Your Toes Can Predict If You'll Die Early And Heres's How To Fix Your Plantar Fasciitis! - Dr. Courtney Conley (Foot Expert)

29:55Initially, because you want to offload something that hurts. Yeah. But if you don't use it, you're going to lose it. So what they're not the part of the conversation that's being missed, is the and conversation. It's where this insert and strengthen your foot. Because the goal should be to have an exit strategy for the insert and get your foot back on the ground. Because I have patients Stephen, they will come in with 20 pairs of orthotics, 20 pairs of inserts. They've tried this one, they've tried that one, they've tried different shoes, higher heel to toe, drops more cushion, and I'm sitting there going, we're missing the boat here.

30:43Let's have the and conversation. One of the muscles that is a good predictor of having heel pain, okay, is it runs parallel to the planar fascia. So it's flexor digitorium brevus. It basically takes the four toes and presses them down. There's ways you can assess for this. So we'll look at their toe strength. And then it almost always correlates with the side that has the heel pain on because it shouldn't be one of those conversations. You're like, man, I wonder where this came from. No, your foot is weak. Your foot is weak. There's a lot of load going through it. And the structures are getting beat up.

31:27There's something Daniel even said to me, which I've never forgotten. He said, if you took a child and you put them in two inch thick gloves from the day that they were bored. And then you took those gloves off at 30 years old. Can you imagine how deformed their hands would be? And that's like very much the way that we live our lives. We spend pretty much all day wearing these big cushioned shoes that sometimes have these heels on. So it's no wonder that so many people are getting foot problems, ankle problems, back pain. Yeah. So one in three people. One in three people. Foot pain. I mean, it is, it really is a statistic that we need to be paying attention to.

32:05We use this word planter fissiitis, but we didn't explain what it is and what the symptoms of it are. Is it essentially like pain in the heel of your foot? Pain in the heel, yes. And they've played around with the terminology of being at planter fissitis, so more of an acute issue versus planter fissiopathy. Because oftentimes these cases will turn into having heel pain for very long periods of time. So then you have to treat it differently. You don't treat something that's acute the same as you would treat something that's chronic. And so you have to look at how can I build the resiliency of the foot?

32:44How did it happen? How did all of this happen? How did planter fissiitis happen? Like how did I get it? So I'll tell you what I was doing. I was living my life as normal. Yeah. And then I started training to play for this soccer game. And I started training several, maybe twice a week. And then maybe by week four or five or six, I get this horrific, ongoing pain, which lasted throughout the entire day, where I couldn't walk easily. It was especially bad in the mornings. And yeah, I thought I'd like broken something or ripped something in my foot. And when they told me that it was planter fissiitis, I'd never had that term before.

33:26But understanding what I did though, how did I get it? When I see I hear very similar stories with that diagnosis. There's always there always seems to be some impetus of I added load too fast too soon. I went on a longer hike. This is one of my favorites. I went barefoot during COVID around my house. And everybody wanted to blame the fact that you know, don't ever go barefoot. And I was like, maybe it's just because your foot was weak and you weren't ready to handle these loads. You add loads too fast, too soon. And the foot just says, you know what? You weren't ready to give me this amount of load this quickly.

34:11And that's, you know, when you asked me earlier about why do we need to pay attention to our foot strength? Is it just because, you know, we're going to we want to prevent falls on R70. This is the why. Because we want to have healthy feet, strong feet so you can say, hey, I want to go play a soccer game and I don't want to worry about having planar fasciitis in my 30s. Or I mean, now with this, this ankle spray that I have, pulling my ligaments, which takes you out of activity for so long, which is horrific. That's like a big part of this, which is if you get an injury, if you get a bad injury, if you get like an Achilles tendon issue or the utera ligament like I have or even planter for shietas, the inactivity that stems from that causes a bunch of downstream issues.

34:57So my muscles are going to atrophy. I'm going to lose muscle over this next couple of weeks in my lower half. I'm going to get probably a little bit lopsided because the injury is on my right side. So now my left side's having more of the burden. My lower legs, my upper legs, my lower back is probably susceptible now to some kind of injury as well. And it feels like, you know, this down, downward spiral of injury just because I didn't strengthen my foot. What do you think of these are women's heels, but listen, anyone can wear them. It's 2025. What do you think of these shoes? Well, it doesn't look like a foot.

35:37Your foot in that position is not the position it's supposed to be in. Now with that being said, there is a time and a place. You know, I don't think I'm going to win the battle of, you know, you need to wear, you know, functional footwear 24 hours a day, seven days a week. Time in those shoes should be limited. Just like with, you know, other things, it's moderation. Do you see a lot of women getting injuries because they spend too long wearing heels? I don't know if acute injury, but, but a weakening of tissue. Yes. Because, you know, I live in Colorado now. So I don't have that there's not too many women in Colorado that are wearing heels.

36:24However, when I go to New York City, it's a different conversation, different environment. So, you know, I have to say, I have to use the, that is not the position that you want to keep your foot in. It's changing the structure of your tissues, changing the pressures in the foot. Not to mention that those are, I don't care what anybody says, that's not comfortable to walk around it. People will be like, oh, I'm really comfortable on heels. I'm like, are you really though? The links we go to to look good, they're right? That's right. Okay, so let's talk about some good shoes then. Okay. I've got two pairs of shoes here.

