtney Conley, we're so excited to have you here.”
The Importance of Foot Health in Strength Training
2:16 to 4:39
Discussion on how foot health impacts overall strength and stability in midlife women.
“Yeah, it's really, I think it's really interesting because, you know, people think, oh, she's into feet.”
Effects of High Heels on Foot Health
4:40 to 6:32
Exploration of how wearing high heels affects mobility and strength in women.
“So they can, um, it's, it's a very close, close real estate in the brain.”
The Role of Shoes in Strength Training
6:33 to 10:17
Insights into how footwear choices affect balance, stability, and strength training performance.
“Well, well, better now than I did in my 30s.”
Identifying Foot Problems Through Observation
10:18 to 12:40
Understanding how to identify foot abnormalities and their implications on health.
“So in other words, if I wanted to see if my knee was going through abnormal loads, I'd have to take an x-ray, right?”
Training the Soleus and Foot for Power
12:41 to 14:00
Dr. Conley emphasizes the importance of training the soleus muscle for strength and power.
“I'm not saying you have to throw your shoes away.”
The Importance of Foot Power Training
14:00 to 16:43
Learn the significance of power and speed training for foot health as we age.
“It's training with, and a lot of that speed and power comes from below the knee.”
Home Exercises for Foot Strengthening
17:44 to 21:04
Explore effective exercises for improving foot strength and balance at home.
“You know, if you're jumping into, jumping and some of these power programs, if you haven't done the preliminary drills, that can be seen as really, you know, not as fun, a little bit more boring.”
The Impact of Aging on Foot Sensitivity
21:04 to 24:32
Understand how aging affects foot sensitivity and the importance of sensory feedback.
“When we turn 50, all those receptors I was talking about on the bottoms of the feet.”
Show all 22 chapters
Hormonal Influence on Foot Mechanics
24:32 to 27:44
Learn the relationship between hormonal changes and foot mechanics in women.
“There is a direct correlation between your pelvis and your feet.”
Daily Foot Care Routine
27:44 to 28:00
Discover the importance of a daily foot care routine for overall foot health.
“So with the exercises that you said, if we do the toe spacers, we have toe yoga, we have some of these, the seated calf raise, any kind of calf raise, anterior tip.”
Daily Foot Health Routine
28:00 to 33:37
Learn about the importance of a consistent foot health routine for overall mobility.
“I mean, I feel like that usually gets lost too.”
Managing Orthotic Use
34:26 to 38:28
Understand the appropriate use of orthotics and building foot strength.
“So for example, if I have someone with acute heel pain, acute plantar fasciitis, fine, put a foot orthosis under there.”
Foot Health and Kinetic Chain
38:28 to 42:00
Explore the relationship between foot health and overall body mechanics.
“plantar heel pain because they've been in orthotics for 20 years.”
Understanding Foot Problems and Their Impact
42:00 to 45:00
Learn about how foot issues like bunions and structural weaknesses affect overall mobility and strength.
“And it's like, oh, this is a hip problem.”
Foot Pain and Its Broader Implications
45:00 to 48:20
Discover how foot pain can stem from broader body mechanics and how these issues are often interlinked with other health concerns.
“Like my toes could, I mean, it was almost, it took me a while to get used to it.”
Foot Pain and Its Broader Implications
52:03 to 53:04
Discover how foot pain can stem from broader body mechanics and how these issues are often interlinked with other health concerns.
“Finding great candidates to hire can be like, well, trying to find a needle in a haystack.”
Managing Hallux Rigidus and Its Effects
53:04 to 56:00
Explore treatment options and management strategies for Hallux Rigidus and how to maintain mobility despite joint restrictions.
“but if they tell me that they've had heel pain on both sides, you don't have the same injuries on both sides.”
Understanding Foot Health and Footwear Choices
56:00 to 1:04:24
Learn about the importance of foot health, ankle mobility, and the right footwear for strength and longevity.
“If I can't roll through my big toe, people's gait starts looking like this.”
Promoting Foot Health Products and Resources
1:04:24 to 1:06:11
Explore the different resources available for improving foot health and strength, including products and programs.
“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?”
Promoting Foot Health Products and Resources
1:06:24 to 1:06:52
Explore the different resources available for improving foot health and strength, including products and programs.
