The Foot Health Mistakes Making Us Age Faster

Dr. Courtney Conley is one of the leading voices in foot health and human movement — and this conversation will completely change the way you think about your body from the ground up. In this episode, we dive into why modern footwear and modern life may be weakening our feet more than we realize, why so many people assume pain is just a normal part of aging, and how strengthening your feet can play a major role in the way you move throughout your life.

We talk about the hidden role our feet play in everyday movement, the surprising importance of toe strength and mobility, how chronic foot pain develops, and the simple daily habits that can help you move and age better. Dr. Courtney also shares her own story — from ballet dancer and runner dealing with constant foot pain to becoming a specialist helping people rebuild strength from the ground up.

This episode is packed with practical takeaways on foot health, movement, strength training, walking, footwear, longevity, and why being proactive about your body now matters more than waiting until pain shows up later.

See omnystudio.com/listener for privacy information.

Episode Transcript

Speaker 1 (00:00):
Just because we age doesn't mean that's associated with pain.
You can strength train your feet like you could strength
train the rest of your body. Most people have weak
feet just because we don't pay attention, and we're building
these jet engines of bodies on paper airplanes of feet.

Speaker 2 (00:16):
Doctor Courtney Conley is one of the leading voices in
foot health and human movement. This episode is all about
our feet, why they're the foundation for how we move, age,
and feel, and how modern life and modern footwear may
be weakening them more than we realize.

Speaker 1 (00:29):
We have to sleep, we have to breathe, and we
have to walk. It's like the most easily accessible, underutilized
treatment that we all have access to. People who walk
slower can predict things like dementia's years in advance. Want
to be proactive not reactive?

Speaker 2 (00:46):
Is it true that your toes can predict if you'll
die early?

Speaker 1 (00:51):
What they found with toe's strength.

Speaker 2 (00:54):
Is Hi, guys, Kate here, Thank you so much for
tuning in to today's conversation with doctor Courtney Calmly. If
you are enjoying post run high, please be sure to
follow the show wherever you're listening, and we will be
right back after this shortbreak. Doctor Courtney Connolly, you are

(01:20):
a foot expert that has said modern footwear and modern
life are weakening people. So what do people misunderstand about
their feet?

Speaker 1 (01:29):
It's one of the parts of our body that I
want people to start paying attention to because we really
have come a long way from a rehabilitation perspective on
strength training and power training and getting our bodies strong,
which I love, but we don't look have that same
view at our feet. And when you look at the foot,

(01:51):
it's the only interface we have with the ground. It's
what keeps us upright and balanced walking and running, and
we need to start looking at it and paying attention
from the ground up.

Speaker 2 (02:01):
What is the most common thing you have people coming
to you for?

Speaker 1 (02:05):
One in three people over the age of forty five
have foot pain. It's like one of the most common diagnoses.
And for all those reasons we just talked about, right,
So people don't pay attention to their feet. So when
they come into my office, they'll have things like heel pain,
plantar fasciitis, achilles, tendinopathies, a lot of four foot injuries,
so things like bunyans and neuromas and metatarsal pain, stress fractures,

(02:29):
So we really have to pay attention because of these diagnoses.
When you get foot pain, there's nothing else that will
stop you on your tracks.

Speaker 2 (02:40):
And how early should people start caring about their foot strength?

Speaker 1 (02:44):
I tell my daughter this, you know what, I'm probably
dating myself here, but they would do scoliosis checks like
in school. I think people should start doing that, Like
we should be looking at our children's feet, because if
we get our kids in the right type of footwear
and we start paying attention at that young age, I
don't think we'd see a lot of the problems that

(03:05):
we see in adulthood.

Speaker 2 (03:06):
Coming out of our conversation today, what do you want
everybody to learn and know about their body?

Speaker 1 (03:11):
That you can strength train your feet like you can
strength strength train the rest of your body. Like that's
what I want people to understand is that when you
look at your foot, it has layers of muscle, multiple
joints that can be mobilized and the tissues can be strengthened.
And it is important as we age because where we

(03:34):
get our power from is a foot and ankle.

Speaker 2 (03:37):
It's so interesting because I never in a million years
have thought about strengthening my feet because I just assume
that they strengthen through movement and all the walking that
I do and running.

Speaker 1 (03:49):
It's you know, when you think about it too. If
we want to start the footwear conversation when you put
if you look at most footwear out there, it doesn't
re back the anatomy of the foot. So the widest
part of your foot is your toes. If you look
at most footwear, most of the toe boxes and shoes

(04:11):
are tapered. So if you can just visualize what that
would do to the ball of your foot, to the
front of your foot, it literally takes your toes and
squeezes them together. When we're walking, when I go in
the push off phase of gates, so this is when
I'm rolling through my foot and I'm pushing through the
ball of my foot, I put many times my body

(04:31):
weight through the ball of the foot. So the foot
should be the toes should be splayed. The foot needs
to be strong in order for that propulsion to occur.
So when you squeeze your toes together, you're compromising the
function of the foot. And I think that's why we
see so many foot problems, is not only are we
not paying attention to the strength of our feet, but

(04:52):
we're compromising the function by the type of footwear that
we're wearing.

Speaker 2 (04:54):
I want to have a whole conversation on footwear, and
we're going to dive into that section in a little bit.
And guys, I have so manyamples of shoes, like scattered
throughout this studio right now. We've got stilettos, We've got,
you know, kind of a more basic sneaker, a really
really more basic sneaker, a comfy sneaker, stilettos, We've got
the whole, the whole bit of shoes. So we're going
to dive into that. But first I would love for

(05:16):
you to take us back. How did you become so
interested in feet?

Speaker 1 (05:21):
That's a good question. From a very young age. I
was a ballet dancer, so I spent a lot of
time in point shoes. I started developing bunyons at a
very young age, and they were painful. Once I was
done dancing, then I became a runner and just always

(05:41):
suffered from foot pain from bunyons, aromas, fractures, basically everything
you could think about. And so it was like this
personal quest because movement was my therapy and still is.
It brings me back to baseline. So, when you can't
walk and you can't run because your foot hurts, it

(06:01):
really takes a toll on not only your physical health
but your mental health. So I started figuring out what
I was going to do, and I was like, Okay,
I'm going to go to a chiropractic school and we're
going to learn about the foot n angle. And we
had about a half a semester and it was basically,

(06:22):
if your foot hurts, cast someone for a foot orthotic,
and if it hurts more, referred them to get surgery.
There was very little conversation of strength, and so I
got out of school. I worked in a couple of
foot orthodic labs and started making foot orthoses for people

(06:43):
and myself, and you know, things would get a little
bit better, but the pain would come back. And so
that's when I started saying, Okay, we need to start
looking at the foot a little bit differently. And I
went down this rabbit hole of learning how we can
get stronger from the ground up.

Speaker 2 (07:00):
So what was the first step to getting rid of
the paint?

Speaker 1 (07:02):
Well, I was in foot orthoses for years and what
those do is they change loads, right, So it's a
load modifier if you will, and they can be very helpful.
There also should be the conversation with those of having
an exit strategy, right, So it's the and conversation. If
you're going to wear one of those, it's wear them

(07:25):
and strengthen your foot. But we don't often hear the
and part. It's just wear these. And so that's when
I was like, Okay, we're going to start strengthen my foot.
I switched my shoes around and then I weaned myself
out of the orthotic and I really did start getting
a lot stronger. And you have to put the work in.

Speaker 2 (07:47):
Yeah, so what does that work look like?

Speaker 1 (07:49):
Years? It was years to this day. But you know,
I mean, we all have things to work on. That's
what I wanted to really educate people on is we
don't have to make it this. I have more stuff
to do now because there's little things that you can do,
but you just have to pay attention.

Speaker 2 (08:06):
So tell us some of those little things that you
can do.

Speaker 1 (08:08):
First, the getting into different footwear that respects the anatomy
of the foot, getting your foot on the ground. We
have thousands of receptors on the bottoms of our feet.
If you look at any baby on the planet, the
first thing they do is like take their shoes and
socks off because their brains are developing, so they want
to feel from the ground up. So a lot of

(08:28):
my patients when they get out of bed and like
even in the middle of the night, they'll put their
slippers on, Like their foot's never on the ground. You
have to feel, so take your shoes off, even if
you've had chronic foot pain five minutes, So that's like
an easy place to start. We'll also do different assessments

(08:49):
like can you lift just your big toe? And these
are the fun things we do on my clinic.

Speaker 2 (08:53):
By the way, clicking up my towel.