36:58Okay. One of them is Vivo Beffert, who are actually a sponsor of mine. Ever since I started talking about feet. And then I don't know this brand. What is this brand? That is ultra running. So, let's talk about the things you want to look for in a functional shoe. My non -negotiable is the wide toe box. The toes have to be able to display. When you think of all the diagnoses that we talked about, bunions, neuromas, hammer toes, when the four foot can display, the foot's going to function better. So that's number one. Number two is having the heel and the toe in the same plane. In number three is having a shoe that is thin and flexible.

37:48When you wear this type of footwear, I call this a workhorse shoe because there is more loads going through all of your tissues, through your bones, through your ligaments, through your tendons, through your muscles. So your foot gets stronger when you wear this type of footwear. There's research on that. Now, you have to earn your right. This is the Plantar Fashiyapathy conversation. You can't go from wearing a aggressive high cushion shoe. Like this one here. Yes, with an insert, for example, and say, oh, this stuff makes sense. I'm going to go take that off and I'm going to go wear this 24 hours a day.

38:34You won't like me. Why? Because you'll say, hey, my heel's hurting. Because you haven't done the work. It's, hey, let's do these foot exercises. Let's wear this for 10 minutes a day. And then people are like, wow, that does feel better. And then it's a transition into wearing this more often. Now, when you have patients that have had a very weak foot or clients that have had a very weak foot with different diagnoses, this is a hard, you know, shoe to walk around in for extended periods of time. So that's when we'll talk about footwear that still puts the foot in a wide position, wide toe box. I love this shoe.

39:19And I also like the mesh upper because you can, the toes can expand in here. I still have zero drop. Right? We're the heel and the toe sit in the same plane. But you'll notice the difference between the two shoes is the amount of stack height or the amount of cushion. There's more stuff. Yeah. So on this, on this shoe, the it does look like the, you call it a plane looks level. Yes. Okay. And it's got a good toe box. Yes. You can see from this side that the toe box is wide so you can display. But it is elevated. It's elevated off the ground. Yeah. But the heel and toe are in the same plane. Okay.

40:02Fine. But it's still elevated though. Yes. Quite a thick. Yes. That's not too much of a problem because it's depends on what your goals are. From running. That is, that is I think a great shoe to run on, to run with, right? If you're running on concrete, if you're running on asphalt, you want a little something underneath the foot. What about the night heat alpha flies, which is why we start sweating. Really? This is my current running shoe. And I bought it because it looks great. Yes. I mean, you know, it's, it's, I have torn the ligaments to my, in my ankle, but I look good. Here's the super shoe.

40:46Right. So here's this shoe, right? And here's your super shoe over here. Yeah. Okay. When you look at that shoe, there's certain characteristics to that shoe that you definitely do not see in this shoe. One of them being the toe spring. So see how it kind of lips on the front of the shoe. Yeah. Okay. This part here. Yes. So if I had that shoe on this table, and I went like this to the front of the shoe, it would literally rocker for me. So it facilitates the rocker of the foot. Sounds great. You put that on you like, man, this is great. I can fly. If you don't use it, you're going to lose it. So there is research that shows when you put your foot in a position with toe spring, you will weaken the intrinsic muscles of the foot.

41:30So I'm not saying don't have race day and wear that shoe, right? You get, the research will tell you two to four percent running economy. People run faster because the shoe has the technology to facilitate gate. But if you train in that all the time, and you never let your foot get stronger, it's just a matter of time. You're going to say my hamstring, my foot, my this, my that. And it's like, that's why the conversation has to happen is this is the shoe that you're going to get stronger. Spend time in your training shoe. And then that's your speed day. That's your race day. So it's having the shoe spectrum knowing when to dance along the spectrum.

42:16I feel like I can bounce in these. I mean, you probably can. I literally, when I put it on, I was like, wow, I can bounce. That's right. I think it has like a piece of metal going through the middle of it. There's carbon in there. You know what? Another fun fact is though, certain plyometrics. So plyometric is training the spring of the body. So I think like jumping. There is research that will show you that plyometrics also increase capacity and running by two to four percent. So my conversation I have with my patients is listen, what if we stacked therapies, right? What if you did plyometric work, which is jumping, you know, once or twice a week.

42:58And we worked on your strength. And I had you in these shoes, the majority of the time. And then on race day, you want to throw that shoe on. It's like you're running, you're like a running fairy. You're like running and things look beautiful. And everything is, you know, because you have a strong body on top of the shoe. But if you put a weak body in a weak foot in that shoe, you got to earn your right. Should we be standing more often? Because most of us work in live in offices now. And we sit at desks and I, you know, I do this podcast sat down. Do you think much about standing desks or how often we should spend bipedal or I think if that's what you referred to as?

43:41I think that it's more about movement. Okay. I don't know if standing in one place is any better than sitting in one place other than when you're standing, you can actually like, you know, move around and you know, make it more active standing. But it is a matter of taking movement breaks. Like that's, I call them, you know, movement snacks. All of us spend a lot of time either sitting all day long or, you know, standing at our desks. If we were to take micro walks, a five minute walk, a couple times a day, the system stays moving. You're staying active. And you're slowly, you know, inching up of that step count that we know is so important for not only physical health, but emotional and mental health.

