Born To Walk: How To Reclaim Your Feet, Fix Your Pain & Transform Your Health with Dr Courtney Conley #629

Summary

---

Feel Better, Live More with Dr Rangan Chatterjee

Episode #629
Born To Walk: How To Reclaim Your Feet, Fix Your Pain & Transform Your Health with Dr. Courtney Conley
Date: February 25, 2026

---

Episode Overview

In this transformative episode, Dr Rangan Chatterjee sits down with Dr Courtney Conley, a leading authority on foot mechanics and gait, as well as the founder of “Gait Happens”. Together, they break down the crucial but overlooked role of our feet in overall health, why walking is a physiological necessity on par with breathing and sleeping, and how modern footwear is compromising our bodies. Dr Conley offers practical advice, self-assessments, and a hopeful roadmap for children and adults to reclaim foot strength and function—regardless of age, pain, or starting point.

---

Key Discussion Points & Insights

The Critical Importance of Walking

• Walking as a Human Biological Imperative (03:45)
  Dr Conley asserts that walking is a fundamental human need—not just exercise, but a physiological necessity:

  “If you were to take any system in your body—cardiovascular, musculoskeletal, nervous system, lymphatic system, endocrine system—every system is benefited from this rhythmic motion of walking. It is what we were designed to do. We were born to walk.” (00:01)

• Walking, Breathing, Sleeping: The Trilogy of Survival (05:26)
  Conley frames walking as part of a trilogy with breathing and sleep:

  “When one suffers, the other two suffer… If I have a poor night's sleep, my respiration rate could be higher. I could be in a state of more stress, increased cortisol. I'm not gonna wanna do a lot of activity because I'm tired… when they're all functioning well, we're optimized.” (03:45)

• Evolutionary Mismatch & Modern Footwear
  Our feet evolved to carry us over diverse terrain, not to be restricted by rigid, narrow, highly cushioned shoes.

  “Footwear was designed for protection… but as history evolved, fashion started trumping function. And instead of footwear respecting the anatomy of the foot, it did the opposite.” (14:22)

---

Modern Environment, Pain & Neglect

• Underappreciated Prevalence of Foot Pain

  “One out of three adults over the age of 45 will suffer from foot pain at least one point in their lives.” (11:32)
  Yet, unlike with back pain, the approach is not “let’s strengthen and mobilize”, it’s “let’s add support or restrict movement.”

• Footwear & Weakening Feet
  Shoe companies respond to consumer pain by adding more support or cushions, often creating a vicious cycle of weakening feet:

  “If you don’t use it, you’re going to lose it… instead of training, we just create a shoe that rocks him forward.” (18:48)

---

Rethinking Shoe Choices

For Children

• Elementary Foot Health Habits

  • Encourage barefoot time at home and minimal interference between foot and ground (39:07)
  • Shoe priorities: wide toe box, thin and flexible sole, flat (heel and toe same plane) (40:53)
  • Don’t panic about “flat feet” in young children—it’s normal and resolves as they grow (35:45)

• Children’s Sensory–and Motor—Development

  “If you think of the foot as a sensory organ… there are thousands of receptors on the bottoms of our feet.” (33:18)

For Adults

• Three Key Shoe Features (44:45)

  1. Wide toe box—#1 non-negotiable
  2. Heel and toe on same plane (“zero drop”)
  3. Thin, flexible sole—but transition slowly if you’re not used to it

• Functional vs. Minimal Footwear Explained

  • Minimal: Wide toe box, zero drop, thin flexible sole (55:00)
  • Functional: Useful as a transitional category; wide toe box, low (≤6mm) to zero drop, some cushioning/“stack height” (58:01)
  • Gradual transition is key: “You have to earn your right to wear minimal footwear.” (55:27)

Notable Shoe Brands

• Minimal: Vivobarefoot, Bielenka, Xero (55:10)
• Functional: Altra, Topo Athletic, Notus (62:07)

---

Self-Assessment & Practical Drills

“It’s not too late. Our brains love novel stimulus… it is never too late to drive new information to our brains. If you’ve never put your foot on the ground, start there.” (135:31)

Daily Assessment/Exercises Include:

• Big Toe Lift: Keep four toes down, lift big toe straight up (83:15)
  • Poor dexterity often correlates with side where people develop symptoms (84:00)
• Toe Splay/Spread: Lift all toes, then spread them apart – daylight between each toe (108:30)
• Single Leg Calf Raise: On beat to music (Fleetwood Mac’s “Landslide” at 60bpm) to see how many you can do—compare to age-based norms (23:06)
• Single Leg Balance Test: Crucial as 40% of walking cycle is spent on one leg; feet’s receptors dull with age, so maintain challenge and loading (123:54)
• Progressive Overload: Train feet like any body part; gradually add loads, e.g., loaded calf raises, farmer’s carries (104:09)

Bunions & Foot Deformities

• Bunions are largely a modern phenomenon, strongly related to footwear choices (85:20)
• Early intervention can reduce or slow bunion development; even with established deformities, building strength can restore function and reduce pain (96:39)

  “If you were to say what’s more important for you—get rid of the bunion or have less pain and more function? That’s a very easy question. Less pain, more function.” (96:39)

---

Notable Quotes & Moments

• On Footwear Fashion vs. Function:

  “The majority of footwear… does not respect the anatomy of the foot. Shoe designers don’t have knowledge of how the foot functions, which is wild to me.” (16:54)

• On Building Foot Strength:

  “We’re building jet engines of bodies… on paper airplanes of feet.” (25:06)

• On Hope and Empowerment:

  “If your mum or grandma had bunions… it’s not your destiny, it’s just a predisposition. Maybe that’s even more of a reason to go, ‘Wow, I don’t want that. Let me get onto it.’” (91:43)

---

Walking Speed as the “Sixth Vital Sign”

• Walking speed can predict onset of dementia up to seven years in advance (128:40)
• Recommended: 120–130 steps per minute for brisk walking—sustain for 30 minutes where possible (131:59)
• Crucially: Even increases from low step counts can yield dramatic health gains

---

The “Cost of Comfort” Principle

• Highly cushioned, supportive shoes trade off sensory feedback, weaken feet, and may reduce balance and power

  “You compromise sensory acuity… there’s always a trade off.” (49:51)

• You don’t have to wear minimal shoes 100% of the time—live on a spectrum but avoid chronic use of restrictive footwear (65:34)

---

For Those Who Think It’s Too Late

• Neuroplasticity applies at any age: Start where you are.
• Walking, foot exercises, and appropriate footwear always offer improvement potential (135:31)

---

Actionable Steps & Takeaways

For Listeners:

• Assess your own foot health with toe lifts, splay, and calf raise tests (83:15, 23:06)
• Notice the shape of your shoes—are your toes compressed?
• Start by increasing barefoot time at home
• Consider transitioning to functional or minimal shoes gradually
• Incorporate daily foot exercises, even at your desk or while standing in line (100:41)
• For parents: let children spend as much time barefoot as possible and choose shoes with wide toe boxes and flexible soles

To Remember:

“Walking is the most easily accessible, underutilized treatment that we have at our hands. It should be on every physician’s treatment protocol.” (135:31)

---

Important Timestamps

• [00:01] – Walking as physiological necessity
• [03:45] – Walking, breathing, sleep trilogy
• [14:22] – Evolutionary mismatch and footwear history
• [35:45] – Footwear advice for children & flat feet
• [44:45] – Dr Conley’s footwear criteria
• [55:00] – Minimal and functional shoe discussion
• [83:15] – Toe dexterity and foot assessments
• [108:30] – Toe splay, practice and correlation with symptoms
• [123:54] – Balance, aging, and feet’s sensory receptors
• [128:40] – Walking speed predicting dementia
• [135:31] – Message of encouragement: It’s never too late

---

Further Resources

• Dr Courtney Conley & Gait Happens:
  Website: gait-happens.com
  Instagram/YouTube: @gaithappens
• Book: “Walk: Your Life Depends on It” (Available May 5; pre-order globally)
• Practical Videos & Drills: See Dr Conley’s and Dr Chatterjee’s social media

---

Final Message

Every step you take is a step toward reclaiming your health—but only if you start respecting your feet and how you walk. It’s never too late to begin.

---

(Compiled and structured faithfully to the episode’s content, tone, and spirit, with all key topics and timestamps.)

Transcript

[A]

If you were to take any system in your body, cardiovascular, musculoskeletal, nervous system, lymphatic system, endocrine system, every system is benefited from this rhythmic motion of walking. It is the most easily accessible, underutilized treatment that we have at our hands. It is what we were designed to do. We were born to walk.

[B]

Hey guys, how you doing? Hope you're having a good week so far. My name is Dr. Rangan Chatterjee and this is my podcast Feel Better Live More. Walking is something most of us take for granted. We do it to get from A to B. We track our steps on our phones. We might even use it as a bit of exercise. But what if walking is far more than just that? What if, quite literally, your life depends on it? Dr. Courtney Conley is an internationally recognized authority on foot mechanics and gait dynamics and the founder and creator of Gait Happens, which provides evidence based foot education for athletes, movement professionals and regular humans like you and me. She has over 25 years worth of clinical experience and has worked with a wide variety of organizations including the New York Yankees, New York Giants and the San Francisco 49ers. Her first book, Walk youk Life Depends on It, officially comes out on May 5. I have been fortunate enough to be sent an early copy and it is a fantastic read which is available for pre order right now all over the world. In our conversation we discuss why walking should be considered a physiological necessity, potentially on a par with sleeping and breathing, why Courtney believes that our feet are the most neglected parts of our bodies, and how modern footwear has put fashion ahead of function with some serious unintended consequences. We also discuss why our big toe might be the most important joint in our body, how our walking speed can predict our future health, and why even a small increase in daily steps can dramatically reduce our risk of cancer, dementia and depression. Throughout our conversation, Courtney shares plenty of practical advice such as simple foot assessments that you can do at home, easy exercises to build strength and mobility, and a clear framework for choosing better footwear for yourself and your children. Courtney is such a passionate individual who wants to help as many people as possible reclaim the true function of their feet. Her message is one of hope and empowerment and I'm quite sure that this conversation will give you a different perspective about the importance of walking and inspire you to start taking a bit more care off your feet. In your brand new book, Walk, you, Life Depends on It, you say that walking is a physiological necessity that your body requires for survival. I think many of us know that walking is Important, but it's required for our survival. That's quite a bold statement.

[A]

It is, it is. When I was thinking about how I wanted to broach this topic, I want people to think of walking as not just exercise. If you think about human biology, it is built around locomotion. And I didn't say biology is built around locomotion. Human biology. So when you add that word in there, we know that humans are bipeds. And when you look at what walking provides, which is this rhythmic low intensity movement, it's that facilitates every system in our body. So our musculoskeletal system, our nervous system, our lymphatic system, our endocrine system, all of those systems function based on the integration of walking. And I talk about it in the book as a trilogy with breathing and sleeping. And I think when you think of those three components, and one could add eating as well, they all have this symbiotic relationship. So when one suffers, the other two suffer. So if I have a poor night's sleep, for example, my respiration rate could be higher. I could be in a state of more stress, increased cortisol. I'm not gonna wanna do a lot of activity because I'm tired. So if you look at that trilogy of breathing, sleeping and walking, you can see how they all feed one another and when they're all functioning well, were optimized.

[B]

Yeah. As well as you calling walking this physiological necessity that the body requires for survival. That comparison in the book to breathing and sleeping I thought was brilliant. Very provocative, but absolutely spot on. You know, and you've detailed a lot of this research in your book about what might more walking does and says if cancer risk, dementia risk, all these kind of things. What's really interesting is you could reframe it, couldn't you? Instead of it being that walking more reduces your risk of these problems, you could almost look at it the other way and go, no, we're designed to walk. When we don't walk enough, we get all kinds of problems.

[A]

Correct. In the book I refer to it as vitamin W. Yeah. That if we start to view this as an essential nutrient for our survival, I think we take a completely different spin on it. That it's not just exercise, it's a necessity for our survival.

[B]

You mentioned a few things earlier. The lymphatic system that gets sort of properly activated when you walk. Blood returning from your feet.

[A]

Yes.

[B]

Will only happen when you're contracting your calf muscle. Right. Which happens when you walk.

[A]

Yes.

[B]

So everywhere you look, every system you

[A]

need walking Every, if you were to take any system in your body, cardiovascular, musculoskeletal, like I said, every system is benefited from this rhythmic motion of walking.

[B]

Is there a perfect or correct way to walk?

[A]

That's the question I get very often in my clinic. Patients will actually say to me, I think I forgot how to walk. And it's always very fascinating to me. I think walking. Each person has a unique walking signature, if you will, because our walking gait can be influenced by many things. Your environment, past traumas. The other example I like to use is you can. If someone was going in for a job interview, for example, when they walk out of the room, you can tell if they got hired or if they didn't. I have a 14 year old daughter, when she walks in from school, I can tell if she had a good day or a bad day. So when we look at someone's walking gait, I appreciate that. I think it's like a window to their nervous systems. And with that being said, you want to respect the uniqueness of someone's walking gait. But at the same time, I think that we want to create efficiency. And that's what I think it's about when I'm working with improving someone's walking gait. How efficient can we make them? Because that will allow them to be on their feet longer, go for longer distances and then get all of the benefits that happen when you have sustained walking.

[B]

Yeah, I really like this idea that we're all different. We've all got this unique signature. As he states in the book, a person's walking gait tells a story.

[A]

Yes.

[B]

You can tell if someone is happy, sad, confident, scared, in pain, or feeling like they're on top of the world just by watching them walk.

[A]

Isn't that beautiful?

[B]

It's gorgeous.

[A]

I know, I love it.

