Dhru Purohit Show - Walking Might Be the Most Underrated Longevity Tool: How Your Gait Impacts Pain, Brain Health & Aging with Dr. Courtney Conley

Episode Date: May 6, 2026

This episode is brought to you by BiOptimizers, LMNT, and Branch Basics. One of the strongest predictors of how long you’ll live has nothing to do with your labs or your workouts—but how you move every day.  Today on The Dhru Purohit Show, Dhru sits down with renowned foot and gait specialist Dr. Courtney Conley to unpack why walking may be one of the most overlooked yet powerful drivers of health and longevity. Dr. Conley breaks down the science of walking as medicine and explains why foot health plays a far bigger role than most people realize. They dive into gait speed as a key indicator of longevity and challenge the idea that pain means you should stop moving. She also shares practical ways to improve how you walk, rethink your footwear, and recognize early signs that your body isn’t getting what it needs. Dr. Courtney Conley is a leading foot and gait specialist and founder of Gait Happens, focused on helping people restore foot function and move without pain. She runs Total Health Solutions and Total Health Performance in Colorado, where she specializes in improving gait mechanics and resolving foot issues. She’s also a founding member of the Healthy Foot Alliance, promoting natural footwear and stronger foot foundations. She is the coauthor of the book WALK: Rediscover the Most Natural Way to Boost Your Health and Longevity—One Step at a Time. In this episode, Dhru and Dr. Conley dive into: (0:00) Intro (0:32) Why Walking Matters (2:04) The Prescription We All Need  (4:08) The Surprising Link to Dementia Risk (6:43) Preventing Chronic Disease (8:49) Key Benefits of Walking (11:06) Big Toe & Longevity (18:04) Why Foot Pain Is So Common (22:23) Walking Speed & Strength (26:09) Lifestyle Impact of Walking (29:56) Why You’re Walking Less Than You Think (35:44) Simple Ways to Move More (52:12) The Footwear Problem (1:07:12) How to Walk Smarter  (1:14:45) Pain & Movement Myth (1:22:21) Your Body’s Early Red Flags (1:24:50) Small Changes, Big Impact (1:29:22) Final Takeaways Also mentioned in this episode: Walk: Rediscover the Most Natural Way to Boost Your Health and Longevity―One Step at a Time For more on Dr. Conley, follow her on Facebook, Instagram, LinkedIn, YouTube, or her  Websites: Gait Happens and Dr. Courtney Conley. This episode is brought to you by BiOptimizers, LMNT, and Branch Basics. Upgrade your digestion with enzymes! Go to bioptimizers.com/dhru now and enter promo code DHRU to get 15% off your entire order, plus a free bottle of MassZymes added automatically Check out LMNT’s new refreshing pink lemonade and lemonade iced tea flavors. Right now, LMNT is offering my listeners a free 8-count sample pack with any purchase. Head over to drinkLMNT.com/dhru today. Right now, Branch Basics is offering 15% off the Premium Starter Kit; just go to branchbasics.com and use the coupon code DHRU. Make 2026 your cleanest, healthiest year.  Sign up for Dhru’s Try This Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Courtney Conley, welcome to the podcast. I'm excited for this conversation, which is for anybody that cares about longevity, anybody that cares about thriving, anybody that wants to reduce their risk of some of the top killers that are out there, cancer, dementia, and for anybody that wants to understand that a simple thing in our life that many of us have overlooked is actually the central aspect to so many aspects of our health.

and what that thing is is walking. Yes. Convince our audience, give us the big picture. Why is walking so crucial to our health and longevity? You know, it's always interesting to me when I get the question of, why do you think we've forgotten about walking? Because as a human species, as a biped, it is literally what we were designed to do.

We were designed to walk on two feet for long periods of time. And there's a reason for that. It's a core biological input that literally stimulates every single system in our body. And I want people to start thinking about walking like they do breathing and sleeping. That it's this physical necessity, not necessarily optional.

When you think about breathing and sleeping, those things need to happen every single day. And they need to happen well. You need to have quality respiration. You need to sleep well. And walking needs to be added into that trilogy if we want to thrive, if we want to live well into our later years. So that's what was really cool about reading all of this research. I'm like, I think we've forgotten that we have this tool at our hands that is so easily accessible.

So underutilized, especially from a treatment perspective and on the clinical side of things, that a lot of us just aren't taking advantage of. Yeah, you actually call in your book, which is fantastic, by the way. We have a link in the show notes. You actually call in your book walking the most under-prescribed medicine. Medicine.

That's like a very specific word for somebody who has an incredible background of making sure that they're not sensational. So give us one little preview of how walking is literally medicine for the body. One of the things that we're seeing a lot now and bringing a lot of is bringing a lot to everyone's attention is dementia and Alzheimer's and the risks of all of this. When you look at walking, I think this should be on every single physician's

prescription pad. This is the number one thing that we should be doing. It is the panacea of medicine. When we think about a step count, for example, when you look at dementia, if you wanted to reduce your risk of getting dementia by 25 percent, what do you think? think the step count would be for that, a daily step count. Ooh, I don't know, a lot of people see different numbers that are out there, they're probably thinking like, I need to hit like 12,000, 15,000 steps. Right? And that's what, you know, we'll get into those higher

step counts, but it's 3,800 steps a day. 3,800. That's not a lot. That's very digestible. If that number goes up to 9,800 steps per day, you can reduce the risks of dementia by 51%. So this is science. And when I'm reading, when I was researching all of this for the book, I'm going, we need to be telling everybody this. This should be, at a minimum, we should be getting, telling people 3,800 steps if you want to facilitate your brain health. And there's really cool things that happen to your brain when you have regular aerobic activity. And, you know, one of those is you have increased blood flow.

So we have increased blood flow, increased heart rate, increased blood flow to our brains, and in particular, at the prefrontal cortex. This is where we have decision-making and focus. You know, we're going to go into it in a second, but you talk about in the book how walking has been engineered out of modern life. And when we take something like dementia and also related to it, cognitive decline, Alzheimer's disease, when we take those things, those are on the rise. And a lot of people listening today, I think like 75% of my audience is women.

Yeah. Above the age of 40, many of them don't know that actually women are at twice the risk of getting Alzheimer's disease than men. And that's a whole separate conversation. We've done podcasts on that. But this idea that you can reduce your risk of dementia by 51% by hitting 9,800 steps a day, that should be on the front page of every news that's out there. As a single mom that's about to turn 50, when I was reading these numbers, I was like, okay, I'm busy. And I know that there's a way that we can start to fit these numbers in. These numbers, a five-minute walk is about 500 steps.

A 10-minute walk is about 1,000. So I think that makes it very digestible for people to understand, And, you know, and just thinking of your audience here, too, like when I go to pick up my daughter from basketball, if I'm 10 minutes early, I'm like, perfect. I'm going to park the car and I'm going to go for a walk for 10 minutes and I'm going to grab a thousand steps. That was one of the things that I wanted to, you know, really encourage people that we can find little places within the day to squeeze this stuff in and the effects that it has on your health are so profound. Yeah, you know, there's a couple ways of looking at it. Some people say that, hey, walking is a great added bonus to your life. And yes, you're not saying that, sure, we should be walking more.

But the mindset shift that's there is literally that if you don't walk, you're ignoring your survival and you're ignoring your opportunity to thrive in the modern day and age. If you were to think of it as taking little, we talk about this in the book, like little movement snacks throughout the day. One of the questions I got asked this week was, you know, what's better? sitting or standing at your desk. And I said, well, neither really. You're still stagnant. The body still isn't moving.