44:26That's what I like about it. I think you mentioned there was an association with movement walking and dementia outside of his risk. What does the science say there? You know, when you look at step counts, if that was going to be our baseline, 99 ,800 steps per day can reduce the risks of dementia. But what I think is the cool part with that is 3 ,800 steps. You get 50 % of the maximal benefit. So if you were to, let's just call it 4 ,000, shoot for 4 ,000 steps, you're going to get a benefit. A 50 % benefit. And some of my favorite research on looking at that population with walking and relationship walking, there's really cool studies looking at walking in groups for the elderly population and how that has a social connection.

45:35And it improves their emotional health. And it combats loneliness and feelings of isolation. And that is the beauty of a walk. Run clubs are getting incredibly popular at the moment. Yes. Around the world. Are you seeing more people come to you as a result of that? Yes. I think also, you know, I was interesting. I was working at the running event in Austin, Texas. And I was teaching there. And so a lot of the shoe stores were there. And one of the bigger shoe stores had said that the majority of their clients now are actually walkers and not runners. And I thought that was pretty interesting. And I'm thinking to myself, I wonder why that is?

46:18Like, are more people reverting to walking because they're getting injured when they're running? Are they, you know, I'm making all these conclusions in my head. I'm like, well, is it because we're going in the wrong direction with footwear? Because we're creating the shoe that is basically doing the work for us. And it feels so good. And, you know, people aren't putting the work in anymore? I don't know. But I'm certainly going to do my best to change that. You brought me a box, which I have here in front of me. Yes. Foot health kit. That's what it says in the front of the box. Foot health kit.

46:57I mean, what is in this box? It's like my little like bag of treats. You know, when I started doing this, it was funny. This is what you give people as a bag of treats for their bathroom stuff. I want people to start thinking about their feet because I think there's such implications for their health. And I wanted to make it easy because when we think about all the things we need to do to stay healthy, it's like, I have to strength train. I have to, you know, eat this. I need to VO2 max. I need my cardio respiratory fitness. There's a lot. So I wanted to make it easy. So I, um, first, one of the things that is in there are toe strength centers.

47:45So I'll pull them out the box. So those are toe spacers. Toast spacers? Yes. So is this all the same thing, right? Yes. So these are toe spacers. Correct. And then there's this. Yes. What's this? Those are toe strengtheners. Toast strengtheners, okay. So that's my toe workout. There is this thing. A band. And then there's this ball. Yes. So this is like, this is my foot gym. That's right. Can you show me how this stuff works? Absolutely. Okay. So these are my feet. And these are my ankles. So I had plantar fasciitis in, I believe it was this foot actually. And then right now I've got a high ankle sprain, which is some kind of ligament here has been torn.

48:31And they told me that it's torn on all three sides. So I've been in a boot for the last couple of weeks, but I've taken it off over the last week or two. And I was on crutches as well. What are you, the minute I took my socks off, you became excited on my feet? Yes. What, what, what do I need to be thinking about? And what can you see just by looking at my feet? You know, when you're looking at this foot here, you can start to see this little, see this little bump here. You can start to see bumps on the top of the big toe. Okay. And the diagnosis is a Halux limitis or a Halux rigidis. And basically what that means is that you have formed our thritis on the top of the toe.

49:15So it prevents you from getting that full range of motion that we need when we walk and run. Okay. Okay. If the bump goes out to the side, that's what we call Halux Valgus. That's the bunion. The bunion. Okay. Okay. So that's why the foot is a window to mechanics, because you can see loads, a -barant loads, right? Why is this forming here? So, you know, one of the first things I want to look at is how much range of motion, the big toe, it's all about the big toe. When we're walking, we put a lot of loads and force that go through the big toe when we walk. You should have about 40 to 45 degrees to walk out of that big toe.

50:04So here's Eddie, here's 45 degrees up. Okay. So yes. So what I want to see is how much range of motion. Can you see how he's off the ground though? I want the ball of the big toe on the ground. That's a good amount of range. That's the first nice thing you said about my feet. We're just getting started. I'll find something else. And then you want to look at toe dexterity. So in other words, can you isolate your toes? So can you lift just your big toe on the right? Good. And then on the left. It's actually quite hard. I've never had to do that before. It's funny, because when you'll see people that have poor awareness to their feet, when they try to lift their toes, you'll see them like their hands and like your back isn't going to extend your toe.

50:59Okay. And then put your big toe down and then extend your four toes. Yes. And they have that pinky is not that's not listening. There you go. And here. Okay. And then what I want you to do is you're going to lift up all of your toes and spread them. And you can see two, three and four, right? They don't want to spread as much. Earlier, we talked about those neuromas. The neuromas live within the toes here, right? Within right in between the toes. So if we have issues with nerve problems here, you got to be able to display.

51:43So you wear beboes. You know, when you allow your foot to be in a shoe where the feet can actually display, you'll start to see changes. But imagine if you, you know, we're going to shoe where your foot, I mean, I had a, I was in an expo working a couple weeks ago. And this woman came up to me and she's like, man, I can't figure out why my foot hurts. And I took her shoe off and I'm telling you her foot looked like this. It looked like a shoe. And I took a picture and I showed it to her and I was like, did your foot look like a foot? Or does it look like a shoe? We didn't mean any of the differences.