[B]

And I tried this because I've been tuned into this through my own movement coach, Helen, over the past few years. And what Helen used to say to me is that, and it really reminded me of something in your book is this idea that if she's watching someone run, it's like, does something catch my attention? Yeah, like if it's a smooth, efficient style for that person, nothing catches her attention. But when something's not quite, I shouldn't say, right. If it's not as efficient as it could be, it just catches her. And that's kind of the case you've made in your book as well. You say, well, we've all got different walking gaits, but you can usually tell when something's like a little bit off, can't you?

[A]

Yes. And some examples of that. For example, if someone were to walk but only swing one arm.

[B]

Yeah.

[A]

That's something that a non trained individual can pick up pretty easily. And I'll even video my patients and I'll say, what do you see here? And I'll say, well, geez, I'm not moving my right arm. Mm. It's little things like that. Walking is rotation. We take advantage of forward momentum and this rotation that we get in our bodies. So something as simple as looking at someone and saying, hey, let's start swinging your other arm, then it creates this momentum. And so it's those little things that I think can have a profound effect on creating that efficiency.

[B]

What's going on in the modern world, Courtney, whereby something that is so innate to us as humans, the ability to walk and cover large distances on foot, why is it that we need help doing something as basic and fundamental as walking?

[A]

Yeah, we don't think about it. I think when you start looking at. I think people think they might walk a little bit more than they do because one of the questions I consistently ask my patients are, do you know how many steps you're taking a day? And then they start looking at it like, well, geez, 3,000. And these numbers are pretty low. And I ask them, why do you think that is? And I think there's several reasons for that time. I think time is a big one. We've become very busy and it's, can I fit this in? Pain. I have a lot of patients with chronic pain, and I don't think there's any other diagnosis in your body that will stop you in your tracks from movement and in particular walking than when you have foot pain.

[B]

Yeah.

[A]

The numbers of people with foot pain is very high. One out of three adults over the age of 45 will suffer from foot pain at least one point in their lives. That's a high number.

[B]

That's a huge amount. Because of course, when you're in foot pain, you're not gonna want to walk on it or go to the shops or you're gonna want to get off it, aren't you?

[A]

Yes.

[B]

Why do you think 1 in 3 adults over the age of 45 have foot pain at some point in their lives?

[A]

I think the foot is probably the most neglected area of our bodies from a rehabilitative perspective. If you look at training every other part of the body. So for example, we'll use low back pain. If someone comes into my office with low back pain, we have the discussion of strength. Do we need to improve strength somewhere? Do we need to create stability to your system? Do we need to stretch? Do we need to mobilize? And then we create this program that involves getting this patient a more resilient body. Let's make you stronger. When someone comes in with foot pain, our education has not gone down that road. It has been, well, here's a foot orthotic, foot orthoses. Here is a shoe with more cushion. So instead of taking this proactive approach with, hey, this foot has four layers of intrinsic muscles in it, many joints where range of motion can be improved and stabilized. We should be having that conversation at our feet, not, let me see what I can do. So we brace that movement or inhibit that movement. And that's where I think we really have an opportunity here.

[B]

Yeah, it's kind of interesting, isn't it? As you say, that's really great comparison with back pain. What I'm interested in, as well as that is the foot is how we as humans move around in the world. It doesn't make sense to me on an evolutionary or through an evolutionary lens, that a third of us would have foot pain. Do you know what I mean? It's like, well, how could that have. How could our ancestors have survived? Or it would have been harder for them to survive if they had significant degrees of foot pain, which then meant they wouldn't go out and hunt or, you know, dig for tubers or whatever it is they were doing. What do you think is going on? Like, is it just our modern lives that are causing these foot pain?

[A]

Or can you be misunderstood? Evolutionary mismatch. So we have evolved. Our foot has evolved to handle loads. When we're walking, our foot takes two to three times our body weight. It does not need arch support. It does not need anything when it is functioning as it was designed because it is very strong and is very capable of handling these loads. So what happened? Why do so many people suffer from foot pain? And why do we see all of these diagnoses? And I think a lot of that has been a lot of that we can see with the development of footwear. And footwear was designed for protection. That was the extent of it. And then, as you see with history, what started to happen was fashion kind of started trumping function. And instead of footwear respecting the anatomy of the foot, it did quite the opposite. Yeah, and that's a problem. And then you take footwear that doesn't allow the foot to function. You take not being able or being aware that this part of our body can be strengthened and mobilized and you kind of marry those two and we have an even bigger problem.

[B]

Yeah. What I was thinking about when you were just talking there, Courtney, is I get this, right, Because I had a problem and I've been wearing barefoot shoes. I've been wearing vivo barefoot shoes now for, I think, 12 plus years, almost exclusively, apart from one wedding that I went to maybe seven years ago when I wore these Italian dress shoes that I got married in. And I thought, how the hell did I ever do this? It was horrid. I felt so disconnected from the ground. I thought I felt like the front of my feet were almost squeezed. I would've been wearing that stuff for years, and I didn't realize. Right. But I meet so many people around who listen to this podcast and they'll tell me all the things that they've changed from listening, which is wonderful. Lots of people will tell me how they've started wearing barefoot shoes and have told me, are my back pain's gone, are my knee pains gone, are my hip pain's gone, wherever it might be my. But there's a lot of people who I meet who listen to this podcast who still haven't changed their footwear, which I understand. But the point I'm trying to make is why is it such a hard sell for people to change or think about changing their footwear?

[A]

It's fashion, it's society. We have for many, many decades. That's what we have been trained to think is beautiful. And to think is, you know, this is what we should be wearing on our feet. And what you see is not what you get. The footwear that is, most of the footwear that is designed today does not respect the anatomy of the foot. You know, I've talked to several people that have been in the shoe industry, and it's really interesting to me that a lot of the shoe designers don't have knowledge of how the foot functions, which is wild to me. You would think that that would be on their resume. I have a very good understanding of the foot anatomy. Thus I can a shoe, and that's not the case. The other thing, when you also look at not only fashionable footwear, like dress footwear, but when you look at the industry of what's happening with trainers and running shoes, for example, shoe companies respond to what people need and what they want. So a lot of the things that I will hear in my clinic, it's hard for me to walk, it's hard for me to push off. My father just had this conversation with me. He said, you know, Courtney, I was walking around the mall, and it was really difficult. I feel like I couldn't push through my foot. He's gonna be 80 this year. Now, instead of having the conversation of, hey, dad, if you can't push through your foot, these are the exercises we're going to do. We're going to work on your calf strength. We're going to work on your foot strength so that you can start to regain your power when you walk. The shoe company says, hmm, well, he's having difficulty pushing through his foot. So let's just create a shoe that

[B]

rockers him forward so we make it easier for him.

[A]

Correct. So now this shoe looks like a boat. So he puts this shoe on and he says, courtney, this is great. I can now roll through my foot. Why would my father, who doesn't have this type of knowledge, think anything other than this must be a great idea? And where I challenge him is that if you don't use it, you're going to lose it.

[B]

So the rocker shoe, it does help in the short term. Is that fair to say? Is at least his, you know, his perception of this problem where he can't push off is initially getting better. The problem is there's an unintended consequence, which is his feet are gonna get even weaker. Cause they're not being used.

[A]

Doing more of the work for him.

[B]

The shoe's doing the work.

[A]

Yes. And that shoe can be beneficial for someone who has, for example, a fusion of their big toe or some type of surgical intervention. But outside of that, your foot is very capable of being retrained. Your strength is very capable of improving. And those are the conversations we need to be having. Because I don't want my dad walking around not having the strength and power to be able to propel him forward.

[B]

Courtney, make the case to someone who's listening to this, who doesn't have any foot pain. You know, pain is a. It can be a very powerful motivator to do things right. Because if you've got pain, you want to be out of pain. But if someone is listening to this and they're not in any pain, and they've been wearing thick, cushioned shoes their entire life. And let's say, I don't know, they're in their 40s and they're functional. Let's say it's a woman, they wear high heels when they go out. Maybe they wear high heels for work and they're not experiencing pain. How do you convince or inspire people who are not in foot pain to focus on their foot health.

[A]

This is where I really get excited about this conversation. Because I think this is where healthcare is going. And hopefully people are being amour that more aware that we should be proactive instead of reactive with our health, instead of waiting until there's a problem. Because oftentimes by the time there's a problem and you are experiencing pain at the foot, this has been there, it's been building. There's been problems for a long period of time and now movement is deterred. So I always like to have the conversation of being proactive with these things. I think the other beautiful thing about the footage is it's the only place in the human body where you can start to see aberrant loads or changes. So what I mean by that is, if you were wanting to, I had knee pain, you have to take an X ray or an mri. Is there arthritis? Is there some type of tear? But at the foot, if you see a bunion, regardless if it's painful or not, if you see hammer toes, if your toes are more narrow. So the widest part of the foot should be the toes. Pete. Yep. Everybody starts looking at me.

[B]

I'm looking at my feet now. I think I'm okay, but you can tell me later.

[A]

So if you see these things, we know that changes in the foot, bunions, hammertoes, increase our risks of falls. It changes the stability of the forefoot, it's changes the strength of the foot. So that's what I encourage people to do. Take a look at your foot. Are there things that shouldn't be there? Can you do exercises like lifting your big toe, having toe dexterity? These are all things that can be very good indicators of good foot health, which will also have implications up the kinetic chain.

[B]

Yeah. There's a whole section in the second half of your book where you go through these exercises, these self assessments that we can all do. And you know, it's interesting. I've been paying attention to my foot health, I would say for a good 12 years now. And this morning, as I was finishing reading off the book, there was an exercise, I think it was calf raise, single leg calf raises. But in essence it was great. Cause you put some songs in there which have a 60 beats per minute cadence. And the one I chose, cause I love the song was Landslide by Fleetwood Mac. Put it on, put my stopwatch on and tried to see how many I could do on the beat, basically. And I was, you know, as I said to you before, I have just come back literally from four Days skiing, and it was, you know, difficult, steep, off piste terrain, and my legs are crushed, but still I thought I'd be okay, but I think I only managed 24 in a minute. And I was like, that's less than the average that you would expect at my age. I thought, what the hell? Like, I was really shocked to see that now. Yes. Could fatigue from the last few days be playing a role? Maybe. But I think that's gonna be so useful for people to just assess where they are.

[A]

I love that chart. It's a research that looked at how many single leg calf raises one should be able to do per decade.

[B]

Yeah.

[A]

And it is one of the assessments I do with all of my patients. And I get very picky, not only about can they do it, but can they do on the beat, what does the height of the calf raise look like? Are they able to push through their big toe? Or they kind of look like they're gonna sprain their ankle. There's a lot of information that you can get from watching someone do a calf raise. And unfortunately, the majority of my patients, when I pull out that chart, sit well below what they should be able to do.

[B]

You say majority of your patients, as well as Joe Public, you deal with a lot of elite athletes. Do you also see elite athletes fail or not do so well on these tests?

[A]

Oh, yes. This is what the elite athlete conversation, I think, is so fascinating to me. And as a good friend of mine, Jay decerry, he always says this. We are building jet engines of bodies. So we're getting stronger, we're getting faster, we're lifting more weights, we're training power on paper airplanes of feet.

[B]

Yeah.

[A]

And that, I think, is so very important because our feet take on the loads of our body. So we want to get faster, we want to get stronger. You have to pay attention to that strength below the knee. And so when I have worked with players in the NFL and all over these professional sports, I always look at these assessments and I'm sitting here going, these are the elite, the top of the top. And they're using their bodies very well without using the third that's producing the most power and speed and agility.

[B]

So you're probably thinking you're doing this well and you're not looking after your feet. If we could just do 20 minutes a day on your feet.

[A]

That's right.

[B]

You could unlock all kinds of potential.

[A]

Yes.

[B]

And I guess we're in a generation now. Cause one of my favorite bits in the book is when you talk about how footwear changed maybe 100 years ago. Was it Phil Hoff?

[A]

Yes, Dr. Hoffman.

[B]

Yes, Dr. Hoffman. Yeah. And how he was sort of raising the flag back then. He's been warned, hey, listen, this is gonna cause a problem, but a lot of the top athletes now have grown up, of course, with, you know, poor footwear.

[A]

Yeah.

[B]

You know, overly cushioned, you know, maybe pronation supports, heel lifts, all this kind of stuff. And what's also really interesting is that I've had the privilege of talking to Eliud Kipchoge twice on this show. You know, the guy who's regarded as one of the fastest marathon runners of all time. And I know he wears the,

[A]

you

[B]

know, the modern super shoe now for running. But actually when he was growing up and training, you know, it was a lot of barefoot, it was minimal footwear. So probably at the formative years of his life, he probably was living a lifestyle that grew strong, functional, wide feet. Do you know what I mean?

[A]

And I think when you look at his running gait, he is an elite, elite runner. It's a beautiful, beautiful running gait. And I think we need to pay attention to that. The shoe in that case is icing on the cake because he has these beautiful mechanics. When you take most runners and, you know, recreational runners who don't have his speed or there's his grace, if you will, that's an entirely different conversation when they're wearing a shoe like that. And I do think that when growing up and you have your foot on the ground and you're running and you barefoot, you start to adopt a different running gait. And I think that's important to consider.

[B]

Yeah, it's a bit like away from sort of physical health and foot health. We know for our emotional well being later on in life, our early childhood years are really important. Yes, right. What are the messages we get when we're young kids? You know, what are our attachment bonds like with our adult caregivers? Maybe your parents, if you're, you know, or whoever is in your life. We know that that can have implications when you're 30, 40, 50. And I'm kind of seeing a similar pattern with, you know, our feet and this kind of foundation upon which we interact with the ground. I wonder if, you know, Kipchoge was the example I just used now. But perhaps if we as a society really focus on the first 15 years of life and said, right, for our children, we want to make sure that we teach them about good foot health, we put them in the right shoes, maybe not overly cushion them or whatever. Maybe they'll build such a strong foundation that I'm not saying they can get away with poor shoes later, but it probably insulates them somewhat later. Would you agree with that?

