Dhru Purohit Show - Big Idea: What Your Feet Say About Your Health and How to Strengthen Them With Exercise and the Right Shoes with Courtney Conley

Episode Date: June 16, 2025

This episode is brought to you by Manukora Honey, Square, and Levels. We don’t often think of foot health as a factor in longevity. However, falls, hip fractures, and early mortality statistics show that foot health is just as essential for long-term wellness as other factors we prioritize. Today’s guest has made it her mission to bring foot health to the forefront of conversations about optimal health, especially as we age. Today on The Dhru Purohit Show, we’re sharing one of our most talked-about moments with Dr. Courtney Conley, an expert in foot and gait health, on why your feet matter more than you think. She explains why you should be able to move your feet as freely as your hands, how to assess your foot health at home, and the key signs it’s time to improve your foot and toe strength. Dr. Conley also shares simple exercises anyone can start doing today, along with her top recommendations for everyday footwear.  Dr. Courtney Conley is a leading foot and gait specialist and the founder of Gait Happens, where she helps people restore healthy movement from the ground up. She also leads patient care at Total Health Solutions and Total Health Performance in Colorado, focusing on gait mechanics and foot function. As a founding member of the Healthy Foot Alliance, Dr. Conley advocates for natural footwear and strengthening the feet to reduce unnecessary surgeries and support lifelong mobility. In this episode, Dhru and Dr. Conley dive into: Building toe strength for beginners, intermediate, and advanced levels (2:01) What you can do at home to improve foot strength and overall foot health (7:00) The shoes Dr. Conley recommends—and her non-negotiables (17:00) The ideal number of daily steps for optimal health (30:19) Top hacks and habits for people with a sedentary lifestyle (32:10) Final thoughts and key takeaways (35:49) Also mentioned: Full episode with Dr. Courtney Conley This episode is brought to you by Manukora Honey, Square, and Levels. Upgrade to the creamiest honey, packed with antioxidants and prebiotics. Just go to manukora.com/dhru to get $25 off the Starter Kit and boost your energy, immunity, and digestive health today! Get everything you need to run and grow your business, without any long-term commitments with Square. Right now, you can get up to $200 off Square hardware at square.com/go/DHRU Right now, Levels is offering my listeners an additional 2 FREE months of the Levels annual Membership when you use my link: levels.link/DHRU. Make moves on your metabolic health with Levels today. Sign up for Dhru’s Try This Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi everyone, Drew Prode here. We all know that mobility is one of the most important factors in aging well. And the research is clear. Losing mobility increases your risk of injury, isolation, and even early death. And you've likely heard that falling is one of the biggest threats to our mobility as we age. But something we don't hear much about is that foot health. And specifically, foot and ankle mobility is one of the biggest. my most overlooked keys to preventing falls and staying independent as we age.

That's why I'm excited to share a highlighted portion of one of my top conversations with one of the renowned foot and gate specialist, Dr. Courtney Conley. We talk about how so many people, unknowingly set themselves up for weakness and instability through their lifestyle and modern footwear choices. Yes, you heard that right. Some of the footwear choices that were making on a daily basis could actually actually actually be accelerating aging by making our feet weak. We get into that in today's episode.

And Dr. Conley also shares quick and easy tips for building your toe strength. Your big toe is a huge factor when it comes to aging and ankle mobility and foot mobility. She also talks about picking the best shoes for your feet and creating lasting habits to support long-term mobility. We also discuss how many steps per day you actually need. and the answer might surprise you. So let's dig in to today's special moment that we're highlighting from a past conversation with Dr. Courtney Conley.

Take us from beginner to now more advanced in terms of people getting serious about training their feet and their toes the same way that they want to get serious about it like doing strength training. So what's the beginner way that we can start building up to stronger feet and toes. And then what's the intermediate?