Speaker 1 (08:56):
Can you lift your foe toes? It's toe dexterity. It's
being able to move your foot around. Can you lift
all of your toes and splay them? This is a
fan favorite.

Speaker 2 (09:06):
This is my favorite too. I used to think this
was like a fun thing that some people could do,
some people couldn't.

Speaker 1 (09:12):
It's you should be able to lift all your toes,
spread them and see daylight between each toe. So you
have a bunch of nerves in the foot, so you
don't you want your foot to be strong and stable
a lot of people can't do that, and that's a
muscle imbalance.

Speaker 2 (09:28):
The concept of being barefoot, Yeah, I love it because
it's so primitive. And I like that you brought us
back to the example of a baby, because I feel
like there is so much that we can learn from
just watching kids and how they move their bodies.

Speaker 1 (09:41):
Yeah, it's you know, I've thought it was really interesting.
After COVID there was a lot of articles that came
out that said, don't go barefoot at home because all
these people are getting foot pain now. And I'm like,
they're having the wrong conversation. When you go from zero
to one hundred, you're gonna see problems. So most people

(10:02):
have weak feet just because we don't pay attention. So
when you go from wearing traditional footwear and your foot
isn't strong, and then now you're home and you go
barefoot all the time, it's too much load, too fast.
The conversation I'll have with my patients is you wouldn't
squad one hundred pounds one week and then two hundred

(10:24):
pounds the next week. The foot takes on multiple times
our body weight when we're walking. It was designed to
do that, though, But if you go too fast, you
run into problems.

Speaker 2 (10:36):
So if there's somebody listening today that has chronic foot
pain or is having some of the pain that you
experienced through being a dancer and then a runner, and
you know, really they have foot pain that just isn't
going away, what can they start tomorrow and what does
the proper build look like.

Speaker 1 (10:51):
So those first things that we talked about is like
step one, but there's a lot more that can be done.
So I'll usually progress my patients from those types of
exercises and drills standing leg balance, barefoot into bandit exercises,
so like you would do a bicep curl with a
band if you will, we'll do those with your toes.

(11:11):
Then we progress them into heavier loads things like sled pushes,
farmers carries. Whenever my patients are in the gym and
their strength training, they are in either a minimal shoe
or barefoot. That's that's an exercise for your feet is
lifting heavy things and allowing your foot to feel the ground.

(11:32):
So there's a there's a progression there. Things like calf
raises amazing. I think everybody on the planet should be
doing some type of calfhrays standing seated you know, you
have to train the plantar flexers, especially if you're a runner.
That's the powerhouse of the lower leg.

Speaker 2 (11:48):
And so I'm somebody that has always had knee issues.
I've torn my ACL twice. Now I the second time
I tore it, I never got surgery. And the biggest
thing that I learned about my body through going through
those two traumatic and reason going through the rehab was
that certain muscles and ligaments and joints compensate to protect
that knee and help stabilize it. So the biggest thing

(12:10):
for me, and I know this isn't isn't the foot,
but I feel like it can relate is now that
I don't have an ACL, I can't sprint anymore because
when I sprint, my hamstring poles and it's my body's
way of compensating and protecting that lateral movement and the
instability in my knee. But I'm curious when it comes
to chronic foot pain, do people need to get a
full body assessment?

Speaker 1 (12:31):
Yeah, I mean, I'll tell my patients it's never just
a foot problem. You have to assess the entire body.
You know, someone with knee pain, you have to when
you're walking for example, when the heel hits the ground,
it initiates pronation. Pronation is required for rotation of the tibia.
So there's this cascade of events that occurs when your

(12:55):
foot does what it's supposed to do, and it will
affect the knee and the hip and the low back.

Speaker 2 (13:00):
So then say you're somebody like myself, knock on wood,
I have not had feet problem yet, you know, And
there's a lot of people in my life who have,
whether it's through over usage or an actual injury that
they haven't recovered from fully or properly. But I'm not
somebody that has had feet problem yet. I do know
that this is something that happens to people commonly as
they get older. So as somebody that's going to be

(13:21):
twenty nine soon, going to be thirty soon, what are
the preventative things that I should be thinking about to
strength in my foot and how important are they?

Speaker 1 (13:28):
So if you strength train things like taking your shoes off,
caphraises foot strength walking around barefoot when you can just
to get that stimulation into your body in the right footwear.

Speaker 2 (13:44):
So it's the same protocol as somebody that has chronic pain.

Speaker 1 (13:47):
And you want to be proactive, not reactive, like what
I'm hoping with this work. You know, when you go
into a grocery store and you go to the foot
care section, all of the things that are being sold
are for symptoms, right, It's like, buy this for your
heel pain. Here's a heel cushion, here's pads for your toes.

(14:08):
Instead of having the conversation of what can I do
to not have to need those things? You know, and
that is strength mobility, you know, making sure that Like
I think the big toe is the most important joint
in the body. But I'm biased.

Speaker 2 (14:23):
But when some of the statements in this podcast so
far the most iconic, I'm like obsessed with you. That
was iconic. It tell us why.

Speaker 1 (14:31):
Your big toe when you're walking needs about forty forty
five degrees of range of motion. Okay, when you're sprinting,
those numbers go up to sixty sixty five. When someone's
big toes starts to decrease range of motion so they
can't hit forty forty five degrees, you start to see
compensations up the entire chain, so they might spin their

(14:52):
foot out when they walk. They might they won't be
able to roll through the foot One of the biggest
ones is that compromises hip extension for example, so back pain,
hip pain. So when you decrease range of motion at
your toe, and for someone who is listening to this
who has pain there, they will tell you it is

(15:14):
literally every step. So you don't want to get to
that point. So being able to you know, mobilize, you
would stretch your calves, you can mobilize your big toe.
I'll have patients like take a like a golf ball
that size, and they'd have their foot on the ground
and they'd put the ball just underneath their big toe

(15:34):
and you can just hold that there and it'll stretch
the bottom of the foot. You can kind of press
the big toe into the ball and then try to
lift it off, so you're almost doing like contractions at
that end range of the joint. But those things are
really important.

Speaker 2 (15:48):
Isn't the pinky toe really important too for balance?

Speaker 1 (15:51):
Yeah, it's not just to get broken on furniture. You know,
when you look at most people's pinky toes too, they
curl under their foot, like the fourth and fifth toes
curl under and that's footwear. If you look at shoes right,
there'll be tapered on the outside. That's a muscle imbalance,
so there's a muscle that actually extends the toes. So

(16:14):
that exercise we talked about the lifting the toes, spreading them,
and reaching them. That's a great drill to do. If
those toes curl under, you need stability on the outside
of the foot. We talk about the arches of the foot.
Everybody gets excited about the medial arch, but there's one
on the outside too, and that foot has to be

(16:35):
stable in all those different planes.

Speaker 2 (16:38):
Why do people get excited about the medial.

Speaker 1 (16:40):
Arch because they think it drops as they age. Right,
flat feet, and that's you know, when your foot gets weak,
you're going to see changes to your foot. But the
conversation of all flat feet are bad is not true.
It's how does the foot function. So, but we've grown
accustomed to if some if you see someone with a

(17:01):
flat foot, their response is they have to get into
some type of foot orthosis, foot orthotic, and they need
a shoe that has a lot of support. And I
really want to challenge that thinking because flat feet can
be strong feet. So it's how the foot functions, not
necessarily how it looks. I've seen some very strong flat.

Speaker 2 (17:22):
Feet how common is it to have a flat foot?

Speaker 1 (17:24):
You know, I see a lot of them because they
come into my office. A flat foot that's weak is
a different conversation because they don't have the capacity to
handle the loads that are required when we're walking. So
they come in with a lot of issues. He'll pain
to a lot of tendon diagnoses, and so that's what

(17:46):
we work on is getting their foot stronger.

Speaker 2 (17:48):
So people with flat feet, it is something that they
have to kind of think about throughout their life.

Speaker 1 (17:52):
I mean, if it's causing symptoms, yes, but you know,
when you have a foot, it has to change shape.
So if someone has a flat foot and you were
to stand and rotate your body, so you'd be standing
and rotate your hips, you should see the arch of
the foot increase because the hips, the rotation of the

(18:14):
hips affects the foot. So if you can't get your
foot to change shape, that's always a signal for me
that you know, we want to take a look at this.
Why can't the arch drop and why can't it lift?

Speaker 2 (18:40):
How did it setting to become a chiropractor help you
when it came to now specializing in feet.