[A]

I think that's our biggest opportunity really, is with the children.

[B]

So what would you ideally do for a child in terms of footwear? Today's episode is sponsored by vivobarefoot. Now, one of the simplest ways to improve your whole body health is to start with your feet. Most of us don't realize this, but 95% of us are born with healthy feet. And by adulthood, 77% of us have foot problems. And a big reason is the shoes we wear. Modern shoes are rigid and narrow and over cushioned. They disconnect us from the ground and weaken the very muscles that support our posture, balance and movement. That's why I've been wearing Vivo barefoot shoes for well over a decade now. They're the opposite of conventional shoes. Vivos are designed for fit, flex and feel, to let your feet do what human feet have evolved to do. When you free your feet, you free your whole body. And studies have shown that wearing minimalist footwear like Vivos can increase foot strength by up to 60% in just six months, improving balance, natural posture and the way in which you move. If you've never tried barefoot footwear before, Vivo make it really easy to do so. They offer a 100 day money back trial so you can wear them, live in them, move naturally, and if they're not for you, you just send them back, no risk at all. So if you're curious to reconnect with your Natural Movement in 2026 and give your feet the freedom they're designed for, try VivoBarefoot. And get 15% off your first order by heading to VivoBarefoot.com LiveMore Free your feet and the rest will follow. Today's episode is sponsored by Peloton. Now, we all know that moving our bodies more is good for us. But despite that knowledge, many of us find it hard to actually implement. And that's where the new Peloton Cross training Bike plus powered by Peloton IQ can really help. It's built for fitness breakthroughs with real time insights and endless ways to move. And you can go from cycling on the bike plus to strength training off it with one smooth spin off the swivel screen, which offers endless ways to train for a well rounded routine. While you lift, Peloton IQ counts reps, corrects your form and suggests new weights. So you're always making progress towards Your goals and Peloton's movement tracking camera provides real time feedback so that you can train safer, lift smarter and make every move count more. With over 15 types of workouts, expert instructors to keep you motivated, and a personalized plan tailored to your goals, the Cross Training Bike plus takes the guesswork out of working out so that you can move freely and let Peloton handle the rest. Let yourself ride, lift, stretch, move and go. Explore the new peloton cross training bike plus at one peloton.co.uk. that's O N E P-E-L-O-T O N.co.uk and please note, peloton All Access membership is required to access all Peloton content and applicable features on your Peloton hardware.

[A]

If you think of the foot as a sensory organ, if you will, because there are thousands and thousands of receptors on the bottoms of our feet, the same amount of real estate as the hands in the lips, in the brain. So these are sensory powerhouses, if you will, that are gathering information from our environment and telling us how to improve, how to improve our motor outputs, how to move. So with kids, their little nervous systems are developing. So when their foot is on the ground and they're gathering all of the sensory information, whether they're walking on grass or sand or all different types of materials, their brains are developing, their foot is developing. And so when we interfere with that, if you watch a baby crawl that has a very stiff shoe on, for example, their foot's range of motion is restricted. If I had a very rigid shoe on and I'm crawling, I can't go into plantar flexion.

[B]

You see, it's so obvious when you, for people listening, Courtney's got up at the moment a, a model of the human foot and you just see how much complexity is there and how much potential movement is there. You think, yeah, of course, if a baby is crawling with a stiff shoe on, it's going to lock down a lot of those joints. So there will be a compensation.

[A]

Yes. And if you look at any baby on the planet, the first thing they do is take their shoes off. They take their shoes off, they take their socks off. They want their foot to gather information. And I think that's so important as that foot is developing. Six, seven, eight, nine years old, the foot needs to feel.

[B]

So for a parent listening to this, right, because we need to, and we will address at some point for people who have maybe got foot problems or have been in inappropriate footwear for a number of years, you know, of course they're gonna be listening, going, well, you know, is it too late? Can I do something about it? And of course it's not too late. And you. There's many things you can do to retrain your feet. But let's start with this blank canvas. If there are some new parents listening. When I say new parents, parents of maybe babies or young kids, what are some common things that you would recommend that they do or don't do with their children to protect the health of their feet?

[A]

We get a lot of calls into the office about flat feet. And so parents are very concerned with their child's flat feet. That is common in young children. They have flat feet. Their bodies are still developing, and that can be associated with knock knees, or the knees are coming together. And so they'll say to me, do we need some type of foot orthosis? Or does my child need a brace? They need sensory stimulation. So we will let children go barefoot as long as they can so they can gather information to improve motor outputs. And the shoes that we do put on our children's feet should respect the anatomy of the foot, meaning a thin and flexible sole so the baby's foot can move, so the toes can extend, so the ankle can dorsiflex or bend the wide toe box so the toes can splay. It's really interesting when you see even young children's feet who have been in restrictive footwear, you will start to see that change. I was talking about the formation of little bumps on the inside of the foot that should not be there.

[B]

Cause what's interesting when I hear this, Courtney, is, you know, problems in the foot go up the entire chain in the body.

[A]

Yes.

[B]

Right. So how many cases of injuries later on in life, even as teenagers, you know, back pain, hip pain, knee pain, neck stuff. How many are actually downstream consequences of the fact that our feet don't move properly? So you lock something up there because of the footwear you wear, and then it just goes up the chain?

[A]

Yes. My patients, when I see them, I always say, I wish it was just a foot problem. Cause it would make things easier. But it never is. It is never just a foot problem.

[B]

What do you mean? You mean if it's something further up?

[A]

Yes. Neck pain, low back pain, hip pain. I'm always assessing their entire bodies. There's a person behind this diagnosis of heel pain. So you can't just look at the heel because there's so many other factors that are driving how that foot is hitting the ground. So there is certainly is a Correlation between what that foot is doing and how those loads and ground reaction forces are going up the rest of the body.

[B]

Yeah. So like, I'm no builder. Right. As this will make very clear. But let's say you're building a house and we're talking about the foundation. The feet are the foundation of the entire body. Right.

[A]

It's like building a house on sand.

[B]

Yeah. Or you're building a house that, let's say it's uneven at the bottom. And therefore, let's say it's a two story house. You're like in the bedroom going, hey, the ceiling is. It's not flat. Right. We need to do something. We need to get someone to see it. It's like, yeah, but of course the ceiling isn't flat because your foundations aren't. Right. Right. So it's like, why don't we fix the foundations first and maybe this will naturally correct itself.

[A]

Yes. Or you're gonna have to keep fixing the ceiling.

[B]

Yeah, exactly.

[A]

And you're not going to ever get the result you're looking for.

[B]

So in practical terms, I think what you're saying for a child is, in the house, keep them barefoot as much as you can. Does that mean without socks as well?

[A]

Anytime there's an interference between the sole of the foot and the ground, you change the sensitivity of the receptors or the amount of pressure that stimulates these receptors. Sock obviously is going to be better than, say, a very thick sole, but when the foot can feel barefoot, that would be ideal.

[B]

Okay, so keep them barefoot as much as they can. Obviously, if it's super cold, you might want to put some socks on. But if so, as thin as possible. I guess you would say, what about when that child is going to leave the house? What are the key things? I know you've sort of touched on this, but I just want to make sure the point is landed. Like, should they be wearing shoes and if so, what? Shoes?

[A]

Yeah, I think it's, you know, that such a. There's so many kind of layers there. I think the environment is important. In certain parts of the world where children are used to being barefoot more often, the transition into minimal footwear or barefoot footwear tends to be easier. But in other cultures where shoes are still worn inside or they're not used to barefoot, there's a different conversation there. When we look at footwear for children overall, thin, inflexible sole. So again, you want the sole to be able to move like the foot moves.

[B]

And just, you know, for people who feel that they're not Necessarily trained and you know. Cause of course, sometimes the store staff will tell them something different to what you're saying, Courtney. But is it as simple as them just feeding the soul?

[A]

Roll it up in a ball.

[B]

Roll it up in a ball. Cause that's what the vivos I wear.

[A]

Yep.

[B]

You can just roll it up, roll it up, scrunch it right up. Which basically means that your feet can do what your feet want to do without the soul negatively influencing it.

[A]

Yes.

[B]

Okay. So thin and flexible sole, wide toe box.

[A]

That's kind of my non negotiable. The wide toe box is really my number one because when you start to taper the toes, you change what the foot was designed to look like.

[B]

So, you know, I know this is obvious to you and to a degree to me, but you just think about whether it's guys or women, like women with high heels and these really narrow soles, men's dress shoes with these pointed soles. I mean, we're quite literally deforming our feet.

[A]

That's exactly what we're doing. That's exactly what we're doing.

[B]

It's almost. You can't. You know, I say that I almost have to catch myself. Cause that can be seen as quite an inflammatory comment to people. But that's what we're doing. We're wrecking our feet by trying to shove it into these things. It's like, what other body part would you do that with? You wouldn't and be okay with it.

[A]

Yes. It really.

[B]

Marketing's powerful.

[A]

It is. And it really. I love when I hear my patients say, well, that really makes sense. And you've given me hope. Like, this is not a hard conversation. If you really think about this. This is not. Wow, that's. You know, that sounds odd. It makes sense. It makes sense. And that wide toe box is very important for not only the development of a child's foot, but also an adult foot. And then this heel. The other factor with the footwear is having the heel and the toe sit on the same plane.

[B]

So you don't want the heel above the toes.

[A]

Correct. When you have the heel above the toes, you're changing how the foot is feeling the ground. So you're shortening the Achilles and the calf complex. You're putting more pressure through the ball of the foot, and now you're putting more pressure through the ball of the foot when it looks like a point.

[B]

I mean, if you guys are watching, you know, if you're listening to this, maybe just have a quick look at the YouTube version of this video, because. Just put that up again, Cordy, because it's crazy. You've got this gorgeous. You know. Who do you quote? You quote Leonardo da Vinci in your book. The human foot is a masterpiece of engineering and a work of art.

[A]

Yes, it is.

[B]

Right? It looks gorgeous there. Yes. And you're just scrunching it up and squeezing these beautiful joints, which is the high heel shape, right?

[A]

Yes. And if. This is really, I think, is really fascinating, if. When people say to me, the foot needs arch support, if my foot looks like a foot. So, for example, when the toes are wide and splayed and strong and I go to push off when I'm walking, this foot was designed to get stiff and to be strong, to propel us forward. Now if I take this big toe and I squeeze it together, when I go to push off, I lose the integrity of the foot. So you're changing the dynamics and the forces going through the foot. To me, that is. It doesn't make any sense.

[B]

Which is why, of course, when I was in, you know, wedding season with my mates, as it were, it's not uncommon for, you know, my wife or her mates or my mates at the end of the night to say, you know, want to take those high heels off?

[A]

Oh, yeah.

[B]

As soon as possible after the wedding.

[A]

Yes.

[B]

Yeah. Okay, so two big non negotiables for you. You say, number one, and this goes beyond children. This is now adults as well. When we're choosing our footwear, you want a wide toe box and you don't want this drop. No. Sor. Was it a thin and flexible sole?

[A]

So if I had to put these in order. And there's a reason for this.

[B]

Yeah.

[A]

The wide toe box, the sole, the heel and the toe sitting on the same plane, and then the thin and flexible sole. This is where I was going with the adaptation piece. The thin and flexible sole component is difficult for people to get used to if they have not been walking around barefoot, if they don't have a lot of experience with their foot on the ground. Because thin and flexible can also be a little uncomfortable for someone who's not used to it.

[B]

Okay, so I like this. So you're saying there's a way to progress.

[A]

Yes, and that's very important because a lot of my patients live in cities, for example, and they've been walking around in poor footwear for decades. For decades. And so if I said to them, if we have this conversation, and it will make sense to them, so they'll want to go all in, they'll say, Give me a minimal shoe. And I said, well, hold on. Yes, I want you in a wide toe box, but you've been walking around in a trainer that has a 10 millimeter drop. That's a high heel in my world. So to drop you down to zero and put you in something thin and flexible, that'd be like me telling someone to squat 100 pounds this week and 200 pounds next week. It's too much load.

[B]

Which is, of course, where some of the critique comes at, you know, innovative commerce. Barefoot shoes, or minimal shoes, whatever you want to call them. Because we're looking at people who've spent decades in poor footwear. Suddenly they try and go and run a half marathon in a barefoot shoe and go, oh, you know, I got injured. Yes, barefoot shoes are a load of rubbish. It's like, well, wait a minute, wait a minute. You need to transition, perhaps. Okay, Courtney, just to make sure, this is landing with everyone, right? So if in my head, there's almost, well, two or three categories of people we need to be thinking about. Okay. One is children. So assuming your child is born and there's no issues, what we're trying to do is not create issues for them in the future. That's right. So as much as possible, do the things that we mentioned so far.

[A]

Yes, Right. And I think also for parents, it's also understanding that your child might play football, they might be on ice skates. It's okay.

[B]

Yeah, exactly.

[A]

It's okay. They're gonna be in certain footwear at times because that's what the task requires. It's when they're out of that footwear, that's when we want to make sure that they're in minimal footwear. Functional footwear.

[B]

Yeah. That's really reassuring. Okay. For people. So, yeah, wear the football boot with studs when you're playing football. Yes, no problem. But just don't wear them all the time.

[A]

That's right.

