The Life Changing Magic Of Walking & How To Do It Better with Dr Courtney Conley #660

Summary

Podcast Summary: The Life Changing Magic Of Walking & How To Do It Better with Dr Courtney Conley

Podcast: Feel Better, Live More with Dr Rangan Chatterjee
Episode: #660
Date: May 26, 2026
Guest: Dr Courtney Conley, Movement Specialist, Author of "Walk: Your Life Depends On It"

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Episode Overview

This episode is a deep dive into the underestimated power of walking as a cornerstone of human health, longevity, and daily wellbeing. Dr Rangan Chatterjee is joined by returning guest Dr Courtney Conley, who shares practical and science-backed insights from her new book, “Walk: Your Life Depends On It.” The conversation covers the myths and truths behind daily step goals, how to walk more efficiently, transitions to minimalist footwear, foot health, and the profound physical and social benefits of intentional walking throughout life.

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Key Discussion Points & Insights

1. The 10,000 Steps Myth & What Science Really Says

[02:47–05:34]

• Origins: The 10,000 steps daily goal is rooted in a 1960s Japanese marketing campaign for a pedometer, not in science.
  • Dr Conley: “It’s actually based on what we call a marketing hangover.” [03:02]
• Evidence: Health and longevity benefits plateau well before 10,000 steps.
  • Dr Conley: “Longevity benefit: anywhere from seven to 8,000 steps.” [03:44]
  • Even increases from 2,500 to 3,800 steps reduce all-cause mortality by 7%. [04:42]
• Key message: Any increase is valuable; perfection isn’t necessary.

2. Incremental Gains: Small Increases, Big Impacts

[07:21–08:53]

• Just 1,000 more steps per day (~10 min) can:
  • Reduce dementia risk by 25% at 3,800 steps
  • Decrease depressive symptoms at 5,000 steps
• Benefits stack: Improved sleeping, breathing, eating, overall wellbeing.

3. Walking Is a Biological Necessity, Not Just ‘Exercise’

[12:56–13:58]

• Walking stimulates “every system in our body” – metabolic, musculoskeletal, brain, even digestion.
• Should be as non-negotiable as sleeping or breathing.
  • Dr Conley: “Walking … should be viewed as this physiological necessity.” [12:56]

4. Modern Lifestyles and the Need for Conscious Movement

[10:17–11:50]

• Our environment encourages sedentarism.
• Movement must now be intentional—movement snacks and breaking up prolonged inactivity are key.
  • e.g., air squats, walking lunges, “microwalks” (5 min / ~500 steps).

5. Efficiency in Walking: Technique Over Quantity

[33:56–44:51]

• Cues for efficient walking:
  • Roll the Earth Away: Plant the heel, roll through the foot, push through big toe [33:56–35:05]
  • Walk Taller: Imagine lifting your head towards the clouds, enhances posture and breathing [40:27–41:57]
  • Nasal Breathing: Calms the nervous system, improves diaphragm use [42:29–43:46]
  • Arm Swing: Promotes upper-body rotation and better gait [65:11–68:27]
  • Walk Softer: Reduce excessive heel strike, especially if feet are stiff [62:34–64:02]

6. The Footwear Conversation: Minimalist Shoes & Transitions

[20:10–94:23]

• Gradual move from cushioned to minimalist (wide toe box, low heel drop) shoes is best, starting with short time periods and increasing as tolerated.
  • Dr Conley: “Wide toe box is my non-negotiable... That’s usually pretty easy.” [82:57]
• Transition tips:
  • Start with one feature (toe box), add ankle mobility/strength work, don’t rush to zero drop.
  • Use toe spacers, build up intrinsic foot muscles, and listen to your body.
  • Dr Conley: “You don’t want to have the always or never conversation... meet people where they are.” [85:26]
• Walking barefoot or in minimal shoes trains proper gait and foot strength.

7. Pain and Walking: Fear, Adaptation, and Confidence

[22:12–28:45; 105:12–110:54]

• Chronic pain and foot problems (e.g., plantar fasciitis, Achilles tendinopathy) shouldn’t mean stopping movement.
  • Movement builds confidence, even in pain; progression is rarely linear.
  • Fear makes pain worse (“fear-avoidance” cycle).
  • Dr Conley: “The goal is not to wait to move until you’re pain free.” [22:12]
  • Load and strengthen, don’t simply rest or deload indefinitely.

Notable Case:

• Christian, the firefighter: He overcame chronic heel pain by starting with microwalks, building confidence, and gradually increasing movement despite fear. [22:12–26:24]

8. Not One-Size-Fits-All: Step Goals, Age, and Types of Movement

[45:45–60:23]

• Focus shifts for those over 40/50/60: brisk walking is critical, but some intensity (VO2 max, power) remains important.
  • Dr Conley: “It’s not either/or, it’s and” (re: walking vs strength/cardio) [45:49; 55:05]
• Power (moving loads with speed—e.g., quick chair rises, “explosive” calf raises) is lost faster than strength. Both are vital for ageing well.
• Example: Jane, a “cardio queen,” reduced 15k daily steps to add strength/power, gaining bone health and eliminating back pain. [57:02–60:23]