And is there something for the advanced individual? Yes. So when I'm first evaluating someone, the first thing I want to see that they can do is have good toe dexterity. Can they move their toes and their feet like they can move their hands? So for example, I'll have them stand

and I'll say, can you lift just your right big toe? Can you lift just your left? left big toe without the other toes coming up. Can you lift your four toes? Can you lift all your toes and spread them and reach them forward? And oftentimes people will not be able to do this. It's like there's a disconnect between what I'm telling them to do with their foot. They're trying to do this and their motor output, there's like static on the cell phone. They're not getting a clear message on how to move their foot. You have to start there. You have to start with just driving information to the brain. And it's always interesting because typically on the side of the foot or

the side of the body that I will note pain. So if someone comes in with heel pain, for example, almost always, they don't have a good toe dexterity. They don't have a good strength. There's just a high correlation between can their foot do what it's supposed to do and symptom. So that's kind of entry level stuff. Then we'll look at things like toe strength. In my office, I have, it's a dynamometer. So you can actually look at the strength of the toes. So our big toe, we should be able to produce about 10% of our body weight.

Big toe is, that's the, when we're walking, our majority of our body weight is going through our big toe. we better know what it's doing. We better be able to feel it. And we better be able to have strength to be able to push off of it. Then we also can measure the strength of the four toes. If they're not hitting those numbers, and I really like that test because it's an objective measure. Pain is a poor objective measure. You break up with your girlfriend, you have a bad night's sleep. Your pain is going to be higher. But objectively, when I look at your toe strength, what is it today? You're going to do this stuff and then what is it tomorrow it's a good measurement for me moving forward so then we can

look at things like banded tower and then as they start to get stronger we want to make movement meaningful and functional if i'm working with the runner then i want to make sure they have a lot of calf strength because now those numbers that i mentioned four to six times your body weight going through your foot when you walk they jump up to 11 times your body weight when you run So doing banded toe exercises isn't going to cut it. You have to progress. So things like calf raises with load. And if you want some fun numbers,

if you were to look at there's a return to run, Dr. Peter Maliaris has done research on this, a standing single leg calf race, half your body weight six times. So you're standing, so typically people will be doing this at a home gym or a gym, and they're holding weight, right? And they're standing on one foot,

and they're now trying to do a calf race. and you should be able to do half your body weight. Half your body weight six times. Or building up to it. Is that an entry level or is we want to get to that place? Obviously, every person is going to be different. But is that like a goal or is that like, hey, we should all at least be able to do that. If we don't, then we need to go and find somebody to work on our foot health, a professional like yourself or your team to help us correct some imbalances that are there.

That's goal. That's like return to sport. Okay, got it. I have a chart that looks at, and I can send this to you, so you can put it in the show now. It says each decade of life. So in our 20s, males should be able to do around, this is body weight stuff, around 40 single leg calf raises. And I get picky because if it looks sloppy, if the timing is off, then I call it. But in our 20s, men, 40 women, a little bit less.

And then each decade, there's research that will say, this is how many calf rates. as we should be able to do. And I will tell you, in the 25 years I've been doing this, there are very few people, and I mean from a professional athlete to, you know, all across the board that can rarely, rarely do I see those numbers hit. And that's body weight. Because I just think from the knee down has been so ignored

from not only a perception perspective, but also strength. So being able to assess single-leg calf-raise, toe strength, all very, you know, I think easy ways to assess in build off of. Some of that advice is things that people can do if they come and see you in person and to get an assessment. Is there the, I'm going to loosely call this, that at home do it yourself version of assessing. And then for most of our audience,

that's just working on making sure that they get there at least, you know, 8,000 steps a day because they realize they're a little bit more sedentary or they're just starting to strength train for the first time in their life after not prioritizing it. People like my mom who listens to this podcast, I'm cheering her on. I see her working hard at LA Fitness with her trainer. What are the things that they could be doing, exercise, assessment, or even just basic things to make sure that their foot health and toe health doesn't fall behind as they're

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That's Square, S-Q-U-A-R-E dot com slash go-G-O-D-H-R-U. It's time to run your business smarter with Square. Get started today. Yeah, I think so at home. Obviously, most people do not have a toe dynamometer at home to measure those exact numbers. But I will have, you know, you'd need two people. You'd have someone sit in a chair, have their foot directly underneath their knee. And then you would take a card, like a credit card, for example, and you put it underneath the big toe.