We as species were designed to move. We need movement variability. In breaking up our day, even whether it's for five minutes or 10 minutes with this walking, this repetitive, low to moderate intensity activity, it has so many effects on the other end of that and just these small doses. Do you think, going back to

cognitive decline, dementia, Alzheimer's disease, all these different diseases of the brain, which are on the rise in modern society. And it's not just because we're living, quote, unquote, longer. There's so many factors that are there. When you look at our ancestors who are walking so much more than we are, do you think that walking and the lack of it could be the central driver, one of the central drivers behind these diseases? I do. I do. I think that this lack, we are moving literally in the wrong direction. Because so many of us are moving so much less. The average step count is about 4,700 steps, which means that there's many of us that are walking less than that. One of the beautiful things I loved reading about and studying was

the concept of neuroplasticity, which is basically our brain's ability to reorganize and adapt. And I think that's such a conversation of hope, because when I have my patients that are in chronic pain, I always talk to them about neuroplasticity, no matter what you've been through, a addictions, traumas, pain, we can start to reorganize and change your brain with something as simple as walking. Because it stimulates this protein, BDNF, which is brain-derived neurotrophic factor. Think of it as like fertilizer to your brain cells, to your neurons. And it helps those neurons grow, and it helps them maintain basically their function. So when you look at it from that perspective, it's like, man, all I, I just have to walk.

And I'm like, yes, just start walking more. And you reap these benefits from a neurological perspective that, you know, I don't think really can be beat. You know, one of the things you talk about in your book is that you regularly meet with people that you take care of, your patients that are out there. And you'll talk to them about the benefits of walking. And most people have actually no idea. how little walking they're doing in their life, which is why an episode like this

and a book like yours is so needed because we think it's kind of like the fish and water, like I don't know who discovered water, but it wasn't a fish. Like we all think, oh yeah, I walk a little bit, I'm going around the house, I'm doing this, I'm doing that, but most people are walking so little. Talk about your patience and that idea.

That's such a good point. So even with my own personal history with this, when I'm in my clinic, I feel like I'm always moving. I mean, I'm with patients for eight hours a day. I'm never sitting. And at the end of the day, I'll look at my watch and I'll see how many steps I took. And I'm convinced that I'm like, well, close to 10,000. And it'll be like 4,000 steps. And I'm like, wow. Because I have ambient walking, right? So I'm walking around my office. I'm walking into the gym. I'm doing all of these different things. But there wasn't any repetitive, intentional walk there. So it's a good

reminder for me that when I get home that night, regardless of how tired I am, I know that if I just go out for 10 to 20 minutes, I can take that number, that 4,000 and get to 6, 7,000 steps, and that's a minimal day for me, but that's right where I want to be. So it's a good marker for people if you can figure out your baseline. Because you're correct. I don't think people realize that even though they may be active, moving what that step count looks like. Going back to this idea that we shared earlier, that this book is really putting people in the sense of like shifting their entire mindset. Number one, by getting this incredible information about the power of walking as medicine, and we're going to continue to drill into that.

But then number two, about how beautiful our feet are as a central process of allowing that medicine to take place. And then number three, from the way that I look at it, how to actually turn this into a plan that stays with you because consistency over time is key. Did I get that right? You got all of it right.

I always get excited when we start talking about feet. I know, I know. People love to talk and hear about feet, especially when they understand how crucial it is to their longevity. So just because we're on that, right? Just because we're on that.

The last time you're on the podcast, I think we had a clip that went super viral that you had shared. And it was this idea that you're a big, Big toe is one of the predictors of longevity. Okay, you brought up feet. I say that for later, but since you brought it up, gave our audience a reminder of big toe, feet, longevity, survival,

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What do you want the last decade of your life to look like? That's going to vary across the board. But I can probably be pretty certain that everybody would say they want to be able to walk. And when you think about the body part, the only body part that interfaces with the ground that is designed to keep us upright and balanced, I don't think most of us think about it,

and that is our feet. Our feet are sensory, organs, if you will, and there's thousands of receptors in our feet that are designed to gather information, and this is what keeps us upright and balanced. You'll see with the baby, when you see children, the first thing they want to do, babies, is take their shoes and socks off, because their little brains are going, I'm developing, I want to feel things. And so their foot wants to feel the ground because that stimulation, that sensory stimulation, is what's going to keep them upright and balanced. When you look at strength of the foot, the big toe, if you were to measure

strength at your big toe, in my office we have this little, like, it's a little dynamometer, and you can actually measure how strong the big toe is. And I think most people should figure out how strong their big toe is. It should be at a minimum about 10% of your body weight. The big toe, the muscles that surround the big toe are responsible for posture. They're responsible for balance. And it also, again, weakness at that structure, at the big toe, at our toes, is a risk factor for falling as we age. So we know that sarco-pele. penia is a thing. We lose muscle mass as we age,

but do we think about that at our foot? Because if we lose muscle mass, that doesn't mean you don't lose muscle mass at your foot. You lose muscle mass at your foot. Your foot starts to lose strength. You also start to lose sensitivity to the receptors in the feet that keep us upright and balanced.

So all of these things, if we want to stay walking, as we age, the most important part of our body that we really need to pay attention to is how we're going to stay upright and balanced, and that is our feet. So important because we often ignore our feet. Yeah.

We cover our feet. We hide our feet. And then we spend our entire life, not knowing it, but our feet are shaped in a way that goes in the complete opposite direction to what would support. our longevity. Until you've had foot pain, I don't think we think about it. One out of three people

over the age of 45 experienced foot pain. That's a very high number. Next to low back pain, foot pain is one of the highest diagnoses that people will suffer from. And until you've had foot pain, when you're walking, I saw someone the other day and she goes, you know, Courtney, I'm starting to have pain in my big toe, and I never realized how much it alters my function. Because you can have low back pain and hip pain and shoulder pain and neck pain and still go for a walk. But if you have foot pain, you don't want to do anything. You don't want to walk to the mailbox. And very quickly, you're not walking to the mailbox for one day, turns into a week.

and then it turns into two weeks and then it turns into months and then you're in my office and so a lot of the patients that I see are under 2,000 steps a day under 2,500 steps a day for years because their foot started with an injury

it was never appropriately taken care of and now they're afraid so there's this this complicated factor that is happening that started with a musculoskeletal diagnosis that is now complicated by emotional and mental fear.

It's a completely biocycle social issue now. And it stops people on their tracks. And it's heartbreaking to me. It's why I'm doing all of this. It's so heartbreaking. And that is literally the driver of your work that's out there. You know, let's build a little bit on this thread

that we were sharing earlier. Like what's actually happening in detail when we're walking. Yeah. Right? Because it's a unique thing. You talk about in the book how humans,

we were built to walk. Right? We were born to walk. And it's a central part of what has allowed us as a species to do all the things that we can do. It's made us even, you know, this is kind of surprising

for people to hear. It's made us more resilient. Yes. Than a lot of the animals that are out there, animals that we look at and think like are so tough and strong.

and can do anything, our ability to walk has actually helped us win as a species and allowed us to do many different things, including having the big brain that we do. Yeah. Can you talk about that? Humans were designed to walk. It's a bipedal locomotion. When we went from quadrupede to a biped, there's many reasons for that. It allowed us to become more efficient.

