The Diary Of A CEO with Steven Bartlett - Your Toes Can Predict If You'll Die Early And Heres's How To Fix Your Plantar Fasciitis! - Dr. Courtney Conley (Foot Specialist)

Episode Date: May 29, 2025

What if the secret to fixing back pain, avoiding dementia, and living longer is…your feet? Dr. Courtney Conley breaks down why your shoes are failing you. Dr Courtney Conley is a physician specialising in foot and gait mechanics. She is the founder of ‘Gait Happens’ and ‘Total Health Solutions’, where she aims to educate people about the importance of the human foot to overall health. She explains:  How foot pain leads to emotional distress, depression, and inactivity How 500 extra steps a day can cut heart attack risk by 7% Why 4,000 steps a day can slash dementia risk by 50% How Courtney’s overcame addiction and used movement to save her life Why children’s shoes are sabotaging their future health 00:00 Intro 02:22 Why Care About Feet 06:07 The Most Common Foot Injuries 07:49 What People Get Wrong About Foot Pain 11:48 The Link Between Walking, Longevity, and Depression 19:20 What Shoes Should I Wear to Help My Foot Strength? 25:55 Our Feet vs. Tribe Feet 28:09 Insoles Help Initially but Not Long Term 30:58 1 in 3 People Will Develop Foot Pain 31:36 Pain in the Heel (Plantar Fasciitis) 34:04 Bigger Problems from Foot Issues 35:34 Problems with Wearing Heels 37:54 Characteristics of Good Shoes 39:54 Super-Cushioned Running Shoes: Good or Bad? 43:59 The Shocking Link Between Movement and Dementia 45:16 The Rise of Run Clubs 47:49 The Foot Gym 48:26 Bunion Diagnoses 57:12 Ads 59:16 Importance of Strong Feet at the Gym 1:06:17 What Is a Running Gait? 1:10:02 Are We Supposed to Be Barefoot? 1:17:42 Ads 1:19:42 Should We Wear Socks? 1:21:47 Viewer Comments 1:23:46 What Happens After Ankle Injuries Heal 1:26:58 What You'll Most Likely Regret in 10 Years 👀 DOAC Circle: https://bit.ly/circle-youtube Follow Dr Courtney: Instagram - ⁠https://bit.ly/43mfyoU⁠  Gait Happens - ⁠https://bit.ly/43EXDZq⁠  The 1% Diary is back - limited time only: ⁠https://bit.ly/3YFbJbt⁠  The Diary Of A CEO Conversation Cards (Second Edition): ⁠https://g2ul0.app.link/f31dsUttKKb⁠  Get email updates: ⁠https://bit.ly/diary-of-a-ceo-yt⁠  Follow Steven: ⁠https://g2ul0.app.link/gnGqL4IsKKb⁠  Sponsors: Vivobarefoot - https://vivobarefoot.com/DOAC with code DIARY20 for 20% offStan Store - Visit https://link.stan.store/joinstanchallenge to join the challenge! Learn more about your ad choices. Visit megaphone.fm/adchoices

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Conditions apply to all benefits. Visit pcfinancial.ca for details. I want people to start thinking about their feet because the implications it will have for longevity is massive. But there is plenty of things we can do for foot strength and performance. And you can actually do this at home

and I'm gonna educate you here. There's a lot we can talk about here. That didn't sound like a compliment. Dr. Courtney Conley is a world renowned foot doctor. Who's making people rethink everything they know about their feet. And the shocking truth about their shoes. One in three people will experience foot pain, and it really starts to deter your physical health,

your emotional health, your mental health, because you can't do most things. And I know this because I was a ballet dancer and then a triathlete. I had all of the diagnoses, bunions, neuromas, heel pain, and not being able to walk and not being able to move, you can go to some pretty dark places. But when you look at the statistics,

5,000 steps a day can reduce the risk of having symptoms of depression, and also reduce your risk of all-cause mortality by 15%. Wow. Here's a bigger wow. 9,800 steps can reduce the risks of dementia, so it's the most underutilized, easily accessible activity that most of us are not doing.

What about footwear choices? Footwear has such a big implication on our function. For example, around 70% of children are wearing shoes that are too narrow. I've got a range of footwear here that most people wear. So what do you think of these shoes? You shorten the muscles in the back of the leg. What is the issue with wearing these?

So they change the structure of the foot. What about this one here? You're going to make me start sweating. So let's talk about some good shoes then. Okay, so these are the things you want to look for in a functional shoe. First... Quick one, just give me 30 seconds of your time. Two things I wanted to say.

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

you. What are we getting wrong? And at what stage in our life do we get it wrong? It feels like you have a little bit of beef with shoes. A little bit. A little bit of beef. I've got a range of different shoes here, but what is it that we're being sold or told that is fundamentally not aligned with what it is to be a healthy, strong, happy human? I always say that if we started with our children and put them in the right footwear, I'd be out of a job.

Because that's when it starts. That's when the foot starts developing. And that's when we start to build strength and structure to the foot. And from a very young age, we start interfering with what goes on the foot. And when you think about all of the things that the foot can do, it's why I'm obsessed with it. I mean, there's bones and ligaments, and the foot should be designed, it's designed to move. The arch recoils, so it should lengthen and then it should contract.

There's four layers of muscles in here. So when we look at the function of the foot, we have to respect that. And I think footwear can deter the function of the foot. So is the biggest risk, just to make sure I'm super clear, that I will fall when I'm older, is that the key risk? I mean, I don't, I think that is one of the sequela of what's going to happen if we don't start paying attention. But when you look at function as a whole,

things like walking, one in three people, and probably over the ages of 45, will experience foot pain. Yeah. So other than low back pain, there's really no other diagnosis that you'll see those types of numbers. And here's the issue with foot pain.

You can't do much. You can't go for a walk. You can't go for a hike. You can't do most things. You can't walk to the mailbox when you have severe foot pain. So it really starts to deter your physical health, your emotional health, your mental health.

So it's one of those things I'm extremely passionate about because it's not just about pain. It's about what happens when you can't walk and you can't use your foot. And is the foot connected to the ankle which is connected to the arm which is connected to the calf which is connected to the back. Is there sort of a whole body holistic issue here? Is it all interconnected? Yes, 100%. Especially when I see, you know, patients that have bilateral symptoms at their feet. So that would be both sides. Okay. So for example, if I see someone with bilateral bunions, okay, which would be the bump on

the inside of the big toe. Yeah. Okay. You have to ask yourself, where is this abnormal load coming from? Let me just check my bunions. Yeah, check. Check. Yeah.

Right? Where is it coming from? Is it, you know, is it something that has to do with the pelvis? Right, because when I'm standing, if I tilt my pelvis forward, I should feel my arches drop. So there's a direct correlation between what's happening at your hips and your pelvis and what happens at your foot. And when I were to tuck my pelvis, you should feel the arches lift. So when we start to see things happen at the foot,

it's a window. It's a window to what's going on, not only at the foot, but everywhere else in the kinetic chain. When patients come to you, what kind of symptoms do they have that are connected to the foot? Bunions, neuromas, hammer toes.

What's a neuroma and hammer toe? So a neuroma is a nerve irritation in between the toes. So the most common you will hear of is a Morton's neuroma. And that's typically in between the third and fourth toes. And it can be very painful. Remember we talked about when you go to push off when you're walking? The wider and the stronger the forefoot is, the more stable it is. So if I have a foot that doesn't have splay or that looks like this and you're trying

to push off of it, you can irritate the nerves within the forefoot. And you can develop these nerve symptoms at the forefoot. Very painful. What are the other types of sort of injuries or symptoms that people come to you with that you then root back to the feet? Hammer toes. Hammer toes, which is? The clawing of the toes.

Oh, okay, yeah. Right. And this is what's cool about the foot, because it's the only place in the body where you can see aberrant loads. What does that mean? Abnormal load, dysfunction, because you can't see it at the knee, you can't see it at the hip unless you were to take imaging, where you'd start to see structural change, but you can see it at the foot. So you should be asking yourself, man, why am I developing hammer toes?