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Transcript
Automatic transcript. May contain errors.0:00What's going on everyone, it's Bluff here and you know what's more American than America's 250th birthday? Supporting American-owned companies like SpinQuest, America's number one social casino with over a thousand games like Live Dealer Blackjack and Craps. They're offering new users a$30 coin package for just$10. Go to SpinQuest.com and sign up today. SpinQuest is a free-to-play social casino. Void where prohibited. Visit SpinQuest.com for more details. Quality proteins aren't just for special occasions. With Omaha Steaks, you get mouth-watering proteins delivered right to your door. Individually packaged and portioned, so a great dinner is just minutes away.
0:42From Taco Tuesday to a weekend feast. Taste the Omaha Steaks difference. Start getting flavorful proteins delivered today. Visit omahasteaks.com and get$35 off with promo code AUDIO at checkout. That's omahasteaks.com, code A-U-D-I-O. Terms apply. See site for details. Hi, everyone. My name is Haley. And this is Laura. And welcome to The Body Pod.
1:14Dr. Courtney Conley, we're so excited to have you here. This has been, we've been counting down for this. So we've had these questions for a long time, and we're just stoked that it's finally time to hear from you. So welcome. Thank you so much. So Courtney, as we were just saying offline, we're both in Colorado, which I feel like is the greatest state in the United States. We'll see. We'll see if everyone else says that, but, but I love it. I'm, I'm, uh, I was just mentioning, I wish I could come into your clinic because this is fascinating. And as I've been, I was actually introduced to you a couple of years from a mentor of mine who actually lives in Sydney.
1:58And he was like, Haley, why haven't you? Well, first of all, her company is Gate Happens and you're Haley Happens. What's going on here? It's like, I got to meet this lady. I got to meet this lady. So how did you, what sparked your passion? I'm always curious about people that work with the feet or that are just interested in the feet. how did you come to that? Yeah, it's really, I think it's really interesting because, you know, people think, oh, she's into feet. It's kind of weird. I mean, I have, I like to say I have a healthy obsession with the foot, healthy. I have always been fascinated by human movement, and it's been kind of a passion of mine since I've been a, since I was very young.
2:42I was a ballet dancer and then I was a triathlete and my biggest Achilles heel, if you will, had always been foot pain. I had, you know, bunions and neuromas and everything kind of under the sun. And so I think with anything that you become passionate about, it becomes this personal quest of how can I help myself? Because I had to stay moving. I knew that surgeries and that going down that route was not going to be the way. So that's kind of what got me interested in all of this. I went to school and we really didn't get what I was looking for. It was more of treating the foot very differently than we treat the rest of the human body.
3:26So for example, it was if someone's foot hurts, here's a foot orthosis. And if it hurts worse, here's surgery. But we don't have those conversations with other parts of the body, say your low back, the first go-to isn't, well, wear this brace. And then if it doesn't work worse, go get surgery. It's how can we make you stronger? How can we make you more resilient as a human being? And that's what I really wanted to do from a foot perspective. Okay. I love that because the only, the, the, the people, the only people I've ever had to block on Instagram are people that are obsessed with the feet. Well, if you saw the messages that we get, you might, um, that number, that count might be higher.
4:09I don't understand. I don't understand it. I understand what you just said about the, the foot and being interested in it, but that that's a whole other topic. I just think it's funny because I'm like, where did these people come? Where do they come from? Where do they come from? But anyhow, if you were to look at the homunculus, which is like the mapping of the brain. Yeah. The foot area and the genitalia area are right next to each other. Is that why people have these sexual foot fetishes? So they can, um, it's, it's a very close, close real estate in the brain. So when people say they have a foot fetish, there is some science behind some of that.
4:51Okay. I'm like, wow. She's like, we're done. That's all I need to do. I could be making a lot of money if I didn't block these rules. I wanted to share my feet, but I'm like, this is funny. Okay. So I have so many questions and what we really want to focus on today is obviously midlife women. So that's our whole demographic. And from the strength, if we start from the strength world, because this has been something that I've seen from the, from the get go in strength training is this, um, you know, again, my mentor was really big into training the foot stabilizers and working out barefoot or in socks or, you know, a minimal issue so that, um, when I see women in this 35, 40 plus and older age range, the, the lack of ankle mobility and, um, you know, the, the weak soleus muscle, it's always the soleus and the anterior tip.