[B]

Which, of course, they wouldn't do with that. But I'll tell you what you do see a lot these days is you see a lot of these premium running brands, which are. I won't necessarily mention the name of one of them, but they're very, very thick, cushioned running shoes. And you could just about. Well, I'd love your perspective on what you think about these inadvertent commas. Running shoes, But I think one of the problems is that people are not just wearing them for running. They're wearing these floaty, heavily cushioned shoes for work, for walking around the airport, for going to the supermarket, it's like, well, okay, maybe there's a case for wearing it when you run. Although you may have a different perspective on that, but don't spend the rest of your life in it as well.

[A]

Yes, there's a different tool for the task at hand. You know, your running shoe, your trainer is not your strength training shoe.

[B]

Yeah.

[A]

If we go, let's talk about strength training for a second. When I'm in a gym and I'm carrying heavy things.

[B]

Yeah.

[A]

Your foot has to feel the ground. It has to be strong and stable. If I was going to deadlift, for example, or heavy squat, I don't want to be squatting or deadlifting with a lot of weight in my hand. Standing on a pillow, that would change the pressures going through my knee and through my hip. It would basically your body sitting there going, wait a second, I need to feel something.

[B]

Connie, that's such a provocative analogy. Standing on a pillow. Everyone kinds of gets that, right? You wouldn't do that in the gym. You wouldn't stand on a pillow and try and do this stuff. You'd want to feel the ground giving you traction and, you know, get that feedback. Why is it okay then to run on pillows?

[A]

Depends on what type of runner you are. I guess I want to say pillow.

[B]

I'm talking about these thick cushioned soles where, frankly, you can't feel the ground.

[A]

There's always a trade off with footwear. So if we look at cushioned footwear, for example, when someone puts that on initially, they say, wow, this is comfortable. I have a lot of protection. You are getting protection. There's a lot of material between the sole of your foot and the ground. But here's the trade off. You compromise sensory acuity.

[B]

What does that mean?

[A]

You compromise sensory information because there's an interference between all those beautiful receptors on the soles of the feet and what they are trying to feel when you put a lot of sole between your foot and the ground. So as I'm. If my goal is I want to help someone's balance, my dad, I want to make sure he doesn't fall. Does it make a lot of sense for me to make that harder on him by putting a lot of material between what he's supposed to be feeling in the ground? So we need to think about those things. Is your goal to walk 10 miles on a trail and does your foot not have the capacity or strength? Do you need more cushion in that scenario? Possibly. But keep this in mind. You will compromise what you're getting, what you're feeling from the ground. So you have to ask yourself that question. What are my goals?

[B]

It's the cost of comfort, right?

[A]

That's right.

[B]

We can see the cost of comfort in other areas in life. If we drive everywhere comfortable in our heated car with our favorite music playing. Wonderful. But if we keep doing that and don't move our bodies, there comes a cost. We get that if we use our phones for everything and, you know, get all our shopping delivered and our food delivered to us. Very convenient. Yes, but there's a cost.

[A]

Yes.

[B]

And I love the way that that also applies to our footwear. A nice cushioned shoe, beautifully, you know, you bounce and go, oh, God, this is nice. But you're switching off your nerves, your proprioceptive kind of inputs to the body, your balance. So are you aware of the trade that you're making when you purchase your footwear?

[A]

I just. That is my goal. My mission in life is to just get people to start thinking about the foot like we do everything else. All those examples you just gave, if we took those examples and applied them to the foot, we would all be asking ourselves that question.

[B]

Yeah. Let's go back to these three groups of people I had in my mind, children who have got healthy feet. Let's try and not do stuff that messes their feet up.

[A]

Correct.

[B]

Then the second category of people for me was people, I guess, who were. Well, maybe they don't have, you know, in adverse commas, a problem like a bunion or plantar fasciitis or, you know, foot pain or whatever it is, but they realize that, you know what, I'm not wearing the best footwear for me, and as I get older, I better start paying attention to my feet. And then I guess the third category is people who do have established problems.

[A]

Yes.

[B]

From the modern world, maybe from inappropriate footwear. So I want to make sure I keep those three groups of people in mind. Throughout this conversation, you've mentioned how to choose footwear for children if you're in that second category. You know, like, I imagine many people listen to this podcast. They're sort of. They're pretty well. They try and look after themselves. They're interested in health, and they're realizing, I've not really thought about my foot health, but I don't want to have a four when I'm older. I don't want to have other problems. So let me start paying attention. And let's say they're used to wearing modern cushioned, supported footwear. Help that person understand what to do. And I think what might be useful is this distinction you make in the book of minimal footwear versus functional footwear.

[A]

If someone. It's been really interesting to see my practice change, too, because years ago it was people would come in with foot pain and say, hey, can you help me with my foot pain? But now I think because this education is. Is becoming more widespread, I'm seeing people in the second category. They're like, I know I haven't been wearing the right footwear. I don't necessarily have problems in my feet, but this makes sense to me. So what do I do? So we will run them through the assessments of their foot. How does it move? Do they have dexterity? Do they have good strength? And then based on that, we will talk to them about footwear. If I put them into a minimal shoe, which those requirements, again, are wide toe box, zero drop, so heel and toasted on the same plane, and thin and flexible sole.

[B]

So those are the three criteria for a minimal shoe.

[A]

Yes.

[B]

And could you just, top of your head, mention some brands which qualify as a minimal shoe?

[A]

Vivobarefoot.

[B]

Yeah.

[A]

Bielenka.

[B]

Yep.

[A]

Zero.

[B]

These are minimal shoes. Okay.

[A]

We will have the conversation of duration. So I always say you have to earn your right to wear minimal footwear.

[B]

Okay.

[A]

Because there are more loads going through all of your tissues, your bone, your tendons, your ligaments, your muscles. This is a good thing.

[B]

Yeah.

[A]

This is when we get stronger. But again, taking everything we know about the human body and how we would train the human body, we have to apply that to the foot. So it is slow. You're gonna wear this shoe for five to ten minutes a day. You're gonna see how you feel that night. You're gonna see how you feel the next morning. If things are good, you slowly add time. But if you wake up the next morning and you're like, hmm, my heel's a little sore.

[B]

You wait.

[A]

You wait. It's not the shoe's fault. That was one of the, you know, with the pandemic. I saw all these articles come out. You know, people are. Don't walk around barefoot at home because you're going to damage your foot. And I'm going. We have the message. Wrong. It's not.

[B]

It's not just wrong. That's the most ridiculous statement. I mean, if you just look at our history as humans.

[A]

Yes.

[B]

We have walked around barefoot for the vast majority of it. It is ridiculous to think that walking around barefoot at home for most of us is damaging our feet. It's kind of messed up.

[A]

It is.

[B]

I Don't get it.

[A]

I think the biggest argument that people will say is, well, we weren't designed to walk on man made surfaces.

[B]

Yes. Okay. And what do you say to that?

[A]

Okay, so if that is the argument, you can still put your foot into its functional position here. Enter functional footwear.

[B]

Okay, so minimal footwear is maybe, what is that the ultimate goal, would you say for people? But is functional footwear a bridge?

[A]

Yes.

[B]

Okay.

[A]

I think more people will live in the functional footwear kind of area, ideally as their foot strengthens and they can transition. You can move into a shoe that is going to require more out of you. But the functional footwear is where I take everybody.

[B]

Is that like a transition?

[A]

Yes, it's wide toe box.

[B]

But that's the same as minimal, isn't it?

[A]

Yes.

[B]

Okay, so you still got wide toe box.

[A]

That's my non negotiable.

[B]

Okay. So that's in both minimal and functional. You have a wide toe box.

[A]

That's right.

[B]

So, okay. Put another way, don't buy a shoe that's going to deform the front end of your foot.

[A]

Yes.

[B]

Okay.

[A]

Yes.

[B]

I mean that should, it's a kind of basic. When you say like that, it's like, why on earth would you compress the front of your feet? Okay, so wide toe box. Yes. Then what's next in this functional footwear casting?

[A]

When we talk about the heel to toe drop, functional is low to zero drop, so 6 millimeters or below. And that's with research saying we've done the studies and low to zero drop is 6 millimeters to zero.

[B]

Okay. So minimal footwear is zero drop, where the heel and the toe are on the same level. And you're saying when you're transitioning, perhaps go to a functional shoe where there is a drop, but it's just not very much.

[A]

Correct.

[B]

Okay.

[A]

Especially if someone has had plantar fasciopathy or heel pain or they have a history of Achilles tendinopathies where they have some type of issue where we know we have to work on strength and mobility. You don't want to take them down too quickly. So it's, hey, let's try this, let's try this zone. And then the functional footwear is where you can play with variations of stack height. So that's how much cushion is under the sole of the foot.

[B]

So in functional footwear you still will have some cushioning, maybe just not as much as you're used to.

[A]

Yes. So a lot of the footwear, there's companies now where you'll see stack heights of 55 millimeters. I mean, it is gigantic. That is a significant cushion under your foot. So these brands that are aware of the anatomy of the foot, so respecting the toe box, dropping the heel a little bit, but still giving people some of that cushion that they often seek because their foot hasn't felt the ground in decades, that's a nice lane to sit in as they start to transition.

[B]

Yeah. What are some of the brands that sit in the more functional footwear category as opposed to minimalist? Today's episode is sponsored by the Way. I have tried so many meditation apps over the years, but I've never come across one as good as or as effective as the Way. I've been using it most mornings for many months now and I absolutely love it. I find it a fantastic way to start off each day and it has really helped me feel calmer, relaxed and more present. In fact, I love this app so much that I recently decided to invest in the company and join them in their mission to get more people meditating. I believe that more people meditating will help create a more compassionate world. And as the Dalai Lama himself said, if every eight year old in the world is taught meditation, we will eliminate violence from the world within one generation. Meditation has been shown to have all kinds of benefits. Reducing stress, increasing calm, improving focus, and over time has even been shown to result in positive structural changes in the brain in areas linked to memory, focus and emotional regulation. But of course, you only get those benefits if you actually do it. And that's one of the main reasons I love the Way so much. It makes it really easy to establish a meditation practice that sticks. If you don't believe me, I would encourage you to give it a try and find out for yourself. In fact, to help you do that, the way are offering my podcast listeners an incredible 30 free meditation sessions to get you started with your practice so you can try it out and see if you like it completely free of charge. To take advantage, all you have to do is go to thewayapp.com livemore to get started and begin your journey towards peace, calm and purpose. What are some of the brands that sit in the more functional footwear category as opposed to minimalist?

[A]

There's not many. Ultra Running.

[B]

Is that Altra?

[A]

Altra Topo Athletic. Yeah, notice is a newer brand, but they're. That's what I think happened here when this conversation of minimal footwear is not new. All right, in 2007, the Vibram Five Fingers, I mean, we were having these conversations and people got Real excited about it. And they went from zero. They went from over here into minimal. And people were saying, wow, I have, you know, my foot isn't ready for this. And they were saying, my calf hurts or my foot hurts. And again, not the shoe's fault. The fact that we didn't build capacity, but this lane of functional footwear didn't really exist. So people either said, you're gonna be in this real aggressive shoe, or you have minimal.

[B]

Got it.

[A]

And so that's where I think this education and these brands are saying, hey, people do need. This might be a lane for some people to start in.

[B]

Could we make the case, Courtney, or would you agree with this? Let's say we turned the clock back 150 years or even 200 years. We wouldn't need any of this stuff because our feet would just be stronger.

[A]

Yes.

[B]

But because we've been in inappropriate footwear as a society for so long now, for some of us, if we want to do the work of restoring our foot health, we need to gradually transition. I mean, some people can clearly go to minimal footwear straight away. If they're careful, they have no problems. But for some people, you're saying you might be better off going to this halfway house first.

[A]

And you know, we're talking decades, decades of people's feet getting weak. This doesn't happen overnight. So that second category that you mentioned, with people that don't have any symptoms or pain, I have plenty of patients that can walk around in cities in minimal footwear with no problem. But that third category, and I sit in that third category because that's how I got into all of this. I have bunions, I've had neuromas, I've had all the things. Because my foot structure has changed due to me not paying attention.

[B]

Can you tell us a little bit about your story? Because one of the things I found really interesting in the book is that you seem to understand the benefits of walking for you quite early on. And from what I remember, you used to walk regularly. Cause you knew it helped you until you started to get problems in your 20s, I think.

[A]

Yes. Movement has always been my therapy. I didn't realize it at the time when I was growing up, but it was my, you know, through some pretty dark times. I didn't quite know what I was doing, why it was so beneficial for me. But anytime that something was going on, I'd just walk and I'd keep walking until I felt better. And I grew up as a ballet dancer in pointe shoes. And then I transitioned into the triathlon world. And my feet were just perpetually shoved into footwear that was restricting its motion. And I developed bunions and neuromas. I've had stress fractures. I've pretty much had all the diagnoses that my patients come to see me

[B]

with, which is, of course, why you do what you do today, right?

[A]

And walking became very difficult, and that was very hard for me because I didn't have any other coping strategies at the time. I was young. I'm like, I can't walk. And you start to see this cycle of what happens, and you see how depression and anxiety can set in very quickly when you can't move your body. And so as a personal quest, I just became. I was like, I have to get a hold of this. And so that's what started all of this. So to get back to that footwear conversation, I. Because I have structural change in my foot now, albeit it is much better. There are no symptoms there. 80% of the time I'm in minimal footwear, but I know I have that bunion. If I'm going to be standing on concrete, if I go to a concert and I'm not walking per se, I'm just standing still, I know I still want my foot in that wide toe box. Non negotiable. I'm okay with my heel and toe being in the same plane, but if I'm standing in one place, I want a little stack height. And that's where I live in the functional category. So I have this shoe spectrum, and I think that's important for people. We are not saying 100% of the time you need to be doing this. We're not going to, you know, that's not how we should be educating. No, it's live along the spectrum. Dance over here for a little bit. This is where you're gonna get stronger, but it's okay. You can live here, keep your foot in its functional position. But where you can't live is in footwear 100% of the time. That is restricting your function and interfering with your sensory acuity, that's going to affect your longevity.