And maybe I should pay attention to that. Because bunions and hammer toes also will increase your risk of falling and also decrease balance. That's a problem. I had a plantar fasciitis, which meant that I struggled to walk for a couple of weeks a few years ago when I was training for a football match. And that's really what started me on my journey of understanding the foot and trying to understand how to strengthen it so that I could be more active. Because if you've never experienced plantar fasciitis, which I'm sure some of

my listeners have, it really is an awful, awful thing. What's the rest of the list of those kinds of injuries that people can get from having a weak foot? Is there anything else that we haven't covered? Well, plantar fasciopathy is probably the most common. That's your heel pain. Okay. And I do think that that is a diagnosis that we need to look at a little bit differently. Achilles tendonopathy, also very, very common.

Other tendon diagnoses, posterior tibialis tendon. So that's the tendon that runs along the inside of the foot and it's one of the biggest stabilizers of the medial column of the foot. It's a powerhouse. That in the soleus, which is your calf, lower the calf muscle, powerhouses of the lower leg. And all of these tissues can be strengthened and produce power. And we need to start looking at the foot just like we look at every other part of the body.

So what do you do for a living? And who are you? Well, I'm a chiropractor by nature. I went to chiropractic school. You know, I knew that I wanted to get into some type of medicine that was proactive, you know, not reactive. I didn't quite have interest in surgeries or pharmaceuticals. Movement has always been a very big part of my life. And so I knew I needed to stay in that arena.

So what did you do? When I was younger, I was a dancer. I was a ballet dancer, and then I shifted gears into being a runner and then a triathlete. And I didn't know at the time why movement was a necessity for me. You know, I certainly wasn't thinking, oh, you know, I need to do this because of longevity or because I'm going to have a better VO2 max.

You know, and now in hindsight, when I think about it, it was a means of survival. Movement was survival for me. And in my teens and into my 20s, you know, I had some personal demons that I fought. And the one thing that was consistent that I felt I could control was making sure that I stayed moving. And the problem is, is when you have foot pain, you can't do that. And because movement was a lifeline for me, it was a mode of survival, there were days where, you know, I was a dancer.

I had all of the diagnoses we just talked about, bunions, neuromas, heel pain. And when you tag on day after day of not being able to walk and not being able to move, you can go to some pretty dark places. And so I just, it was a mission of mine to figure this out and figure out how I can personally be able to continue to move, but then also be able to hopefully help other people. It got tough for you, didn't it? I can see it in your face. Yes. Because for this to matter this much to you, then it's personal to say the least. It changed my life.

When you're, you know, I think whenever we have a passion, there's always this quest personally behind it. And so I saw what it did for me and then over the past 20 years, being able to see what it has done for my patients is why I'm even more heart pressed to get this information out there. Walking. Yes. We don't do much of that these days. It seems to have gone out of fashion with all the Ubers and the other ways to get around and all the sedentary behavior that we do living and working in offices. What should we know about walking and how important it is? Because I'll be

honest, I don't walk that much. Yes, I always say it's the most underrated, underutilized, easily accessible activity that most of us are not doing. If you think about, if you look at the research on average step count that most people globally are taking, it's about 45 to 4,900. Which means that there's a lot of us that are taking less than that.

So when I'm working with my patients, we always look at baseline numbers. What's your baseline? So for example, if you had a person who was walking 2500 steps a day, I mean, some of us would be like, wow, that's not a lot. But for a lot of us, it is. If you were to walk an additional 500 steps in a day, your baseline is 2,500, you can reduce your risk of cardiovascular mortality by 7%. Wow.

Here's a bigger wow. If you have a thousand step increase, you can reduce your risk of all-cause mortality by 15%. Dying of anything? All-cause mortality. 15%. That's a big number for a thousand steps. So I have a story for you. This is a patient of mine and it just, you know, warms my heart to talk about him because when I saw him, he was two years into a diagnosis of heel pain, 27 years old. So he had gone to see a bunch of people and the last doctor that he had seen told him to limit his step count to 2,500 steps a day.

Why? To rest, to rest the foot. Now this is chronic pain now. We're not talking acute heel pain. We are two years into this song and dance, and he's being told at 27 years old to take 2,500 steps a day. So he comes into my office, we're talking about all of this, and he's also a quadruplet. So it was one of the first quadruplets I think I've ever treated. So he has, you know, which why I think pain is so difficult, it's so complicated because now you have

this 27 year old who's seeing his siblings who are at 27 like enjoy their life and doing all these things and he's being told he can take 2500 steps a day. So he's now living in his father's basement and he's afraid to go above 2,500 steps. And he used to tell me, he's like, I cry a lot. I'm depressed. And wouldn't you be if? So there wasn't any magic exercise that I was going to give him two years into this.

There wasn't any magic orthotic or magic shoe. He had done all of that. Shame on me if I would have done the same thing. So we had a conversation. And I knew I needed to get him outside and I needed to get him walking. That was my goal. Forget about the heel pain.

We didn't even focus. We didn't even talk about the heel pain. I knew I needed to get him outside and start loading his foot. Two years, this foot, by the way, when you're walking, four to six times your body weight. It can handle four to six times your body weight when you're walking. But you don't load it appropriately. And muscle's atrophy. So I told him, we had a long conversation, and I said, we're going to slowly start to

introduce steps. And if you think about this, if we were to say, add a thousand steps a day, to some people that might not sound like a lot, but to someone who's taking 2,500 steps, that's almost 50% of what they're doing. So we introduced the concept of a micro walk, which is a five-minute walk. So a five-minute walk is about 500 steps. A 10-minute walk is about a thousand steps. So that makes it a little more digestible.

So you're talking to him, you're like, listen, all I need is five minutes. And so we started five-minute walks. And for the first couple of weeks, it was, you know, there were good days, there were bad days, and there still are. But we were starting to build his confidence and movement. We were starting to get him comfortable on his foot again. And it was, you know, it was one of those cases where I just like, I really enjoyed working with him and watching what had happened.

Because if you look at step counts, I knew what number I was trying to get to. Because if you look at depression, for example, 5,000 steps a day can reduce the risk of having symptoms of depression. If you get to 7,500 steps per day, it can reduce the prevalence of the diagnosis, of depression. So that was in the back of my head. I'm like, we just got to keep working towards these numbers.

So while we were doing that, we were strengthening his foot. I had him in different footwear. And at the end of each week, we were also talking about three good things. Tell me three good things that happened to you this week. And in the beginning of treatment, it was a struggle, Stephen. It was a struggle for him to think about good things happening in his life. And I spoke with him probably about a month ago. And his email is like my why.

He was like, on average, he's walking between 5,000 and 6,000 steps a day. He still has good days, or still has bad days, more good days than bad days. But he said to me, he's like, I can't tell you the last time I cried, he's going to church, he's spending time with his dad, you know, and it's not the step count. It's the person behind the step count. And that's why I think this stuff is so powerful. I saw it change my life. I saw what it does to my patients. I mean, it has the capacity to improve not just your physical health, but how you interact

with the world. It has a completely different meaning when you understand the real sort of human consequences it can have on someone's life, for better or for worse. And it's not often until we have some kind of injury or issue that we realise that our feet and ankles were there. And that's certainly been the case in my life. It wasn't until I got plantar fasciitis that I was like, oh my God, I should have been doing something about this sooner. And then as I told you before we started recording, I've currently got a high ankle sprain. I've pulled some ligaments in the top of my ankle, training for this game called Soccer Aid.

So I'm now going through the whole process once again of figuring out what I did wrong and what I should have been doing as a preventative measure to try and strengthen my feet. One of the things I think most of us get wrong is our footwear choices. And I've got a range of footwear on this table

in front of me here. These are the types of shoes that most people wear. From a very young age, I think we all wear shoes like this. Yes. So narrow shoes with a big heel, if anyone can't see our conversation at the moment. So like the typical trainer. What is the issue with wearing these from an early age?