5:58It's these two exercises that nobody ever wants to do amongst others, but from women wearing high heels, most women coming in are like, everyone's worn high heels and they, it's, it's really messed them up. So I see that in like the back squat where There's just no movement at all. But if I put them in, say, like a hack squat or a pendulum, like they can get all the way down into that. So why is that is that for, you know, women and men? Is it more common in women? Does it creep up in midlife? I think I'm about I'm turning 50 next year. So I'm kind of right in this kind of. Yes. And I do feel better now than I did.
6:42Well, well, better now than I did in my 30s. And I truly attribute a lot of that to the strength training that I have done so much more recently, but also getting stronger from the ground up. The foundation that you build yourself on, it's like building a house on sand if your foot and ankle are weak. You can't create significant power. You're unstable on your foot and therefore the amount of loads that you can actually lift decrease. So I think it's very, very important. You bring up a lot of good points there, especially when we look at the gym, like strength training in the gym. I see people all the time and I have to keep my mouth shut because it's hard.
7:28But if I was going to squat, if I was going to do a back squat with 200 pounds, would it make sense to do that on a strong, stable platform or on a pillow? yeah it's not a trick question right so if i'm on a highly cushioned shoe for example trying to lift something heavy it's going to make it more difficult for when you say it that way it's like a no-brainer it's like why are we yes and you know people will be like well i can't you know i work in an environment where I'm standing on concrete. There's a different shoe for each task. We're talking about strength training here. So when I'm carrying heavy loads or I'm trying to lift or push something heavy, your foot has to feel.
8:20That's what's so beautiful about the foot. I'm going to introduce Eddie. Yes, we love Eddie. Eddie, hi. There's thousands of receptors on the bottoms of our feet. and they basically give us information on how we should be moving. How stable are we? Where is our balance? Where is our center of pressure? So when we start interfering with that by putting a bunch of cushion underneath the foot, you're really making it harder on yourself and you're really changing the loads that are going through the rest of the system. I really think it's a it's a no brainer conversation. And if we want to start with anything, put your foot on the ground when you're in the gym.
9:03So you're a big fan of no shoes then. So no socks and shoes or just no. No, it depends on what kind of gym you work in. But if you have a minimal, if you can't take your shoes off, having a minimal shoe and the research is kind of iffy on that. So I always say, if you can get something below like 14 millimeters, which is thin and flexible, you're going to have better sensory acuity, but the footwear is going in the wrong direction because everything is going thicker and more cushion and more toe spring. And, you know, that's not what you want to be lifting heavy weights in. No. So when somebody comes into you and you're, you're checking this for whatever, maybe they, whatever they're presenting their issue with, can you tell right away if someone has been wearing like high heels for a good majority of, or is it pretty much an issue, not just a high heel?
10:08I mean, I think the most beautiful thing about the foot is it's the only place in the human body where you can look at it and see a barren load. So in other words, if I wanted to see if my knee was going through abnormal loads, I'd have to take an x-ray, right? Or an MRI. But all you have to do is look down at your foot. The widest part of your foot, from an anatomical perspective, should be your toes. So if you were to look down at your foot, the toes should carry the width. Not the ball of the foot, the actual toes. So when you look down at your foot, most people's feet look like a shoe. Yeah.
10:53My patients come in and their toes are the most narrow part of their foot. It almost looks like they've shoved their foot into a high heel for years. So you can immediately tell. And when women especially form things like bunions or hammer toes, it's not just a conversation of aesthetics. we know from a research perspective that when you have abnormalities or forefoot deformities like a bunion or a hammer toe it affects things like balance and increases your risk of falls so those are the conversations that i think we need to be having not just you know my foot doesn't look good it's you're going to have an issue with a lot from a longevity perspective, if your balance sucks and you're going to increase your risk of falls, that's not what we want to do.