[B]

Could we take that principle, let's say for a woman, if a woman, let's say, lived 90% of their lives in good footwear, but on a Saturday night to go out, they wore high heels because they like to. Right? They like the way they're looking at it. You know, I'm not sort of criticizing that at all. I'm saying a good, strong, functional foot, I'm guessing, can tolerate being in different kinds of footwear now and again. If the vast majority of the time you're in the correct footwear.

[A]

Yes. I tell women, go for it if you want to. If that's what makes you feel good. That's powerful.

[B]

Yeah, exactly.

[A]

Just when you get home. In the book, we have a high heel rehab. If you're gonna wear high heels, do these things. You know, I used to still have my occasional high heels in my wardrobe. But about six years ago, I also was going to a wedding, and my fiance, I put on my heels and I sat there for a second, and the look on my face, he looked at me, he goes, please take him off. Cause you're gonna complain all night long. And from that moment on, I have not worn a pair of heels. Cause the second I put my foot in there, I'm just like, oh, no.

[B]

So what did she wear?

[A]

I wear sandals.

[B]

These are hard. Like, if you're going somewhere where you have to dress up, like, do you find it difficult to go? Yeah, but because there is this sort of. I wouldn't say an expectation, but there is a sort of thing you wear at certain events, right?

[A]

Yes. You know, it's such a good question. First, when I first started doing this, there were maybe a handful of companies that made minimal footwear or appropriate footwear. Now there's many. So the options are much greater. But. But I think about this. When we get dressed, we want to feel confident. Right? That's the goal. We want to feel confident and comfortable in our skin. For me, being able to walk with confidence and feel strong and feel stable, a lot of that comes from how I'm interacting with the ground. So I feel like I'm walking more confidently and I look more confidently when I'm. When I have my foot on the ground.

[B]

Yeah. Could someone make the case that if you have well functioning feet, let's say you had the time, knowledge, and discipline to spend 30 minutes on your feet each day. I expect very few people listening to this have done that or will do that. But let's just do a thought experiment for a minute. If all the tests that you write about in the book, you know, the lean to wall test, the credit card toe strength, single leg car for a single leg balance test. Right. Let's say you worked on all these things and your feet, your toes, your calf muscles were functional and strong. If that was the case, could you argue that you can kind of wear whatever footwear you want because it's really your feet function that determine the vast majority of the outcome? And you know? Cause I guess what I'm trying to get at, you could, for example, someone could listen to this. I go, all right, you know what? I've heard wrong, and bang on about this for a number of years. But, you know, I wasn't sure, but Courtney's persuaded me, right, I'm gonna get into this. And they may go to a functional shoe or a minimalist shoe, but if their feet are not working well, it's not necessarily gonna correct that by going into a different shoe, is it? They could still have issues with the way their feet interrupt with the ground unless they do some of the rehab work. Do you see what I'm saying?

[A]

Yes. The priority is the foot itself.

[B]

Yeah.

[A]

It's what you put into the shoe.

[B]

Exactly.

[A]

You have to pay attention to that. The shoe is. It's icing on the cake. Like I say to my patients, it's icing on the cake. Pay attention to what you're putting in the shoe.

[B]

So Kipchoge with excellent foot function and strong feet from childhood. Well, he'll probably be all right in anything.

[A]

I was just gonna actually use that example because in my runners, if they wanna run on race day in their super shoes, where they get their running economy, fine, I'm not going to win some. I'm not going to win all those battles. But when they're training and they're practicing and they're trying to become the most efficient runner and the strongest runner, you're not going to be training in your super shoes. I want your foot to get strong. I want your ankle to get strong. So, again, having this shoe spectrum work in an environment that's a little more challenging, so that when you go and put your foot into your super shoe now, you have this strong, resilient system. Maybe your running gate mechanics are better. So those are all the things that I like to think about. It's. You can't cheat the system forever without thinking that there will not be a consequence.

[B]

What about these cultural ideas that we pick up? Right. So take me, for example. So, you know, you don't know much about my history, but I used to have really, really bad back pain in my 20s. Had time off work, couldn't lift my baby boy when he was born, you know, really affecting my quality of life in a massive way. Now, I've subsequently realized there were multiple contributing factors to my back pain, including emotional things about, you know, having to carry the weight of. My father was very sick and, you know, I was. The person in the family is, I guess, the medical Son who was kind of semi in charge of all that care. But there was also a physical component. Right? Cause I think with chronic pain, you know, this stuff's multifactorial. There is. It ain't just one thing. But on my journey to being completely pain free, which I've been for many years now, there was this amazing guy, Gary Ward, who's a really good friend of mine. I found. Do you know Gary?

[A]

Yes.

[B]

Yeah. Basically I found this guy and he was like, I think he's gonna be able to help me. And I went down and I studied. I took his anatomy and motion courses. I think was the first doctor to do his courses.

[A]

And. And it's a great course.

[B]

It's brilliant. And Gary said to me, this is back probably in 2011, 2012, he's like, your right foot is not working properly. Or, you know, he didn't exactly say that, but that's my colloquial way of trying to describe it. And he gave me some foot exercise. I said, oh, Gary, I've got a flat foot. He said, no, no, wrong. Listen, your foot is stuck in pronation. Pronation's not a problem, but we need to help it get out of pronation.

[A]

That's right.

[B]

And so he gave me a couple of exercises for my right foot. I remember doing them. I was walking, I was like, where's my back pain gone? It was the first time that I was like, wait a minute, how my right foot is functioning is contributing to my back?

[A]

Yes.

[B]

So that was kind of. It was really interesting for me. And that in many ways started off my journey with, oh, my feet is really important. As I said to you when you came to my house this morning, I said to you, 12 years I've been wearing VVOs. But I think it's longer because my first time I bought them was in. I think it was October 2012, when I made my first Vivo barefoot purchase. So what we're looking at maybe 13 and a half years now. People will say, yeah, okay for walking, maybe okay for running if you've trained. But for lateral movements, you need supportive footwear. Well, here's the thing. I took up paddle about six months ago with my son. Do you know paddle sport? So quite a lot of lateral movement. I wear my Vivos playing padel. I have no problems at all. So we have these. And again, I'm used to wearing minimal shoes. I was going to say bare thought, but I like your definition of functional and minimal. So I will say minimal shoes. What's your take on that? Maybe I can manage it. Maybe some people who are not used to it will need some lateral support. But what's your take on that? Because the belief system is, yeah, but these modern sports, you need lateral support. What would you say again?

[A]

Going back to. If we just think about the foot like we think about the rest of the body, if I was going to train my shoulder and strengthen my shoulder, would I only train it in flexion or extension? Wouldn't I want to train it in internal rotation and external rotation and abduction and adduction? So when we talk about the foot, one of the foot's most incredible capabilities is its ability to invert and evert, which is this motion. So the foot going in and then it going out, the foot moves in all these different planes of motion. So rather than avoid these movements, we train into them. We don't say, hey, your foot's flat. We need to avoid pronation. We want to find pronation. We want to get you to control pronation. You've sprained your ankle. That doesn't mean go get a brace and never allow your ankle to go into inversion again. That's life, that's environment. You have to train the brain to see inversion again. So I'm a very big proponent of training the foot especially into inversion and eversion or lateral motions. I think that's very important.

[B]

So are you saying that. Obviously I've chosen to. So I think, I think it's the vivo. I think it's the vivo barefoot motus that I use when I play paddle. But could we argue that? Well, listen, when I'm doing my footwork away from the paddle courts, I'm training all these movements. But if I wanted to play in a traditional tennis shoe or. I don't know, I haven't seen paddle shoes, but I'm guessing they're similar to tennis shoes with lateral support. That's fine as well, isn't it?

[A]

It's fine. You know, there's so much research coming out that the, you know, shoes don't cause the injuries. And there's so many layers. There's so many layers. You can't blame footwear for injuries. That would be. There's other factors. It could be sleep. It could be lack of strength. It could be you just want to give your body the best chance you can. And that means creating resiliency, which means training your foot like you would train the rest of your body. And then when you put it into a shoe where you say you're gonna play tennis or you're going to do that, Just play, have a good time.

[B]

Yeah, Put what you need to put on to go and have fun.

[A]

That's right. Some people like playing in minimal footwear on a tennis court. Great.

[B]

And some people don't.

[A]

And some people don't also great.

[B]

Yeah.

[A]

But just pay attention to your foot. Make sure your foot is strong and mobile.

[B]

Yeah. I remember this as a kid. I used to go to India every other summer for six weeks to see my grandparents and my family. And I remember at my maternal grandparents house they used to live in a block of flats on the second floor. And because it's hot in the day, every day at about 4pm There was like three or four sort of blocks of flats around there. All the kids would kind of congregate downstairs at about 4pm and do all sorts of stuff. And yeah, I'm on holiday playing with my cousins and my young cousins say oh yeah, we're going to play football. So I'd go down and with my shoes on and they're all playing football like full on barefoot. So obviously I take my shoes off and it's a little sore for me cause I'm not used to it. But then by the end of the summer you're like, yeah, there's no problem, you see, tackling, sliding, whatever, completely barefoot. And we would think in the west we think you can't play football like that. And I'm not at all suggesting anyone does that. But it does show you how resilient and adaptable our feet are when we start to use them. Right?

[A]

That's right. Give them what they need.

[B]

Okay. So if it's the foot function that's the most important thing that is the most important. Which is what Gary would definitely say.

[A]

Yes.

[B]

You know, I think Gary's viewpoint would be if your feet function well, you can probably get away with anything. But I think a lot of us, in fact, how

[A]

think about it like stacking behaviors.

[B]

Yeah.

[A]

If you don't pay attention to your feet and you don't strength train your foot and you don't mobilize your foot and you're wearing foot orthoses forever and you're wearing restrictive footwear, you're putting a lot of things not in your favor.

[B]

Yeah.

[A]

Do you see? It's this stacking concept. So we have to do something. Some people choose to just wear minimal footwear. There's studies saying if you just wore minimal footwear you improve the strength of your foot.

[B]

Yeah. 62% increase in just four months. And that study I think University of Liverpool was remarkable. Cause it's like if you're someone who goes to the gym, Right. If someone could tell you you could get a 62% increase in your biceps or your quads.

[A]

Everybody's in.

[B]

Yeah. But the crazy thing is that you're not actually doing anything. You're just wearing minimal shoes, so your feet are naturally getting a workout. And, you know, it's crazy. It's like, it's kind of free money sitting there for some people.

[A]

You know, when I was doing the research for this book, I was looking at so many studies, and a lot of them were delineated in what happens when you wear this type of footwear versus what happens when you do these exercises. And I would love to see more research where those conversations are combined. The. And conversation. What happens when you wear functional or minimal footwear and you exercise your foot? You know, I think that would be. But for those who are saying, hey, I would just prefer to wear minimal footwear, you will get benefit. There's others who say, hey, I'm just gonna. I'm gonna work on strengthening and mobilizing my feet. Great. Do something.

[B]

Okay, on that topic, then, of doing something, there are so many tools in this book for people to think about doing right, but let's start to stratify it. Let's say someone's listening to this, Courtney, and they're like, yeah, I'm not sure about changing my footwear, but I'm interested in improving the health of my feet. What are your sort of top

[A]

daily?

[B]

You know, three, four times a week? Like, what are some of these top drill stroke exercises you would recommend people start doing?

[A]

I think the first thing is, do you have good foot awareness? Most of the time, people have not paid attention to how their foot feels. And so that's where we'll start. So we'll have people keep their four toes down. And can you just lift your big toe?

[B]

Okay, hold on. So they'll keep the four toes down and just lift their big toe. Now, I know because I've done this before with Helen, that it's different on my left than right.

[A]

Yes.

[B]

So on my left foot, for example, I can keep my toes down. I lift up my toe on my right one, my second toe starts to come up.

[A]

Yeah.

[B]

Okay. I know you haven't examined my feet, but is that common? And if so, why does that sort of happen?

[A]

It is common. And what's. I think very interesting is a lot of the times when I see that the foot that has poor dexterity or poor awareness will often be the side where you'll start to see symptoms.

[B]

That's true with me for sure.

[A]

So pay attention to that. Also, when you're lifting the big toe, I also look at how you're lifting the big toe. When you lift the big toe, does it deviate away from the middle of your body? So think of a bunion. If I was going to lift my big toe, my toe should go straight in the air. If you lift your big toe and it goes towards your second toe muscle, muscle weakness, because there's a muscle that straightens the big toe.

[B]

Can we just pause there on bunions a minute? Because bunions are so common, as you've said, you experienced them, I think, in your 20s. I have a couple of questions around bunions, which I guess relate to this exercise. Number one is, are bunions a modern problem? Okay, so, I. E. Do we get them in traditional societies to the best of your knowledge? And then if so, once you have a bunion, is there anything you can do about it?

[A]

Yes. So let's attack the first one. The first one. One of the studies that I found so interesting in regards to hallux valgus or bunions, when I was researching the book was there were scientists who looked at centuries and they said in the 12th and 13th century versus the 14th and 15th century, and they dug up the skeletal remains, and they noticed that in the feet of the men in the 14th and 15th centuries, there was more of a prevalence of hallux valgus.

[B]

And what is hallux valgus?

[A]

Bunion.

[B]

Yeah.

[A]

There was also happened to be more fractures in that population as well. Now we can't make the correlation that a bunion is directly a cause of fracture, but I thought that was interesting. Okay, so when you look at those two areas, what changed in the 14th and 15th centuries? Why when they looked at these skeletal remains, was there an increased prevalence of hallux vougus in that century versus 12th and 13th, the medieval times. And it was the introduction of the Krakow and the poulain boot, you know, the very pointy medieval boot.