You try to pull the card out and the person who's sitting in the chair tries to press the card down. Obviously, you're not going to get a number here, but you should be able to feed. tension in the arch of the foot because you're engaging the muscle in the foot. Then you can take that credit card and you can put it underneath the four toes. Can someone keep that card? Can they feel tension in their foot? By the way, fun fact here, the muscle that presses the four toes into the floor, flexor digit farm brevus, weakness in that muscle,

is a very big predictor of plantar fasciitis. When we look at these things like strength of the big toe, strength of the four toes, not only are they creating a better environment for our foot, but they can also be very impactful on preventing diagnoses at the foot like heel pain. So that's something you could do at home. That lean test, right?

You'd have to go get one of those little laser construction laser things, but you put it on your belly button, and you lean into the wall, you want a difference of four and a half inches. Okay, so you're standing against, you're standing upright. Yes. And you're leaning towards the wall, but you're not smacking your head into the wall, right? Yes. And if you think you are, just put out your hands and obviously brace your fall, right?

We don't want anybody getting hurt over here. And your goal is with the strength of your toes and the muscles that are supporting them and the feet, you're trying to lean enough like Michael Jackson style, not all the way down. Right? You're trying to lean enough Michael Jackson style to have what you're saying is lean forward at least four and a half inches. Four and a half inches is what we're looking for. Okay. Got it. And for some people, they might only be able to do an inch and that's fine. If they're, they start there and then how do you build it up. Is there a protocol of how often you might be able to do that to strengthen that? Is it 10 minutes of that activity a day? Is it, well, what's your recommendation? If we were doing banded toe work, for example, because it's lower load, right? You're just using a band. I would say like 40, 50 reps on the big toe, 40 on the little toes.

And you're doing that every day. It literally takes maybe two minutes, three minutes. So in your wind down routine as we're all getting ready for bed and trying to lower our heart rate to have a good night sleep, just in your room with the lights dimmed or your red lights on, if you're, you know, trying to protect your circadian biology, you could just be doing a little bit of this on the floor while you're talking to your wife, your husband, your partner, just reading a little bit. Do you have a video of you doing banded footwork for people who like really need an instructional? Yes, we have, I have a ton of videos.

I've actually designed like a whole 12 week fit feet program because these are the questions we get. So he's like, we start with awareness. Then we look at banded stuff. Then we look at more balance. then we look at strength of the entire chain. So it really progresses nicely. You know, other little easy wins are like keeping a ball underneath your desk when you're at work. Because you can roll the bottom of the foot.

You can take the ball and extend your toes. All these little things help immensely. And, you know, I think another very low-hanging fruit, if we were looking at how do we implement getting our foot stronger? If you are new to the whole minimalist shoe world, I would start small like 10 minutes a day. And you go and put on a shoe that's minimal where your foot can feel the ground. The soul is thin and flexible. It's bendy.

The toe box is wide. And you start by a 10 minute walk. because there is research. Sarah Ridge did a bunch of research where just wearing a minimalist shoe showed increase in those intrinsic muscles of the foot. So if you wanted to do nothing else, go slowly and just start with 10 minutes a day.

You will get sensory information. You will start to form foot strength. And then you can see how you feel. feel that night, you can see how you feel the next morning. If things are going pretty good, you slowly start to increase your time. You increase the pie chart so that more time ends up with you in an environment where your foot is helping you or your footwear is helping you, not deterring your function. And I think that's a, you know, for people who don't want to be like, well, I have to do X, Y, and Z. That's an easy one right there.