It allowed us to start using our hands. we had more energy to be used for our brains. So there was a lot of reasons why we started walking on two feet. Because of the efficiency that that has enabled us to do, you have to be able to maintain your system in order to walk long distances. When you look at the foot, for example, it's always interesting. Like, I'll have patients come in. And for something that we were designed to do, it's always interesting for me to hear

when they say, you know, I just feel like I'm walking weird. Or I feel something feels off. Or I don't feel like I can walk very long. Or I start having pain after about five minutes. Now, because we have evolved to be very efficient endurance walkers, the question we have to ask ourselves is why? Why is this happening? And when you look at the foot, for example,

when the foot hits the ground, there's these beautiful things that occur that allow us to absorb shock not only at our foot, but at our knee, at our hip, and our low backs. So that's where I think the conversation between feet and walking go hand in hand because we have to be able to take care of our feet

in order to walk long distances and also for the effect that it has above the kinetic chain. You know, I love connecting everything that you're sharing about how powerful our feet are when taken care of, right? When taken care of, they're so powerful for us along with these ideas of things that people know that they care about, right? They care about longevity. They care about aging well. They care about health span. And something that a lot of people would not be aware of is that walking speed predicts how long you live, which directly connects into our foot health and how strong our feet are. And how strong

our feet are. Can you talk about that? When you go to a doctor's office, they take your vital signs. They take your temperature. They look at your oxygen saturation. They look at your blood pressure. They take, if there's something wrong with any of these vital signs, it's like a red flag. They're like, hey, let's do something about this. It's an indicator that something could be going on. And everyone stops and figures it out. In the book, we talk about it. how walking speed is the sixth vital sign. And here's why. When you have a slower cadence,

so when your walking speed is slow, this can be a predictor of things like dementia up to seven years in advance. That's a big deal. Huge. So if we were able to identify with someone's walking speed, hey, why are you walking slowly?

is this an indicator that there's some type of cognitive decline happening? Is it an indicator of musculoskeletal weakness? Is it an indicator that there's something wrong with your balance or your coordination? It's a signal, it's a warning sign saying, hey, pay attention to me. And that's where I think this conversation is so important because we want to be proactive with our health, not reactive. And if we have something like gate speed that can predict something like dementia

up to seven years in advance, then let's do something about it. And when you look at the research of taking advantage of all these health benefits, a lot of the research will talk about walking speed. What should you be walking? How fast should you be walking? And the research will say around 3.5 miles an hour,

4.0 miles per hour, which is a, a little bit faster than I think most people realize. So the way you can kind of look at that at home is if you were to count how many steps you take per minute, you'd want to be around 135 to 140 steps per minute. And that's a fast clip. Yeah, it's fast.

Anybody who's been on a treadmill and put it up to like three and a half miles per hour, four miles per hour, it's like, okay, that's pretty quick. You're not, you know, it takes some real focus. Yes. I was, I'm flying today, so I'm always, before I fly, I'm in the gym on the treadmill. 4.0 miles per hour is about a 15-minute mile for 30 minutes. So you want a brisk, fast-paced walk for about 30 minutes. And that's, you do, your stride length changes. You have to shorten your stride a little bit. You know, you put that on an incline and you're getting your heart rate into zone two, sometimes zone three,

depending upon how high you climb. I live in Colorado, so I live at elevation too. So walking around at that pace for 30 minutes up and down a mountain, you know, it's no joke. You know, going back to this idea that walking speed predicts dementia up to seven years early, a lot of people could look at that if they've heard about it for the first time and think, oh, wow, okay, so if you're on your way to getting dementia, something going on that prevents you from walking as much.

But it's kind of the other way around, if I'm understanding that, well, they might be both connected in different ways, is that if you can't walk, that is actually a signal that all these things, all these benefits that you're getting from walking regularly, like glucose control, blood sugar, all these different aspects, the BD and F for your brain, those things not being around is actually correlated with the likelihood that your lifestyle is contributing to one where your body is creating the environment for dementia to exist or come a lot earlier than it should. Hormones don't just respond to what you eat.

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That's such a good point. Because I think when I'm talking to my patients, I'm always talking about stacking behaviors. There's not one fix out there. You have to look at your health as a whole. And so if we, my foundation that I use with my patients is foot health and walking. So when we have the conversation of how important this is, and I say to my patients, hey, we're going to start walking faster, you're going to walk more frequently, you're going to take care of your health.

The sequela of that is that they start sleeping better and they start eating better. And so it has this impact globally rather than just me saying, I want you to increase your walking. And so that's my entry point, my scope with my patients. There could be someone else that says, I'm a sleep expert. Well, this is where that trilogy comes in. If I was a sleep expert and said, I want you to start sleeping better, guess you're going to feel better, which means you're going to start doing what? You're probably going to walk more.

So they all kind of feed one another. And that's why I think this tool, because it's so easily accessible, can be an entryway or a neurological window to really opening up someone's health and improving their health. What are the top reasons that your patients and people that you talk to say that they're not walking enough? Pain. Pain is number one. Pain is number one for me. And for sure, you know, you are somebody that deals with you. deals with that, so that's why people come to you, but people understand the statistics.

What was it? One out of every four people? One out of three. One out of three. One out of three is going to be dealing with foot pain at some point in time, or knee pain or some sort of pain that's there that prevents them. So number one is pain, which is crazy because if you read your book, you see how we'll be diving to this more soon, you see how at the first signs of pain people pull back and

That's the worst thing they can do. We'll come back to that. Okay, so number one is pain. Yes. What's the next one? We've engineered our way out of walking. You know, when you look at some statistics, for example, after COVID, when people started working from home more, we saw a drastic decrease in step count because we didn't have to really go anywhere.

You can now work from home. We can stay in our houses. We have, you know, very easy ways to get around. And I'm not saying that technology is bad. It's wonderful. But you also, with technology comes great responsibility. And so we have to be very well aware that we have engineered our way out of, you know, moving as much as we should. So we have to be very diligent and very aware of when we can take these little movement breaks

so that we can make sure that we're stimulating our system. So just the fact that ease in the modern society has decreased our activity levels, pain, and then the third one that I think is very important and probably most people don't think about is their footwear. Amazing. Okay, we're going to talk about that. Going to the second one that we've just engineered it, a lot of times people don't even realize how much their daily life has been set up, even if they're not trying to walk less. Yeah.

They just inherently do it because it's this milieu that we were all kind of born into, right? Give us some examples of simple things that people are doing on a daily basis, whether they realize it or not, it just becomes habitual and it ends up creating a situation where they end up not getting as many steps as they could.

Well, I mean, I'm just thinking about my past three days being here and I was in my hotel room. and I did not have to leave that room. I had to actively decide to leave, but I could get all my work done. I could hold all of my meetings on Zoom from my computer. I could order everything that I needed from DoorDash. And the conveniences that we have,

I could have been in that room with probably under 1,000 steps. We have so many ways that we can just, have things brought to us where you start to take away those steps. You don't think about it, but if you're like, oh, I'm going to go to the grocery store, you probably grab a lot of steps, a couple thousand walking around, parking your car. But when we don't have to do those things, when things get brought to us, it's just a little way that we're slowly engineering our way out of movement. And that's not what we want to do.

It's crazy because we can do more, right? I'm putting this in air quotes. We can do more, we can fill more. I even look at my schedule sometimes and I'm like, oh, wow, you can get an extra meeting. You can add so much more because we're able to do things through the computer, which is beautiful. We can do all this stuff. But then what gets crowded out, if you don't actively fight to include something like walking, which also is really great when you're doing it outside, you're getting sunlight, you're

supporting your vision health and you're not, you know, so tunnel vision on the computer, you're supporting your mental health, you're getting fresh air sometimes, depending, you know, on the day in LA that's out there. So there's so many benefits that are there, but you have to, like, fight for it. You really have to fight to prioritize it. Otherwise, our modern world will suck all of that out of you. And you'll wake up one day and think, I don't feel good. It happens slowly. And I don't think a lot of people realize how poorly they start feeling because it's this gradual decline. And I have my patience that come in all the time. And it's been this slow trickle of decline until the point where they

just feel miserable. And then that's, we have to start at baseline. You know, I was thinking this as thinking about this as you were talking to, an interesting statistic that I always think about is, did you know that in national parks, there's more paved roads? And so, a lot of people, you think you're going to a national park where you're going to be walking around, but you can pretty much drive up to most of the monuments or things that you want to see in all these national parks. And a friend of mine was saying,

if people would just get out of their cars and actually walk around the area, you'd have a better view or you'd be able to actually move more. And I always just found that to be interesting that even in a national park, we have engineered our work. out of walking around and moving. This really goes back to this idea of a mindset shift.