Speaker 1 (18:45):
I mean, I've always loved movement. So it was you know,
in the school that I went to was very movement based,
and I really liked that. I wish we did have
more education in school. A lot of my education with
this was post grad because I think we just haven't

(19:07):
really there's something I think people like get scared about
with the foot. It's complex, but there's a lot that
can be can be done, and so yeah, I think
learning about movement in general was kind of my driver there.

Speaker 2 (19:23):
Why do so many people assume pain is a normal
part of aging, especially when it comes to the foot.

Speaker 1 (19:30):
That's such a good question. I don't know, because it
shouldn't be. You know, just because we age doesn't mean
that's associated with pain. We can age well. I feel
better turning. I'm going to be fifty this year.

Speaker 2 (19:46):
I'm sure, sure you don't look fifty. Oh that's crazy
to me.

Speaker 1 (19:50):
But I feel better now than I did in my
twenties because my training has completely changed. I was like
cardio Queen triathlon my thing, and I didn't strength train,
and I had back pain and neck pain. You know,
I'm on my trainer or my bike for like hours.
And when I turned forty, I was like, huh, I

(20:12):
have some Achilles issues going on, and I have some
things are starting to pop up again, and I'm like,
this is we got to switch it up. So that's
when the strength training became a really almost more of
my training than some of the cardio basket or stuff
I was doing.

Speaker 2 (20:32):
It's also interesting your your athletic background to go from
dance and being a ballerina and doing point there's a
lot of like strength training involved in that sport, right, Yeah,
I mean, I guess it's like body weight more so.
But then that transition to running, it's a big difference.
Like you don't hear a lot of dance about a
lot of dancers that like to run because you lose

(20:53):
flexibility right when you run.

Speaker 1 (20:54):
Yes, yeah, it was. It was a very big kind
of switch, and I I enjoy it. I enjoyed both.
I just wish I was a little more well rounded
when it came to fitness, which is now what I
focus on.

Speaker 2 (21:10):
I feel like it's one of the most important things
for women, and I think it's something that women forget
because it's like especially I mean, I'm a runner, so
like my whole life, I've been running, and it wasn't
until probably two years ago that I started leaning more
into strength training and doing like more circuit workout classes
and really enjoying it. But it's hard because it's like
you get so addicted to that cardio high totally. But

(21:32):
osteoporosis is a big thing for women, like it's important
for us to be strong. Yep, let's talk about movement
as medicine. You just read a book. It just came out.
It's called Walk. Yes, talk to us about your book
and the power of movement as medicine.

Speaker 1 (21:44):
Movement has always been, like I said, my therapy and
especially walking, and even from a young age, I would
always rely on being able to walk to make myself
feel better physically, mentally, emotionally, bad day, I'm going for
a walk. It was just a constant for me. And

(22:06):
now that I'm working with patients who are in pain,
it's such an important conversation to have because it is
the panacea of medicine. If you look at every system
in our body, the metabolic system, the nervous system, the
muscular skeletal system, the digestive system, your mental health, your

(22:27):
brain health, all of it is helped by walking. It's
like this constant stimulus that we need to function in
age well. And that's how I wanted to educate on
it is it's this physiological necessity. It's not an option.
Not sleeping is not an option, right. We have to sleep,

(22:50):
we have to breathe, and we have to walk. So
I want to kind of flip the script on that
conversation that this is something that has to be done
every day, and I think we would all feel better.

Speaker 2 (23:00):
In addition to the workout that we're already doing.

Speaker 1 (23:02):
I mean absolutely so with my runners, they'll say, well,
I ran and I do my run in the morning,
and then we talk about what the rest of their
day looks like. Are you sitting at a desk for
then eight to nine hours? Because if so, I'm sorry,
but that hour in the beginning of the day doesn't
negate you from getting your steps in throughout the day.

(23:23):
It still has to happen. It's this stimulus that needs
to occur throughout the day. So it's the and conversation
if you strength train in the morning and walk.

Speaker 2 (23:35):
Interesting. I feel like that's something that so many people
don't think about, because I mean I think about myself.
You know, obviously I'm eight and a half months pregnant,
right now, I'm not moving as much as I would
like to, but I am getting a lot of walks in.
But previously, if I would run, you know, six miles
in the morning or whatever it was, five or six miles,
I would hardly be going for a walk in the afternoon.

Speaker 1 (23:55):
Think about it. From this is how I explain this
to people. After you eat, one of the best times
to go for a walk is after you eat. And
there's the reason for that is because when we eat,
we have a spike in our glucose. So when you
go for your run in the morning, that spike in
the glucose still happens after you eat. And so when
you walk after you eat, you have muscle contraction and

(24:19):
you're pancreas grabbing glucose from your bloodstream and getting it
into your cells. So those things still happen. That's why
we have to use walking throughout the day.

Speaker 2 (24:30):
So what is the protocol for walking? Because you hear
a lot, right, it's like ten thousand steps a day,
some people try to do twenty thousand. So how many
steps a day do we actually need to be taking
and what are the long term effects of getting x
amount of steps in?

Speaker 1 (24:46):
Yeah, it's very individualistic, right, so everyone should assess what
their baseline is. If you look at the science from
a longevity perspective, that number sits around seven to eight
thousand steps. Get a lot of benefit in that range.
Some people say, well, I walk fifteen thousand steps, wonderful,
that's great. My conversation to them also is are you

(25:10):
strength training? And if they say no, I don't have
time because I'm getting fifteen thousand steps, and that's when
I'll have the conversation. Well, okay, let's dial it down
a little bit and then give yourself time to strength
train or have the and conversation. But for someone who
doesn't get a lot of steps in like let's say
you're at twenty five hundred, increasing your step count by

(25:32):
five hundred steps, which is a five minute walk, decreases
all cos mortality by seven percent. Like these numbers are
really when I was researching for this book, thirty eight
hundred steps a day decreases your risks of dementia by
twenty five percent. Thirty eight hundred steps, so you see
a lot of magical things happen when we get just

(25:53):
a little more active in that range. Some of the
other ones that I really like is the depression the
mental health. How I mean walking is it should be
on every doctor's prescription pad for mental health disorders. But
at five thousand steps you reduce your symptoms of depression.

(26:15):
And I think with me personally, that's always been, I
mean a go to of mine is that when I
don't feel good, it's a non negotiable for me. I
am outside and I am like going for a walk,
and I've never come back and said, wow, I feel worse.

Speaker 2 (26:31):
Ever, No, I completely agree. Yeah, And for me, it's
always been go for a run. And now I'm at
the stage of life obviously being slowed down with pregnancy,
that it has been going for a walk. But it
really is so important. And we just had a doctor
on a sports medicine doctor from the hospital for Special Surgery,
and his name Jordan Metzel, and he talks all about
the power of movement, same as you in terms of longevity,

(26:55):
and he's like, there's so many different things out there
with biohacking. You know, there's from red light there be
to sitting in hyperbolic chambers to doing all this expensive
stuff when the simplest things you can do to increase
your longevity. Yes, is move and they're free.

Speaker 1 (27:11):
Yes, it's like the most easily accessible, underutilized treatment that
we all have access to just walking out your front door.

Speaker 2 (27:28):
What were some of the other stats that you uncovered
in your book that you were floored by?

Speaker 1 (27:33):
Gate speed? Walking speed? So, and it has been touted
as the sixth vital sign. So when you go to
the doctor and they take your blood pressure and your temperature,
if there's a problem there with a vital sign, it's
a flag. It's a red flag saying hey, we want
to look into this because there's either a problem happening
or one is going to happen. They looked at gate

(27:56):
speed and what they found was that people who walk slower,
So a slower cadence can predict things like dementia's years
in advance. So we can identify that there is a
could be a potential cognitive decline by watching how fast

(28:18):
someone walks. It's it was fascinating to me. If someone's
walking slower, is it because they have poor balance? Are
they weak? Do they have poor muscular endurance? You know?
Is their fall risk? So when we identify these things,
we can work on them. And I think that's very encouraging.

(28:41):
I think it's a hopeful conversation.

Speaker 2 (28:43):
I mean, there's not a single person listening to this
that wants to have dementia in twenty five years, you
know what I mean. I think that's the scariest thing
when it comes to getting older is losing our mind. Right.
I remember, like all of my grandparents have said, you know,
the one thing that I hope for is I just
don't want to lose my mind, which is complete. Like
I could totally understand that. So if there's indicators when
you're in your thirties and forties and twenties to identify

(29:07):
some of these things, I mean, that's huge.