great. I love that recommendation. That's something that everybody can do. Since you were holding up a shoe, and for those that are listening that are not watching on YouTube, Courtney was holding up a shoe and you are bending it. Give us some of the other properties and just repeat it again of what we should be looking for. Is there terminology that we should be looking for? And I think you have a list of the different brands that are out there that you recommend. Is that correct? Yes. I think one of most common questions I get asked is what type of shoe should I wear? It literally, in my evaluations, it's not only this gate assessment and physical assessment, but it's also a shoe consultation, because people need to know what type of shoe. What is their entry point? So when you look at footwear,

my non-negotiable, like I said, is the toebox. So I want a wide toebox, different than a wide shoe. I want the toes to be able to display. It will improve stability and it aligns the foot better. It aligns the toes better. Yeah, a lot of the big shoe brands that we all know, some of them rhyme with Mikey and other things like that. They all have wide shoes. But again, you're talking about a wide toe box that's different than just wide shoes, just so everybody's clear. It is a very different animal. I wish they had. I wish they had. had different names for it because they're not even the same remotely the same you know in some of these companies as before mentioned um one in particular just came out with a toddler shoe and in the research

in the way they're selling the shoe they're like we are going to we've paid attention to the research and this shoe will help your child's foot develop it has a wide toe box it has a thin flexible soul so that the foot can move. I mean, there's many joints. When the foot can move, we have health to our tissues. So they designed this toddler shoe that was like, it's wide, it's thin, it's flexible, it's going to help development. And I'm like, why are you stopping at the kids?

Then why do you have to like change you with all of us adults going back to rigid and stiff and narrow? And what do you think it is, right? There's always a, is there a big shoe conspiracy or is it just economics, you know, when a lot of people look at a lot of these minimalist shoes, and I hear from the females in my life, often they'll say, even though they hear my story, countless stories out there, they've heard you on Peter Atia's podcast.

They'll visually look at the shoe, and they'll say, those look like clown shoes. I'm not going to wear them. I'm sure you've heard that many times before. I mean, even my brother. I mean, my family, like my brother was in New York. city and he's like, I will not wear those shoes. And so this is why, you know, I talk about having the pie chart, you know, and like the shoe spectrum, because if we're going to win the, if we're

going to win the fight here and get people stronger from the ground up, I have to meet people where they are. Start small. Like, I told my brother, just get a pair of these shoes and wear them to the park with the kids. That's all I'm asking you to do. You don't have to wear them out when you go out at night. You don't have to wear them to work. Just start with a little bit. And then what happens is I can usually keep my mouth shut because once you put your foot in an environment where your foot is comfortable, where you start to get stronger, then my patients tell me, you know what, I started wearing that shoe longer or things started to feel better. And then I don't have to fight to fight because they make it easier. But yes, I mean, it's the function over fashion thing. I mean,

my 13-year-old comes home and she's like, you make me wear these platypus shoes and all the other kids get to wear, you know, and I'm like, but she now, I don't say anything now and I let her choose. And the days where she's going to go play outside or she has sports after school, she never wears the fashion shoes. And I think we know which ones those are. She'll always pick the wider toe box, the shoe that's more comfortable. And that's where I think the win is, is because you can't argue you comfort and there's nothing more comfortable than a shoe that's going to allow your foot to be in its natural position. Yeah, one trick that I always have for my friends that are getting serious about strength training, resistance training for the first time in their life, they're in the

gym, that's often a great place to introduce these barefoot and minimalist shoes because first of all, they'll realize that if they're working with a trainer, almost every single trainer that I've met in Los Angeles that knows what they're doing is wearing one of these shoes. Yeah. They're wearing the minimalist shoes. All my trainers have worn them, and they're all hip to that idea. And they see how much better they perform my friends who are getting serious about strain training, even if they're completely beginners of the space because they see

the balance that plays a role in a deadlift or a leg squat, the stability that's there, the ability to have range of motion for the ankle and not be so claustrophical. like some cotton, so like some coffin or a cast, and then people start to bite the bug a little bit. I have some friends that will only wear the minimalist shoe when they train. And I'm like, okay, if that's all I can convince you to do, that's good enough. And maybe one day you'll evolve your thinking from that. It's like better than nothing, you know? It's like, it's better than nothing.

Yeah. Do you want to just mention because people are listening, they might be working out, they might be somewhere, people forget to take show notes sometimes, but they'll remember, do you have any favorite brands that you feel like you want to at least give an honorable mention to that come up regularly?