Once you see it, just how much modern life by default has engineered walking out of it, you start to now think of the opportunities of it there. You know, you've mentioned you're a business owner, you're busy, you're an author, you're doing a lot. There's a lot on your plate. You mentioned your small mom, right? what are the ways, you know, let's just give people a couple little things that you're doing as we continue in the conversation to make sure that even you are having those cues, time slots,

those opportunities to get, you know, even 500,000 more steps in the day, which is not just good for your long-term help, but actually just makes you feel better on the course of the day. This was a fun part of the book to write. we talk about taking a time inventory. So you can do this for one day, two days, do it for a couple days, during your weekday. And just go through your day on an hourly basis and see what's happening. And then if you look at your time, think of a couple categories. Are there any places where you can either substitute,

stack or squeeze a walk-in. So what I mean by that? Let's say in the morning, you find yourself scrolling on social media for 30 minutes. That would be an opportunity where you could substitute a behavior, even if it was for five minutes. The second example would be to stack a walk.

So the example that I like to give for this is my mother lives in Pittsburgh and I'm in Colorado and she's Italian and I talk to my mother three times a day. And so when I get home from work, if I don't have my steps in and I haven't talked to my mother, one of those is going to give me a bigger problem than the other. So what I started doing was stacking. So I have my headphones. I will go for my 10 minute walk, but I call my mom. So I'm starting to stack behaviors. And that has turned in true to one of like my favorite times because I'm outside, I'm telling her about my day, I'm walking,

and it's just, it's a really, it's really special to me. And the other is to squeeze it in. So I talked about that earlier. If you're picking up your kids, you can go a little bit earlier. If you are in between meetings, keep in mind that you, these little micro walks of five minutes or 10 minutes can have a profound effect on your health for every system in your body. So we have these opportunities if you can take this time inventory to look at, is there a place

where I can substitute? Am I where I would be not wasting time, but I could be doing something more productive like walking? Can I stack a walk or can I squeeze it in? And I think when you look at your day, you'll be able to find these little windows of opportunity. Yeah, it seems so small. And it is in the way of incorporating it as a habit, right? These are all very doable things, tiny things that you could be doing on a regular basis.

But when you zoom out and you stack things together, you understand now how something, you know, I didn't even know this research and I feel like I'm always looking in this space, how something like walking more, especially faster walking can lower the risk of cancer. Yeah. Like that's crazy. Crazy. Right? Can you talk about that? When we looked at that research, it was brisk-paced walking for 30 minutes. And if you look to five to 7,000 steps, you can decrease your chance of getting cancers by 11%.

Five different types of cancers. That number jumps to 16% when you get to 8,000 to 9,000 steps with this 30-minute fast-paced walk. I mean, that is so profound to me. when you look at cancers, diabetes, dementia, like these pretty significant diseases that a lot of us have been touched by, walking faster for 30 minutes a day can help reduce the risk of these things?

I mean, again, on every prescription pad, on every single prescription pad. Yeah, it's not just that walking is medicine in the way that I'm looking at it. It's actually not walking and being sedentary is poison for the body. You know, it's scary, but the beautiful thing,

about it is that when people really get it, and I hope that the audience is like, you know, feeling that enthusiasm and excitement and sort of, you know, getting that bug for walking is it's so within your control, no matter how busy you are. Yeah. Because you don't need any equipment. You don't need anything special that's there. Everybody has that opportunity. Sure, it can take a little bit of work to re-engineer your life to go against the the momentum that's trying to get you sedentary, but it's all available for you. It's just really actually feeling motivated enough, excited enough, and now saying, I'm going to make it consistent as part of my lifestyle. It's an immediate mood enhancer. And when you have something, just like you said,

that's so easily accessible that if you do not feel well, mentally, emotionally, physically, and you have the opportunity to walk out your front door for five minutes, I don't. I guarantee you, I 100% guarantee you that in those five minutes you will feel better. There's not much else I think you can say that we do that can produce that type of result. It's crazy because so many people have this feeling and I've had this feeling where you have such a busy day or a busy day turns into a few weeks or a few months for people. And then you finally get a chance to go out and really say like, I need to like go and take a walk. and you're outside, you know, in the sunshine, even if it's cloudy, it's so much brighter outside

than it is indoor, you're walking, you're getting fresh here, and you're like, why the F do I not do this more regularly? I feel amazing. So much better. You're like kicking yourself for forgetting how good you feel with something as simple as a walk. You know, one of the other things

that I'm so grateful for when I was working on this project was the research that I found for relationship walks. And you made me think of that when you're like, man, why don't we do this more? I mentioned I have a 14-year-old. And there was research that we found that should be of no surprise

that when mothers and daughters walk together, their communication improves and their relationship can change. And when she walks on the front door after school, this is the other beautiful thing about watching someone walk. I can tell if she had a good day, if she had a bad day, what happened with her friends just by her gate. You know, that's what's beautiful about walking gate.

It's like a window. It's a neurological window to your soul, really. And so I'll ask her, how was your day? Fine. How are your friends? Fine. How are your classes? Fine.

Can you take me to Starbucks? Like that's what happens, you know? And so as I was doing it, I'm like, gosh, Courtney, just have her walk with you after dinner, which is almost like pulling teeth, by the way. But I said, listen, just come with me five minutes, five, ten minutes. And I'm not going to ask you any questions. We're not going to, we're just going to go outside.

Drew, within five minutes, we're outside. The very first time we did this. And it was like the floodgates opened and she just starts going. It was so-and-so is doing this. And this is what happened. And I was like, man, I don't know what it is. Like, are we outside? Is it that she's neurologically distracted?

Is it not that I'm sitting across the table from her, drilling her, like, how are things? But once we got moving and she could just kind of relax a little bit, it was so awesome. And I can't get that kid to shut up when we're on a walk, which is really a really great thing, you know? So, she is even starting to like when she's studying for,

she'll be like, mom, I need to go for like a five minute walk, clear her head, you know, and break up the pace, the monotony of sitting in front of her computer. And that message to her is what gets me excited to.

Oh, you know? Amazing. It reminds me of a few things. Number one, you know, listeners of this podcast know that we just had a baby. My wife gave birth last year.

And, you know, There's so many different things that you're doing as first-time parents and stuff that you're worrying about. And often it'll be a thing where either my wife will tell me or I'll tell her like, hey, this is a walking conversation. Right. Where you might be overthinking. That's right. It doesn't mean don't talk about it.

It's just that, hey, this is one of those things. Let's talk about it while walking. Yes. It could be a layered conversation where we're trying to figure out, you know, what's the best type of nanny that we need and the schedule and that sort of thing. It could be something that somebody's overthinking, right? Your emotions are heightened after you gave birth and you're in sort of protection mode. You're worried about your child.

And so, but when you walk and you get that perspective and you get that bilateral movement of your eyes sort of scanning the horizon, and you feel like all of a sudden things are a lot easier to talk about. They're a lot easier to make sense. I don't know if on the last time you were on the podcast, I mentioned to you, but for the last 10 plus years, years, I have a group of guys that meet every Thursday morning, right? If there's 52 weeks in a year,

we meet probably like 30 weeks out of the year at least. Love it. And we call it man morning. Yeah. And it's beautiful because we're in L.A. There's generally great weather. And we have about four or five spots around L.A. where we will meet up. It's always on time, 8 a.m. and there's a captain. And the captain does two things. They pick the location and they pick the question of the day. but we don't sit down and drink coffee and talk, right? We go on a walk. And the things that end up happening that people are sharing, these are all busy entrepreneurs,

some of running like massive hundreds of millions of dollars companies, and people always have the same sort of feeling. I'm like, man, I haven't even said this out loud to myself. The reflections that come from guys who tend to be not as great as women in terms of talking about their emotions or what's on their mind, like, dude, I really needed that. I needed that opportunity. I love hearing that.

It makes all of this work just so worth it because that is exactly what happens. It's a calming to your nervous system. It kind of lets the nervous system dial down. We get more creative. We get more open. And some of my best ideas have come from me staring at my computer and I'm being like,

I don't know what I want to say right now. I don't know what I run a right. And then I go out for just 10 minutes. And then you come back and it's like a reset. It's literally a body reset for pretty much everything. But that community that is built around walking that you have is such a gift. Like, I really hope that people hear that and, you know, are encouraged to even start their own walking group like that. You know, that's what I would love to see happen with this book, too, is that these little walking clubs and people getting together and having this

social community because there's so much power in that. Yeah. Not only do you get the benefits of walking, sunlight, fresh air, but now also getting the social aspect of connecting with another human being. Yes. And getting a chance to hear that, you know, even if they're problems or what they're navigating or what they're celebrating, that's actually one of our default questions. Yeah. Tell us one thing you're celebrating. Love it. Tell us one thing you're navigating. Yeah. We all have something in our life that we're happy about, but maybe we haven't shared it out loud or even pat ourselves on the back. Type A personalities are great. and not remembering, you know, something different that they've done.