Speaker 1 (29:10):
And you know, when you look at some of the
cancer research, it's walking. Being able to walk for thirty
minutes at a brisk pace and you reduce your risks
of many types of cancers about that seven to nine
thousand step range. But the speed was about four point

(29:30):
zero miles prowur on a treadmill, one hundred and thirty
five steps per minute. So I'll tell my patience, I
want you to go do this. It's not as easy
as it sounds. It's a fast clip and in order
to walk for thirty minutes at a faster pace like that.
You have to have good cardiovascular health. You have to

(29:53):
be strong from the ground up. What do you think
allows you to push through that speed. It's your foot
and ankle. That's why it was like such a beautiful
thing to be able to write this book and then
kind of marry my passion for foot and ankle health
because it's like, you can't do some of these things
when your foot and ankle can't produce power. Yeah, they

(30:15):
go hand in hand, they go hand in hand.

Speaker 2 (30:17):
And a four point zero like that is I mean,
as a frequent treadmill person right now, if four point
zero is fast, Like when I turn the treadmill on.
For my I try to round a five k every day.
That's been like my goal throughout pregnancy, and I am
very impressed that at thirty graduation it literally thank you.
Like sometimes I go on the treadmill and I'm like,
I deserve a congratulations for doing this right now because

(30:38):
this baby is heavy. Yes, you know, And I turned
the treadmill on and I started a five and then
I gradually go to like five point two and then
I try to end around like a six point two.
But anyways, walking, just if you're familiar with treadmills and
the numbers like four point zero is fast. And there's
a big fitness trend right now. It's called the twelve
three thirty on the treadmill. If you heard of it, yeah, okay,
so it's basically, uh, it's a really good workout. It's

(31:00):
basically you put the incline to a twelve. Okay, you
do it for thirty minutes, and you put the speed
at a three. But maybe we should be putting the
speed at a four.

Speaker 1 (31:08):
I mean I think that's if you're at a twelve
percent incline with the three, I mean, that's that's a
good workout.

Speaker 2 (31:14):
Yeah, people like spare by it.

Speaker 1 (31:16):
Yeah, and if you wanted to increase the speed, you
will notice very quickly where you get that from. And
it's you'll feel your foot in calf for sure.

Speaker 2 (31:25):
I feel like the calf is the biggest thing. Especially
like if you're somebody that's new to running even or
like new to going for getting a lot of steps
in the first place, you notice this soreness. Oh yeah,
it's in your calf.

Speaker 1 (31:36):
Like when people go on vacation and their step count doubles.
You will hear them say often the next day, my footsore,
my calves are sore, and it just should tell you, hey,
pay attention to me.

Speaker 2 (31:51):
Is it true that your toes can predict if you'll die.

Speaker 1 (31:54):
Early when you look at toe't strength. There's really fascinating research.
Karen Michel did a bunch of it. They also compared
it to grip strength, you know, because grip strength can
be an indicator right of your longevity, your capacity. And
what they found with toe's strength is it's a predictor

(32:15):
of falls. It increases your risk of falls. So if
you were to stand up and stand straight and lean forward,
what's stopping you from falling is your toes. So falls
a lot of falls, the majority can occur at the
initiation of gaits. So if I was going to start

(32:37):
walking towards you, so the strength of the toes decelerate
our body. So as we age sarcopenia, and we know
that's a thing muscle loss of muscle mass. We have
to think about the foot too, because that also occurs
at the foot. So when you lose strength at your feet,
your your risk of falls goes up. And we know

(32:58):
what happens when we fall.

Speaker 2 (33:01):
And that's the biggest thing you hear about it, and the.

Speaker 1 (33:03):
Stats are not good. All right. You know what happens
when you have a hip fracture. People's lives are changed,
So we have to really pay attention to that. It's
one of the biggest things I work on with my
patients is toe strength, because I don't want them falling.
And unfortunately, what we've done is if someone does have

(33:30):
weak feet. For example, I was having this conversation with
my dad. He was like, you know, when I'm walking,
I feel like I can't push through my foot. So
had I not been his daughter, he goes to a
shoe store, right, and then he gets a shoe that
basically looks like a boat, right, and it's facilitating his gait.

(33:53):
So he puts that shoe on and he says, wow,
I can roll through my foot now, right because it
has a little toast spring on it. Uh, that's not
the conversation I want having with my father because if
you don't use it, Dad, you're going to lose it.
So even though he puts the shoe on and he says, wow,
I can push through my foot, the shoe is helping him.

(34:16):
So again, if that's the kind of shoe he wants
to wear, and you're strengthening your foot. We're not going
to ignore the fact of why you can't do it
in the first place. So toe exercises.

Speaker 2 (34:30):
And it's so interesting because I feel like with my grandparents,
like we have started, like with my grandparents that are
left and also Jeremy's grandparents that are that are left,
we have been talking a lot about falling and so
Jeremy has my husband has two grandparents that are well through,
three grandparents that are so alive. Two of them are
married and they're in their nineties, and one of them

(34:51):
is literally like such a gold standard for like the
gold the gold standard when you talk about like your
book and longevity. He's somebody that has always prioritize movement,
and Jeremy could speak to it so much better. But
for his entire life, he and obviously the movement has
weaned back as he's gotten into his nineties, but like
he was somebody that would wake up every morning and
you know, go for a run, go lap swimming, like

(35:12):
five am. He just really prioritized it and movement has
been a huge part of his life and he has
like completely outlived his ancestors and like his family members,
like a lot of them died in like their sixties
and you know, their early seventies. And he's ninety two
years old and still moving his body. But we have
started having these conversations about falling. So I'm curious, why

(35:35):
do we fall as we get older.

Speaker 1 (35:37):
Well, I mean there's multiple reasons. Strength capacity endurance capacity
is one. So if we start to lose strength, we
can increase our risk of falls. And that's whether it's
strength of your toes or the rest of your body.
Losses of range of motion. Right, So, ankle mobility is
another very important factor. When you walk up and down

(36:01):
a stair or you sit into a chair, that requires
joint mobility. So if we're not paying attention to those things,
our body can't respond. The other conversation I like to
have is we lose power. We lose power faster than
we lose strength, and so we need to be paying

(36:22):
attention to those things and training for them. And I
don't think it's never too late to start. So, I mean,
these are the conversations I have with my father who's eighty,
my mom seventy six. You know, like this is we
need to be having these conversations.

Speaker 2 (36:38):
Yeah, and I loved your example of saying, you know,
in your twenties and thirties, you were doing a lot
of cardio and triathlons and running, and then you moved
into strength training in your forties and you've never felt better.
Like that's a great example because there are so many
people listening to this today that are in their twenties
and thirties and going into their forties and maybe they
are now inspired to take on strength training.

Speaker 1 (36:56):
Yeah, my mom had suffered from chronic low back pain
and it got worse as she got older. And now
she is in the gym strength training two to three
times a week. She's walking every day, and it's changed.
You know, it changed your life. But she wasn't strength
training for a long time. But you know, it's so

(37:17):
good to see. It's so good to see.

Speaker 2 (37:19):
Yeah, I mean, there's nothing better than seeing somebody like also,
like I mean when we talked about Jeremy's grandpa in
his nineties, Like to be able to see somebody in
their nineties that can walk a couple of blocks around
the block, that's amazing.

Speaker 1 (37:31):
I mean when people ask that question, like what do
you want the last decade of your life to look
like there's not anybody on this planet that would say
I don't want to walk. Everybody. That is the one
thing that is will be on every single person's list
is that I want to be able to walk. I
want to be able to walk with my grandkids, I
want to be able to walk with my friends. We
don't realize the importance of that because if you reverse

(37:55):
that statement and say, well, what if you couldn't walk,
it is think it, it's panic, it's a prisoner in
your body. So that's why this conversation is so important
because we can do it right now.

Speaker 2 (38:10):
What do you want people, especially women, to stop thinking
about so much when it comes to fitness and start
thinking more about.

Speaker 1 (38:18):
There's so much out there, especially like I'm going through perimenopause.
So it's like every time you turn around, it's like,
we got to do this, and you have to eat
X amount of protein and we got to do all
these things and you do. I mean, there's there's things
that you need to do, but we complicate it. We
just make things hard. Like the power of a walk

(38:39):
has been a saving grace for me throughout my entire life,
and especially now you know with my daughter. You know,
she's fifteen, so that's a whole nother a whole nother thing,
and being able to even go on walks with her

(39:00):
is so nice. It's so nice.

Speaker 2 (39:02):
We actually just had doctor Mary Clair Havebron, who specializes
in perimenopause and menopause, and it was a fascinating conversation.
And I'm excited and that perimenopause is getting the moment
that it deserves that it hasn't had because I feel
like it's been so under talked about. I don't know
if you watch your Friends and neighbors, but they're currently
showing perimenopause in it with one of the main actresses

(39:25):
or the main characters. And I'm like, okay, that's kind
of nice. Yeah, because for so long it's been like, oh,
all of a sudden, you're in menopause, and well, there's
so much that happens before it.