11:48So our toe separators, that's one of the main things that they are helping achieve is to get that the widest part. It brings the toes into alignment so that you can start to engage the foot better. I am a big fan of them. They've helped me tremendously. I wear them all day long. The only time I don't wear them is when I'm sleeping, but you have to be careful that you're wearing them in the right type of footwear. If you're not like wearing them at home barefoot, because 95 % of the footwear out there has the width in the wrong part of the shoe. So even wide shoes are very different than wide toe box shoes.
12:32Wide shoes are here. A wide toe box extends into the width of the toes. And, you know, I know there's a lot of, you know, women listening to this. I'm not saying you have to throw your shoes away. I'm just saying, think about it from a, you know, 24 hour shoe clock. If you're going out to dinner or you're going and you want to wear your heels. Great. But for the rest of, for the beginning of the day, or when you get home, put on a pair of toe spacers, walk around barefoot, put on a shoe that allows your foot to splay a little bit. You just can't be in restrictive footwear that's compromising the function of the foot all day long.
13:15Yeah. So if they're, if they're coming in and, and this is an issue and you're, what are the muscles that are really being, because I know that you're big on the soleus too. And that's so hard because I feel like there's not more gyms. I always put these into my programs, the seated calf raise for that reason. It's really hard to mimic if you don't have a seated calf raise machine, but they're not as, they're just not as available as the standing calf raise at most gyms. Most gyms have that if they have one of the two, but the seated it's, you know, it's just not as used or it's empty when you go to a gym.
13:56I never have to fight. I'm like, this should be the longest line in the gym should be behind the seated calf raise. Yes, yes, exactly. Okay. So if you're looking at that, tell us why when you think of propulsion or power which you know as we age we know we have sarcopenia so we lose strength but we actually lose power faster than we lose strength and i think that's a problem i think we're getting the strength training conversation out there i'm not getting the power conversation out there, which is different types of training. It's training with speed. It's training with, and a lot of that speed and power comes from below the knee.
14:43Yeah. So it's being able to produce this power. And that's why I think training the soleus, training the foot is so very important. And doing a seated calf raise, almost like focuses, makes it like it's a more focused exercise. Yes. It takes, when you drop the knee or flex the knee greater than 60 degrees, you can really target the soleus. And there's some research out there that would say, well, you're still getting hypertrophy doing a standing leg calf raise into both tissues, which you are, but in a seated calf raise, you can actually go into a deficit there and you can really lengthen the soleus.
15:26And I think that's important. I think calf variability. So standing seated, you know, whatever you can do. Sometimes my patients that can't do a single leg calf raise, we'll start them on their backs doing a calf raise up against the wall, which is incredibly difficult actually. So there's always ways to modify. I never say can't. it's how can we modify this so that you can start to load these tissues appropriately okay so tissue loading because that is um i feel like i i'm preaching from the the rooftops all the time because with the heavy loading conversation same thing with the foot it's like okay i hear this now i'm gonna go do it and those tissues are going to be the first thing that start chatting.
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17:44Terms apply. See site for details. You know, if you're jumping into, jumping and some of these power programs, if you haven't done the preliminary drills, that can be seen as really, you know, not as fun, a little bit more boring. But where does how long would you say if somebody came in and they had this what you see every day in this? The feet that look like a shoe is still on it. And you start there. What is like the basic treatment that you would do that someone could do? because I'm trying to foresee the questions of great Haley. Now we have to strength train. We have to do cardio. We have to do mobility work.
18:30And now you're adding on, you know, toast. What would like the top three be the top three exercises be if somebody was just at home and they're not going to go in and see someone, but they, they want to work on some of these. Yeah. I I've thought about this quite a bit because, you know, as women like perimenopausal women, it's like, we have one more thing now, you know, now we have to strengthen my big toe is what you're telling me. I'm like, yes. If you look at, there's really cool research looking at if someone wore a minimal shoe, which is a thin and flexible sole, it's a zero drop. So the heel and the toe sit on the same plane and basically it's anatomically shaped.
19:19If someone wore that shoe for six months, you can increase the strength of your foot greater than 50%.
19:29So I tell my patients, if you do nothing but just wear the right footwear as much as you can, you're moving in the right direction. And then if you wanted to add in a couple things, the toes have to be able to splay. So that's like number one. So you either wear a toe spacer, you do things like, you know, when I'm at my desk right now, I'm like lifting all of my toes, I'm spreading them, I'm reaching them forward. You have to have that foot awareness first. But then just like you said, any type of propulsion, like a calf raise, when the heel comes off the ground, that's when the intrinsic muscles of the foot come to the party.