And I'll add one more component. The other thing that I think that's happening is these brands are all working very hard and the design and the fashion is getting so much better than it was even like five years ago. Like there's friends of mine that have minimalist shoes

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off their annual membership today i want to kind of speak to this shoe spectrum in the truly minimal shoe world, which is thin, flexible sole, wide toe box in what is called a zero drop. So the heel sits on the same plane as the toes. Shoes like companies like zero. This is a Belenka. I have bunions from my dance careers and things like that. So everyone who kind of follows my work, that's one of the reasons why I do all of this. This is one of my favorite brands because it is one of the wider at the toe. I have shoes here for it because you were going to ask me that. Wildling is also, these are, these guys are great.

This is a great shoe. I mean, this is a, I'm rolling this thing up in a ball shoe. People will adapt. They will be able to get, and people look at this sometimes. I can't believe. I could never wear that. And my response to them is your tissues and your bodies will adapt. They get stronger.

They will start to move better. it's just time. Vivo barefoot, that's kind of your OG. You know, so this is my like, if I can't be barefoot in my gym, this is one of my favorites to wear in the gym. Moving along the spectrum, if this is newer for you, my non-negotiable is the wide towbox.

So brands like Ultra, Ultra Running in Topo Athletic, they still put your foot in a wide toe box, but they might have more stack height, or cushion underneath the sole. So that might be a nice transition into different footwear, into more functional footwear. So Topo, for example, has wide toebox,

but they also have a 5 millimeter option, a 5 millimeter heel drop. So the heel would sit 5 millimeters higher than the toes. So if someone has really poor ankle mobility, and they come into my office with an Achilles issue. Then I'll get them in the wide toe box. I might start them in the five. I'm working on shoes or icing on the cake.

It's what you put into the shoe. That's very important. If using going out and buying a shoe is going to solve all your problems, you got to think again. So we have someone that's in a five millimeter drop. We work on things like foot strength, loading for the Achilles tendon, their foot starts to feel better, then I can drop them down into a

three or even in a zero. And then we can get them in the minimal shoe world. Why? Because I have more load going through my tendons when I'm in a minimal shoe. What makes tendons healthy? So it's this beautiful progression where you can grab people and put them in a safe. environment where they feel safe, they're controlling things. And as they start to get stronger, and as they start to improve their mobility, then you can really start to work them down the spectrum. And that's where I think you get that payoff, where their function is just spot on. You know, you mentioned something earlier that I'd love to just come back to now that we've addressed the topic of shoes. And you mentioned the idea that the history of the 10,000 steps a day,

was really this thing that came out of a Japanese marketing campaign for pedometers. And yet it is in the zeitgeist. And you do often hear people because it's a round number that just loosely say like it's something to shoot for. It also helps slash doesn't help that as you mentioned, most people in America, their average steps when they track and people are still so surprised. there's even people that are listening today that think that they're getting more steps than this,

but when they actually track, they see that their average steps in a day are 4,500. So even if it's from a marketing campaign and maybe doesn't have any real science, is that something that we should shoot for? And if it's not, what should be something that we can shoot for knowing that walking is one of the most basic aspects

of something that we don't want to lose as we get older, not just in our ability to do it, but in the quantity of steps and range we have in our life. What do you recommend to the people that follow you and the patients that you work with in terms of what should be their target? I think you bring up such a good point is people don't know unless they're tracking the amount of steps they're taking per day. Because there will be days when I'm in my office and I'm like, I feel like I've been moving back and forth all day. and I'll be at the end of my day and I'll look down. I'll be like, wow, I've only had 3,000 steps today.