Speaker 1 (39:35):
It's so good to see all the resources that people have,
you know, And that's why I think that easier conversation
so it doesn't become overwhelming, because then it just paralyzes
people when there's just too much stuff, and walking can
really hit a lot of those a lot of those
benchmarks that we're looking for.

Speaker 2 (39:55):
Yeah, it's a simple habit that you can do every day.
That's all we need. Yeah, simple habits. Right, we've been
teasing footwear. I feel like this whole episode so far.
So first of all, when did you realize modern shoes
were hurting people?

Speaker 1 (40:06):
Because I've had footpain for so for the majority of
my life. When I was younger, I didn't connect the dots,
But now looking back, I'm like, oh, this a lot
of this was being driven by poor footwear, And now
when I see my patients, it's just I'm so glad

(40:27):
to be educating on this because that change makes such
a big difference, and people don't know. I mean when
you look at what shoes are really designed to do,
it's protection for your foot. And years ago we screwed
that up and started going fashion overfunction, and we've just

(40:50):
we've never looked back, but we were warned. I mean,
there's plenty of research saying hey, if you continue to
wear this type of foot where you're going to have problems.
But here we are.

Speaker 2 (41:00):
I feel like it's always been fashion overfunction too. Yeah,
I mean I maybe now more than ever because there's
like so much overconsumption with social media. But I don't know.
I'm even like thinking about in like certain Asian cultures,
wasn't it a thing to like squeeze your feet into
the binding? Footbinding? What was footbinding?

Speaker 1 (41:17):
Just taking the foot and basically binding it, like wrapping
it up and putting it into shoes that changes the
structure of the foot. I mean, some of those pictures,
if you were to google that, it is frightening. And
you know, I would be lying if I said I
didn't see some feats that are pretty what's the word?

(41:38):
I want to look at mangled if you will coming
into my office because they've been ignored for so long
and put into footwear that restricts their function. It's not
what you want to do.

Speaker 2 (41:50):
Do you have people that come into your office that
are in specific industries where you notice it more.

Speaker 1 (41:55):
Women who have to wear heels. In the book, we
have a story from a flight attendant. Oh my god,
because and I've called plenty of airlines and I'm like,
it's time that we have the conversation that women don't
have to be in heels. And they've changed, like you know,
it's changed over the years, but there's still dress dress codes,

(42:18):
and these people are on their feet all day long.

Speaker 2 (42:21):
Who are you calling? Yes, It's like, are you just
like code calling Delta? What's going on with the outfite?

Speaker 1 (42:27):
I mean it's like I get into this stuff, but
I don't think it's fair, you know. I mean they're
in pain walking around in a heel. So when you
and I get it, like, I'm not going to win
the conversation of everybody needs to wear functional and minimum
footwear all the time. I'm not going to win that conversation.
It's not an always or never conversation. But what I

(42:48):
do want to educate people on is sometimes if you
have to wear a heel to go to dinner, or
you have to wear a certain type of dress code
when you get home or for the rest of your day,
wear better footwear. Where's something that allows your foot to
display in function. And then again it's the and conversation.
It doesn't have to be or.

Speaker 2 (43:08):
It's like everything in moderation and it comes down to
But yeah, it's so funny too, because I remember growing
up one of my mom's friends was so in on
footwear and she would like, look at even just like
flip flops that I was wearing, and she was like,
those flip flops have no support, and you we're on vacation,
you're walking around all day and those shoes kate and
it's so bad for you. And I was always like, oh,
but they're so cute, Like you know, I'm fine, But

(43:31):
it really is the long term effects. You know.

Speaker 1 (43:34):
We hear that all the time, right, like, make sure
you find a shoe that has a lot of support.
And it kind of drives me crazy because the foot,
when it is doing what it should do, it doesn't
need support. It has four layers of intrinsic muscles, muscles
that live within the foot. It's very well, we've evolved

(43:56):
very well to handle the loads of walking and running.
Now here's the problem. When the foot is compromised by
being stuffed into a shoe that doesn't respect its anatomy,
or we don't strengthen our feet, then yes, the foot
does need arch support or some type of support. But
it's almost like we're leaving out half of the discussion,

(44:18):
which is you can strengthen your foot so that it
doesn't need support. Rather than just saying everybody's foot needs
arch support, we would say that nowhere else in the body.

Speaker 2 (44:30):
Are cushioned shoes making people's feet bicker.

Speaker 1 (44:34):
That's such a good conversation, right. I feel like it's
like the alien invasion of footwear. They're getting like thicker
and cushier, and there's a trade off. Again, it's not never,
but when you wear cushioned, very highly cushioned shoes, people
put those on and they're like, this feels great protection comfort. Right.

(45:01):
The more stuff you have between the sole of your
foot and the ground, the more sensory acuity you compromise.
You can't feel anything. So when we have the discussion
of fall risk, does that make sense. You don't want
to have a foot that can't feel. You don't want
to take away someone's sensory inputs with a lot of cushion.

(45:25):
So you have to really figure out why am I
wearing all this cushion. I always say to people the
least amount of cushion necessary to complete the task. So,
if you're someone who's walking around New York City all
the time, wearing a minimal shoe, which is a thin
and flexible sole, might be uncomfortable for you because you're
walking on concrete. And in which case, you can still

(45:48):
wear a shoe that allows for tostplay, wide toebox, low
heel to toe drop, and just enough cushion to get
yourself comfortable. But that doesn't mean you need, you know,
ton of millimeters of cushion underneath your foot.

Speaker 2 (46:02):
It's like you have to find the right balance for you, yes,
because I do have to say when it comes to
walk around in the city. And when Jeremy and I
first moved to the Upper West Side, we were getting
we still are getting a lot of steps in. But
when we first moved here, we were like, this is great.
We're near so many parks, Like we're walking in Central
Park every day, and Jeremy and I were like looking
at our step count and we were getting like fifteen
thou seventeen thousand steps a day. It was crazy. And

(46:22):
we still are, Okay, we still are trying. But I
remember I was like, I need to put on a
shoe that's a little bit more cushioned because my feet
literally hurt at the end of the day. So I
think you're right. It's like you have to find the
right balance for you based on where you live at.

Speaker 1 (46:37):
The and conversation right, so like where the amount of
cushion that's necessary and strengthen your feet.

Speaker 2 (46:44):
What brands would you never wear and what brands would
you recommend.

Speaker 1 (46:51):
We'll start with the ones I'd recommend, because there's a
few of them. I wish there were more. There is
a difference between a wide shoe and a wide toe,
So a lot of the companies will say, I make
a wide shoe, but the toes are still tapered. That
doesn't work for me because if I can't wear my
toes facers in the shoe, it's not a functional shoe.

Speaker 2 (47:13):
We're going to get to the toaspace.

Speaker 1 (47:14):
So Ultra running wide toebox Topo Athletic Notice is a
new company that has wide toe box, but they have
varying stack heights on the shoe. So that can be
really nice for people who want to have more cushion
underneath their foot shoes that I won't wear. You won't

(47:37):
see me in a Nike Converse, you know anything that
really the majority of shoes traditional footwear I'm not going
to be wearing.

Speaker 2 (47:47):
That is so interesting because I feel like Nike prides
themselves so much on the manufacturing of their shoe.

Speaker 1 (47:52):
Well, you know they did you see their toddler shoe.
Now they designed a baby shoe and the market was wonderful.
It was like, we really want to help your child's
foot develop. So in the in the campaign it was
wide toebox, flexible, right, And I'm like, oh my gosh,

(48:13):
this is perfect. So why are they changing it as
we get older? Like make the same kind of shoe
for adults. And I thought that we'd see that, but
we're not quite there yet.

Speaker 2 (48:26):
Nike take notes, you know.

Speaker 1 (48:27):
Yeah, my daughter, you know, she's fifteen, right, so she's like,
you make me wear these platypush shoes, you know, And
I'm like, I get it. So she has her pair
of Nikes. But when she has to make the decision
if we're going on a walk, if she's going to

(48:48):
be like going to do something, she makes the right
choice simply because wearing the Ultra that she wears makes
her foot feel better. And once you aren't putting your
foot into footwear where your toes can actually expand. I
usually my patients will come to me and they'll be like,

(49:08):
I can't wear my other shoes anymore. So those tell me,
they're like, it just feels too tight. You know, if
you look at diagnoses like bunyons or neuromas, and you
were to google what type of footwear should I wear?
It will say get a wide shoe, get a wide
toebox shoe. And so again my response to that is,

(49:30):
why wait till you have a bunyon or a neuroma.
Just wear the right footwear to begin with.