52:19No. Because remember, the widest part of the foot should be the toes. So that's what we want to look for in the front of the foot. We also talked about that muscle. What side did you have the heel pain on? I believe it was the right side. So one of the things we'll do, and you can actually do this at home, you could use like a credit card. So in my office, we can actually measure that. But if you were to do it at home, you just take a card and put it underneath the toe. Okay, and make sure you're lined up here. Yep. And some people also do that. See how you're like holding your leg just the toe.

53:01And then I'll try to pull the card out from under you. And I shouldn't be able to do that. I should feel some tension. And then I'll ask the patient, where do you feel this? What's working? And if they say, my hip, my quad, it's a wrong guy. We're talking about the foot. So you should feel that in the arch of the foot and maybe into the calf. Okay, big toe flexor, howlusus, longest. This guy, by the way, this muscle starts over here. It's very important to strengthen this muscle when you have a history of ankle sprains starts on the fibula, which is the outside of the leg. It comes down the foot crosses under and inserts into the big toe.

53:49Then I'm going to take the card and I'm going to put it underneath the four toes. The muscle that we're looking for, yes, that's beautiful. See how you got that little, see that's the second compliment I gave you, I'm going to put this underneath your toes. Yep. Right. Little, yep. And then don't let me pull the card out. And you should feel that in the arch of your foot. Patients that have. I'm not really feeling it's been I'm not feeling any. Okay, oh, what? Okay, there you go. Roll the, roll the bottom of the foot like this. Yes, just wake it up a little bit. There's a bunch of receptors on the bottoms of the foot.

54:31So when we can't feel things and it shouldn't surprise us, you know, we've been walking around and footwear that compromises the function of the foot or we've had injuries and you start to lack what we can feel. So just wake it up a little bit. And how long would you do that for in the morning? Sixty -ninety seconds. Do you do this every day? I do. I'll tell you when I like if I'm standing at my desk, I'll keep the ball there. Okay. When I come back from a run, I do this whole little setup. But I wear these all day. What is that that you're wearing? So these are toe spacers. So they do exactly that.

55:09They display the foot. And why are you wearing that? I remember when I was telling you about my years of being a valid answer. In point shoes, I wore a thoughtex for a long period of time. I wore ill -fitting footwear and my foot was weak and things hurt. Okay. And we talked about why I needed to fix all of that. You can see my bunion here. Okay. So I work on all of this stuff all the time in toasts play is a big part of that. So when I have these toe spacers in, they display the foot for me. Every pair of shoes that I wear is compatible with a toe spacer. Okay. So you don't wear any narrow shoes?

56:00Yeah. That's my non -negotiable. Okay. And this is important. There is a difference between a wide toe box and a wide shoe. So people will say, well, I ordered the wide. The width will come here. That's where they change the width. But if the toes are still tapered, the width has to extend into where the toes are. So that's where you got to be careful. It's a wide shoe is not a wide toe box shoe. And if you try to wear these in just a wide shoe, you're not going to be comfortable. So if I wore this for one year, what promise could you make me? What could you tell me the benefit and the upside would be?

56:47You would definitely see improvement of the display of your foot. Yeah. And when you have the tissues, the the display, you can start to improve the strength of the foot. And what's downstream from strong foot? Go up the chain. You have better toe strength. You're going to build a better platform. You're going to have a jet engine on a jet engine. So your ankle mobility, then your knee extension, your hip extension, because your foot is doing what it was designed to do, which is be mobile and be strong. We need to pay attention. If you if things go south from here, you can expect there to be changes up the chain.

57:35I see it all the time. This one change has transformed how my team and I move train and think about our bodies. When Dr. Daniel Lieberman came on the diere of a CEO, he explained how modern issues with their cushioning and support are making our feet weaker and less capable of doing what nature intended them to do. We've lost the natural strength and mobility in our feet. And this is leading to issues like back pain and knee pain. I'd already purchased a pair of Viva barefoot shoes. So I showed them to Daniel Lieberman and he told me that they were exactly the type of shoe that would help me restore natural foot movement and rebuild my strength.

58:10But I think it was planter for shilters that I had where suddenly my feet started hurting all the time. And after that, I decided to start strengthening my own foot by using the Viva barefoot. And research from Liverpool University has backed this up. They've shown that wearing Viva barefoot shoes for six months can increase foot strength by up to 60%. Visit Viva barefoot .com slash DOAC and use code diary 20 from my sponsor for 20 % off. A strong body starts with strong feet. Is there anything else that we need to be aware of? What is this other stuff here? You've got toe strength in it as well.

58:42So before we get to those, with the big toe on the foretoes, this is when you can use that band. So you just put your heel on there. You grab your foretoes. It's like you're doing a bicep curl but you're doing it with your toes. And you press into the band and you lift up and you press into the band. There is research. Four sets, 12 reps. These are some of the things that they work on to improve function of the foot that helps with planar fasciitis. And then you go around the house and you grab the big toe. Keep that ball the big toe on the floor and then press. Yes.