20:15So if you wanted to increase loads, sled pushes, any type of calf raise, I mean, the foot can push. So we need to let it do that. So it depends on where you are in that spectrum. If your foot's really weak, you work on just toe splay and things like that. But if you're in the gym and you're already loading your foot, load it.
20:42okay so then we have balancing to go along with that and we have if we if we focus on what you said earlier of fall prevention because that's the number one fear of a lot of women over i would say over 60 in 40s and 50s you're still kind of like oh yeah i see that but that's so far away um in reality it might not be so far away but if we look at fall prevention then we obviously have to have some muscle to help there where does the foot come in to play with that if you when we think about what prevents us from falling there's a lot of factors but i'm a foot person so i'm always like thinking about the relationship between fall risk and foot in the foot.
21:33When we turn 50, all those receptors I was talking about on the bottoms of the feet. Yeah. When you turn 50, you lose sensitivity to those receptors. So in other words, it takes 25 % more pressure to stimulate these receptors in your feet. So you lose sensitivity. When you turn 80, it takes 75 % more. So the sensitivity of our feet goes down and it goes down rapidly the older we get. So we can't feel things. And you couple that with sarcopenia. Sarcopenia happens in the foot too. You lose muscle strength. So now you can't feel and now you don't have strength. So if you were to stand up, keeping your feet on the ground and lean forward, what you should feel is your toes pressing into the floor to help give you feedback.
22:41Hey, don't go that way. You better step back a little bit. So if you don't have the strength in your toes and you certainly can't feel them, where do you think you're going to go? Yeah. You're going to fall. And then our solution is, well, my foot hurts. So I'm going to go, let me go put a shoe on. That's going to make me feel less. It makes absolute zero sense to me. So is there anything you can do to help decrease the risk or decrease the receptors losing? it's a great question the one thing we know of that increases sensory nerve fiber branching is exercise so just like we would exercise our glutes we can exercise our feet so when we do exercises for our feet whether that's balancing whether that's toe exercises calf raises, all those things count.
23:43You're increasing circulation, you're increasing nerve fiber branching, which helps with sensation and strength. I think it's a very important conversation because it doesn't take much. Most people don't think about their foot like they think about, you know, strengthening their hips. And I will tell you, the stronger your foot gets, the stronger you'll be able to load your hip. I mean, that information you just shared with us, the statistics, I mean, you told women those statistics, I think that'd be way more apt to wanting, like making those exercises important. I now I'm like, I can't miss the feet so how what role does estrogen play does that play a role in the receptors of losing those as we you know lose estrogen i mean if you the majority of the people that i treat are women of our age and you do start to see changes globally in the system i think what's really interesting when we talk about hormonal changes and what happens with our pelvis and our pelvic mechanics.
25:05There is a direct correlation between your pelvis and your feet. Especially when there was a really cool study that looked at strength of the big toe, so flexor hallucis longus. And there was synergistic muscle activity of the pelvic floor. those two guys work together. What? Yes. Wow. Did not know that. So when I see bilateral symptoms or women going through perimenopause and you start to see these hormonal changes, shame on me if I'm not addressing what's happening at their pelvis and what's happening at their feet, because it all goes together. And I think we all know this, that our response when our, you know, nervous systems go into, you know, fight or flight, high stress.
25:58When we get tense, you can feel like, you know, the pelvis contract, right? Gone are the days of telling women to like do a bunch of Kegels, right? It's like, relax, try to relax your pelvic floor. When you see someone in that high stress state, you will also see it at their feet because their feet look like they're these high arch stiff kind of. And it's like, I'm telling my patients all day long, chill, chill, let your pelvis relax. Let your pelvic floor musculature relax. Let your foot relax because there is a massive connection with all of that. So do you have an opinion? And I know this is a, there's a lot of different ways that could go, but about hormone therapy, does this help with anything that you see specifically, or is it really just individual?