Speaker 2 (49:35):
Ohka, I have a question. So when you go to
certain run stores and I actually am even going to
do this at HSS with Jordan Metzel, you can get
on a treadmill and they kind of analyze your stride
and they see whether you pronate or I don't know
what the other word would be, superate, superinnate. I think
I pronate, That's why I know it. And then they
pick out a shoe based on your stride. Yeah, how

(49:59):
do you feel about those?

Speaker 1 (50:00):
Okay, there are a lot of things there. Okay, First,
when my patients say to me I'm a pronator, right,
I usually say congratulations, you should be. We don't want
to demonize pronation. It's a motion of the foot that
we need. It's what allows for shock absorption. We just
want to be able to control it. And what controls

(50:21):
it is strength. So there's a lot of muscles in
the calf and in the foot and the hip that
help control rotation when the foot hits the ground. So
it's not that we want to say this person's foot
cannot pronate. We need arch recoil so that it can
bounce back, so that it can stiffen up to propel

(50:42):
us forward. So when these analyzes are taking place, I
just want people to be aware of how is your
foot functioning. We don't want to block motions, and so
a lot with a lot of my patients, I'm teaching
them how to find pronation. How do you how do
you find the lengthening of your foot? If you think

(51:04):
about bicep curl, if I wanted to get a stronger bicep,
I wouldn't start my range at a ninety degree angle right.
I would lengthen my arm first and then lift. It's
the same concept at the foot. The foot has to lengthen,
the muscles have to lengthen so that they can engage
and stiffen to propel us forward. So there's really cool

(51:29):
research looking at the importance of muscular capacity and endurance
and strengthen power at the foot.

Speaker 2 (51:36):
So are there shoes that technically work for everyone? Like
when you do one of those tests and you're on
the treadmill and they're like, Okay, you should definitely wear
this version of A six, or you should wear this
new Balance ten eighty, whatever it may be.

Speaker 1 (51:48):
How accurate is that when so Ben Omnig has done
a lot of research in this world, and if you
were to ask or look at some of this research
on what is the best shoe, the end of the day,
it's what's comfortable. What's comfortable for you, And that's where
my argument is, put a shoe on that actually allows

(52:09):
for the foot display a little bit, and then put
a shoe on that doesn't allow that display. The most
people are going to be like, wow, this one is
more comfortable. But there's just not a lot of options
out there.

Speaker 2 (52:22):
Okay, wait, so we go through the list of brands
that we should be uh look.

Speaker 1 (52:27):
Running, Ultra, Running, Topo, Athletic. Okay, notice these brands respect
the anatomy of the foot. They have the wide toe
box and say within the brands they have different models, right,
so you would want to, you know, see where you fit.
The other thing people can do is like take out

(52:47):
the factory insert of the shoe.

Speaker 2 (52:48):
Let's look at let's look okay, so this is the
shoe that I've been wearing.

Speaker 1 (52:53):
Okay, I'll always take the factory insert out of the
shoe and I'll look at the wear pattern, so you
can usually see how their foot is smoothing. I have
a little ink pad in my office that I'll do
it on too, But with a lot of people, often
you won't see any where underneath the ball of the
big toe, and so that will tell me we need

(53:17):
to work on getting them to use their big toe better.

Speaker 2 (53:21):
So what are you noticing with me?

Speaker 1 (53:22):
It's pretty good?

Speaker 2 (53:23):
Oh really?

Speaker 1 (53:24):
Yeah, So you want to have when we walk. Walking
is different than running gate So when I walk, I
want to be grazing the heel. That's what initiates pernation.
That's what initiates the unlocking of the foot. So you
would look and have wear pattern on the outside of
the heel, and then the foot rolls. One of the
drills we talk about in the book is like rolling

(53:45):
the earth away. So you want the heel to strike,
then you're going to go on the outside of the foot.
The foot unlocks, you roll towards the big toe and
the second toe, and then you push forward.

Speaker 2 (53:57):
So it's this interesting and is it the office it
when you're running.

Speaker 1 (54:01):
Well, it depends on how you're striking. So if I'm
a heel striker four foot midfoot, that will change what happens.
But in a walking gate, it's this rolling through and
you're pushing through one and two. But if I don't
see where underneath the big toe, they need to get
there because the majority of our weight goes through the

(54:24):
first and second toe, so we have to be able
to use it. That's why we need good range of
motion there too.

Speaker 2 (54:28):
Now these are a popular running sneaker. These are called
the New Balance ten eighties. I find them to be
really comfortable. I do have to say I think they
changed the style of them because and I can later
after this sepod, i'll show you. I'll compare the two.

Speaker 1 (54:40):
I like.

Speaker 2 (54:40):
Never change my running sneakers, which is kind of bad.
I know, I like and I but not that I've
been getting as many miles and then recently because whatever.
But the first pair of New Bound ten eighties that
I had was much wider in the toe box, which
I loved because I have a wide foot, and I
just found them to be comfortable. These ones are a
lot more narrow like even when you just look at
the shoe like it's.

Speaker 1 (55:01):
It looks pretty narrow. It's narrow, and if you look
at the toes, see how it just tapers. Right, So
you would take put your foot on here, right, Yeah,
when you stand on that insert, is your foot's expanding
over the insert?

Speaker 2 (55:18):
Right?

Speaker 1 (55:18):
I mean it's like, right, you can completely see how
the big toe is falling off of the insert and
the little toe. So yes, so when you put it
in this shoe, it's gonna basically do this, It's gonna
squeeze your foot and you actually have a nice wide forefoot.
So what I'll have people do, like I've seen people's

(55:41):
feet that look more like a shoe than a foot,
where their toes, instead of being splayed, actually look like
they're together. So I'll have them stand on that, lift
up their toes, spread them like they should be, and
tell me if your toes expand over the factory.

Speaker 2 (56:00):
Insert, and that's the biggest thing you should be looking for.

Speaker 1 (56:02):
I mean, it's like the lowest hanging fruit.

Speaker 2 (56:05):
I knew when I got them. I was like, they're
so much less white. And that's annoying when brands update
their models, because yes, you just never.

Speaker 1 (56:12):
Know, but you know, these companies right, like they'll make
the upper of the shoe out of mesh so that
when you put your foot in there, you have they're
allowing the foot to expand a little bit. So the
ones that you know are really difficult, or when the
they'll have like a seam right over the ball with

(56:35):
the big toe or over the pinky toe, and you
know that shoes not expanding, so you know, I mean,
if you're going to wear a shoe that has a
narrow toe box, which I would not recommend, just make
sure the material can expand you'd be surprised how many
people wear the wrong size shoe.

Speaker 2 (56:52):
Oh mean, okay, crazy. I have been wearing the wrong
size shoe for years. I've always thought I was a
size nine. My wedding came around, I had to start
buying heels and I wore this one pair of heels
for my bridle shower that was a size nine and
I was like, they're so uncomfortable. And my mom's a
size nine and she put them on. They're like, they're
so comfortable. What do you mean I found that imsize

(57:13):
ten and a half. Yeah, yes, Like that's insane.

Speaker 1 (57:16):
It's I hear it all the time. When you look
at this the statistics on that, it's crazy, especially with
children because they can't tell us, hey, mom my, toes
are squished in the front of the shoe, so their
feet need to be checked like every three months adults feet.
Our feet change size.

Speaker 2 (57:34):
Yeah, especially when you're pregnant. No, Mignma size eleven now.

Speaker 1 (57:37):
So you have to wear footwear that is the right size.

Speaker 2 (57:42):
You have to.

Speaker 1 (57:43):
It's it's a non negotiable. So like brandic device you
know that like silver yep, So you can measure from
the heel to the toe, but also the width and
whatever number is bigger. That's one way to get your
shoe size. There's ways you can just measure with your
foot on the ground, you know, and just with pencil, right,

(58:05):
But people should be doing that.

Speaker 2 (58:06):
People should be And I feel like women mess it
up the most because we want to fit in certain
shoes and we think that that sometimes heels shouldn't be comfortable.
But what I've realized as I've gotten older is like, no,
like maybe a pair of lubatonts is just never going
to fit you because it's too narrow, you know. And
then it's like on top of that, maybe you need
a bigger shoe size.

Speaker 1 (58:25):
Yes, Oh my god.

Speaker 2 (58:26):
And I tell you it sounds so stupid, but truly,
I was wearing a shoe size I was two and
a half. Size small.