59:25Right. And it's a good place to start. You're building shrinks in your foot. And if you want to really get after it, go for just the little guy. Oh my gosh. It'll piggy.

59:41It's really wild because the abductor digi -de -minimly, the muscle that abducks the little toe is just as big as the big one. And we like just like, oh, that toe is just there to hit furniture. It stabilizes the outside of the foot. What is the difference between someone that does this and doesn't do this? Well, let's start with pain. Yeah. They - and I use the word prevent injury. That's tough for me. You want to create an environment where you can have the best opportunity for function. So when people strengthen their foot, they are going to have a foundation that's going to have resilience to their rest of their system.

1:00:24This is what we walk on. You cannot build a jet engine on a paper airplane. I'm working with a lot of athletes right now are getting bigger. They're getting stronger. They're getting faster. And if you look at the rates of injuries at the foot, they're going up because we know the amount of loads that go through the foot when we walk and when we run. So if we want to do a bunch of squats and do a bunch of dead lifts and do all the sexy stuff, but not pay attention to the foundation on which we're putting all of this on, you're going to run into problems. So from a function perspective, you're improving your function from the ground up.

1:01:05You're providing a better environment for your body to decrease pain. And when we get older, it's, you know, you don't want to be chasing your tail at this stuff. How does this stuff turn into mobility and flexibility? Because that's something I'm thinking a little about the moment. I realize that as I do a lot of upper body workouts and stuff like that, when you watch me pick up the weights and stuff, I fall back down, I look like I'm, I've got the mobility of someone that you would think was double -edged. I wonder if a lot of it starts with our feet. So we talked about the big toe. When you're walking, the big toe has to extend a certain amount.

1:01:42Okay, I'm going to show you here. Okay. So when I'm walking, I have to have a certain range of motion out of my toe. And that gives me range of motion out of my knee and out of my hip. If I cheat the system, so let's say this is the only amount of range I have, let's say I have a big toe that's only going to extend 20 degrees. You're going to compensate. You might shorten your stride. You might take shorter steps. You might not get access to hip extension because your toe isn't going into full extension. So you will see some type of compensation. The other one I think about is ankle mobility. I was listening to one of your podcasts and you were talking about the story of you rafting in Bali, I think.

1:02:32And how you were walking down the stairs and how it's something that you want to be able to do. And I was thinking to myself, I'm like, if you were to ask someone, if you wanted to continue to be able to do that as you age, what would you wear? Probably via two marks. Endurance? Yeah. Your hip strength maybe? Yeah. Right? Your core strength, your hip mobility. I think very few people would say ankle mobility and toe strength. But here's the deal. If you don't have good toe strength, where are you going? You can be falling. If you don't have good ankle mobility, same thing. So ankle mobility is a big one.

1:03:19Also, it gives us access when we squat, when we go up and down a stair, even walking. So what do you mean by ankle mobility? Do you mean my ability to go like this? This dorsiflexion. The ankle also plant our flexes and it inverts in everts. But the one I'm talking about when you're you know, this ankle dorsiflexion is something I look at with all of my patients. And it's not stood up. Is it? It's not sat down. Is it stood up? He would. If you can do it, you look at it seated. Yes. But you want to keep that heel on the ground. Okay. I mean, that's that's all we've got there. Okay. I'm looking for about, you know, between 20, 30 degrees.

1:04:10But this range of motion is very restricted. Remember the high heel conversation? Yeah. You walk around in a high heel for a long time. ankle dorsiflexion is affected. And what can I do to improve my ankle mobility to prevent myself getting injured or getting pains or issues with my lower leg up a leg back? Um, you know, I think joints, you have to look at joints from two perspectives, both mobility and stability. How well does it move? And how well can you control that motion? Yeah. Right. So you can work on static stretching, dynamic stretching. The other thing I would be looking at here, though, is the strength of one of my favorite muscles, which is the soleus, this big calf muscle back here.

1:04:59Okay, because it's the soleus, right, that helps control this motion. And, you know, if you had a seated calf raise machine here, and we wanted to look at baseline, like, what can you do with your single, single leg seated calf raise? Which is this one right? Yes. The capacity that the soleus can produce is it, you can put eight times your body weight going through your forefoot. That's a lot. So there was a study that looked at return to run. So they were looking at how much strength, if you will, can we produce out of a seated single leg calf raise? Yeah. One and a half times your body weight six times.

1:05:53Well, six reps. Yes. Single leg. Okay. So you would put one and a half times your body weight plates six times. That's a lot. If you were to do it standing, holding half your body weight, six reps. But we don't train the lower leg like we do everywhere else. No, especially men. Yes. And don't care about legs. Yeah, I always say it's, you know, the the machine at the gym that it should have the longest weight line is the seated calf raise machine and it's always open. What would you see the biggest mistakes that runners make outside of the alpha fly issue wearing as big cushion shoes? Is there a certain way that we run that is causing us problems?

1:06:40And also, are we running too much? Because some people, they really get hooked on running. I mean, I love it. I think running is one of the best forms of activity. I think if we wanted to keep it very simple, overstriving is the enemy. Overstriving. Yes. What's an overstriving? So if I'm running, right, here's my foot. Yeah. I want my foot to strike as close to my center of mass as possible. As close to your body as close to your foot as you can. Yes. Okay. So overstrived would be as if I landed with my foot all the way out here. Okay. Yes. Good. So our cacanius, this heel bone, was beautifully designed to absorb shock.