And we all have something that we're navigating. Yeah. I stole that question from a group that I was part of called Summit Series, but we've continued to use that. And it's really, really powerful. So walking is not just good for you, for your immediate health, for your long-term help to avoid all these big killers or at least reduce your risk of getting them.

It's not just great for your relationships, whether it's your daughter, your son, your husband, your wife, whatever. You know, I love walking with my parents. consistent walking is one of those things. A lot of people in our age range, you were talking about your mom, right? I was going to ask you, like, you're walking. Have you been able to convince her to walk while she's talking to you at the same time? My mom's a big walker.

Okay, great. Yes, yes, she is. Because, you know, many of us who are in that 40, 50 age range, we have focused on our help, but now we're thinking about, like, how do we keep our parents healthy? And getting them to walk more is such an important aspect. I think a lot of people listen to podcasts like this and all the ones that are out there and are like, man, I got to get my parents on resistance training. I got to get them on this and that. And yes, those are important things.

And, you know, there's ways to go about that process. But they forget about the power of just simple things that you can do like calling your parent. You know, a lot of people get that sort of guilt trip text. Like, why don't you call me more, right? I'm on the same board as you. I'm super close to my parents. I've been calling them all the time for as long as I can remember. of living out of the house.

But having that component of like, hey, mom, why do we, you know, talk on the phone? But we'll go for a 30-minute walk, right? You can go for a walk, I'll go for a walk, and we'll both be on the phone. Like, that's so powerful and easy to do for so many people. Now, I was talking to my father. He's turning 80 this year. And he's a big golfer. So he'll golf three times a week.

And but the other four days a week, he's not. not as active. So that's what we talk about with this regular aerobic activity where you have to be consistent day after day. So I've been telling him, Dad, I know it's, I love that you're golfing three times a week, but on these other days, you got to start small, five to ten minutes. And that, at least him in that generation, they, the idea of strength training for him was a little, it's a little more difficult for him to get comfortable with. The walking was a much easier conversation. But I was struggling to get him out there. And then this is a funny story. He calls me a couple weeks ago. And he's like, I went to see my doctor. And my dad doesn't take any medications.

He's pretty healthy guy. But he said, you know, Courtney, he said, Dr. Campbell told me I need to walk more. And I was like, dad, I'm going to kill you. I was like, I've been writing a book on this for three years. I've been telling you about this for three years. And now you're going to start doing it because Dr. Campbell told you to do it. So we laugh about it all the time. You know what that's called? You know what that's called? It's called Powdered Butt Syndrome.

Okay, I stole this from Dave Ramsey, the financial advisor. He talks about this. He says, once somebody's powdered your butt, which, you know, people used to do back in the day, once they've put talcum powder on your butt, they think that there's no advice that I could take for you. Hey, I've seen your butt. I used to put powder on it. what could you possibly tell me about life? Yeah.

But I love that you didn't stop. Because I feel like it's sometimes still, again, going to this conversation of like helping our aging parents, you know, just double down on the basics and walking is one of those central basics. Even if they ultimately end up taking action because they heard it from somebody else or somebody else's podcast or some sort of WhatsApp group meme that's there, they, it's always in their subconscious, right? It's always in their subconscious because they've seen you.

do it or they've heard you talk about it. And then finally somebody says something and they're like, oh my gosh, have you heard about this? Yes. It's exactly what happened. Yeah. That's amazing. We can't have this conversation without talking about the problem with footwear. Yeah. And why it's so central to this idea.

You know, you said pain is one of the top reasons that people stop walking. The number one reason, especially I'm sure, you know, as people get older. and pain and footwear are directly connected. Talk to us about that. When you look at the foot, if you were to take your shoe off and look down at your foot, the widest part of your foot should be your toes,

not the ball of the foot, not any other part of the foot. And there's a reason for that. Because when we walk or when we stand, when we balance, we want to have a foot that can feel the ground. We want to have a lot of real estate. so the toes should be able to splay they should be strong and they should be wide

when you look at most modern day footwear footwear footwear does not respect the anatomy of the foot if you were to take out your factory insert of your sneaker and stand on it most shoes

your foot will expand over the factory insert so the big toes hanging off one side the little toes hanging off another side, and then the toe box is tapered, so it comes into a point. And this is a problem for many reasons, but from a societal perspective, we have put fashion over function

when it comes to footwear. And as a result of that, we see a lot of problems at the foot. So when you take your toes and you squeeze them into a toebox that is going to change the function and structure of your foot, we shouldn't be asking ourselves why one out of three people have foot pain. It would be like me walking around with a sling

on my bicep for 20 years. My bicep would get weak, or it would get sore, or it would not function like it should, and that's what we've done to our feet. So a lot of these diagnoses, bunions and hammer toes, a lot of them, I believe,

can be alleviated, and obviously one caught earlier, by just putting on a shoe that respects the anatomy of your foot. And that is how it plays into walking, because like I mentioned, there's really no other diagnosis that will stop you in your tracks when your foot hurts. Yeah, it's so crazy to think about, you know, this is a man and woman problem, But I look at like my wife's history with her foot health.

She was an investment banking for years. You know, she's with clients, other stuff, living in Manhattan, doing all the things that are there. And essentially, there was no room to not wear anything besides heels. Yep. Right? You would have been an outcast. Your boss would have said something to you.

I feel for so many women who then later on in life, luckily my wife didn't have to go through this, but then they end up with bunyan surgery. Yeah. Right. And they end up with these other issues. And then, you know, dress shoes for men. Yeah. Right. I heard you on my buddy, Dr. Rungan Chatterjee's podcast. He was talking about how he mostly wears these barefoot shoes. Yeah. The same. I do the same. I mostly wear Vivo barefoot shoes. I had actually heard about them from him. But then a couple times over the years, I've had to wear like these dress shoes, right? That like my wife picked out that are these beautiful Italian dress shoes and everything. I met at like a wedding. I'm like, like, a wedding. I'm like, Like, my feet hurt so bad. In fact, before I started wearing barefoot shoes, and you have recommendations of that, we'll touch on that in a second,

I was wearing like a standard sort of, I had a friend that was at Nike. And like as a gift, they got me all these shoes to say thank you, because they would always stay with me when they would come to Los Angeles. And I was like, oh, amazing, I have like all these different shoes that I can wear from Nike or New Balance or whatever was there.

And over a period of time, right around the age of like 30, I would have this, like, knee pain. And I just thought, this is weird. Oh, maybe it's because I used to run, but I'm not running as much. And, you know, you come up with all these different mental gymnastics to try to justify. And then Dr. Chatterjee was in town. He was visiting me here in Los Angeles with his family. This was like many, many years ago, probably now almost eight years ago, 10 years ago. He's like, you know what, man?

Like, sometimes that knee pain is just your shoes. try wearing something like Vivo or another brand that's out there and see what happens. And I switched over to them and pretty much within two weeks that knee pain went away. How could something like wearing

appropriate shoes that are not crowding your feet and are giving them room to splay as you mentioned, how could that, you know, get rid of knee pain? I love hearing that story. I hear it all the time in my clinic. All the time.