When I was doing research to have this discussion with you, it was fascinating to me when you look at the statistics of especially with children, with girls, around 70% are wearing shoes that are too narrow. Too narrow, the end part. Yes. Remember we talked about the widest part of the foot should be the toes. So when you look at a shoe like that, that is not the widest part.

It's tapered. See how the toe box looks like it's tapered? Yeah, it's pointy. Correct. So when you put your foot in there, it's doing this. It changes the structure of the foot. It's like the lowest hanging fruit for me is just wear a shoe that fits your foot. Because when it's in that position, it changes the structure.

If I walked around with my arm in a sling for 10 years, would my bicep get weak? Yeah, you'd lose your mobility as well. Correct. If you don't use it, you're going to lose it. And so that's why I think footwear has such a big implication on our function. Men's dress shoes. Men's dress shoes. Yeah.

I mean, that is crazy. The point on that. Yes, it's funny. My brother lives in New York City and we have this conversation all the time. And he's like, look at this one. It's wide. I'm like, nope, that's not wide. And they're stiff and they're, you know, again, changing the structure of the foot.

A lot of those shoes also have a little bit of a heel to toe drop. Yeah. Yes. So that is when the heel to toe drops, so the heel and the toes sit in one plane. But when you have a higher heel to toe drop, it's like you have a mini high heel on. Yeah. What's the problem with that? Well, if my foot is supposed to sit flat, I have tissues in the back of my leg that

are in a good length-tension relationship. I have even pressures across my foot. The second I go and change those things, where I go into a heel, you put additional pressure on the front of the foot. You shorten the muscles in the back of the leg. So you start changing the function in the structure of not only the foot, but everything that sits above it. Your calf, your hamstring, your back. Do you see a lot of back injuries that are relating to things like heels?

Yes. You do? relating to things like heels and you do. It's all, you know, I see mostly people come in for foot pain. And I always say to my patients, I wish it was just about the foot. I wish I could just look at your foot and say, this is what it is, it's all right here. But it's not, because there's a body that sits on top of the foot.

But it's not. Because there's a body that sits on top of the foot. The strength of the hip, for example, controls the foot. It controls how the foot unlocks. So you have to take that into account when you're looking at patients with foot pain. But this is the shape because it's fashionable, right? Yes. It's my biggest, you know, I always tell my daughter, because my daughter, you know, she's like,

you make me wear these platypus shoes. And I'm like, listen, it's function over fashion. But I get it. That is my biggest challenge, is making, you know, is looking for shoes. But they've come a long way. They've come a very, very long way. And I think that we're getting there.

Is there an issue with the thickness of the heel on these shoes? This big, when I say the thickness of the heel, I really mean the thickness of the sole. So the cushion and the... The cushion. I mean, it's really, really soft and cushiony. There's about an inch at the back here of soul. Yeah. The cushion conversation is always very interesting. There's always a trade-off.

So there's a lot of popular shoes right now that have a lot of cushion on them. Yeah. And it's hard to argue when someone goes into a store and they're given this shoe that has this pillow on it and they're standing on it for three seconds and they're like, man, this feels really good. The problem with cushion is that the more stuff that's between your foot and the ground,

the less you feel. So there's a loss of sensory acuity. There's a loss of sensory perception. Remember the foot is, imagine the foot's a sensory organ. And it is. Because there's thousands of receptors that are, you know, screaming for information to help keep us upright in a biped.

So when we start interfering with how that foot feels, you can expect there to be problems. Now, if you have someone that's standing in place all day long, right, on concrete, on man-made surfaces, there's a time and a place. But my non-negotiable is at least keep the foot in its functional position, which means a wide toe box. So you want to stand on concrete all day long, fine. is at least keep the foot in its functional position, which means a wide toe box.

So you want to stand on concrete all day long, fine. Put some cushion underneath your foot. Help yourself out, that's okay. But at least allow those toes to splay so that you can have balance, you can have your foot in a position that can propel you forward. I was just thinking about my foot as you were talking. And I'm pretty sure, like, my...

I'm pretty sure that my pinky toe looks... I'm not gonna be able to sell pictures on OnlyFans of my feet, because my pinky toe is kind of, like, crumpled in. It, like, curls under, right? Yeah, it's, like, curled under. Right. Kind of looks like a shoe, like you had a shoe there, like... Excuse me. No, but you're right, it's like curled under. Right, kind of looks like a shoe, like you had a shoe there. Excuse me. No, but you're right, it is.

It is like that. It's kind of like been pushed in and underneath. And I guess that's not natural. No, it is not. How does a natural foot look? Have you been to see a tribe who don't wear these cushioned shoes? Have you seen what an unchioned foot looks like?

I'm obsessed. I watch People's Feet all the time. I was just in Belize with my mother and daughter for spring break. It's slightly creepy. Sorry. It is, isn't it? And you're looking at People's Feet on holiday. I'm always looking at People's Feet because it tells a story. It's like someone's gait. You know, watching someone walk tells a story. You can tell if they just got fired or if they just got promoted, you know? But when you look at someone's foot, I was in Belize with my mom and daughter, and there were these two guys building a house a little bit off the beach, barefoot. And I'm looking at their foot and I'm going, wow, it was wide, it looked thick, it looked

flat. And you know, I think in our society, if you will, when we think of a flat foot, we think, oh, this is bad news. We better go get an orthotic. An orthotic is a... A device that you put underneath the foot to help modify loads. What do they call those in the UK? Insoles? Like an insole.

Okay. Yes. And so I'm watching these guys build this house and they're like coming up on their toes and they have all this, you know, toe range of motion and all this strength and power to their foot. And I'm like, that's what our foot was designed to do, is to be strong, to support. It's like building a house on sand. Yeah. You have to have a foundation that you can build upon.

And it was really cool to see. It really was. When I had that pain in my foot, which they told me was plantar fasciitis, they recommended that I go to some foot doctor person. And this foot doctor person measured me up for incels. Yes. And I put the incels in and then I took the incels out. And instead of that, I just wore different shoes. Yeah.

A lot of people's first sort of diagnosis and the thing that they're told to do whenever they have foot pain or back pain or whatever is go get some in-cells. Is this what you think we should be doing? Because it's really, really common. It seems to be the... Like in medicine, they throw pills at you if you have certain symptoms. It seems to be the first thing that we do when someone has a foot problem or an ankle problem.

First line of intervention is that's why you want to change how we're viewing the foot. It's either if your foot hurts, here's an orthosis. Which is a foot orthotic, an insert. Or if it hurts worse, good surgery. If you look at the research on plantar fasciitis, okay, so itis being acute. It will tell you that putting an orthosis or something to modify the load underneath the foot can be beneficial initially because you want to offload something that hurts. But if you don't use it, you're going to lose it. So what they're not, the part of the conversation

that's being missed is the and conversation. It's where this insert and strengthen your foot because the goal should be to have an exit strategy for the insert and get your foot back on the ground. Because I have patients, Steven, they will come in with 20 pairs of orthotics, 20 pairs of inserts. They've tried this one, they've tried that one, they've tried different shoes, higher heel to toe drops, more cushion.

And I'm sitting there going, we're missing the boat here. Let's have the and conversation. One of the muscles that is a good predictor of having heel pain is it runs parallel to the planar fascia. So it's flexor, digitorum, brevis. It basically takes the four toes and presses them down. There's ways you can assess for this. So we'll look at their toe strength and it almost always correlates with the side that has the heel pain on

because it shouldn't be one of those conversations where you're like, man, I wonder where this came from. No, your foot is weak. Your foot is weak. There's a lot of load going through it. And the structures are getting beat up. There's something Daniel Lieberman said to me, which I've never forgotten. He said if you took a child and you put them in two-inch thick gloves from the day that they were born, and then you took those gloves off at 30 years old, can you imagine how deformed their hands would be?