1:07:26Okay. When I overstried and I can feel it, what am I going to do? That's going to hurt. So you're not going to do anymore. You're going to overstriving. You're going to overstrived and bring that foot closer to me so you strike differently. You want the foot to hit in line with your body. A little bit in front of the body. Okay. It's the heavy overstrived you want to avoid. Okay. Okay. But if I can't feel anything, you don't know. That's the more stuff on the shoe. You can overstrived hot and heavy because you have all this cushion there. You're like, yeah. So that's the argument of allowing your foot to be able to feel things.

1:08:13What about this whole thing with gates and stuff? Because sometimes when I was videoed from the back and someone in the comment section was like, you're like, gate is wrong or something when you once did. So I don't know what he meant. I did cacanius qualifications. So I kept it moving. But everybody has a certain gate. What is a gate? You have a running gate or a walking gate. It's just your what happens when your foot strikes the ground to the time it hits the ground again. So you have certain stride lengths and step lengths. Okay. So when I'm if you were if we had a treadmill here yeah, and I would have you start running, that would be your running gate.

1:08:52I'd be looking at you from the back, from the side, from the front and seeing what happens when your foot hits the ground when it comes back up into swing phase. What's happening above the foot? So what are your hips doing? What is your pelvis doing? So you're really looking at the person and then you're also looking at, you know, what am I seeing that I think could be a factor in either pain or poor performance. And then you see those things and you're like, okay, let's start working on this. But this is the interesting thing that's gate, right? Someone will see something and they'll say, okay, you need to start doing calf raises.

1:09:36If they also don't queue gate, right? Or let's work on your cadence. Let's work on some type of skill. Strength and skill light up different parts of your brain. So you can get really good at calf raises and great. But if you want to be a good runner, you have to look at different things. So what's the most common issue for someone's gates? The overstried. And then also kind of the crossover. Why is that a bad thing? It takes away some of that efficiency. So oftentimes, you can see, you know, if someone's crossing over when they land, they'll have more of this kind of collapse through the extremity, if you will.

1:10:21Okay. Okay. We want to control the foot when it hits the ground. That's why the hip conversation, right? The hip controls what happens at the foot. Are we supposed to be better? We are supposed to let our foot function how it was designed. And that is letting the foot feel now we live on man -made surfaces and we walk around on concrete. So for me to say, yes, we should all be walking around barefoot. That's a conversation that's difficult to have. But the stronger that your foot becomes and the more resilient that it becomes, you can handle these things a lot better. And it makes interacting with your environment so much more fun and easy.

1:11:06What did he say? Okay. My daughter was a rock climber and she was up in her room one day and she had the bands around her fingers and she was like, strengthening her hands. And I was looking at it and I was like, man, I'm like, I want one of those for the foot. And I'm looking for them and I couldn't find them. So I said, wow, here we go. So I designed these in their different resistances. So it's the same concept as you would with your hands. You just put them around your toes. Okay. Hey. Give me the easy one. Which one's easy? That's the easy one. Okay, here we go. Well, the same size which you need different sizes for different size feet.

1:11:44No. So when your toes play, you can slide those on a little easier. My little piggy is completely redundant. It's doing nothing. It feels like it feels like it's disabled. Well, we're going to change that. Okay. So when you lift up all your toes, try to get your big toe to touch my finger. Yes. That's abductor houses. That's this muscle right here. So people that have like bunions, it's like just strengthen that muscle. Right? So that guy goes in and you hold right there. So now you're strengthening inside of the foot. You're strengthening the muscles inside the arch of the foot. If you can get that little guy to go out, you're going to strengthen this guy.

1:12:31So you're just going to lift all your toes. Good. And then spread. Reach them forward. Try to keep the tripod of the foot though. Okay. So I'm trying to lift all your toes, but keep that tripod. One, two, center of the heel. So lift. Yes. Yes. Yes. Yes. Yes. Now press those toes to the ground as you spread them. Lift. Spread. Reach. That's pretty. Thank you. Okay. So and that goes, you've got ones that get increments. Yes. So this would be harder. This would be hardest. Okay. So we're doing like 30, 40 reps a day. That's how you'll know someone needs to work on this because they can't keep those points.

1:13:17So they're kind of like it looks like their foot's on a nice scape. Yeah. So that's the front of the foot. Yeah. When you get into this part of the foot, the rear foot, there's certain things you want to pay attention to. We already talked about mobility at the ankle. But you also want to look at what happens when that heel comes off the ground. Because this is when all the magic happens. Because the foot engages, the intrinsic muscles engage. It's basically like I'm getting ready to to propel forward. So there's certain muscles that you want to have some good capacity to be able to get your foot in this ready position.

1:14:02So two we can talk about is one that runs along the inside. And then this is posterior to be Alice, one of the very big stabilizers of the arch of the foot. And his best friend, which is the soleus, those guys help do this to the foot, help invert the foot. Okay. So go ahead and stand up for me. Put your foot in here. I'm going to put this around your ankles. There you go. Okay. Spread your feet a little bit. Toes pointing straight ahead. Which by the way, we want to talk about gates. When I'm moving from point A to point B, my feet should also look like they're moving in this direction. If someone's walking like this, with their feet pointed out.