26:52Maybe, maybe not. I think it's individual. I think with everything, it's context dependent and individual specific. I will say personally, it was a game changer for me when I started going down that road of like exploring my hormones and it all, you know, there's this big umbrella of wellness, right so we have hormones and strength and mental and emotional health and I think the conversation of you know our health from the ground up should be included in all of that and so I can only speak from my personal experience and what I've seen with my patients that yes when we balance all of that and that includes hormone replacement I have seen better results across the board.
27:44People feel better. Yeah. So with the exercises that you said, if we do the toe spacers, we have toe yoga, we have some of these, the seated calf raise, any kind of calf raise, anterior tip. I mean, I feel like that usually gets lost too. That's a forgotten one. But if we look at this, like how many times a week, I know from mobility, just in general, general mobility, spine, hip, whatever, that it really tanks, even the ankle that it, you can't just do it once a week for a few minutes and then be like, I'm good. I checked that off. I did it once a week. Does it have to be, is it better multiple days every day, maybe five minutes?
28:31What, what would that look like? I think if you were doing like a daily foot routine, it's a couple minutes a day. You know, if you were wearing your, if you were walking barefoot around your house. Now, I think the conversation is important that there's transition. You know, during COVID, for example, there were a lot of articles that came out that walking around barefoot at home is very bad because people were getting heel pain and they were getting all these symptoms. And I'm like, they're explaining it incorrectly. It's not that walking around barefoot is bad. It's that people have really weak feet.
29:05And then they chose to walk around barefoot all the time. Most of us have weak feet because of the footwear that we've been in and the fact that we don't pay attention to them. So things like walking around barefoot are great. If you have weak feet, you start small. It's like five, 10 minutes a day, get your foot on the ground. If you're used to that, then like I said, you can be in the gym. And I usually tell my patients about two to three times a week, I want some type of calf work done. Add it into your leg day. You know, soleus is slower twitch fibers. We can train that guy a little bit more.
29:44So we can do that more consistently. So I like about two to three times a week from loading the lower from the knee down. And then daily, you're like walking around barefoot. You can wear toe spacers, just, you know, moving your toes around. What about the short foot muscles, like the grabbing the, with the arch, grabbing the dish towel or something like that, or the ball under the foot just to kind of do that? The picking up marbles concept and like, you know, squeezing a towel. I usually tell my patients not to do that. And here's why. If you think of the walking gait cycle, when you're walking, our toes don't do this, or they shouldn't.
30:37They shouldn't be gripping the ground. You're rolling the earth away when you're walking. So it's an eccentric strength. It's a lengthening of the foot. typically 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.
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31:21Okay. So there was a PT in Boulder. I won't say the name. You may have told it when you were there. Every person that goes in gets a 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, to 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.
32:17It 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
33:13by load.
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34:12The needle in the haystack. See why four out of five employers who post a job on ZipRecruiter get a quality candidate within the first day. ZipRecruiter, the smartest way to hire. And right now, you can try ZipRecruiter for free. That's right, free at ZipRecruiter.com slash zip. That's ZipRecruiter.com slash zip. ziprecruiter.com slash zip. So for example, if I have someone with acute heel pain, acute plantar fasciitis, fine, put a foot orthosis under there. Let'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.
34:55It 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? What'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.
35:54They'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. So 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.
36:47so 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. Is 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.
37:29So 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.
38:00And 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. 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.
38:47Courtney, you're going to change my life right now. This is so exciting. I know it's life changing. So really to, to, 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's muscle hypertrophy.
39:38Strength takes weeks, months. That's what I will tell people right in the beginning. I'm like, this is not going to happen overnight. No. You got to put the time in. And I'm talking three months, six months, a year. Hey, everybody. Lady Luck here. And we're celebrating America's 250th birthday. Now, all summer long, I'm going to be celebrating by playing on SpinQuest.com, which is an American-owned social casino. It obviously features over a thousand slot games and live blackjack, live craps, live bubble craps. Head on over to SpinQuest.com. Get yourself a$30 coin pack for just$10. SpinQuest is a free-to-play social casino.
40:19Void where prohibited. Visit SpinQuest.com for more details. Warning, the following ZipRecruiter radio spot you are about to hear is going to be filled with F-words. When you're hiring, we at ZipRecruiter know you can feel frustrated, forlorn even, like your efforts are futile. And you can spend a fortune trying to find fabulous people, only to get flooded with candidates who are just fine. F***! Fortunately, ZipRecruiter figured out how to fix all that. And right now, you can try ZipRecruiter for free at ZipRecruiter.com slash zip. With ZipRecruiter, you can forget your frustrations because we find the right people for your roles fast, which is our absolute favorite F word.