My knee pain got better. hip pain got better. My low back pain got better. When you start altering the function of your foot, you best believe that it's going to affect every single joint above your foot, above your foot and ankle. So when my foot is in a position where it can be strong and it can be mobile, that affects all of the joints sitting above it. So for example, when I'm walking, my big toe needs to extend a certain amount of degrees. And that big toe extension, so that would be this motion, my big toe lifts, when I'm pushing off, that big toe extension sets up extension at my knee and at my hip. So when we start compromising joint function at the foot, we start moving differently above the foot. So someone

might start lifting their leg instead of rolling through their foot. There's a little bit. There's a lot of different compensations that you will see when someone isn't using their foot correctly. The other thing with knee pain that I think is really interesting is when you're walking, it should be a grazing of the heel. So the heel should touch the ground and soft. Because when you can feel the heel strike the ground, it gives you information. So, So the fat pad at the bottom of the heel is filled with receptors. And it's, again, this sensory organ. And so when you hit the ground, if you were to hit the ground hot and heavy, you're overstriding.

So you're reaching your leg out in front of you and you're hitting the ground heavily. That puts a lot of load through your knee, for example. And a lot of people walk that way. Yes. And here's why. They can't feel their heel. because when you look at all the footwear out there, it's like the alien invasion of footwear.

It's like, this thing doesn't look like a foot. And not only that, but there's enough cushion on there that you could probably, you know, bounce your way through gate. That's not how we were designed to walk. So when you have a lot of cushion or stack height or too much stuff between the sole of your foot in the ground, your heel can no longer feel what it's supposed to feel. this sensory acuity, the sensory perception is now decreased.

So I can overstride and I can land hot and heavy. And that's going to change the forces going up my knee, up my hip, and into my back, for example. So that's why when you allow the foot to feel the ground and you start wearing footwear that is allowing your mechanics, the way we were designed to move as humans, to function appropriately, and not to interfere with it, then people are like, man, this feels good. And here's the conversation I have to have. If you've been wearing footwear, that either doesn't look like the shape of your foot, it's very aggressive, there's a lot of stuff going on, this conversation is going to make a lot of sense to you,

and you're going to say, well, this makes sense. I'm going to go get rid of all my shoes and start walking around in a minimal shoe. and I will caution you, you have to earn your right. Because, yes, we are designed to walk with our foot on the ground, but if you haven't been doing it for long periods of time, you have to transition slowly. And that's a very important conversation. So it's like start with five minutes, start with ten minutes.

Some of us are able to transition in two weeks, and you don't even think twice about it. Others, it takes longer, but it's well worth it on the other end. Yeah, I think I spent so much time barefoot growing up. Yeah. That the transition was so easy for me. But then I got some of these barefoot shoes for my wife.

And initially it was like, I actually feel worse wearing it. Oh, yeah. And you hear that from a lot of people. And starting slow and building up is definitely one of the keys. And, you know, you shared another big key. The last one you're on this podcast with people that I'd love to mention here again, because it's in your book, is that even separate from that, just being barefoot more often, and just how powerful that is because the human foot,

there are all these intricacies in there that if we don't use it, we'll lose it. That's right. And it's directly related to the eventual pain that stops people from walking at the degree that we know is connected to healthy aging. I can't stress how important this is. I don't think people realize that when you start losing the capacity

and strength at your foot, it will affect every system in your body because you aren't walking. So even being able to put your foot on the ground, I have patients who have had foot pain for years, and when they get up in the middle of the night to go to the bathroom, they have their slippers or their sandals right by the bed so that as soon as they get up, their foot doesn't have to hit the ground. We need to create resilient bodies.

We need to be resilient. We can't baby this guy. He wants to feel things. So that is so important to be able to, regardless of where you are, just start with little bits of just little duration, even if it's a couple minutes. You know, I think from for the aging population, too, you know, it seems counterintuitive because it's like, well, you know, I was talking to my mom about this. She's like, well, my knee hurts and my hip would hurt. And you'd think, she thinks that, I must need more cushion.

That must mean I need more stuff. And we have dropped her down into a shoe, an ultra-running shoe that has about 22 millimeters of stack height. So basically what that means, it's a little more than a Vivo barefoot, but it's not this big cushion shoe. She loves it. No back pain, no hip pain, no knee pain.

And it also, I feel better about that because she's closer to the ground. Now she's also going to be close to 80 years old. Do you know what I don't want her doing? Falling. Yeah. And so the closer I can get her to the ground and she can feel more stable,

her risk of falling is going to go down. When I see people walking around on these shoes that are very high off the ground, all I see is like if they step off a curb and their foot does this, They're spraining their ankle and they're going down. And you see so many people that are above the age of 60, 70, 80, they're wearing these shoes. You're taking away their proprioception.

You're making it harder. You know, and the challenges as we age, you know, the fat pads of the feet start to decrease and the foot starts to get a little bony, things like that because of muscle atrophy. So they have to have a little something under there. Right. But it doesn't have to be a lot. It really, really doesn't. And if we can work on that transition, I think that you'd see a lot of positive changes there, a lot.

Because people like you have been talking about this for so many years now, the exciting thing is there's a ton of different brands that are out there that are trying to solve this and also make it fashionable, which is important. You know, when I first started wearing barefoot shoes, people would look down and say, dude, those look like clown shoes, right? I'm like, I don't give an F because they feel great. And kind of like, if you're really committed to it, that's kind of your answer in the early days. But now there's brands that are out there that look really great. Yeah. And, you know, there's a lot of options. We'll link to your website.

You have a bunch of things there. And also in the book, you have a bunch of recommendations as well, too. That's important. When I first started this, there was one brand out there. And now there's hundreds. And in the book, we talk about the difference between functional footwear and minimal footwear. So I think that's an important delineation. If this is a new conversation to you, the functional footwear category is where you want to transition

because it's going to give you the wide toe box, the lower heel to toe drop, so it's going to bring your heel down so that your heel and toes sit on the same plane, but it's going to give you more stack height or cushion, which is, again, a transition for people. And then the minimal category is what takes you down into like a vivo barefoot, where the soul is very thin and flexible. So you can dance between both. You can have, you know, two different types, but I think that's important. But there are so many companies out there. I was very excited. My daughter, I get, I have a bunch of shoes at my house. And she said to me the other day, because she's usually like, you make me wear these platypus shoes and all the other kids,

you know, get to wear Nike's. I'm like, well, you'll thank me one day. But there's been a couple companies lately where she's like, all right, I'd wear those. can get on board. I can get on board with those. So that's exciting. So, you know, the, the fashion conversation is is improving, we'll say. Yeah, yeah. I bet if you look at who follows you on Instagram, there's probably some celebrity or influencer that she cares about. And just like your dad, she needs to hear from somebody else. That's a really good idea. I'm going to look into that. You look into that. See who follows you, right? I bet there's somebody, do leap, somebody is following you, right? And then you should be like, Mom, oh my God.

Did you know X and so-and-so is wearing it? And you'd be like, uh-huh. That's a great idea. Let's talk about what people can do to start significantly improving their health today, their brain health, their cancer risk, their sleep, all the things that you've mentioned, minimum dosage that people are looking at, right? You talk to your patients, many of them don't even know how much they're walking is one of the steps to audit that and take a look.

You took the words out of my mouth. That's number one, is find your baseline. Figure out where you are, because anything is better than nothing. So no matter where you sit along the spectrum, if we were looking at step counts, if you're less than 2,000 steps, if you're less than 3,000 steps, improving your step count by 500 steps per day decreases all-cause mortality by 7%. Huge. huge. So even if those step counts are low, the power that you can get from just improving that by

500, a thousand steps is a very, very good place to start. So we have to find what our baseline is so we know where we need to improve. In the book, we have three different programs that are built. So there's a base, there's a build, and there's a boost. So based on your assessment of yourself, you can plug yourself into one of these three categories. Some of them are more focused on just building your step count. Some there's added strength in there. Some we talk about speed. So there's a way to really improve no matter where you sit there.

And I think that's a very good place. We all should know that. I feel like in every doctor's appointment it should be, you know, these vital signs, and then also, what is your step count? Every single patient that comes into my office now, it is, what is your step count? You'd be surprised. You know, when it comes to step count, you know, you talk about in the book how everybody knows the term, 10,000 steps.