And that's very much the way that we live our lives. We spend pretty much all day wearing these big cushioned shoes that sometimes have these heels on. So it's no wonder that so many people are getting foot problems, ankle problems, back pain. Yeah. So... One in three people. One in three people.

Foot pain. I mean, it is... It really is a statistic that we need to be paying attention to. We use this word plantar fissiitis, but we didn't explain what it is, it really is a statistic that we need to be paying attention to. We use this word plantar fasciitis, but we didn't explain what it is and what the symptoms of it are. Is it essentially like pain in the heel of your foot? Pain in the heel, yes. And they've played around with, you know, the terminology, being it plantar fasciitis,

so more of an acute issue, versus plantar fasciitis, so more of an acute issue versus plantar fasciopathy because oftentimes these cases will turn into, you know, having heel pain for very long periods of time. Yeah. So then you have to treat it differently. You don't treat something that's acute the same as you would treat something that's chronic. And so you have to look at how can I build the resiliency to the foot? How did it happen?

How did all of this happen? How did plantar fasciitis happen? Like, how did I get it? So I'll tell you what I was doing. I was living my life as normal. And then I started training to play for this soccer game. And I started training several, maybe twice a week. And then maybe by week four or five or six,

I get this horrific ongoing pain, which lasted throughout the entire day, where I couldn't walk easily. It was especially bad in the mornings. And yeah, I thought I'd like broken something or ripped something in my foot. And when they told me that it was plantar fasciitis, I'd never had that term before.

But understanding what I did there, how did I get it? When I see, I hear very similar stories with that diagnosis. There's always, there always seems to be some impetus of, I added load too fast, too soon. I went on a longer hike. I, this was one of my favorites. I went barefoot during COVID around my house and everybody wanted to blame the fact that, you know,

don't ever go barefoot. And I was like, maybe it's just cause your foot was weak and you weren't ready to handle these loads. You add loads too fast, too soon. And the foot just says, you know what? You weren't ready to give me this amount of load this quickly. Okay. And that's, you know, when you asked me earlier about why we need to pay attention to our foot strength, is it just because, you know, we're going to, we want to prevent falls when

we're 70? This is the why. Because we want to have healthy feet, strong feet, so you can say, hey, I want to go play a soccer game and I don't want to worry about having plantar fasciitis in my 30s. Or, I mean, now with this ankle sprain that I have, pulling my ligaments,

which takes you out of activity for so long, which is horrific. That's like a big part of this, which is if you get an injury, if you get a bad injury, if you get like an Achilles tendon issue, or you tear a ligament like I have, or even plantar fasciitis, the inactivity that stems from that causes a bunch of downstream issues.

So my muscles are going to atrophy. I'm going to lose muscle over this next couple of weeks in my lower half. I'm going to get probably a little bit lopsided because the injury is on my right side. So now my left side's having more of the burden. My lower legs, my upper legs, my lower back is probably susceptible now to some kind of injury as well. And it feels like, you know, this downward spiral of injury just because I didn't strengthen

my foot. What do you think of these shoes? These are women's heels, but listen, anyone can wear them. It's 2025. What do you think of these shoes? Well, it doesn't look like a foot. Your foot in that position is not the position it is supposed to be in. Now, with that being said, there is a time and a place. You know, I don't think I'm going to win the battle of, you know, you need to wear, you know, functional footwear, 24 hours a day, seven days a week. Time in those shoes should be limited.

Just like with, you know, other things, it's moderation. Do you see a lot of women getting injuries because they spend too long wearing heels? I don't know if acute injury, but a weakening of tissue, yes. Because I live in Colorado now, so I don't have that. There's not too many women in Colorado that are wearing heels.

However, when I go to New York City, it's a different conversation, different environment. So, you know, I have to say, I have to use the, that is not the position that you want to keep your foot in. It's changing the structure of your tissues, changing the pressures in the foot. Not to mention that those are, I don't care what anybody says, that's not comfortable to walk around in. People will be like, oh, I'm really comfortable in heels. I'm like, are you really though? The lengths we go to to look good. That's right.

Okay, so let's talk about some good shoes then. Okay. I've got two pairs of shoes here. One of them is Vivo Barefoot, who are actually a sponsor of mine. Ever since I started talking about feet. And then I don't know this brand. What is this brand? That is Ultra Running. So let's talk about the things you want to look for in a functional shoe.

My non-negotiable is the wide toe box. The toes have to be able to splay. When you think of all the diagnoses that we talked about, bunions, neuromas, hammer toes, when the forefoot can splay, the foot's going to function better. So that's number one. Number two is having the heel and is thin and flexible. When you wear this type of footwear, I call this a workhorse shoe because there is more loads going through all of your tissues, through your bones, through your ligaments, through your tendons, through

your muscles. So your foot gets stronger when you wear this type of footwear. There's research on that. Now, you have to earn your right. This is the plantar fasciopathy conversation. You can't go from wearing an aggressive high cushion shoe. Like this one here? With, yes, with an insert for example, and say, oh this stuff makes sense, I'm gonna go take that off and I'm gonna go wear this 24 hours a day.

You won't like me. Why? Because you'll say, hey my heel's hurting. Because you haven't done the work. It's, hey, let's do these foot exercises. Let's wear this for 10 minutes a day. And then people are like, wow, that does feel better. And then it's a transition into wearing this more often.

Now, when you have patients that have had a very weak foot or clients that have had a very weak foot with different diagnoses, this is a hard shoe to walk around in for extended periods of time. So that's when we'll talk about footwear that still puts the foot in a wide position, wide toe box. I love this shoe. And I also like the mesh upper because the toes can expand in here.

I still have zero drop, right? Where the heel and the toe sit in the same plane, but you'll notice the difference between the two shoes is the amount of stack height or the amount of cushion. There's more stuff. Yeah. So on this shoe, it does look like the, you call it a plane, looks level. Yes.

Okay. And it's got a good toe box. Yes. You can see from this side that the toe box is wide so you can splay, but it is elevated. It's elevated off the ground. Yeah. But the heel and toe are in the same plane. Okay. Fine. But it can't, fine. But it's still elevated though. They're still quite a thick.

That's not too much of a problem because it's still flat. It depends on what your goals are. If I'm running. That is, I think, a great shoe to run on, to run with, right? If you're running on concrete, if you're running on asphalt, you want a little something underneath the foot. running on asphalt, you want a little something underneath the foot. What about the Nike Alpha Flies?

You're gonna make me start sweating. Really? This is my current running shoe and I bought it because it looks great. Yes, I mean, you know, it's... I have torn the ligaments in my ankle, but I look good. Here's the super shoe, right? So here's this shoe, right? And here's your super shoe over here.

Yeah. Okay, when you look at that shoe, there's certain characteristics to that shoe that you definitely do not see in this shoe. One of them being the toe spring. So see how it kind of lips on the front of the shoe. Yeah. Okay? This part here, yeah. Yes. So if I had that shoe on this table and I went like this on the front of the shoe. Yeah. Okay?

This part here, yeah. Yes. So if I had that shoe on this table and I went like this to the front of the shoe, it would literally rocker for me. So it facilitates the rocker of the foot. Sounds great. You put that on, you're like, man, this is great.

I can fly. If you don't use it, you're gonna lose it. So there is research that shows when you put your foot in a position with toe spring, you will weaken the intrinsic muscles of the foot. So I'm not saying don't have race day and wear that shoe, right? The research will tell you 2% to 4% running economy. People run faster because the shoe has the technology to facilitate gait.

But if you train in that all the time and you never let your foot get stronger, it's just a matter of time. You're going to say, my hamstring, my foot, my this, my that. And it's like, that's why the conversation has to happen is this is the shoe that you're going to get stronger in. Spend time in your training shoe and then that's your speed day. That's your race day. So it's having the shoe spectrum, knowing when to dance along the spectrum. I feel like I can bounce in these.