[B]

Right.

[A]

That was worn mostly by men. Because we think of bunions today for women. For women.

[B]

That is so interesting.

[A]

It is.

[B]

I never heard that before.

[A]

I would argue, is it really a female problem now? It could be because the female footwear is very different. These are all just things to think about.

[B]

Well, there was a very powerful story in the book about was it a female air hostess who came to see you and, you know, she's just required as her job. You know, they have to have a minimum heel height as Parts of her job.

[A]

Yes. It's so upsetting to me.

[B]

Yeah.

[A]

I've written so many letters to airlines.

[B]

Have they ever written back to you?

[A]

No, not yet.

[B]

Not yet. Well, but your book, the podcast you appear on, the more all it takes, I realized all it takes is for someone in a position of power at one of these companies to have experienced the problems themselves, because ultimately, that's what changes things, Right? Humans. When it affects you, suddenly you're motivated to do something about it. Right. If you were the female CEO of Pickya International Airline Company, and you experienced this and ended up at your clinic, you might go, hey, this is crazy. Right? We're gonna change our policy. But until that happens, it gets tricky, doesn't it?

[A]

Yeah. She said to me, she goes, you know, I wish we took care of our feet as much as we're supposed to take care of our passengers. I said, that's very fair.

[B]

But just on that, if there is an air hostess listening to this Courtney, who, for her job, has to wear heels, you're still, I guess, gonna argue that. Well, not argue. You're gonna perhaps make the case that when you're not at work.

[A]

Yes.

[B]

You need to be really paying attention. And maybe when you're walking, I don't know, maybe when you're on your break on a long flight, get the heel. Do you know what I mean? There are things that you would recommend they do to mitigate the downside.

[A]

They have changed. There are several airlines now where they used to require that there is a small heel worn both in the airport and on the flight. Some of these airlines have changed. Now they only have to wear the heel on the flight so they can wear different footwear when they're walking through the airport.

[B]

It's kind of interesting, isn't it? Yes.

[A]

Yes, very.

[B]

Because, I guess. What is the thinking? I guess the thinking is, whenever you see one of our. I guess we're talking about women at the moment, female air hostess. They're going to have a certain look rights.

[A]

The goal with any company of an airline, I would think, is customer service. You want your flight attendant to, you know, be interacting with your passengers and be happy and be, you know, confident and comfortable. If they're not comfortable and anybody who's had foot pain, you're not walking around with a smile on your face.

[B]

Yeah. You're gonna be more reactive, less forgiving when you get asked for something for the fifth, 500th time on the flight or whatever. Okay, so basically, I think where we're up to at the moment as we're saying, traditional societies, we don't think had bunions. We think, well, I don't know if that's the case you're making, but Certainly in the 14th, 15th century, it looks as though there's this increased prevalence because of footwear.

[A]

Yeah.

[B]

Okay.

[A]

And then there always is the argument with bunyans about are they genetic? So my mom had a bunion, my grandma had a bunion, so that's why I have a bunion. And there are certain, you know, factors. We can say connective tissue laxity, hypermobility. There are factors that are inherited that would make a foot more likely to have a bunion. But this is always my argument with that. If you went to the doctor and they ask you for your family history, do you have a history of cancer? Do you have a history of heart disease? And you say, yes, my mother had heart disease, what do they tell you to do?

[B]

Change your lifestyle.

[A]

Change your lifestyle. So when someone says, my mom has a bunion or my grandma has a bunion, what I'm going to tell them to do? Change your lifestyle, change your footwear, start strengthening your foot. It's not a. Just because now you are going to have bunions. Have the conversation of education. What can you do? Empower the person to make that change for themselves.

[B]

Yeah. A couple of things go through my mind there. First of all, number one, we're talking about earlier on in this conversation, how do you motivate people to start caring about their feet if they don't have a problem? And it could be if your mum or your grandma or your dad even had bunions. So maybe you have a genetic predisposition.

[A]

Yes.

[B]

Right. It's not your destiny, it's just a predisposition. Correct. Maybe that's even more of a reason to go, wow, I saw how much pain or discomfort my mum was in. I don't want that to be me. Let me get onto it. So, number one, it could be a motivating factor. The other thing that has come up several times to me, Courtney, this conversation is the similarity between the way you look at the feet and the way that, let's say, I might look at physical health. So let's take type 2 diabetes. Right. We know that by the time you get a diagnosis of type 2 diabetes, the process and the physiological changes that led to it probably started five to 10 years prior to that. So you've got this long period of time where you're living your life. Your sugar hasn't quite gotten to the diabetic range yet. But it doesn't mean things are good. And you made that case earlier on with the feet, Right. Just cause you're not in pain at the moment, you know, by the time they come and see you with their problem in their foot, that didn't start the week before that has been building up because of your lifestyle and your footwear and how you treat your feet for maybe a decade. Right. So there's this latent period where you could intervene. There's also a similarity in terms. A similarity in terms of what you just said, which is people will say sometimes, oh, you know, doc, yeah, but my dad had diabetes, type 2 diabetes, so of course I'm going to get it. So hold on a minute. Your dad may have had a genetic predisposition, but I can guarantee you, if you eat in this way and you know, you keep your weight here and you do this sort of exercise, whatever it might be, you're not gonna get it.

[A]

Yes.

[B]

Do you know what I mean?

[A]

It's an exciting conversation. Yes, it's an exciting conversation. It's one of empowerment. And I think people get excited about that, that there's something that you can do. It's part of the journey, if you will. And that's why I love when people say, oh, you've given me hope. Because that is what it's about.

[B]

Your whole book is a message of hope, actually. I think it deals with everyone. I love the way with footwear you take this very nuanced approach, saying, well, it kind of depends. Depends where you currently are. Right. You take this approach with walking. We haven't gone into in depth your build program, which, you know, maybe we'll get to today, maybe we'll have to leave it for a part two. But this idea that actually looks short. Our ancestors may have done 15,000 plus steps a day, but let's not make the aim for 15,000 or 10,000 put you off. Even if you can increase from 2,000 to 4,000 steps a day, you're getting benefit. Right? So this message of hope, I think comes through in all of your work, which I'm sure comes from your own experience personally with yourself and with dealing with patients for so many years.

[A]

I think that's the where it comes full circle with the foot strength, footwear conversation and walking. Because I think that's such a great question. How do you convince somebody to pay attention to this stuff when they don't have foot problems? And that's where I think the integration of the conversation of walking. Because if you were to ask someone if Something would deter you from walking in the future. What do you want to do when you age in your 80th decade? What do you want that to look like? There's not one person that would say, I don't want to walk. Yeah, they might. You know, it might vary as far as strength training or this or that, but every single one of my patients has always said, I want to be able to walk, whether that's with their spouse or their friends or their children. And that's where the foot is the biggest player in that conversation. Yeah, it's pretty, like so gives me chills. I like it's such an important conversation.

[B]

Yeah, it really is. And of course, it's your foot that interacts with the ground. You know, it doesn't matter how strong your biceps are when you're 80.

[A]

Like, got to be able to walk

[B]

and you're going to want to walk. Okay, going back to these practical exercises. So I sort of took you off on a bit of a tangent on bunions.

[A]

It's okay.

[B]

So let's just finish on bunions for a minute then. So we're basically saying we think they are a modern condition. You, I think, got bunions in your 20s. Right? So a couple of questions then. Do you still have bunions and do you think that the work you're doing, what are you hoping? Are you hoping for a reversal of the bunion or are you hoping that actually, even if it stays like this, I'm gonna still have functional, pain free feet as I age?

[A]

I think that's a great question. When I look at my foot, what is the goal? I used to have a lot of pain that was affecting my walking and my movement. If you were to say to me what is more important for you, that aesthetically you would get rid of the bunion or that you don't have pain and you can be more functional? That's a very easy question. Less pain, more function. When you have early intervention with bunions, mild to moderate, we can see the change in the foot. The bunion might decrease. In my case, I was more on that moderate to severe end of that. So I still have my bunion. If anyone looks at my foot now, it looks a lot different.

[B]

Is it better than it was?

[A]

It's better than it was. The biggest difference, I think when you look at my foot now versus 15 years ago is 15 years ago it looked like skin and bones. It looked like an atrophied foot. You could see the metatarsals, you could see just how thin the foot was. I still have the bunion, but my foot is beefier. It's bulkier, has more strength to it. And that, I think, is a very big difference. If you think about that, you know, the muscles in the feet are just like the muscles in your bicep. For example, If I did 1000 bicep curls, my bicep's going to get bigger. When I start to strengthen my foot, you will see changes in the foot. And so a combination of strength and paying attention in the right footwear, my bunion no longer bothers me.

[B]

Do you wish you didn't have a bunion?

[A]

I think it's part of the story.

[B]

So do I. You know, that's kind of why I asked the question. It's like, because. Yeah, I just, I just. I really wonder your perspective on that, because I guess in many ways, if you didn't have the bunion, you probably wouldn't be sitting here in the studio today.

[A]

And it also, all the other diagnoses the neuromas that I've had, and it reminds me when a patient is sitting in front of me also, that, you know, I've been there and I understand. And I do know that it can cause a lot of problems, not only physically, but mentally and emotionally. So there's a connection there that I'm grateful for so that I can empathize

[B]

and understand to some people, when they come to see you need a manipulation in their foot, because maybe the joints are stuck or locked in certain places and the exercises are not enough. Or perhaps a manipulation can free up a joint, which makes it easier to do the exercise.

[A]

Yes, well, often, for example, the calcaneus, the heel, when we walk, there's a reason we are designed to graze that heel, because think of a pole vault, it hits the ground, it initiates pronation, so it starts to evert or open, and that's our beginnings of shock absorption. So oftentimes, patients will have. The joints will be sticky, if you will. So we'll get in there and we'll mobilize the calcaneus, we'll get the foot to move, and then we say, just like you mentioned with Gary, go do these exercises. Drive it home.

[B]

How much time do you think people could realistically spend on their feet per day or what? Let me phrase it another way. What is the. For the time pressured, busy person who likes listening to health podcasts, and every week has different things that they could be doing to improve their health and wellbeing. And then they hit, oh, my God, now I need to look after my foot health as well as everything else. Right, yes. What is a reasonable minimum that they could spend a day on their feet and get benefits?

[A]

Yes, I've heard this often. I'll tell my patients, start with 10 minutes a day. And we have designed things that you can literally do when you're sitting at your desk so that toe yoga, for example, you can do it sitting at your desk. You can lift all of your toes and spread them and reach them forward. You can walk around barefoot for five minutes. All of these little things count.

[B]

Do you know what's crazy to me? And I guess it's clearly it depends what your starting point is. But as someone who literally lives their life barefoot, certainly in my house, it's crazy to think that, yeah, spend five minutes bare thought. That counts. Of course it does count.

[A]

Yes. It's an entry. I've had many patients, when they get out of bed, their foot goes into a slipper. They will wear some type of sandal even in the shower, so the foot never sees the ground.

[B]

Why is that? For grip pain.

[A]

Because once, for example, someone with heel pain, if you were to Google heel pain, you will see a lot of cushion. Don't let the foot feel the ground. So for years you'll have people deloading their foot. Deloading, taking load away. Tissues need load. We know that. We know tendons need load, we know muscles need load. So you can't deload something forever.

[B]

This is the problem, isn't it? It's a vicious cycle, right? You want people spending more time barefoot at home. At the same time, if you've spent decades not looking after your feet through no fault of your own, right. You may be in a situation now where, like that patient, where you get up, you put something on, you go in the shower, you need something. These are downstream consequences, they're not the cause. It's like, let's go upstream and try and prevent that happening in the first place.

[A]

And then on the other side of the spectrum, you'll have patients that have been walking barefoot. And we'll tell them, hey, when you're in the gym, grab a kettlebell, that's half your body weight and do your calf raises. That's a lot of weight.

[B]

Wow.

[A]

The foot can handle it.

[B]

The foot's strong, isn't it?

[A]

Peter Maliaris, I love his research. And there was a study that he did looking at Achilles tendinopathies and the strength that the foot can actually produce. And in this study, he mentions doing six single leg standing calf raises, holding half of Your body weight. And if you were seated one and a half times your body weight. Okay, that's a lot of weight.

[B]

And what. And what happens if you do that?

[A]

That was a kind of a healthy runner can do. That's how much force that we can.

[B]

That we can do, I. E. Basically, our feet are not fragile, weak structures. They're very, very strong.

[A]

They are.

[B]

We're not utilizing that strength. We're not loading them up enough. In fact, we're doing the opposite. We're trying to protect them and stop them doing any work by putting them on pillows every day. And these cushioned, overly cushioned shoes, whereby they don't have to work. The cost of comfort.

[A]

Again, load the foot like we would load everywhere else. When we started talking about the beginning exercises, toe yoga, spreading the toes, things like that. Then you can move into resisted exercises. Let's say you're doing banded work. Then you move into more loads, Farmer's carries, holding heavier weights.

[B]

So it's like progressive overload for any other part of the body.

[A]

Exactly.

[B]

But you're also just now paying attention to your feet.

[A]

Yes.

[B]

Okay, let me try and get back onto the practical things. I'm so fascinated by this topic. You know, I think we've got at least three podcasts in us.

[A]

I'm here for it.