Speaker 1 (58:31):
Yeah. My daughter was. She's convinced she's a nine and
a half. I'm like, you're a ten. I know you
don't want to be. It's okay, but I'm not buying
you a nine and a half.

Speaker 2 (58:38):
Yeah, tell it. Learned from me, Like I really thought
I was a size nine too. What is your take
on inserts and orthotics?

Speaker 1 (58:45):
Time in a place. So I have a great lab
that I work with in Colorado that when my patients
need foot orthoses, I send them there and they do
a wonderful job. There is a certain place in time
when those can be very helpful. They change loads, right,
So if you think about someone with planar freschitis, for example,

(59:08):
early in that diagnosis, there's great research that foot orthoses
can be beneficial for a short period of time. I
can't tell you how many of my patients will come
in and they'll say, I'll be like, how long have
you been wearing these foot orthotics? Ten years? I'm like, why, Well,
it helped when I had heel pain. We're missing part

(59:30):
of the conversation, which is, yes, where this foot orthosis
for X amount of time and strengthen your foot so
there can be an exit strategy. You don't need it forever.
So it's again why, what's the why behind it? And
so we really need to be careful there because again,

(59:52):
if you don't use it, you're gonna lose it. You
don't want the strength of the foot to decline. So
that's my kind of foot orthoughtic conversation is yes, they
can be helpful, but we shouldn't need them all the time.

Speaker 2 (01:00:07):
I love it too, because it's like you could only
wear a band aid for so long.

Speaker 1 (01:00:10):
And if you are in them and you're thinking about
getting out of them, goes slowly like that's what I
did when I So now when I run, I wear
toe spacers in my ultras.

Speaker 2 (01:00:20):
Let's talk about the toe space. Yes, what are these?
What are you wearing? What are they for?

Speaker 1 (01:00:24):
Talk about I, Like I've said, I've had plenty of
diagnoses in my feet. Bunyan's being really why I started
all of this, and they're they used to be very painful,
and I learned very quickly that I did not want
to have pain in my big toe. So what these
do is they keep my toes straight. They help with
the alignment of the toes. Now, I when I started

(01:00:47):
wearing them, I think on my weaker foot, they would
I could wear them for like ten minutes and I'd
want to throw it across the room because my toes
did dinsplay and I was it was painful. But I
just kept a little bit of time, a little bit
of time, and now I walk and run in these.
My bunion has the pain is I don't have pain

(01:01:08):
in my feet in the bunion, the toes stays in alignment.
I still wear them because I was late to the party.
You know, if we can intervene early, like if you
start to initially see the signs of a mild bunion,
wear toe spacers wear the right footwear, you know. But
because mine had pretty, you know, I had some momentum

(01:01:30):
on it. I wear them every day and it feels
weird when I don't have them on. My foot feels stable,
it feels strong.

Speaker 2 (01:01:37):
They look comfortable.

Speaker 1 (01:01:38):
Yeah, I mean literally, the only time they're not on
is when I'm sleeping.

Speaker 2 (01:01:42):
What about when you're wearing flip flops.

Speaker 1 (01:01:44):
I don't wear flip flops. Oh, I like, I tell
my daughter, it's worse than the F word in our house.
This is why when you wear a flip flop, in
order to keep the flip flop on during the swing
phase of gates, so as the foot's going through the
gate cycle, you have to curl your toes, you have
to grip. You don't want to grip your toes. So

(01:02:07):
sandals are great. Just I prefer ones that have a
backstrap on it so that you can just let your
foot relax when you're walking, rather than grip the flip flop.

Speaker 2 (01:02:17):
Yeah, and I have this right here. We can kind
of show it to show it as an example. So
these are my favorite shoes for the summer. I love them.
I have them in black and white. They're my little
like splurred heels, and I just think they're so comfortable.
I have a wide foot whatever. But they don't have
a backstrop.

Speaker 1 (01:02:34):
I mean not all the time, right, Like this is great,
you want to go out whatever, Yeah, but to wear
this type of shoe all the time, you know, it's
it's not it's gonna Whenever you have any type of heel,
for example, you change what's happening in the calf, right,
the calf shortens. So like in the book we have,
we're not saying don't ever wear high heels. We say,

(01:02:55):
here's a high heel rehab. So it's like, stretch your calves,
do your display after you wear something that's you know,
So it's what to do, not telling people you can't
ever do this.

Speaker 2 (01:03:07):
This is an example of a shoe that I feel
like a lot of women would wear to the office.
In New York. Traditionally people would wear these shoes only
at the office. They'd store them like under their desk,
wear sneakers. And now I feel like, more than ever,
like women are walking to work in their high heels.
But what would you prefer women do that have to wear?

Speaker 1 (01:03:27):
Bring them to work. Bring them to work and walk
in a different shoe. That is going to change your gait.
So it's really going to alter how your foot is
striking the ground. So just wear a walking shoe and
then bring that to work.

Speaker 2 (01:03:41):
Also, you'll keep your shoes nicer for longer.

Speaker 1 (01:03:43):
That's right. I have a lot of women that you know,
they're like, I'm not going to give up my heels,
and they'll have painful bunions and a aroma, and that
shoe is never going to work if you have a
nerve that's unhappy in the forefoot, Yes, it makes it worse.
I've ever I've had a neuroma. It literally feels like

(01:04:03):
when you're pushing off that your foot's broken. That's how
painful it is. So you know, I want to have
the conversation with people to avoid these things because people
who've had chronic pain with the neuromas, it can linger
and the surgery is not fun for that.

Speaker 2 (01:04:22):
Anything with the foot is so brutal. It's like getting
anything orally with your mouth. It's just like you're.

Speaker 1 (01:04:27):
Well, there's symptom surgeries too, right, So it's like, I'm
going to fix the bunion, I'm going to address the neuroma,
but why did it get there in the first place.
Because if you just do the surgery without figuring out
the why, then they're going to be back in with
another problem. And that's when I when I see patients
that have foot surgery after foot surgery after foot surgery,

(01:04:48):
it's a very different conversation. Conversation I mean talk about
not being able to walk.

Speaker 2 (01:04:52):
Okay, So I'm a runner and I have been for years.
Obviously my feet are really swollen right now, guys, because
I'm you know, the four weekwake from uving Earth. What
can you tell immediately from looking at my feet?

Speaker 1 (01:05:03):
I mean, you do your foot looks healthy, right, so
you don't see any structural change, right, So I don't
see any bunions. I don't see, you know, clawing of
the toes like hammer toes. You seem to be able
to display your toes, which is good. In my office,
will test toe strength, so I have a it's a dynamometer,

(01:05:25):
and we'll look at how strong the big toe is
and how strong the four toes are. You should be
able to produce at a minimum, and my runners, I
like to see more of about ten percent of your
body weight out of your big toe. There's a lot
of people that can't do that. So if you're home,
like you could put a credit card underneath the toe,
see if you can, you know, prevent someone from taking

(01:05:46):
the card out. Can you engage the toe? You can
do that on your lesser toes. So th two through five.
The muscle that does that, by the way, two through
five supports the plan of Fascia. They're best friends. So
if someone can't do that, can't press their four toes
into the floor and prevent this card from coming out.

(01:06:06):
You got to strengthen that muscle because then we're going, Oh,
I don't understand know why I have heel pain? Well,
your foot's weak.

Speaker 2 (01:06:13):
You know I have a really like swollen looking pinky
toe right here. Yeah. Do you think that's just genetic
or is that something that's happened from wearing small shoes.

Speaker 1 (01:06:20):
That's a great question, but I would it'd be interesting
if you were different footwear. Yeah, and I would see
what happened. But all of those shoes are going to
compress that little guy.

Speaker 2 (01:06:30):
I've noticed it too, where like my pinky toe and
certain shoes that I've worn in the past has gotten
like numb. Yeah, so runner specifically. So my friend Eric
just ran the London Marathon. It was about three weeks ago.

(01:06:51):
At mile twelve he broke his foot. He continued running
and still ran a sub three marathon. It was an
acute break, he noted like and damage as well. Middle
of the foot still hurts, needs crutches to move around.
It happened again three weeks ago. What realistically should his
recovery timeline be.

Speaker 1 (01:07:12):
Was it a stress fracture?

Speaker 2 (01:07:14):
I think I don't know, so more.