I mean, you probably can. I literally, when I put it on, I was like, wow, I can bounce. That's right. I think it has like a piece of metal going through the middle of it. Yeah, there's carbon in there. You know what another fun fact is, though? Certain plyometrics, so plyometric is training the spring of the body. So think like jumping.

There's research that will show you that plyometrics also increase capacity in running by 2 to 4%. So my conversation I have with my patients is, listen, what if we stacked therapies, right? What if you did plyometric work, which is jumping, you know, once or twice a week, and we worked on your strength and I had you in these shoes the majority of the time. And then on race day, you want to throw that shoe on? It's like you're a running, you're like a running fairy.

You're like running and things look beautiful and everything is, you know, because you have a strong body on top of the shoe. But if you put a weak body and a weak foot in that shoe, you've got to earn your right. Should we be standing more often? Because most of us work and live in offices now, and we sit at desks, and I do this podcast Sat Down. Do you think much about standing desks or how often we should spend bipedal, or I think that's what you referred to as?

I think that it's more about movement. I don't know if standing in one place is any better than sitting in one place, other than when you're standing, you can actually like, you know, move around and, you know, make it more active standing. But it is a matter of taking movement breaks. Like that's, I call them, you know, movement snacks. All of us spend a lot of time either sitting all day long or, you know, standing at our desks.

If we were to take micro walks, a five minute walk, a couple times a day, the system stays moving. You're staying active and you're slowly, you know, inching up that step count that we know is so important for not only physical health but emotional and mental health. That's what I like about it. I think you mentioned there was an association with movement, walking, and dementia, Alzheimer's risk. What does the science say there? When you look at step counts, if that was going to be our baseline, 9,800 steps per day can reduce the risks of dementia.

But what I think is the cool part with that is 3,800 steps. You get 50% of the maximal benefit. So, if you were to, let's just call it 4,000, shoot for 4,000 steps, you're going to get a benefit. A 50% benefit. And some of my favorite research on looking at that population with walking as relationship walking. There's really cool studies looking at walking in groups for the elderly population and how that has a social connection and it improves their emotional health

and it combats loneliness and feelings of isolation. And that is the beauty of a walk. Road clubs are getting incredibly popular at the moment, aren't they, all around the world? Are you seeing more and more people come to you as a result of that? Yes. I think also, it was interesting, I was working at the running event in Austin, Texas, and I was teaching there.

So, a lot of the shoe stores were there. And one of the bigger shoe stores had said that the majority of their clients now are actually walkers and not runners. And I thought that was pretty interesting. And I'm thinking to myself, I wonder why that is. Like, are more people reverting to walking because they're getting injured when they're running? Are they, you know, I'm making all these conclusions in my head. I'm like, well, is it because we're going in the wrong direction with footwear? Because we're creating this shoe that is basically doing the work for us and it feels so good

and you know, people aren't putting the work in anymore? I don't know. But I'm certainly going to do my best to change that. You brought me a box, which I have here in front of me. Foot Health Kit. Yes. That's what it says on the front of the box. Foot Health Kit.

I mean, what is in this box? It's like my little like bag of treats. You know, when I started doing this, it was funny. This is what you give people as a bag of treats. That's right. For their birthdays and stuff. I want people to start thinking about their feet, because I think there's such implications for their health.

And I wanted to make it easy, because when we think about all the things we need to do to stay healthy, it's like, I have to strength train. I have to eat this, I need to VO2 max, I need my cardiorespiratory fitness, there's a lot. So I wanted to make it easy. So I, first, one of the things that is in there are toe strengtheners. So I'll pull them one of the things that is in there are toe strengtheners.

So, I'll pull them out of the box. So... Those are toe spacers. Toe spacers? Yes. So, is this all the same thing, right? Yes. So, these are toe spacers. Correct.

And then there's this. Yes. What's this? Those are toe strengtheners. Toe strengtheners, okay. So, that's my toe workout. There is this? Those are toe strengtheners. Toe strengtheners, okay, so that's my toe workout. Yes. There is this thing. A band.

And then there's this ball. Yes. So this is like, this is my foot gym. That's right. Can you show me how this stuff works? Absolutely. Okay, so these are my feet and these are my ankles. So I had plantar fasciitis in, I believe it was this foot actually.

And then right now I've got a high ankle sprain, which is some kind of ligament here has been torn and they told me that it's torn on all three sides. So I've been in a boot for the last couple of weeks, but I've taken it off over the last week or two. And I was on crutches as well. What are you, the minute I took my socks off you became fixated on my feet. Yes. What do I need to be thinking about and what can you see just by looking at my feet? You know when you're looking at this foot here you can start to see this little bump here. You can start to see bumps on the top of the big toe. Okay, and the diagnosis is a Hallux limitus or a Hallux rigidus.

And basically what that means is that you have formed arthritis on the top of the toe. So it prevents you from getting that full range of motion that we need when we walk and run. Okay. Okay? If the bump goes out to the side, that's what we call hallux valgus. That's bunion.

The bunion, okay. Okay? So that's why the foot is a window to mechanics, because you can see loads, aberrant loads, right? Why is this forming here? So, you know, one of the first things I wanna look at is how much range of motion. It's all about the big toe.

When we're walking, we put a lot of loads and force that go through the big toe when we walk. You should have about 40 to 45 degrees to walk out of that big toe. So here's Eddie, here's 45 degrees. Up. Up, okay? So yes, so what I wanna see is how much range of motion.

Can you see how he's off the ground though? I want the ball of the big toe on the ground. That's a good amount of range. That's the first nice thing you said about my feet. We're just getting started. I'll find something else. And then you want to look at toe dexterity. So in other words, can you isolate your toes? So can you lift just your big toe on the right? Good. And then on the left.

That's actually quite hard, like, I've never had to do that before. It's funny, because when you'll see people that have poor awareness to their feet, when they try to lift their toes, you'll see them like, with their hands, and like, your back isn't going to extend your toe. Hey, and then put your big toe down, and then extend your foretoes.

Yes. No, that pinky is not, that's not listening. There you go. And here. Okay, and then what I want you to do is you're gonna lift up all of your toes and spread them. And you can see, two, three, and four, right?

They don't wanna spread as much. Earlier we talked about those neuromas. The neuromas live within the toes here, right? Within, right in between the toes. So if we have issues with nerve problems here, you gotta be able to splay. So you wear vivos. You know, when you allow your foot to be in a shoe where the feet can actually splay, you'll start to see changes. But imagine if you,

you know, were in a shoe where your foot, I mean, I had a, I was at an expo working a couple of weeks ago and this woman came up to me and she's like, man, I can't figure out why my foot hurts. And I took her shoe off, and I'm telling you, her foot looked like this. It looked like a shoe. And I took a picture and I showed it to her and I was like, did your foot look like a foot or does it look like a shoe? We don't really know the difference these days.

No. Because remember, the widest part of the foot should be the toes. So that's what we want to look for in the front of the foot. We also talked about that muscle. What side did you have the heel pain on? I believe it was the right side. So one of the things we'll do, and you can actually do this at home,

you could use like a credit card. So in my office we can actually measure that, but if you were to do this at home. You could use like a credit card. So in my office, we can actually measure that. But if you were to do it at home, you just take a card and put it underneath the toe. Okay, and make sure you're lined up here, yep. And some people will also do that. See how you're like holding your leg, just the toe. And then I'll try to pull the card out from under you and I shouldn't be

able to do that. I should feel some tension and then I'll ask the patient where do you feel this? What's working? And if they say my hip, my quad, it's wrong, wrong guy. We're talking about the foot. So you should feel that in the arch of the foot and maybe into the calf. Okay, big toe. Flexor, halus, or slongus. This guy, by the way, this muscle starts over here. It's very important to strengthen this muscle when you have a history of ankle sprains.

Starts on the fibula, which is the outside of the leg. It comes down the foot, crosses under, and inserts into the big toe. Then I'm gonna take the card, and I'm gonna put it underneath the four toes. The muscle that we're looking for, yes, that's beautiful. See how you got that little, see, that's the second compliment I gave you about Shreve.