And it's been talked about on this podcast before, so we won't go into the old detail, but it came from a Japanese company that was looking to market, these step counters, they have, and they came up with this number that was there. And when people hear an episode like this and they think like, I need to walk more, often one of the things that they'll do is they'll say, okay, great, I need a dedicated hour to try to get as many of those steps as I can.

And there's nothing wrong with having time to be able to do that. But for most people, your argument is finding those opportunities throughout the day. These snacks, these exercise snacks. Is that one of the next things that people can start doing today?

to increase their walking and improve their health? And that's where you have these little small wins. I think sometimes when we say, okay, we're gonna walk every day for an hour. That is a big goal. You know, that takes a lot of time. And you don't wanna make it difficult right out of the gates on yourself.

You know, there was really cool research looking at glucose levels and what happens when we walk, right? So, and how that's good for your glucose tolerance and your insulin sensitivity. And what they found was that three 15-minute walks after we ate was equivalent to one 45-minute walk. And so I was like, this is great for people.

Because if you don't have the time to say, I'm going to go out for 45 minutes, you can get that, if that works for you better, these little 15-minute windows, by all means, do that, especially after eat. I mean, I think that's pretty powerful. But that's where I think a huge opportunity for people is especially if time is a factor.

Don't be overwhelmed by this. There's so many things to overwhelm us. You know, I have to, I mean, I'm going through menopause. It's like, I gotta eat enough protein. I gotta strength train, I gotta do this, you know, and now this woman's telling me you have to strengthen my big toe. You know, it's a lot of information. So just getting your foot on the ground

in doing something that you can kill a bunch of birds with one stone, I think is very impactful and easily, easily accessible for most of us. One of the studies you talk about in the book is that if you're sitting more than 50% of the day, you have a major risk increase of 16% of all cause mortality, 34% of cardiovascular disease, which, again, a lot of people don't know is the number one killer of not just men, but with as well too, right? More than breast cancer, more than Alzheimer's disease, cardiovascular disease.

So I love this idea of these exercise. snacks because it also helps you counteract. Yes. You could end up walking for an hour but still sit for more than 50% of the day. So just breaking it up on a regular basis is going to help you beat the inertia of modern life that just wants us to be on our ass the entire day. It's such a, I love that because I'll have a lot of patients that'll be like, I get my workout in in the morning.

You're like, I'll go for my run for an hour before my work day or I'll go to my spin class or I'll go to the gym for that window in the morning. But then for the rest of the day, they're sitting in front of their computers. Just because you get your hour in doesn't excuse you from not getting your steps in throughout the day. It's that repetitive, remember, walking is breathing and sleeping. It's something that has to happen every single day.

You have to find a way to trickle this in. So that's a very good point that just because you clear it up in the morning, if you're sitting for the majority of your day, that's not what our bodies want and or need. It's crazy because, you know, there's some data that's out there on these modern hunter-gatherer societies or nomadic societies that are out there.

There's a few around the world, but in particular there's a couple in Kenya, like the Maasai. People know the Maasai. And, you know, you look at their diets and they have primarily a diet that has a lot of, lot of saturated fat because they mostly live off of milk all day. Now, dairy has a protective

benefit, you know, in general, even if you have a lot of saturated fat content. But one of the theories is why do they have such little cardiovascular disease? Well, when you're walking all day long in these modern nomadic groups that are out there, like the Messiah and I went to go stay with one group called the Samburu, which are cousins of the Messiah. You have this benefit of when you're walking throughout the day, you have lipid clearance inside of the body. So any of that lipid that's floating around, your body becomes better at clearing it, metabolizing it, getting rid of it. So even if you have a super high saturated fat instead of the diet, it's not necessarily going to correspond with cardiovascular disease because you're just moving

and getting rid of it through all this movement throughout. Yeah, it's this low-grade stimulus that you can get throughout the day. That's what I think is so important about it. It's this low-grade kind of constant stimulus. And that's going to keep everything moving. It's going to keep literally every system, you know, churning along. We don't have to overtax. You know, I think that's a really important conversation. It's not like more, more, more.

It's like, hey, you know, let's just just be consistent. Yeah, absolutely. You know, I mentioned that we were going to come back to this, but there's some people that are out there that are listening that have been told because they're pain, or they feel like they've been told to not move as much, or to slow down the amount of walking that's there. What do you want to say to that person who's been given that advice? Don't do that.

Plain and simple. Our bodies are designed to move. Movement is what decreases inflammation. This concept of pain, I think, is very complex. very, very complex, and there's a lot of factors. I talk about this one story in the book. I had a patient of mine who was down to 2,000 steps a day because he had had heel pain,

and then over the next three years, he had seen a lot of people in the last physician that he had went to said, you need to drop down to 2,500 steps a day. This kid was 27 years old. He moved into his father's basement. because he was pretty much at home. Now, three years into a diagnosis

and you're telling someone that they can't walk more than 2,500 steps a day, now this is a much bigger conversation because it's no longer a musculoskeletal diagnosis. Now we have a mental issue here, emotional issues. So when someone is in pain, I think the mistake is saying, our goal is to get you pain-free.

We got to get you pain-free before you can start moving. That is not the conversation we want to have. You'll be waiting a very long time for that. And to tell people or patients that the goal is pain-free or to be zero out of 10 is also a disservice. Pain is a normal human experience. So if it's normal and it's a signal to us, why are we all trying to get rid of it all the time?

I think the conversation is we reframe it. we say, okay, you have this heel pain, you're taking 2,500 steps a day. What if we walked for five minutes? Let me know how you feel. He comes back, the same, perfect. So not any worse, not any better. He's not down to a zero, but we're plateauing. We can build off of that.

So it's teaching him and teaching people how to live well with pain. And so that they can stay active. They can reach, they can experience something different when they do have pain. And I think that's how we can dig ourselves out of the hole of you can't move when you're in pain.

Because it's so multifaceted, because if you're not walking as much, you may not start sleeping as well. As sleep could be a big part of helping with mitigating the level of pain that you feel on a regular basis. Right? And then there's this other. which we've talked about throughout this podcast that is a central idea in the book is that

if you don't use it, you will lose it. Yeah. You know, our body is so resilient. You have the, you know, you have a foot in front of you, not a real foot. Although that'd be pretty cool. I will, this will be probably the last one of these podcasts that I do with the foot because TSA does not like him. So I get stopped every time.

And what do they say? And they say, do you have a foot in your bag? And I say, yes, I do. And then everybody starts laughing and then, but it's not. It's, you know, now I got to get through the airport. So you don't want anything that's going to slow you down. You have a foot in front of you. And a crazy stat that I heard you share is that people have to realize, like, how specifically the foot was designed.

Like, the heel of a woman's foot, if I understood this correctly, is bigger than the heel of a gorilla? That's correct. That's a fun fact. That's a crazy fact. Yeah. And what does that fact mean? Because when we walk, our heel is designed to hit the ground. This is human gate.

So when our heel hits the ground, the beautiful thing that starts to happen is it initiates pronation. So pronation is an unlocking of the foot. It's when the foot starts to lengthen. And this is our first opportunity for shock absorption when we move. So that heel, because it hits the ground

and handles this load, that's what causes all this cascade of events when we walk. So our heel was designed to hit the ground. And now just imagine, because of modern footwear, or just not walking that much, yeah. What happens to that heel when it goes through that process? A very good example to think about here is a recovery sandal. So everybody has seen the recovery sandals. It's like a, it's a slip on, and it kind of looks like a boat. And when you put it on, it kind of rockers you forward. Okay. It has what we call a toe spring on.

So if you were to put the shoe on the table and you were to press the tip of the shoe, it kind of, it would rocker for you. Okay. And there's other shoes that do this. They have toe springs built within their shoe. There's a rockered soul to the shoe. So there's always a trade-off. So when someone puts this type of footwear on and they start walking around in the store, the first thing they're going to say is, wow, this feels great. It's like walking on a cloud.