40:58In fact, four out of five employers who post on ZipRecruiter get a quality candidate within the first day. Fantastic. So whether you need to hire four, 40 or 400 people, get ready to meet first rate talent. Just go to ZipRecruiter.com slash zip to try ZipRecruiter for free. Don't forget that's ZipRecruiter.com slash zip. Finally, that's ZipRecruiter.com slash zip. 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.
41:45It 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 strength training of what I see, it's so often that, 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 is it? Is it a knee problem, truly? Or 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 Hallis Valgus and Hallis Rigidus.
42:30But the Valgus, like the toe in there, 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, um, have my big toe that's straight, it helps stabilize the arch of my foot. Yeah. 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.
43:20Now, 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 you 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?
44:27What'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. It 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 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.
45:20Like my toes could, I mean, it was almost, it took me a while to get used to it. Cause there, 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 shoes. Yeah. I was like, I'm never wearing the shoes outside of this hike when nobody can see me. But now I feel like the 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.
46:01And that to me is sexy. And I get it. Like we have a battle. My biggest battle is the function over fashion conversation. I cannot even imagine. Because it is, you know, I split my time between here and New York City in Colorado. It's an easier conversation to have in Colorado. Oh, 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. why 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 because when we're in our 20s and 30s 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.
47:03You 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, um, with the for the ankle mobility of really trying to work with that tissue but that tissue too i i mean i would say by far more women than not i would i would even say dare i say 90 percent 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 onto TRX straps and they can offload it, but it's that like, there's just no move of that forward.
47:58You 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. I'm like, sit in a chair, walk down a step, your knee goes over your foot. yeah 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.
48:47And 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. That'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 because it makes things easier. Yeah. And you know, nobody gets a free lunch.
49:27So you want to wear these shoes that help propel you forward and feel all nice and easy. I would certainly challenge the conversation that too easy is not good. Okay. So for women, again, and these midlife women, we know, and maybe this is because of the foot. I'm curious, but we, 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.
50:14Um, plantar fasciitis. Do you see it as much in men as women or is it pretty similar? That's a good question. I would love to like do research on the etiology of plantar fasciitis. Like where does it, we know that there's a correlation between 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.
50:57I 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. So 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 ACL tear? Hanging out at the pool is great. Relaxing and playing Vegas style games on my phone at the same time. Drinking one hand and a blackjack in the other. It's all at SpinQuest. Over a thousand games, including your favorite slots and table games.
51:50Be cool with this summer special. New players get$30 coin packs for 10 at spinquest.com. SpinQuest is a free-to-play social casino. Avoid where prohibited. Visit spinquest.com for more details. Finding great candidates to hire can be like, well, trying to find a needle in a haystack. Sure, you can post your job to some job board, but then all you can do is hope the right person comes along. which is why you should try ZipRecruiter for free at ZipRecruiter.com slash zip. ZipRecruiter doesn't depend on candidates finding you. It finds them for you. Its powerful technology identifies people with the right experience and actively invites them to apply to your job.
52:32You get qualified candidates fast. So while other companies might deliver a lot of hay, ZipRecruiter finds you what you're looking for. The needle in the haystack. See why four out of five employers who post a job on ZipRecruiter get a quality candidate within the first day. ZipRecruiter, the smartest way to hire. And right now, you can try ZipRecruiter for free. That's right, free at ZipRecruiter.com slash zip. That's ZipRecruiter.com slash zip. ZipRecruiter.com slash zip. 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.
53:12So you have to start thinking elsewhere. Is this more systemic? Is it hormonal? Is it, did they have four kids and they were living in a position of changes in their pelvic mechanics that increases loads into their feet? You 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.
54:10And it's important 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, you'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.
55:07You have arthritis on the top of the joint. There's, it's literally a joint block. And 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, you know, 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. Mm-hmm. 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.
56:02If 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.
56:45So for the shoes, you mentioned like the, 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. I 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 shoes should I wear?