I'm gonna put this underneath your toes. Yeah. Right? Little, yep. And then don't let me pull the card out. And you should feel that in the arch of your foot. Patience that have- I'm not really feeling it to be honest.

I'm not feeling it in the arch of my foot. Okay, oh, what? Okay. There you go. Roll the bottom of the foot. Like this? Yes. Just wake it up a little bit. There's a bunch of receptors on the bottoms of the foot.

So when we can't feel things, it shouldn't surprise us. You know, if we've been walking around in footwear that compromises the function of the foot or we've had injuries, you start to lack what we can feel. So just wake it up a little bit. And how long would you do that for in the morning? 60, 90 seconds. Do you do this every day? I do.

I'll tell you when I like, if I'm standing at my desk, I'll keep the ball there. Okay. When I come back from a run, I do this whole little setup, But I wear these all day. What is that that you're wearing? So these are toe spacers. So they do exactly that. They splay the foot. Why are you wearing that? Remember when I was telling you about my years

of being a ballet dancer? In pointe shoes, I wore orthotics for a long period of time. I wore ill-fitting footwear and my foot was weak and things hurt. Okay and we talked about why I needed to fix all of that. You can see my bunion here. Okay so I work on all of this stuff all the time and toe splay is a big part of that. So when I have these toe spacers in, they splay the foot for me.

Every pair of shoes that I wear is compatible with a toe spacer. Okay, so you don't wear any narrow shoes? No, that's my non-negotiable. Okay. And this is important. You don't wear any narrow shoes. No. That's my non-negotiable. And this is important. There is a difference between a wide toe box and a wide shoe. So people will say, well, I ordered the wide.

The width will come here. That's where they change the width. But if the toes are still tapered, the width has to extend into where the toes are. So that's where you gotta be careful. It's a wide shoe is not a wide toe box shoe. And if you try to wear these in just a wide shoe, you're not gonna be comfortable.

So if I wore this for one year, what promise could you make me? What could you tell me the benefit and the upside would be? You would definitely see improvement of the splay of your foot. Yeah. And when you have the tissues, the splay, you can start to improve the strength of the foot. And what's downstream from strong foot? Go up the chain.

You have better toe strength. You're going to build a better platform. You're going to have a jet engine on a jet engine. So your ankle mobility, then your knee extension, your hip extension, because your foot is doing what it was designed to do, which is be mobile and be strong. We need to pay attention. If you, if things go south from here, you can expect there to be changes up the chain.

I see it all the time. This one change has transformed how my team and I move, train and think about our bodies. When Dr. Daniel Lieberman came on the Diary of a CEO, he explained how modern shoes, with their cushioning and support, are making our feet weaker and less capable of doing what nature intended them to do.

We've lost the natural strength and mobility in our feet, and this is leading to issues like back pain and knee pain. I'd already purchased a pair of Viva barefoot shoes, so I showed them to Daniel Lieberman and he told me that they were exactly the type of shoe that would help me restore natural foot movement and rebuild my strength. But I think it was plantar fasciitis that I had

where suddenly my feet started hurting all the time. And after that, I decided to start strengthening my own foot by using the Vivo Barefoot. And research from Liverpool University has backed this up. They've shown that wearing Vivo Barefoot shoes for six months can increase foot strength by up to 60%. Visit vivobarefoot.com slash DOAC and use code DIARY20 from my sponsor for 20% off. A strong body starts with strong feet. Is there anything else that we need to be aware of? What is this other stuff here? You've got like toe strengtheners as well. So before

we get to those with, you know know the big toe on the four toes? This is when you can use that band. Right? So you just put your heel on there. Okay? You grab your four toes. Right? It's like you're doing a bicep curl, but you're doing it with your toes.

And you press into the band. And you lift up. And you press into the band. There you lift up and you press it into the band. There is research, four sets, 12 reps. I mean, these are some of the things that they work on to improve function of the foot that helps with plantar fasciitis. Okay.

And then you go around the house and you grab the big toe. Keep that ball of the big toe on the floor and then press. Yes. Right, and it's a good place to start. You're building strength in your foot. And if you want to really get after it, go for just the little guy. Oh my gosh. Little piggy.

It's really wild because the abductor digidiiminimi, the muscle that abducts the little toe is just as big as the big one. We like just are like, oh, that toe is just there to hit furniture. It stabilizes the outside of the foot. What is the difference between someone that does this and doesn't do this? Well, let's start with pain. And I use the word prevent injury, that's tough for me. You want to create an environment where you can have the

best opportunity for function. So when people strengthen their foot, they are going to have a foundation that's going to have resilience to the rest of their system. This is what we walk on. You cannot build a jet engine on a paper airplane. I'm working with a lot of, you know, athletes right now are getting bigger, they're getting stronger, they're getting faster. And if you look at the rates of injuries at the foot, they're going up. Because we know the amount of loads that go through the foot when we walk and when we run. So if we

want to do a bunch of squats and do a bunch of deadlifts and do all the sexy stuff, but not pay attention to the foundation on which we're putting all of this on, you're going to run into problems. So from a function perspective, you're improving your function from the ground up. You're providing a better environment for your body to decrease pain. And when we get older, it's, you know, you don't want to be chasing your tail at this stuff. How does this stuff turn into mobility and flexibility? Because that's something I'm thinking a little about at the moment. I realized that as I do a lot of upper body workouts and stuff like that, when you watch me like pick up the weights and stuff,

put them back down, I look like I'm, I've got the mobility of someone that you would think was double-weighted. I wondered if a lot of it starts with our feet. So we talked about the big toe. When you're walking, the big toe has to extend a certain amount, okay? I'm gonna show you here, okay?

So when I'm walking, I have to have a certain range of motion out of my toe. And that gives me range of motion out of my knee and out of my hip. If I cheat the system, so let's say this is the only amount of range I have, let's say I have a big toe that's only gonna extend 20 degrees. You're gonna compensate. You might shorten your stride. You might take shorter steps. You might not get access to

hip extension because your toe isn't going into full extension. So you will see some type of compensation. You know, the other one I think about is ankle mobility. You know, I was listening to one of your podcasts and you were talking about the story of you rafting in Bali, I think. Oh, yeah. And how you were, you know, walking down the stairs and how it's something that you want to be able to do. And I was thinking to myself, I'm like, if you were to ask someone,

if you wanted to continue to be able to do that as you age, what would you wear? Probably a VIA 2 Max. Endurance? Yeah. Your hip strength maybe? Yeah. Right, your core strength, your hip mobility. I think very few people would say ankle mobility and toe strength. But here's the deal. If you don't have good toe strength, where are you going? You can be falling. If you don't have good ankle mobility, same thing. So ankle mobility is a big one. Also,

it gives us access when we squat, when we go up and down a stair, even walking. So what do you mean by ankle mobility? Do you mean mobility to go like this? This dorsiflexion. The ankle also plantar flexes and it inverts and everts, but the one I'm talking about when you're, you know, this ankle dorsiflexion is something I look out with all of my patients. And it's not stood up, is it?

Sorry, it's not sat down, is it? Stood up? Like, he would... If you can do it, you look at it seated, yes, but you want to keep that heel on the ground. Okay? I mean, that's all we've got there. Okay. I mean, that's all we've got. Okay. And we're looking for about, you know, between 20, 30 degrees. But this range of motion is very restricted.

Remember the high heel conversation? Yeah. You walk around in a high heel for a long time, ankle dorsiflexion is affected. And what can I do to improve my ankle mobility to prevent myself getting injured or getting pains or issues with my lower leg, upper leg back? You know, I think joints, you have to look at joints from two perspectives, both mobility and stability. How well does it move? And how well can you control that motion? Yeah. Right? So you can work on static stretching, dynamic stretching. The other thing I would be looking at here, though,

is the strength of one of my favorite muscles, which is the soleus, this big calf muscle back here. Because it's the soleus, right, that helps control this motion. And, you know, if you had a seated calf raise machine here, and we wanted to look at baseline, like, what can you do with your single-leg seated calf raise? Which is this one, right? Yes. The capacity that the soleus can produce is it can put eight times your body weight going through your forefoot. That's a lot.