[B]

Look at this. I'm so interested. And I've experienced the benefits myself, so I want to spread this with the world and say, hey, listen, you know, it's funny, my wife, when I started wearing Vivos, I don't think for, I'm gonna guess, three or four years, she wouldn't wear them. Yeah. She's like, I don't like the way they look. Right. But she has pretty much, I think, been exclusively in them now for maybe eight years. Yeah. You know, I think once you get. And again, listen, yes. Aviva Beth sponsor this podcast, but this is not about that. This is about. You know, you mentioned many brands so far. Right. Which I just want people to start paying attention to their feet, and if they're interested, start experimenting with functional shoes. Whatever brand you want, minimal shoes, whatever. I don't. Yeah. For me personally, my journey has been with Vevo, so I've got that experience. And I'll tell you one thing, on a sign I've always loved about Galahad, who's the founder of Vevo, is that he always used to say to me, like, I want to see the day where there are loads of barefoot companies. Barefoot shoe companies. Like, he.

[A]

I love his mission. I love his. It's Community. It's about, it's a bigger conversation.

[B]

Yeah. It's not about their company. He's like, we're not the enemy. Like, the enemy is big shoe. Right. He wants to see thousands of barefoot and minimalist footwear companies. Because that then, you know, it normalizes it. It becomes the new norm for people. And you know, going back to this societal conditioning, we're saying before I know for a fact there are top world famous athletes who will wear barefoot minimal shoes where they're not on camera because they know the benefits, but they have signed multimillion dollar deals with big brands. So when they're being shot, you know, and again, I'm not criticizing anyone or judging anyone. I'm just saying marketing is mega powerful. And a lot of these top end athletes, they know the benefits. So when they're not being filmed, they wear this stuff.

[A]

You're seeing a lot more of it. Because at the end of the day also that's their careers.

[B]

Exactly.

[A]

They want longevity in their careers. And so the more this information gets out there saying, hey, this does make sense. Yeah, they're gonna do what's next, what

[B]

they need to do. Yes. So in terms of practical exercises, okay, we were getting somewhere where and I pushed us off into bunions. But you said you can look at your big toe and how much it's able to come up off the ground.

[A]

Yes.

[B]

Okay, let's say someone does that. What are they looking for?

[A]

If they can lift their toe, can they lift it straight and can they repeat it?

[B]

And what if, you know what. And I'm guessing you want symmetry in both feet. Ideally, if one foot can do it better than the other, what do they do about that?

[A]

Practice.

[B]

Okay. You just practice.

[A]

Just practice. And a lot of the times it's very frustrating for people to not be able to lift their toe. You'll see their brains going, they're lifting their hands or they're trying to rock back onto their heels,

[B]

basically compensating in

[A]

whatever way possible, you know, and it's eventually when they can start to do it, it's very exciting. That's a, that's a big deal. It's driving information to your brain.

[B]

Okay, so everyone listening to this right now is able to do that at home and assess. Can I do that? And if not, practice. Okay, so that's one exercise I can do. What's another one of your kind of favorites that people could start thinking about each day?

[A]

I think one of the. Because I'm such a fan of toe splay and toe strength, I will always look at. Can someone lift all over their toes? So keep the ball of your foot on the floor. So the ball of the big toe, the ball of the little toe and the heel. Lift up all of your toes. When you do that, you'll see the arch of the foot increase. Keep the arch of the foot and try to spread your toes. You should be able to see daylight in between each and every one of your toes.

[B]

Can you do that sitting down or has to be standing up?

[A]

Sitting, Standing.

[B]

Do you wanna have a quick look at mine now, under the sable.

[A]

Love to.

[B]

Right, okay.

[A]

Every day, I'm always the girl at the parties that's on the floor looking at everybody's face. Okay.

[B]

So obviously, just. We'll make this relatively quick, but. Okay. Left foot.

[A]

Yes.

[B]

I've lifted it up.

[A]

Yes.

[B]

And now I'm spreading.

[A]

Yes.

[B]

I can see. Well, maybe not between my fourth and fifth. Well, I'll let you do the assessment. That's my left foot. My right foot. I don't think it's as good. Lift it. Splay it.

[A]

Yes.

[B]

Okay, talk to me.

[A]

Okay. Let's talk about the little guy who people think he's just there to get broken on furniture. The pinky toe. When you see the fourth and fifth toes, oftentimes they're curled under.

[B]

Yeah.

[A]

This is muscular imbalance. There is a muscle in the foot that extends the toes and there's also one that curls the toes. So when we become flexor, dominant footwear, foot weakness, we can't extend the toes. So that exercise is very good to start to get that splay. For people who've had neuromas where there's an inflammation in one of the nerves in the feet, the toes will actually start to split. If there's a. It's a sign where the second and third toes, for example, the toes will start to split because the body's making room for that neuroma. These are all little things to pay attention to. You have to be able to lift the toes and spread them and. And splay them.

[B]

So these exercises, they're assessment exercises and treatments. They're therapeutic exercises.

[A]

Correct.

[B]

Correct. I love that.

[A]

Yes. It's. Can you do this? And if you can't practice.

[B]

Interesting enough, had you been here five years ago, you would have seen very different feats. So as you said before, it takes decades of, I guess, abuse to these feet to get them a certain way. It's probably not going to reverse.

[A]

No.

[B]

In six months, but it's well.

[A]

Well worth it on the other end.

[B]

Yeah, exactly.

[A]

I had a really cool experience since I've been here. I was at a workout class in London, and I'm sitting there having coffee and someone said to me, Dr. Conley. And I turned around and I thought he was in the running class that I did the day before, but he wasn't. And he said, I just wanna thank you. And I said, oh. I said, this is an honor. And he said, I had patellar tendonitis for a very long time and I started doing your foot exercises that I saw on Instagram and YouTube. He's like. And paying attention to my foot has significantly helped my knee pain. He's like, I no longer have knee pain. And I'm like, this is my heart. Those are the stories I live for because I hear them all the time. Whether it's your foot or your knee or your hip or your back, paying attention to this part of our bodies has such a massive implication on everybody else.

[B]

Goes all the way up the chain.

[A]

Yes.

[B]

How beautiful is that that they didn't even have to go and see you in your clinic?

[A]

Yes, I know.

[B]

Of course it's great if people can. But isn't it so wonderful that you can just pop a video out on Instagram or YouTube and someone 3,000 miles away from where you live, consumed it, did the exercises and suddenly their knees better. That's awesome.

[A]

It was awesome. I mean, it was. It was so great.

[B]

Okay, so we've got toe. Going up.

[A]

Yes.

[B]

Big toe. Sorry, going up. And one thing I haven't mentioned yet, but I wrote this down because I thought it was. I've never heard it put like that before. In your book, you say the big toe is possibly the most important joint in your body, and you've got a bias, of course.

[A]

Yes.

[B]

But I thought that was great. And you say it's more than just a joint. It's a demonstration of how far we've come as humans in movement, resilience and evolution. That is beautiful. Can you just sort of explain that for us?

[A]

If you look at how the big toe has evolved and how important it is in bipedal locomotion, it is the part of our bodies that stabilizes us as we move forward. It's the part of our bodies that we propel forward when we have good range of motion at that joint. So I'm going to get a little technical here.

[B]

It's okay.

[A]

The range of motion of the big toe, if you look at how much range we should have studies, 60, 65, 70. So in the higher range of motion

[B]

there, 65 to 70 degrees off.

[A]

Off the ground.

[B]

Off the ground. So that would be extension.

[A]

Yes. In a walking gait, we need about 40 to 45 degrees to have efficiency. So walking is considered a mid range range of motion activity. Meaning our joints go to a certain range of motion, but we don't take them to its end range.

[B]

Okay, okay.

[A]

If someone has a restriction in that big toe, so let's say they only have 20 degrees, you will not only see symptoms at the foot, but you will see symptoms at the knee, at the hip, and at the low back.

[B]

And how common is it for people to have issues with their big toe?

[A]

It's probably second to heel pain. Probably one of the most common diagnoses I see.

[B]

And of course, you're seeing people who are struggling. Right. So you're not necessarily seeing the general public, healthy population. It's slightly skewed because people are coming in with a problem.

[A]

That's why this assessment is so important.

[B]

Well, that first one you mentioned, where you keep the four toes down and you see how far you can lift the big toe up if you do that.

[A]

And there's a pinching in the top of the joint. So let's say I go to lift my big toe and you're like, wow, it's kind of pinching at the top of the big toe. You need to pay attention to that because something is going on that's saying, I don't like extending. It's not to be ignored.

[B]

That's the key thing, isn't it? It's not to be ignored because you do it don't just switch off and go, oh, screw it, I'm not going to pay attention. It's like, no, no, no, you're storing. You're kicking the can down the road, as we'd say in this country.

[A]

Yes. And here's the next layer to that. Oh, my big toe hurts when I extend it. You go buy a shoe, and then you buy a shoe that doesn't have a lot of flexibility in the toe box, and you put the shoe on and you say, great, my toe doesn't hurt at all. It's not pinching.

[B]

Yeah.

[A]

And so they say, oh, great, I'm just gonna wear this shoe all the time. So then they come home, they take that shoe off, they walk barefoot. Oh, there's the pinching again. I better go grab my shoe. And now wear it in the house. And now that joint is not even getting to the range of motion that it had. And then we start to lose more and more range. You see this cycle there.

[B]

Yeah. If you don't use it, you lose it.

[A]

Yes.

[B]

It's funny, this weekend I was just with my. With my sort of best mates from uni. One of my friends was talking about his mum, who, she lives by herself and was just saying, yeah, we might have to move us somewhere where there aren't stairs. And all I said to him is, you know, I said, I think about this a lot. Like, it's. Stairs are difficult for some people as they get older. But what I've seen so many times is, of course you don't want anyone to fall and hurt themselves. But the problem is there's a cost to security, isn't there? You remove the stairs and suddenly they're not using those muscles at all anymore. Like, I remember when my mum used to go up and down the stairs. It's like she said, you know, it would be slow, it would take a while, but I'm like, this is good. She's like using her quads, not only going up, going down. Magic, you know, you're having to really control the descent. And I wasn't giving him advice. You know, I'm sure there'll be an ot, an occupational therapist, you know, fantastic profession, who will be properly assessing what needs to be done. But you know what I'm saying, you don't want people to fall, you have

[A]

to get a little uncomfortable. Yeah, you do. And I have a story of that in the book where I had a patient who was told to sell her house and buy a ranch.

[B]

Yeah.

[A]

And I hear that a lot. And I would rather have the conversation, especially with movement variability, there's so many different ways we can move. So rather than have the conversation of, you can't do this, how can we get you to do that? I think the squat is a very good example.

[B]

Yeah.

[A]

You can't squat. Don't squat. For whatever reason, sitting on a toilet, sitting in a chair is a squat. So we have to train instead of saying, don't do that.

[B]

Yeah. So wouldn't it be nice? And again, I'm not saying there's amazing healthcare professionals out there who are probably doing this already, but just that mindset shift. Just be very careful before you make your life in advertise commas more safe and easy. There is, as you said before, there's a consequence to everything. You choose a certain footwear, there's a consequence. Just be aware of that. That kind of relates to walking, doesn't it? I mean, I don't know if what your take is on this, but to My understanding, or certainly to my knowledge, the complexity in walking for a human being to walk still hasn't been able to be replicated by a robot to my understanding. I mean, maybe that's changed now, but it just speaks to what a phenomenal movement just walking is.

[A]

It's very complex.

[B]

Very complex.

[A]

We don't think about it because it's just something that we do, like breathing.

[B]

Yeah.

[A]

But it's a very complex movement. There's a lot happening between what we're visually seeing, what we're hearing, our vestibular inputs, what we're feeling. So we're gathering all this information and we're integrating it. And to see a walking gate, I think, is, you know, I could study it forever.

[B]

Yeah.

[A]

Because there's a lot of information you

[B]

can get in terms of practical exercises. We can't cover all of the ones that are in the book. We mentioned a few things so far. There's a couple I just wanted to bring up one I've already mentioned that single leg calf raise that you have in the book, a table at different ages. What should you be able to do? And I think that's an exercise probably like the ones you've already mentioned, that can be an assessment tool and a training tool. Right. So you do it. What are the cheats that people do without realizing it? Okay, so. Because I think I was doing one without realizing it. Right, so you're on one leg, you're lightly touching the wall.

[A]

Yes.

[B]

Why is it important that you lightly touch the wall?

[A]

It's not balance. We're not looking at balance. We want to have a little bit of control.

[B]

Okay, so. And how high should you come up?

[A]

When you look at the height of the calf raise, you want to get to the ball of the foot. And when you look at the ball of the foot, it should be flat on the ground.

[B]

Okay.

[A]

So oftentimes when I see someone do a calf raise, when they get to the ball of their foot, it's almost like it looks like they're going to sprain their ankle. Okay, so that's telling me, have they ever sprained their ankle? Do they have poor ankle eversion strength? Can they not get to their big toe? Do they have a pinching at the big toe that's preventing them from getting to the ball of the foot?

[B]

Do you know what's funny, Courtney? As you're saying that you saw some. I mean, I'm aware of these issues already, but I'm working on them on my right foot. Yes, but that's where I've always had my symptoms. I used to sprain my ankle, my right ankle. I used to play competitive squash as a teenager, and every. You know, with not, you know, with alarm and regularity, I would sprain my right ankle. So, you know, there's probably, you know, was it the foot problems that caused the sprains? Was it the sprain that has caused issues that I haven't properly rehabbed? Probably a bit of both. Who knows? But it's interesting, isn't it?

[A]

Yeah. You can always. Whenever I'm assessing someone's gait, you can tell the gait of someone with chronic sprains. It's their foot has, you know, the ligaments heal, the proprioception, how they feel the ground. That is what also needs to be retrained.

[B]

Yeah.

[A]

And so that's important. Getting them to feel where their big toe is again. You can see that in a calf raise if they don't have that good control or strength.

[B]

Yeah.

[A]

So height is one. You'll see people try to bend their knees. You'll see them try to.

[B]

You want a straight leg. You don't want any through the foot.

[A]

We're not trying to gain momentum and lean into the wall.