1:15:01Correct. Yeah. I want to know why. Okay. Do they have a bone in their lower leg that's rotated out? Which could happen? But if not, you don't get to walk like that. So we want the toes pointing straight ahead as long as there's no compromise structurally. Okay. So what I want you to do here is you're going to keep the ball of the foot on the floor. And I want you to drive your ankles almost like you were going to spring your ankle, right? So you're going to push into that range out. So you're going to take your ankles and drive them into the band. Into the band. Yeah. Watch right here. Okay. So here, this way.

1:15:53Yes. Now keep that big toe on the ground. Yes. Yeah. See there's your other compliment. I didn't sound like a compliment. But what you should feel here is that when you increase the arch of the foot, you should feel it also in the hips. I feel like I just don't have an arch in my foot. I don't know. It's weird. I don't feel like I can... How about this? Put your hands on your chest. Rotate to your left as far as you can. Keep your feet on the ground. See that's pretty. See that arch? Yes. Now go this way. So that's another way to work on how the foot feels. Because the foot should change shape.

1:16:33It should lower. And it should increase the arch. So you recommend people do these types of exercise frequently? Oh yeah. I mean, how much would you do? You're standing at your desk. You know, here's your movement break. You rotate 20 times. Let your foot change shape. Do your toe yoga. Big toe, four toes. Lift all your toes. Spread them and reach them forward.

1:17:03With Physio gave me a towel and he put it on the floor and he said I have to grab it and pull it up and grab it and pull it up as part of my recovery for my injury. Do you have a tell people to do that? You know that? Town thing where you grab it. Yeah, I don't. You don't? No. What? I don't want to get anybody in trouble here. Yeah, I don't know. Okay. When do you ever do this? Never. Correct. So unless you were, you know, and maybe in your initial phases of rehab where you are just trying to wake up the foot, you want to, you know, towel scrunch, pick up marbles like they, you know, that's a very common foot exercise.

1:17:43But from a functional perspective, that never happens in the gate cycle. When you're walking and you're running, your toes never do this or they shouldn't. Most people when their foot is weak, that's one of the biggest compensations that you will see. They toe grip. You'll see them walking and it's like, you know, they start gripping the ground. Because they feel weak. Feel your weak. They're compensating. Yes. I made the biggest investment I've ever made in a company because of my girlfriend. I came home one night and my lovely girlfriend was up at one a .m. in the morning, pulling her hair out as she tried to piece together her own online store for her business.

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1:20:12I do not wear socks. Why? I just haven't found any that I love. My second and third toes, personal information here, are webbed. So basically there's skin that comes up in between two and three. So as far as socks are concerned, most of the socks out there, like if you look at a compression sock, when someone puts it on their foot, it literally like with my bunion, you'll see my foot look like this, because it's just suctioning my foot together. And it's so uncomfortable. So my option would be a toe sock. So a sock that you know just fits over your toes, but because my toes are webbed, I can't wear them.

1:21:00What do you think is the most important thing that we haven't talked about yet, that we should have talked about as it relates to foot health and everything downstream from foot health? I mean, I think, you know, big picture like what I hope to do, like my passion is to bring awareness to the foot. Because when we start doing that and we pay attention from getting stronger from the ground up, things life gets easier. And I mean that not just physically, but just like we talked about wellness, because you're able to move and get out there and walk and run and move like you want to. So that's kind of the big picture here.

1:21:41I think we talked about the importance of foot strength and foot mobility and driving home the importance of footwear. I think the biggest, you know, or maybe the lowest hanging fruit for people is if this kind of work seems overwhelming, like I have to strengthen my toe and do all this stuff, just wear a shoe where your foot can feel the ground and your foot can be in its functional position. Start there because the research will tell you just doing that. You will start to improve the strength of your foot. And I think that's that's key. And start small transition. It's so interesting listening to so many of these, the comments on some of your previous work, people of all ages, but often people that are slightly older talking about how transformative, finding out more information about their feet has been, and changing their footwear in particular.

1:22:40Reading this one comment here from this guy says, he's 65 years old, and when he discovered the zero drop wide box toe shoes, he lost all the pain in his feet, ankles, knees, and hips within a couple of months. I hear it all the time. I hear it all the time, and it's, it seems so counterintuitive to us because I think we've been, you know, trained to think that our foot needs stuff. It needs support. It needs cushion. It needs spring. And that changes the dynamics of how your foot interfaces with the ground. So when you bring it back to what it was designed to do, those comments, you'll hear, you will hear all the time.

1:23:27And it's, it's a wonderful thing. It's literally why I do this. Is there anything else we should have talked about that we didn't that you think is pertinent to anyone that's trying to get control of their foot health? I mean, I think, you know, I just want to make sure that we highlight the conversation of transition because I think that's where we lose people. Is this when people listen to this, there's bells going off in their brains going, man, this makes sense. This makes sense. They want to go home, burn all their shoes, and like go buy a pair of barefoot shoes and call it a day. You got to earn your right.