So there was a study that looked at return to run. So they were looking at how much strength, if you will, can we produce out of a seated single leg half raise? Yeah. One and a half times your body weight, six times. Well, six reps. Yes, single leg. Okay. So you would put one and a half times your body weight, plates, six times. That's a lot. If you were to do it

standing, holding half your body weight, six reps. But we don't train the lower leg like we do everywhere else. No, especially men. Yes. I don't care about legs. Yeah, I always say it's, you know, the machine at the gym that should have the longest weight line is the seated calf raise machine and it's always open. What do you see the biggest mistakes that runners make outside of the Alpha flight issue, wearing those big cushioned shoes? Is there a certain way that we run that is causing us problems? And also, are we running too much?

Because some people, they really get hooked on running. I mean, I love it. I think running is one of the best forms of activity. I think if we wanted to keep it very simple, over-striding is the enemy. Over-striding. Yes. What's an over-striding? So if I'm running, right, here's my foot.

Yeah. I want my foot. Yeah. I want my foot to strike as close to my center of mass as possible. As in as close to your body as possible? Yes. Okay. So over stride would be as if I landed with my foot all the way out here. Okay. Yes.

Got you. So our calcaneus, this heel bone, was beautifully designed to absorb shock, okay? When I overstride and I can feel it, what am I gonna do? That's gonna hurt. So you're not gonna do it anymore. You're gonna overstride and be like, ah, that hurts, so I'm gonna adopt my gait pattern

and I might not overstride and bring that foot closer to me so you strike differently. You want the foot to hit in line with your body? A little bit in front of the body. It's the heavy over stride you want to avoid. Okay? But if I can't feel anything, you don't know. That's the more stuff on the shoe.

You can over stride hot and heavy because you have all this cushion there. You're like, well. Yeah. So that's, you know, the argument of allowing your foot to be able to feel things. What about this whole thing with Gates and stuff? Because sometimes when I was videoed from the back

and someone in the comment section was like, you're like, Gate is wrong or something when you want to. So I don't know what he meant. I couldn't see his qualifications. So I kept it moving, but. Everybody has a certain gate. What is a gate? You have a running gate or a walking gate.

It's just your, what happens when your foot strikes the ground to the time it hits the ground again. So you have certain stride lengths and step lengths. Okay, so if we had a treadmill here and I would have you start running, that would be your running gait. I'd be looking at you from the back, from the side, from the front,

and seeing what happens when your foot hits the ground, when it comes back up into swing phase, what's happening above the foot, so what are your hips doing, what is your pelvis doing? So you're really looking at the person and then you're also looking at, you know, what am I seeing that I think could be, you know, a factor in either pain or poor performance? And then you see those things and you're like, okay, let's start working on this. But this is the interesting thing with gait, right?

Someone will see something and they'll say, okay, you need to start doing calf raises. If they also don't cue gait, right, or let's work on your cadence. Let's work on some type of skill. Strength and skill light up different parts of your brain. So you can get really good at calf raises and great. But if you want to be a good runner, you have to look at different things. So what's the most common issue with someone's gait? The overstride. Overstride.

And then also kind of the crossover. Why is that a bad thing? It takes away some of that efficiency. So oftentimes you can see, you know, if someone's crossing over, when they land, they'll have more of this kind of collapse through the extremity, if you will. Okay.

Okay, we wanna control the foot when it hits the ground. That's why the hip conversation, right? The hip controls what happens at the foot. Are we supposed to be barefoot? We are supposed to let our foot function how it was designed, and that is letting the foot feel the ground. Now, we live on manmade surfaces

and we walk around on concrete. So for me to say, yes, we should all be walking around barefoot, that's a conversation that's difficult to have. But the stronger that your foot becomes and the more resilient that it becomes, you can handle these things a lot better. And it makes interacting with your environment

so much more fun and easy. What are these? Okay. My daughter was a rock climber and she was up in her room one day and she had the bands around her fingers and she was like strengthening her hands. And I was looking at it and I was like,

man, I'm like, I want one of those for the foot. And I'm looking for them and I couldn't find them. So I said, well well here we go. So I designed these and they're different resistances so it's the same concept as you would with your hands you just put them around your toes. Okay. Hey give me the easy one. Which one's easy? That's the easy one. Okay here we go. Are they all the same size which you need different sizes for different size feet? Nope. So when your toes splay, you can slide those on a little easier. My little piggy is completely redundant. It's doing nothing. It feels like it feels like it's disabled.

Well, we're gonna change that. Okay? So when you lift up all your toes, try to get your big toe to touch my finger. Yes, that's abductor calluses. That's this muscle right here. So people that have bunions, it's like just strengthen that muscle, right? So that guy goes in and you hold right there. So now you're strengthening inside of the foot. You're strengthening the muscles inside the arch of the foot. You're strengthening the muscles inside

the arch of the foot. If you can get that little guy to go out, you're gonna strengthen this guy. So you're just gonna lift all your toes. Good, and then spread, reaching forward. Try to keep the tripod of the foot though. Okay, so I'm trying to... Lift all your toes, but keep that tripod.

One, two, center of the heel. So lift. Yes. Yes, yes. And split, yes. Now press those toes to the ground as you spread them. Lift, spread, reach. Oh, that's pretty.

Thank you. Okay, so, and that gets, you've got ones that get incrementally harder. Yeah, so this would be harder, this would be hardest. Okay. So we're doing like 30, 40 reps a day. That's how you'll know if someone needs to work on this because they can't keep those points.

So they're kind of like, it looks like their foot's on an ice scape. Yeah. So that's the front of the foot. Yeah. When you get into the front of the foot. When you get into this part of the foot, the rear foot, there's certain things you want to pay attention to. We already talked about mobility at the ankle.

But you also want to look at what happens when that heel comes off the ground. Because this is when all the magic happens. Because the foot engages, the intrinsic muscles engage. It's basically like I'm getting ready to propel forward. So there's certain muscles that you want to have some good capacity to be able to get your foot in this ready position. So two we can talk about is one that runs along the inside. And then this is posterior tibialis,

one of the very big stabilizers of the arch of the foot. And his best friend, which is the soleus. Those guys help do this to the foot, help invert the foot. Hey? So go ahead and stand up for me. Put your foot in here. I'm gonna put this around your ankles. Oh.

There you go. Okay. Spread your feet a little bit. Toes pointing straight ahead. Which by the way, we want to talk about gates. When I'm moving from point A to point B, my feet should also look like they're moving in this direction.

If someone's walking like this. With their feet pointed out. Correct. Yeah. I want to know why. Do they have a bone in their lower leg that's rotated out? Which could happen. But if not, you don't get to walk like that. So we want the toes pointing straight ahead as long as there's no compromise structurally.

Okay. Okay? So what I want you to do here is you're gonna keep the ball of the foot on the floor and I want you to drive your ankles almost like you were gonna sprain your ankle, right? So you're gonna push into that range out. So you're gonna take your ankles and drive them into the band. Into the band? Yep, watch me here. Okay, so here, this way. Yes, now keep that big toe on the ground.

Yes. See, there's your other compliment. That didn't sound like a compliment. But what you should feel here is that when you increase the arch of the foot, you should feel it also in the hips. I feel like I just don't have an arch in my foot. I don't know. It's weird. I don't feel like I can. How about this? Put your hands on your chest.

Rotate to your left as far as you can. Keep your feet on the ground. See, that's pretty. See that arch? Yes. Now go this way. So that's another way to work on how the foot feels because the foot should change shape. It should lower and it should increase the arch. So you recommend people do these types of exercise frequently? Oh yeah. I mean you're standing at your desk, you know, here's your movement break.