[B]

And you've got some of these videos on your Instagram, have you? Yeah, yeah. And we'll shoot some after as well and put them on mine when the podcast comes out so people can see that. So you can assess that if you're not where you want to be or even if you are, you can work on that, get better at it. The one maybe that I wanted to finish off with is the single leg balance test. And what I found really interesting is, well, in that section, you make the case that when you're walking, is it for 40% of the cycle, you're on one leg, so you have to be able to balance just to walk. Right. But you were saying in that section, which I found fascinating, the feet contain four types of receptors to help you, I guess, feel the ground and feel where you are. And then you said this, and this got me. Probably cause I'm 48. Right. You said, however, in the fifth decade of life. I thought, fifth decade of life. Okay, I'm not 50 yet. I think she's talking about me. I think I'm in the fifth decade of life. You need 20% more pressure to stimulate those receptors.

[A]

Yeah.

[B]

Okay, so talk to us about balance, why it's so important for walking, and what is the relevance of that stat? That when you get into your 40s, you need much more pressure to Stimulate those receptors.

[A]

Again, thinking about the foot like we think of the rest of the body. We know when we age, sarcopenia is a factor. We lose muscle mass.

[B]

Yeah.

[A]

So we also. That also occurs at the foot. So we have a foot that's starting to decrease strength. When we turn 50, all of those sensory receptors on the bottoms of the feet, those also start to dull, if you will. So it takes 20, 25% more pressure to stimulate those receptors.

[B]

When you say 50, it's the fifth decade, your 40s, or is it your 50 years old?

[A]

So 50. Oh, 50.

[B]

Oh, I'm good, I'm good. I should ignore that bit. I'm good. I've got a few more years left. Hey, I'm rocking at the moment. Good.

[A]

Yes. This is the conversation. So we gotta convince you that you need to pay attention to this now. So in the fifth decade, when you turn 50, you start to lose sensitivity to these receptors. This is how quickly things escalate. When you turn 80, that number's 75%. So the feet, they kind of dull.

[B]

They dull.

[A]

Here's the good news. Guess what? Increases sensory nerve fiber branching in the

[B]

foot movement and walking.

[A]

There you go. Exercise increases circulation, increases nerve fiber branching, increases sensation. So here's the hope conversation. We are all going to age, but when you strengthen your foot and you can improve the sensations at your feet, you're going to be able to walk well, you're going to be able to walk long and you're going to decrease your risks of falls. That to me. Sign me up for that.

[B]

Yeah. Have you had cases in your clinic of people with neuropathy already? So maybe they've had high blood sugars around maybe, you know, type 2, maybe they've been diagnosed with type 2 diabetes, maybe not. Or they've got a peripheral neuropathy from some sort of illness where effectively the nerves aren't working as well as you would want them to. Have you had patients who've come in like that and the exercises you've recommended have helped improve things.

[A]

There are so many treatments. Neuropathy is a difficult diagnosis. As you know, there are a lot of treatments that help, or so they say, help neuropathies, and they very well might. My patients that I have seen, they really struggle. But what they. The one thing that has helped these people consistently is exercising their foot, increasing circulation to their foot. And then they can add all the other things, the red light and their supplements and everything else that they're doing. But if you don't have that component of exercise in Conjunction with. I think you're missing a very big

[B]

factor there, goes back to the start of this conversation. Walking is a physiological necessity that your body requires for survival. And arguably, it becomes more important as you get older.

[A]

Yes. When you look at. As we age, too, there is a dramatic decrease in the step counts that you will start to see as people age. And that's what I want to encourage people do. You don't have to get to that 10,000 marker. Even at 3,800 steps, 7,000 steps, you start to see these reduced risks of dementia and depression and cancer. It's like this sweet spot, and we don't want to lose that capacity.

[B]

Yeah. There's stuff that maybe won't get time to talk about today, but I found fascinating in the book this idea that, you know, it's not just walking. It's, you know, you have all these kind of things like, roll the earth away, walk faster. When we walk taller, it lowers cortisol, improves memory. There was this thing about walking softly, and I stopped and laughed when you said that. We've all got that family member who you can hear coming a mile away, Mile away, you know, stomping around upstairs. I'm not gonna mention any names, but you were sort of saying how they might have a heavy heel strike and how you can correct that. But also, I think you were talking about how there's research showing that as you get older, your walking speed goes down and it can predict dementia by seven years.

[A]

I was just gonna say we gotta talk about walking speed.

[B]

Yeah, let's do it.

[A]

There were a couple researchers in 2009 that proposed that walking speed should be the sixth vital sign.

[B]

Yeah.

[A]

So when we go to the doctor, we get our blood pressure, our heart rate, our respiration rate, our oxygen saturation. These are all vital signs that are taken at the very beginning of your appointment to see. Hey, are there any red flags here? Is there anything going on with these vital signs that we need to be aware of? Because they will be predictors of a problem down the road. Walking speed should be in that category because that slower cadence. When you see someone walking slower, you need to start saying, why are they doing that? You can predict dementias by this slow cadence up to seven years. The research will say.

[B]

Does that mean a good annual practice or regular practice for all of us is to keep an eye on our walking speed? To go around my block when I was 40, took me. I don't know. You know, I'm just making it up 30 minutes. Right. Let's say if when you're 45, that has taken you 36 minutes, for example. I mean, that's probably quite a big decline, even 32 minutes, right? What does that mean? I mean, cause there's so many inputs to walking speed, aren't there? It's not just one thing. It could be muscles, nerves, maybe, you know, your visual, maybe your eyes. You know, there could be all kinds of factors.

[A]

That's why it's such a good. That's why it should be in that category. Vital. Because why am I walking slowly? Is it because I'm starting to lose strength and power? That's a problem. We can address it. Am I afraid? Am I starting to lose balance? That's something that we can address when we identify it. Is it slow cognitive decline? Are we having, Are we seeing cognitive decline? Because we know walking helps with cognitive decline. So just by looking at the speed of someone's gait can open up a lot of doors for opportunities for us to be better treating that patient. So if you were to walk, we want to see that number around 120 to 130 steps per minute. And it's not just, can I do this for a minute? The research, when you look at cancer risk reduction, for example, yeah, it's 30 minutes of brisk walking. You're moving. And so it might be great if you can walk around your block at that pace. But we need sustained speed. And I think that in itself is such a good thing for people to focus on. I'll have patients get a metronome. They can get it on their phone, listen to that beat and have every footstep match that beat. And I think you will find it's not as easy as some people think it is.

[B]

It's absolutely mind blowing. The other thing that I just wanted to add there is that maybe links this to your foot exercises. One thing I've experienced when I go and see Helen is that because she measures me every time I'm there. So you will walk on the treadmill at a certain pace. What often happens is that when we identify the exercises for me to do, sometimes it's just literally five minutes a day, right? I'll do them five minutes a day for four weeks. And then, you know, I might go back because my whole body efficiency has improved. I'm not trying to walk faster, but I'll go on and go, Helen, this feels really slow. So I'm at the same speed as I was maybe six weeks ago when it felt, yeah, that feels really good. I. E. My walking gait is improving. Not because I'm trying to improve it, but because I'm working on my feet and my other movements. I mean, do you know what I mean?

[A]

Power. That is something also that I think we forget is walking at a brisk pace is power training. We lose power faster as we. As we age, then we lose strength. And that I think we need to pay attention to.

[B]

What's the difference between power and strength?

[A]

So if I was going to be training strength in the gym, for example, slow, heavy loads. Power is how fast can I move that weight with a speed component. So, for example, if I was going to do a lunge, if I was power training, I would go down for three counts. One, two, three. And then try to shoot up as fast as I can. We need that power.

[B]

Yeah.

[A]

And that is one way to do it is by walking with a fast clip. That's exciting to me.

[B]

I feel like we're just warming up. Courtney, like, I've literally got so much to talk to you about. I feel we're only 10% of the way there. But I need to be respectful of your time. What have we covered so far? We covered so much. We've made the case of why walking is not optional. It is essential. As essential as sleeping and breathing. Right, so you've made that case. We've spoken about walking speed. We've spoken about the need to look after your feet, choose the right footwear. And in terms of practical exercises, we've talked about, you know, assessment exercises that can also be therapeutic. So how far does your big toe go up? How many calf raises can you do on the second in a minute? Single leg balance tests? We've mentioned single leg calf raises. Yes, I've already mentioned calf raises. Okay. We mentioned a lot so far, which hopefully has got people interested. You've also helped people understand how they might want to choose better footwear for their lives. So I think that was really interesting right at the end of this conversation, what I hope is the first of many conversations for that person, Courtney, who has listened to us so far and has had the realization they've never, ever paid attention to their foot health. They basically neglected it for the vast majority of their life. And they're perhaps wondering, is it too late for me to do anything about it? What would you say to them?

[A]

It's never too late. It's the beautiful thing about neuroplasticity. Our brains love novel stimulus. They love to learn new things. And I think that's such an encouraging point, is that it is never too late to. To drive new Information to our brains. If you have never put your foot on the ground, if that's where your journey starts, start there. If you're more into this journey, you can always add more loads, walk faster. So there's somewhere. This conversation is very inclusive because you really can find anywhere along the pathway to start here. And I think walking should be viewed. It is the most easily accessible, underutilized treatment that we have at our hands. It should be on every physician's treatment protocol. It should be on every physical therapist, you know, do these exercises because it's something that our body is craving to do as a human. It is. What we were designed to do was to walk. We were born to walk.

[B]

Yeah. Courtney, honestly, I think you're doing incredible work. The book Walk youk Life Depends on it is absolutely fantastic. Honestly, I'm such a fan of your work and what you're putting out in the book. We didn't get into your beautiful foot health kit today. Maybe we'll do that next time. But can we just quickly go through what is in this? Well, there's the book, of course. But then your company or your clinica. School Gates. Happens.

[A]

Yes.

[B]

Where's that based?

[A]

Colorado. We're pretty much online, though. It's more of a.

[B]

So you're online?

[A]

Yes.

[B]

And this foot health kit that you have that you've very kindly gifted me, and I can't wait to look at it. What is in it and how does it help people?

[A]

You know, we had the conversation of, gosh, you know, now I need to strengthen my foot. It becomes this thing. So what I wanted to do was make things very easy for people. I have been wearing toe spacers for probably seven years, consistently throughout the day. The only time you will not see them on my foot is when I'm sleeping.

[B]

Why not when you're sleeping?

[A]

I'm always. My sleep is my priority. And so I'm like, nothing's on my feet. I'm focusing on sleeping. When you're wearing the toe spacers and you're actively on your foot, the tissues in the foot are moving. So they have certain devices that you can wear when you're sleeping that will work passively. Right. So they'll work on stretching the foot. These are designed to be worn actively.

[B]

So you wear them and then you get on with your life.

[A]

Correct.

[B]

Fascinating.

[A]

On my weaker foot, when I first started wearing these, after about 10 minutes, I wanted to throw them across the room because then my toes were rubbing and it was so uncomfortable because I didn't have toe splay. So it takes time. But now I run in them. I wear them all the time.

[B]

Well, I saw you when you came into my house, you took your shoes off, you had the. What are they called? The toe spacers.

[A]

Yeah.

[B]

You had them in.

[A]

Yeah.

[B]

But you've got this little ball. Is that. What is that to roll? The sole of the foot.

[A]

The sole of the foot. But the reason I wanted that size was because we will also work on range of motion at the big toe. So that's another one of those drills that we'll do on how to improve range of motion at the toe.

[B]

Oh, maybe we'll shoot a little video on that now and see. But okay. So for anyone who wants to get one of these very exciting kits, which I'm actually very excited to see. Oh, my God. How am I going to incorporate these into my life? These are just on the website.

[A]

Yes, on the website. Gate happens.

[B]

Gate happens. Okay, so. And on social media, people want to sort of stay in touch with you and keep up to date with your content. Where is everything?

[A]

Everything's gate happens.

[B]

G A, I, T, G A I, T. Not G, A, T, E. Yes. Okay. Well, listen, Courtney, honestly, I love what you're doing. I love what you're putting out in the world. I really appreciate you making the journey out to the studio, and I hope to have you back here very, very soon.

[A]

Thank you so much. I'm so grateful to be able to share this message. It really is so important. So I can't thank you enough.

[B]

Really hope you enjoyed that conversation. Do think about one thing that you can take, take away and apply into your own life. And also have a think about one thing from this conversation that you can teach to somebody else. Remember, when you teach someone, it not only helps them, it also helps you learn and retain the information. Now, before you go, just wanted to let you know about Friday 5. It's my free weekly email containing five simple ideas to improve your health and happiness. In that email, I share exclusive insights that I do not share anywhere else, including health advice, how to manage your time better, interesting articles or videos that I've been consuming, and quotes that have caused me to stop and reflect. And I have to say, in a world of endless emails, it really is delightful that many of you tell me it is one of the only weekly emails that you actively look forward to receiving. So if that sounds like something you would like to receive each and every Friday, you can sign up for [e-mail] Friday 5. Now, if you are new to my podcast, you may be interested to know that I have written five books that have been bestsellers all over the world covering all kinds of different topics, Happiness, food, stress, sleep, behavior change and movement, weight loss and so much more. So please do take a moment to check them out. They are all available as paperbacks, ebooks and as audiobooks which I am narrating. If you enjoyed today's episode, it is always appreciated if you can take a moment to share the podcast with your friends and family or leave a review on Apple Podcasts. Thank you so much for listening. Have a wonderful week. And please note that if you want to listen to this show without any advertising at all, that option is now available for a small monthly fee on Apple and on Android. All you have to do is click the link in the Episode notes in your podcast app and always remember, you are the architect of your own health. Making lifestyle change is always worth it because when you feel better, you live more

[A]

SA.