1:24:03So there has to be that transition. There has to be that. I'm going to step. I'm going to build. I'm going to have a shoe spectrum. And that, that conversation of a shoe spectrum, there's a time in a place. You have your workhorse shoe, you have your cheat shoe, and you know when to wear what? Where am I now? I'm, I think I'm in the workhorse shoe. I'm trying not to wear any cushion shoes as much as I possibly can. Well, you think about it with ankle sprains. This is what I find fascinating, right? When that thing heals, when your ankle heals, and you say, well, I'm going to go into a cushion shoe.

1:24:47Some of these shoes are getting, getting high. So you put the sole of your foot on a shoe that has a high cushion. You see the distance you have from your foot to the ground. Yeah. So let's say you step on a rock and you have poor, appropriate, reception because your foot can't feel real well because you have a history of ankle sprains and you step on a rock and you have this far to go. Where do you think that ankle's going? Hmm. So my ankle sprains patients, I want them close to the ground. I want them to feel. Right? So it's, it's pretty wild when people are like, I want to wear, you know, all this stuff.

1:25:26You know, hiking boots, another conversation. What's wrong with hiking boots? Well, people will say, I need a hiking boot because I, I want my ankles to feel stable. And that's not what they do. It might be a, and there will be research coming out on this. When you are a hiking boot, it's like a neurological hug. It kind of feels like, you know, that I'm going to have this thing around my ankle. That's going to protect me. It's going to protect me. It doesn't. And when you walk down a mountain, this foot has to do, remember we talked about this ankle dorsiflexion. If you have something that's going to restrict ankle dorsiflexion, you have transfer loads.

1:26:10So you end up transferring load to the knee. So, you know, when my patients say to me, I need a hiking boot. I say to them, listen, why don't we just work on getting your ankle more stable, improving your mobility. So then you won't need to feel like you need this thing around your ankle. And that takes time. But in the long run, is there an issue if I'm wearing the barefoot shoes at the moment, and then I start wearing like football boots again, or I think you guys called them cleats? Yeah. Is there a chance of me getting injured? Because I spent so long in the barefoot shoes. Now, it's here.

1:26:52Sometimes you can't do anything about the environment of the shoe. So think of a cleat, an ice skate, a ski boot. There's certain, you know, sports that require the stiffness. And so, when you pay attention to your foot health, and then you put that foot in the cleat, you just make sure that when you get your foot out of the cleat, you do all the stuff. You take that kit, you roll the bottom of the foot. When I get out of my cycling shoes, even though they are wider now, they have wide toe -box cycling shoes. I'm always doing stuff for my foot. Because it's a, the cleat is an environment for the sport.

1:27:34So, you know, you pay attention before and you pay attention after. Courtney, we have a closing tradition on this podcast where the last guy sleeps a question for the next guy's not knowing who they're going to be leaving it for. And the question that has been left for you. Oh, this is going to be good, huh? It is a good one. What do you fear you will most likely regret 10 years from now? This is a battle that I have in my head pretty much all the time. I love my work so much. It is, it's just the reason that I feel that, you know, there's so much I want to do. There's so much I want to learn.

1:28:10There's so many ways I want to help people. And I work a lot. But I don't look at it as work. I, I enjoy it. But I want most of the mother. And I need to find that work life balance where I, I don't want to fear in 10 years that I look back and said, man, I worked a lot. But I really wish I would have gone to her soccer game. So I've created this life for me where I can say, I'm not going to do that. I'm going to her soccer game. And she gets mad at me all the time. But I tell her, I'm like, this is what happens when you own your own business. She's like, Mom, quit saying that. I mean, she knows I work my ass off.

1:29:02But at the same time, she also knows that I can drop anything and go be there for her at any time. And so that's what I really want to work on and make sure that in 10 years, I don't look back and say, gosh, I missed some of that. As I'm often told you didn't get that time back either, do you? So it's not something that's very easy to correct. Yeah. Courtney, thank you so much for doing what you're doing. I, I'm very much looking forward to your book because it's been a bit of a black box, I think, my feet, my foot health up until more recently when I discovered your work, but also just from this conversation today, it feels like I now have a better understanding of how this thing that I thought was largely irrelevant is having a big downstream impact on a bunch of things that I really, really care about.

1:29:52But also maybe most importantly is just having a set of actions that I find myself in a situation where I'm older and I fall or at least my mobility or movement or the meaning in my life because I have something wrong with my foundations. Hopefully next time we see each other, I will have the strongest feet you've ever seen. I was just thinking the next time we see each other, there's going to be so many more compliments on my feet. On your feet. Yeah. One can only hope. Courtney, thank you so much. Thank you so much. No, no, thank you. Quick one, just give me 30 seconds of your time. Two things I wanted to say.

1:30:30The first thing is a huge thank you for listening and tuning into the show week after week means the world to all of us and this really is a dream that we absolutely never had and couldn't have imagined getting to this place. But secondly, it's a dream where we feel like we're only just getting started. And if you enjoy what we do here, please join the 24 % of people that listen to this podcast regularly and follow us on this app. Here's a promise I'm going to make to you. I'm going to do everything in my power to make this show as good as I can now and into the future. We're going to deliver the guests that you want me to speak to and we're going to continue to keep doing all of the things you love about the show.

1:31:06Thank you.

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