You rotate 20 times. Let your foot change shape. Do your toe yoga. Big toe, four toes. Lift all your toes, spread them and reach them forward. My physio gave me a towel and he put it on the floor and he said I have to like grab it and pull it up and grab it and pull it up as part of my recovery from my injury. Do you ever tell people to do that?

You know that towel thing where you grab the towel and you don't? No. What? I don't want to get anybody in trouble here. No, call him out. Okay. When do you ever do this? Never.

Correct. So unless you were, and maybe in your initial phases of rehab, where you are just trying to wake up the foot, you wanna towel scrunch, pick up marbles, that's a very common foot exercise. But from a functional perspective, that never happens in the gait cycle. When you're walking and you're running,

your toes never do this, or they shouldn't. Most people, when their foot is weak, that's one of the biggest compensations that you will see. They toe grip. You'll see them walking and it's like, you know, they start gripping the ground. Cause they- Feet are weak. Feet are weak. Yes. Okay.

I made the biggest investment I've ever made in a company because of my girlfriend. I came home one night and my lovely girlfriend was up at 1 a.m. in the morning, pulling her hair out as she tried to piece together her own online store for her business. And in that moment I remembered an email I'd had from a guy called John, the founder of StanStor, our new sponsor and a company I've invested incredibly heavily in. And StanStor helps creators to sell digital products, courses,

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closes so if you want to join our private closed community head to the link in the description below or go to d-o-a-c circle dot com. I will speak to you then. Do you wear socks? I do not wear socks. Why? I just haven't found any that I, you know, love. My second and third toes, personal information here, are webbed. So basically there's skin that comes up in between two and three. So as far as socks are concerned, most of the socks out there,

like if you look at a compression sock, when someone puts it on their foot, it literally like, with my bunion, you'll see my foot look like this. Because it's just suctioning my foot together. And it's so uncomfortable. So my option would be a toe sock. So a sock that just fits over your toes. But because my toes are webbed I can't wear them. What do you think is the most important thing that we haven't talked about yet that we should have talked about as it relates to foot health and everything downstream from foot health? I mean, I think, you know, big picture, like what I hope to do,

like my passion is to bring awareness to the foot. Because when we start doing that, and we pay attention from getting stronger from the ground up, things, life gets easier. And I mean that not just physically, but just like we talked about wellness, because you're able to move and get out there and walk and run and move like you want to. So that's kind of the big picture here. I think we talked about the importance of foot strength and foot mobility and

driving home the importance of footwear. I think the biggest, you know, or maybe the lowest hanging fruit for people is if this kind of work seems overwhelming, like I have to strengthen my toe and do all this stuff, just wear a shoe where your foot can feel the ground and your foot can be in its functional position. Start there. Because the research will tell you just doing that, you will start to improve the strength of your foot. And I think that's key. And start small. Transition. It's so interesting listening to so many of these, the comments on some of your previous work, people of all ages, but often people that are slightly older talking about how transformative

finding out more information about their feet has been and changing their footwear in particular. Reading this one comment here from this guy says, he's 65 years old and when he discovered the zero drop wide box toe shoes, he lost all the pain in his feet, ankles, knees and hips within a couple of months. I hear it all the time. I hear it all the time. And it seems so counterintuitive to us because I think we've been trained to think that our foot needs stuff. It needs support. It needs cushion.

It needs spring. And that changes the dynamics of how your foot interfaces with the ground. So when you bring it back to what it was designed to do, those comments, you'll hear what you will hear all the time. And it's a wonderful thing. It's literally why I do this. Is there anything else we should have talked about that we didn't that you think is pertinent to anyone that's trying to get control of their foot health?

I mean, I think, you know, I just want to make sure that we highlight the conversation of transition because I think that's where we lose people. When people listen to this, there's bells going off in their brains going, man, this makes sense. This makes sense. They want to go home, burn all their shoes and like go buy a pair of barefoot shoes and call it a day. You got to earn your right.

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

When that thing heals, when your ankle heals, and you say, well, I'm going to go into a cushioned shoe. Some of these shoes are getting high. So you put the sole of your foot on a shoe that has a high cushion. You see the distance you have from your foot to the ground? So let's say you step on a rock and you have poor proprioception because your foot can't feel real well because you have a history of ankle sprains and you step on a rock and you have this far to go. Where do you think that ankle is gone? So my ankle sprain patients, I want them close to the ground.

I want them to feel. Right? So it's pretty wild when people are like, I want to wear all this stuff. Hiking boots, another conversation. What's wrong with hiking boots? Well, people will say, I need a hiking boot because I want my ankles to feel stable. And that's not what they do. It might be a, and there will be research coming out on this.

When you are a hiking boot, it's like a neurological hug. It kind of feels like, you know, I'm going to have this thing around my ankle. That's going to protect me. It's going to protect me. It doesn't. And when you walk down a mountain, this foot has to do, remember we talked about this, ankle dorsiflexion. If you have something that's about this, ankle dorsiflexion. If you have something that's going to restrict ankle dorsiflexion, you have transfer loads.

So you end up transferring load to the knee. So you know, when my patients say to me, I need a hiking boot, I say to them, listen, why don't we just work on getting your ankle more stable, improving your mobility? So then you won't need to feel like you need this thing around your ankle. And that takes time. But in the long run. Is there an issue if I'm wearing the barefoot shoes at the moment and then I start wearing

like football boots again, I think you guys call them cleats. Is there a chance of me getting injured because I spent so long in the barefoot shoes now I'm performing in? Sometimes you can't do anything about the environment of the shoe. So think of a cleat, an ice skate, a ski boot. There's certain sports that require the stiffness. And so when you pay attention to your foot health, and then you put that foot in the cleat, you just make sure that when you get your foot out of the cleat, you do all the stuff. You take that kit, you roll the bottom of the foot.

When I get out of my cycling shoes, even though they are wider now, they have wide toe box cycling shoes, I'm always doing stuff for my foot. Because the cleat is an environment for the sport. So you know, you pay attention before and you pay attention after. Courtney, we have a closing tradition on this podcast where the last guest leaves a question for the next guest not knowing who they're going to be leaving it for. And the question that has been left for you. Oh, this is going to be good, huh? It is a good one. What do you fear you will most likely regret 10 years from now?

This is a battle that I have in my head pretty much all the time. I love my work so much. It is, it's just the reason that I feel that, you know, there's so much I want to do. There's so much I want to learn. There's so many ways I want to help people. And I work a lot. But I don't look at it as work. I enjoy it. But I'm also a mother. And I need to find that work-life balance where I don't want to fear in 10 years that

I look back and said, man, I worked a lot, but I really wished I would have gone to her soccer game. So I've created this life for me where I can say, I'm not gonna do that. I'm going to her soccer game. And she gets mad at me all the time, but I tell her, I'm like, this is what happens when you own your own business. She's like, mom, quit saying that.

I mean, she knows I work my ass off, but at the same time, she also knows that I can drop anything and go be there for her at any time. And so that's what I really want to work on and make sure that in 10 years, I don't look back and say, gosh, I missed some of that. As I'm often told, you don't get that time back either, do you? So it's not something that's very easy to correct. Courtney, thank you so much for doing what you're doing. I'm very much looking forward to your book because it's been a bit of a black box, I think, my feet, my foot health, up until more recently when I discovered your work, but

also just from this conversation today. It feels like I now have a better understanding of how this thing that I thought was largely irrelevant is having a big downstream impact on a bunch of things that I really, really care about. But also maybe most importantly, it's just having a set of actions that I can take on a daily basis on a weekly basis to prevent finding myself in a situation where I'm older and I fall or I lose my mobility or movement or the meaning in my life because I have something wrong with my foundations. Hopefully next time we see each other, I will have the strongest feet you've ever seen.

I was just thinking, the next time we see each other, there's going to be so many more compliments. On my feet. On your feet. Yeah. One can only hope. Courtney, thank you so much. Thank you so much. Thank you. Quick one, just give me 30 seconds of your time. Two things I wanted to say. The first

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

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