I got all this protection. I got all this cushion. It's basically walking for me. And you can think about that and you can be like, yeah, that sounds great. And this is the conversation. If you don't use it, you will lose it. So when you do not have to produce power at your ankle, and you do not do not have to be able to control your foot

because you have this shoe that is rockering you, the intrinsic muscles of your foot will get, weak, your ankle power will get weak, and I can promise you as you age, that is the last thing you want if you want to continue to walk. So it's a conversation of tradeoff. What are you looking for here? Are there times when wearing a recovery sandal or the shoe can be beneficial? Absolutely. There is a time and a place for everything. What I am saying is you cannot spend your life in a shoe that rockers for you. You have to have a spectrum where if you just ran a race, for example,

and you want to wear your recovery sandal by all means. But if there's no reason for you to be in that type of shoe, wear a shoe where you can actually, you got to work a little bit. It's okay. That's the environment where we get stronger. Now, it's okay to be a little uncomfortable. It's the healthy stress that keeps us active and little. into our later years, which is what everybody would want.

Yes. You don't ever want to be afraid to be in your house and be like, man, I can't, I got to wear my shoes all the time. Like, I don't think people want to live like that, where it's like, I have to constantly have a shoe on, what type of shoe am I going to wear? We want to have a foot that we can put on the ground when we want to and be resilient and not be shackled by being afraid of what's going to happen if I have to walk around barefoot for 10 minutes.

Which, surprisingly, is one of those things that catches up with you. and you end up finding yourself in that position that are cascading on different things. Is there one of the, separate from pain, is there one of the earliest warning signs, especially for people above the age of 40, is there one of the earliest warning signs that you are not walking as much as you should,

or you're not taking care of your feet as well as you should? Is there something that comes out? I think this can happen even before 40. If you look at your foot, notice things. Are there bunions? Are your toes starting to curl? Are there things that you can see at your foot? That's the beautiful thing about the foot.

It's the only place in the body where you can actually look at it and be like, hmm, something doesn't look right here. You'd need an x-ray at the knee. You need an x-ray at the hip, but you can look down at the foot and see aberrant load. And people will say, well, I have a bunion because my grandma has a bunion.

And my response to them is you didn't come out of the womb with a bunion. Now, you might inherit connective tissue laxity or hypermobility. But my response to this is also, when you go to the doctor and they ask you, do you have a family history of heart disease? Do you have a family history of diabetes or cancers? The reason they ask you those things

is so that you can actively do something about it, right? Okay, my mom had heart disease. Well, you better make sure you're walking. You better make sure you have a good diet. You better make sure you exercise. So if we know, if you live in the cancer, that your mother has a bunion and your grandma has a bunion, then my response to you is going to be,

well, do something about it. Start wearing the right footwear now. Start strengthening your feet now. Because that doesn't mean that you're going to suffer like your parents suffered because of what you see. That's what's awesome, that you can just look down and be like, okay, maybe I should start wearing different footwear. You know, if you can't do things like lift just your big toe,

lift your foretoes, spread your toes, balance for 30 seconds, do single-legged calf raises. If you cannot do these things, you have to take a little time out and say, I need to start paying attention. There's a whole foot assessment chapter that we've put in there because I think when you start to fail these basic tests, it's one of those predictors. Your gate speed's going to go down eventually. And you're going to have an issue producing power at your foot and ankle as you age. and that is a problem. And our life literally depends on these things.

Yes, it does. This has been a powerful conversation. And I think that the last item that I want to touch on, which is a psychological component, and I'm sure you deal with this all the time with your patience, is with this modern world that we live in and so many different messages of what we can or, quote, unquote, should do. There's a lot of people that are out there that feel like,

if I'm going to do it, I have to do it perfectly. And then they set the bar too high. Mm-hmm. And naturally, we all fall off the wagon with every aspect of our life, a little bit here and there. And it's not about how many times you fall off. It's about getting back on. What have you seen have been the top things for people who struggle with consistency to make this idea of walking a central part of their life to the degree that they don't even think about anymore?

It's literally why we designed the microwalk and coined this term. because it's so, it's this five-minute window. That's all it is. If you think of James Clear, Atomic Habits and all, if you really want to change something, you cannot set the bar up here. You have to have little consistencies. And so that little micro-walk has been so powerful

for so many of my patients, because it has been something digestible that they can do. It's hard for me to be able to have a conversation, with one of my patients if they can tell me that they cannot fit in a five-minute walk. Like, you have to prioritize your health to a certain degree, and I think that's a very easy window. And then you can start to build off of that.

And that's what's so powerful about it, because when you get outside and it's even for five minutes, there's very few people that will come back from that five minutes and say, well, that sucked. You know? Very few. Even those in pain, because whether it's a few, Because whether it's back pain or knee pain or foot pain, even that little five-minute window is just sub-maximal loading.

Walking's very safe. It doesn't take your joints to their end range. So it's a perfect little opportunity to build someone's confidence in their movement and to start to build a type of consistency that you know that they can do day after day. And for somebody listening who's like, you know what, I'm in that camp. I haven't been giving my walking as much attention for whatever reason. I love this idea of a micro walk. Start off with just even shooting for one or two a day.

Yep. And then what could be a goal that they're working towards? That's when you figure out your baseline. Take a look at your baseline, audit it. You have 2,000 steps, even adding in 500 to 1,000 more in a way that's sustainable for you that you can keep up. That's winning. Even if your step count is low, all the really cool research. where people get the benefit of this

is when the step count is low, is when you're basically sedentary. If you just made small microchanges, that's when all the research is like, hey, you can decrease all-cause mortality. You can decrease your risk of diabetes with very small little chunks of time. That's why every prescription pad,

it's got to be on there. And then if you're one where you're like, okay, like I'm living in this 5,000 step range, that kind of window for maximizing the longevity benefits is about 7 to 8,000 steps a day. Also digestible because the research doesn't say 10 plus. The research actually says that 10 plus the health benefits plateau, which is also an interesting conversation because I'll have patients that'll say,

Courtney, I'm walking 15,000 steps a day. I said, that's wonderful. Are you strength training? And they'll say, well, no, I don't want me time because I'm walking 15,000 steps a day. So that's a perfect opportunity for me to say, hey, let's dial it down. Let's dial you down to 10,000 steps. And now I've given you some time back that you can start doing these other things. So that's where I think, no matter where you find yourself with your baseline, you can tweak it a little bit with small changes to make a huge impact.

That's key. It's not sleep is amazing, but we're not telling people to sleep for 14 hours a day. That's right. If you're sleeping 14 hours a day, there's something wrong with you. That's right. Right? So we want to do the dose that's appropriate that lets us give love and attention to the rest of the things that we care about in life. That's fantastic.

Courtney, this has been an amazing conversation. Thank you so much. I so loved our round two. And you were talking about and giving a little bit of a preview about your book the last time you were on. And I just remember feeling like, dude, this is going to be amazing. I feel like this health, even though walking is not a trend, it's literally the thing that's been part of our survival. From a health perspective, as things kind of become more popular,

less popular in these cyclical movements, I feel like walking being so exciting right now and viral because of your work, this is the time. This is the time where people are ready to hear it. I have my theories about why, which is that health has turned into this such, a long list of everything that you need to do right in these four hour morning routines and et cetera, et cetera. And people have been a little bit fatigued about that. And now they're like,

hey, look, I just want to double down on the basics and live a good life. Yes. Right. I don't want my health routine to take away so much from me that it prevents me from spending time with my family or giving attention to my work or doing these other things. And walking is so central to it. And yet nobody broke it down in the way that it could have been broken down until you wrote this book that got people excited to say like, how did I not know this information? It's not a fad.

It's not a fad. It's not going anywhere. It's not going anywhere. Like when people in my clinic, all runners are like, I'm a runner, I'm a runner. I want people to say, I'm a walker. Like, I'm a walker. It's so important.

And it's not going anywhere. It's what we were biologically designed to do. So it's not a fad. And I think when people really understand, under the power that it can hold, it should be an easy conversation. The book is called Walk. We discover the most natural way to boost your health and longevity. One step at a time.

Courtney, thank you for joining us back here. Thank you so much. Thank you. Hi, everyone, Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode,

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