Even though I've been busy, you don't realize how lack of walking you actually get. And I would argue that any increase, if you can find your baseline. So what would be your baseline over the week during both a weekday and a weekend? Increasing it by just a thousand steps a day can have profound effects on your health, both from a cardiovascular perspective as well as neurodegenerative, dementias in 10 minutes is about a thousand steps when i get home from work if i know i've only had 3,000 steps you bet my dog halics we're going for a at least a 20 minute walk so i can get two more thousand steps so being cognizant of that um i think is really important and i think it's

attainable when you look at the numbers we're really trying to hit i mean when you get you get to 3,800,000 steps, decrease your risk of dementia by 25%. 3800. We're not asking for 10,000. If you wanted to hit 10,000, which I'm all four, you decrease your risk of dementia by 50%. So point being, if you keep, I love this kind of spectrum idea, wherever you are, if you just increased it a little bit, you're going to get benefit. And that's how I think we make this attainable rather than saying you got to hit 10K every day because there are benefits at less. What are the top lifestyle hacks that you recommend to the patients that come in to see you

who maybe are more on the sedentary side where they're like, listen, I believe this. I want to prioritize the barefoot shoes. I want to prioritize the activities. I just need some suggestions. Call them for a lack of a better term, lifestyle adjustments, lifestyle hacks to make sure that I get my just job. general activity and step count up? What are your go-toes in terms of things that make this a habit so that people can keep those steps up for the long term? I love that you said habit there

because I think even when we're dealing with patients and people and pain, it's not necessarily a magic exercise that gets people out of pain. It's changing behaviors. It's changing, you know, incorporating easy things that become a habit. So from a walking perspective, if we know that in just 10 minutes, I can grab a thousand steps. You have to make it organize your day. I'm going to do 10 minutes in the morning and I'm going to do 10 minutes at night or at lunch. After eating, great time for walk. If you wanted to amp up that walk, try to keep your mouth shut, right?

So nasal breathing when you're walking. And that brings a whole other kind of component to things. If you wanted, if you're introducing minimal footwear, have one of those walks with the footwear on. You know, there are so many benefits to just blocking those two pieces of time out. And I think it's an easy, I think it's an easy one. I love that idea about walking after meal because we've talked a lot about the benefits of helping with blood sugar balance. And one of the easiest things is, regardless of your diet,

is just walk after a meal. And it's nice because we tend to forget if we just randomly say, well, I'll go on two additional 10-minute walks in the day. If we don't have anything to anchor it to, it's so easy for us to forget. But if you say, hey, after I eat, if I have a lunch break for 30 minutes or an hour,

whatever it might be, I'm going to take 10 minutes at the end, finish up a little earlier, and just go on a quick little loop around the office or a quick little loop around the neighborhood. And you get the blood sugar impacted that, you get the step count impacted that. Not to mention, you get the mood boosting from being outside in that sense of feeling the progress, which was something that you were talking about earlier. My favorite time for walks is sunrise. It's like my thing.

my daughter's still sleeping I wake up and I'm outside 365 days a year and it literally the days if I miss it it's like I just feel it and I think when you get into those little habits

it becomes you do start to feel so good and I really think if we looked at walking as a physiological need like we sleep and like we breathe when we focus on our breath and we make sure we get seven to eight hours of sleep we feel better. And if something as simple as walking can start to facilitate and make us feel so much

better and it's so easily accessible for everyone, 10 minutes a day. And as the sun's rising, it's a, it is an easy one. I've shared this before, but I used to struggle with knee pain and my personal experience with working to heal that led me to understand just how beneficial the right footwear could be for my body. And I love that Dr. Conley stresses that we can make incremental changes to both our footwear and our movement practices. It doesn't have to happen overnight. These incremental changes done over a period of time will help us feel better today and we can set ourselves up for a healthier future if we care about aging, which I know all of you guys do. All right. So if you've enjoyed this highlighted portion of a previous conversation, this special moment that we've exerted from our

conversation with Dr. Courtney Conley, you can listen to the full-length episode, which is linked in the description below. And if you know someone who cares about aging, who may not know about how important their big toe is to aging well, send them this episode. I guarantee you, they're going to find it surprising, enlightening, and it might actually get them motivated to take better care of their feet through their footwear through being more regular with their steps and working out and all the things Dr. Connolly talked about. And they can give you credit for helping them in their journey. As always, thank you so much for tuning in and thank you for sharing this episode with someone you love. I'll catch you next week. Until next time, Drew Proet, signing off.