Speaker 1 (01:07:16):
Than more than likely that's probably what that was. With
stress fractures, you have to again figure out why it happened.
You can also look at the different bones of the foot.
So when we talk about a stress fracture, there's really
two causes. One is compressive loading right, and the other

(01:07:38):
is tensile strain, so the foot can't handle the loads.
It needs to be strengthened. So depending upon where the
fracture was, if it's in the metatarsals, I think it was,
so a metatarsal stress fracture. That is a foot that yes,
you're going to have to boot it, wait till the
bone heals, but then you have to strengthen that foot

(01:08:01):
because running is all about how well I can control rotation.
So when your foot hits the ground, if you don't
have good strength to control the rotation you get this,
You'll get a tugging on the tissues and that will
start that stress reaction and then lead to fracture. So
that was probably if he was training for the marathon,
probably a lot of steps on his feet, right, so

(01:08:23):
lots of loads and unfortunately the bone will give if
it can't handle the demand.

Speaker 2 (01:08:30):
And I feel like you hear about foot injuries a
lot when it comes to long distance running. You know,
his is obviously extreme because he actually broke something, but
like there's even my husband ran an ultra marathon and
afterwards his foot blew up and he couldn't do any
sort of mileage for weeks.

Speaker 1 (01:08:48):
Jaja Sherry is one of my good friends and mentors,
and he always says, you can't build a jet engine
on a paper airplane. You know, like people are getting
like strong, right, and we're building these jet engines of
bodies on paper airplanes of feet and then we want
to run for you know, five k's are you know

(01:09:10):
it's now it's the ultra conversation. Everybody wants to run ultras. Great,
but train your body to handle these loads and a
lot of that you got to pay attention to.

Speaker 2 (01:09:21):
The foot over usage scares me. Yeah, I mean it's
the biggest thing that I think about when it comes
to my knee. You know, everybody says, do you like
I I would not consider myself a marathon runner. I
do like running marathons. I think I am going to
do the New York City Marathon. This year, just because
I think it'll be cool to do postpartum. Yeah, show
women that you can even though it's going to be hard.
But I'm going to document it with Jordan Menzel because
he's like, this is a crazy thing that you're doing,

(01:09:43):
so we're going to talk about it. But I am
somebody that's so I just hate over usage because it's
so brutal. It's like, I don't want to be somebody
that like runs a marathon and then for weeks after
I have to deal with a swollen knee. Like whatever
your stress might be is if it's feed, if it's
your knee, it's you know what. They can be so
many different things, but yeah, the long distance conversation, you

(01:10:04):
really have to be careful and know your body.

Speaker 1 (01:10:07):
I mean there's certain baseline assessments that people should be
able to do. I mean, running is a single leg
hop over and over again, right, so you know, can
you do certain things? Can you do thirty five single
leg caphrases? That's always like I'm always amazed at some
of the runners that I treat and I'll look at
them try to produce power out of their ankle, Like

(01:10:29):
by looking at a cafrase, and I'm like time out,
we got some work to do, or they'll be you know,
we have the conversation of running in different footwear. You know,
it's like I live in Colorado. The conversation I'll explain
to people is you don't have one kind of bike.
You have a mountain bike, you have a gravel bike,

(01:10:49):
you have a road bike. You have a different tool
for the task at hand. So that's kind of how
I have the conversation with my runners is you can
have your race issue, but you can't train. You know,
you want to train in something that is a little harder,
you know, like get my foot in my calf a workout,

(01:11:11):
you know, like pay attention to those things. And I
think then we really get the economy out of the
footwear when we're putting a strong, resilient body into it.

Speaker 2 (01:11:19):
Where in Colorado do you live?

Speaker 1 (01:11:21):
Evergreen? Okay?

Speaker 2 (01:11:22):
So Jeremy's older brother lives in Colorado Springs. Okay, he's
the he's like my buddy for the marathon. He's going
to be running with me. You guys take movement to
a whole other level, especially running, because you're running at
an elevation.

Speaker 1 (01:11:34):
Always. Yeah, I moved to Evergreen. I'm at about eight
thousand feet and I'll tell you when I first moved
up there and would run up there, I was like,
oh my gosh, this is no joke.

Speaker 2 (01:11:46):
But then you run here and it's.

Speaker 1 (01:11:47):
Like, yes, I love coming to sea level.

Speaker 2 (01:11:49):
Do you run in Central Park while you're here at all?

Speaker 1 (01:11:51):
Or uh?

Speaker 2 (01:11:52):
Yeah, yeah, I know I'm going to be like Alex
and I have been starting to talk a lot about
the marathon, and he's like, it's going to be a
breeze for him because he's to being ultras up mountains.

Speaker 1 (01:12:02):
Colorado Springs has the incline, the Manitou incline too, which
is I'm sure he's like training on that too. It's
a pretty popular like one mile straight up, but yeah,
it is. It's a different it's a different animal.

Speaker 2 (01:12:16):
Okay. So in terms of Eric, so can he do
the Cape Town Marathon in two weeks.

Speaker 1 (01:12:24):
If that foot is still fractured that would be a no.

Speaker 2 (01:12:26):
Can he do High Rocks in three weeks? His questions
are so specific.

Speaker 1 (01:12:34):
You know that bone has to heal or else you
do not want to be chasing. If you don't give
the tissue time to heal, then it's a lot. It's
a much longer conversation of well, can you do something
in six months? I mean, bone needs to heal, and
we also have to figure out why it happened, because
if the foot is weak or there's some type of

(01:12:56):
a barrant load that's occurring there, he's going to be
it's not just going to be the conversation of a fracture.
It will be what other diagnosis is. They're going to
be you don't want to do that, So I would
just take the time to let the tissue heal and
then I'm happy to give him some exercises to do.

Speaker 2 (01:13:16):
Yeah, let's give him exercises. But I completely agree. I
really feel like it's so hard for runners and people
that really prioritize movement to want to get back as
quickly as they can. And I really feel like ACL
recovery taught me this. It's like when it comes to
specific injuries. I mean, obviously that's a ligament injury, so
it's a little different. It's like, truly, no person's recovery
is faster than anybody else's. It's a six month thing.

(01:13:37):
The graph haes to heal, but it really is short
term pain long term gain. Yeah, you don't want to
have a lingering injury.

Speaker 1 (01:13:44):
Yeah, I mean the conversation of pain is one of
my favorite chapters in the book. It's difficult, right, It's
very complex. Pain is so complicated, and especially for our
and I fall into this category who use movement as therapy.
You know, it's it's frightening when you're like, what if

(01:14:04):
I can't do this? And it really makes things complicated.
And there's a difference between someone who has an acute
injury versus chronic pain. You know, the chronic pain patients
are the ones where, you know, we have to encourage
more movement, right, because there's this fear associated with it.

(01:14:26):
So it's an interesting conversation.

Speaker 2 (01:14:29):
To wrap it up. If someone listening wants healthier feet
ten years from now, what are they starting tomorrow?

Speaker 1 (01:14:36):
Check your footoor and just get at least one one
shoe that is functional, right, so you have options. Take
your shoes off and look at your feet. Pay attention.
You know, if you're starting to see things like bunyans forming,
be very cognizant of footwear. Hammer toes. Same conversation, strengthen

(01:14:57):
your foot, you know, do exercise is to improve the
strength of your foot. You can single like balance barefoot,
you could do calf phrases, you could do sled pushes,
farmers carries, take your shoes off when your strength training
in the gym. All of those things are important. Make
sure that your joints are moving well, that your foot
can change shape, your big toes moving and your ankles moving.

(01:15:18):
And that's a good place to start.

Speaker 2 (01:15:20):
And your new book is out. Now, what do you
want people to learn coming out of it?

Speaker 1 (01:15:25):
Keep it simple. You know, we have something that is
so easily accessible to all of us, and it stimulates
every single system in our body. And it is one
of those things you can do by yourself or with
friends or with family. And I just that the benefits
of walking out your front door are endless.

Speaker 2 (01:15:47):
Well, thank you so much for being on post run high.

Speaker 1 (01:15:49):
Thank you so much. That super much.

Speaker 2 (01:15:51):
What do you say we go for a walk?

Speaker 1 (01:15:52):
Okay, that sounds great, let's do it.

Speaker 2 (01:15:57):
Hi, guys, Kate here if you made it, Thanks far.
Thank you so much for being here. This conversation really
changed the way I think about movement, aging and the
importance of taking care of our bodies from the ground up.
Our feet are something most of us completely overlook until
something starts hurting. I know I do, but as doctor
Courtney Conley explained, they really are the foundation for how

(01:16:18):
we move through life. So my hope is that this
episode gave you a better understanding of how small daily
habits and movement patterns can impact our long term health
more than we realize. If you are enjoying post run high,
please be sure to follow the show wherever you're listening
and share this episode with someone who might need it.
I will see you guys next week.