57:23In 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. So 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.
58:23So 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, put yourself, match the cushion that you have on your shoe and start wearing this 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.
59:10Will you get stronger in minimal footwear? Yes. If you jump the gun and go, I'm going to wear this minimal footwear a hundred percent 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 me. And then Ultra is, is that Stuart McMillan's company? Or is he one of them? Walton Harper and Brian Beck said started ultra ultra. And they like, there are some of my favorites for my patients because I see people that have, have had foot pain, their feet are not very strong. So, you know, we have a shoe spectrum.
59:55So 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 10 minutes a day. And 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.
1:00:32You 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 you, what do you do 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 we designed that foot health kit was because I know it's another thing. 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.
1:01:16I wear those every single day, all day long. They're in my slippers right now. It's just an easy thing you can do like around your house. 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. So 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.
1:01:51You'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. But you can sit there and roll your foot. A band, you can like do banded toe exercises. So like I'll be sitting here on a zoom call. I have a four hour zoom call tomorrow. I don't know what I'm going to do.
1:02:25It's like giving me anxiety. I'm like, who schedules these things? Um, but I'll sit there on that call and I will be exercising my big toe on that call. Well, 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. Um, my, my shoes are off. Um, 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, um, plyo, you got to train the spring of the foot. And I think we forget that power piece. I think that's important, but you know, for those, for those, you know, listeners who are already in the gym, just add in a little bit of this stuff.
1:03:15It will go so far. Well, Mike, 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.
1:04:01But if you do not have that power from the ground up, you just pick a diagnosis. Oh, I'm starting today. Yeah, me too. I'm ordering the foot box. I'm getting the foot box. I think it'll be a great giveaway for my current group. I need some giveaways. So I'll be purchasing some. So 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.
1:04:57Our entire Instagram account are like exercises and ways to help people. Um, on our website, we have kind of two platforms. So for the lay person 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. But, 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.
1:05:39Yeah. Wow. Okay. Well, Laura and I are both recommitting. I'm not going to do it like you're reading my life. 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, we're totally vibing with your personality. You are really fun to interview and to have on. So thank you for your time. Thank you both so much. Thanks for listening, everyone. If you enjoyed this episode, please consider giving us a five-star rating and sharing the body pod with your friends.
1:06:23Hey everybody, Lady Luck here, and we're celebrating America's 250th birthday. Now all summer long, I'm going to be celebrating by playing on spinquest.com, which is an American owned social casino. It obviously features over a thousand slot games and live blackjack, live craps, live bubble craps. Head on over to SpinQuest.com. Get yourself a$30 coin pack for just$10. SpinQuest is a free-to-play social casino. Void where prohibited. Visit SpinQuest.com for more details. Warning, the following ZipRecruiter radio spot you are about to hear is going to be filled with F-words. When you're hiring, we at ZipRecruiter know you can feel frustrated, forlorn even, like your efforts are futile and you can spend a fortune trying to find fabulous people only to get flooded with candidates who are just fine fortunately zip recruiter figured out how to fix all that and right now you can try zip recruiter for free at zip recruiter.com zip with zip recruiter you can forget your frustrations because we find the right people for your roles fast which is our absolute favorite f-word in fact four out of five employers who post on ZipRecruiter, get a quality candidate within the first day.
1:07:37Fantastic. So whether you need to hire four, 40 or 400 people, get ready to meet first rate talent. Just go to ZipRecruiter.com slash zip to try ZipRecruiter for free. Don't forget that ZipRecruiter.com slash zip. Finally, that's ZipRecruiter.com slash zip.
From the publisher
We break down how modern footwear, weak feet, loss of sensory input, and overreliance on orthotics can disrupt movement patterns, pelvic stability, hormone regulation, and nervous system function. Dr. Conley explains the powerful connection between the feet, pelvis, core, and brain, and why rebuilding foot strength is essential for aging well, preventing injuries, and maintaining confidence in movement.
This conversation delivers practical, realistic strategies for improving foot strength and mobility, including footwear choices, toe strength exercises, calf training, balance work, and safe transitions away from orthotics. Whether you’re dealing with foot pain, instability, or want to build a stronger body from the ground up, this episode offers actionable insights to help women move better and stay resilient for decades.