9. Beyond Physical: Social, Emotional, & Spiritual Benefits

[69:17–72:50; 121:43–124:21]

• Relationship Walking: Walks with family (e.g., teens) facilitate conversation, bonding, and emotional regulation.
  • Dr Conley: “Within five minutes, that kid couldn’t keep her mouth shut.” [69:17]
• Long-haul walks (pilgrimages, multi-day hikes) offer opportunity for life reflection, growth, and healing.
  • “When your body is tired and your mind starts to quiet, the soul begins to speak. What unfolds is rarely just about the miles.” [122:09]

10. Practical Questions Answered:

[82:47–105:12]

• Transitioning shoes: Slow, deliberate process emphasizing gradual exposure.
• Foot and ankle rehab: Work all movement directions, no unnecessary rigidity/support, build variability and resilience.
• Common foot issues: Rehab focuses on strengthening and load, not just pain avoidance.
• Walking for frail/elderly: Never discourage; adapt with poles, small increments, minimal shoes if possible.

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Notable Quotes & Memorable Moments

• On starting small:

  • “Anything is better than nothing.” – Dr Courtney Conley [04:42]

• On foot pain:

  • “Pain is this normal human body experience. It’s a signal for us, and we should reframe that concept—how do I live well with this?” [22:12]

• On movement and modern life:

  • “With modern convenience comes responsibility.” – Dr Conley [10:27]

• On minimalist shoes:

  • “We can’t take advantage of joint range of motion and strength when our feet are moving like a block instead of dissociating.” [36:31]

• On confidence and fear:

  • “The brain rules the rooster, and you have to really listen to people.” [28:04]

• On walking’s necessity:

  • “Walking is a physiological necessity on a par with breathing and sleeping.” – Dr Chatterjee [26:24]

• On relational walking:

  • “When you get outside...the activity, the increase in heart rate, the increase in blood flow, she really, really opened up.” [71:32]

• On ageing and movement:

  • “You don’t want to have those conversations when you get older: ‘I can’t go on this trip with my grandkids because I’m afraid or I won’t be able to do things like walking up a flight of stairs.’” [79:58]

• Key message:

  • “You can. Anything… can change. It is a hopeful conversation. It’s what we as human beings were designed to do.” – Dr Conley [123:22]

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Timestamps for Important Segments

• 10,000 Steps Myth Debunked: [02:47–05:34]
• The power of 1,000 extra steps: [07:21–08:53]
• Movement as necessity, not exercise: [12:56–13:58]
• Practical cues for efficient walking: [33:56–44:51]
• Footwear & transitioning tips: [82:47–94:23]
• Treating pain with movement: [22:12–28:45; 105:12–110:54]
• Power vs strength; ageing well: [45:45–60:23]
• Jane’s story (strength & variety): [57:02–60:23]
• Relational/connection walking: [69:17–72:50]
• Long-haul walks & spiritual aspect: [121:43–124:21]
• Top takeaway message: [123:22–124:13]

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Flow & Tone

The episode maintains a warm, empowering, and practical tone. Dr Chatterjee and Dr Conley communicate with accessible language, mixing research, actionable advice, patient stories, and memorable analogies (e.g., “You don’t rest a tendon; you load it to make it healthy,” “walking is as fundamental as breathing or sleeping”). Both emphasize hope and agency—“it’s never too late, but never too early.”

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Final Takeaway

Walking is the ultimate, accessible, free tool for enhancing your immediate wellbeing, mental clarity, physical health, and long-term independence. Whether you're overcoming pain, building daily habits, revising your footwear, or connecting with loved ones, a little more intentional movement—one step at a time—has transformative power.

"You can... It is a hopeful conversation." – Dr Courtney Conley [123:22]

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For more practical tips, exercises, and detailed programs, refer to Dr Courtney Conley’s book "Walk: Your Life Depends On It."

Transcript

[A]

People take walking for granted until they can't. We forget that we need to incorporate this into our daily lives. It's never too late. Yes. Is it easier the earlier I start? Yeah. We want to avoid some of these problems. We want to take a proactive approach, not a reactive approach. There's no better time to start than now.

[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 Most of us walk every single day without really thinking about it, but this episode is guaranteed to change that. Because this simple, free, radical act is one of the most powerful things you can do for your body, your brain, and your longevity. This week, my returning guest is Dr. Courtney Conley. Courtney was last on the show only three months ago, and as soon as we finished recording that conversation, I invited her back on immediately because there was so much left for us to discuss about one of my favorite topics. Courtney is a world renowned movement specialist who's passionate about helping people move through life with strength, ease and confidence. And she's also the co author of a wonderful new book, Walk your Life depends on It. In our conversation, we discuss the origin of the 10,000 steps a day target, how adding just a thousand steps each day can lower your risk of dementia, depression and all cause mortality. And Courtney shares some of her best practical cues to help you walk more efficiently, including rolling through your feet, walking tall, and nasal breathing. We also discuss the potential problems of walking too much, especially if that means you neglect strength and power. She shares practical tips for anyone wishing to transition from cushions to minimal footwear, and also how best to manage foot issues like plantar fasciitis, Achilles pain, bunions and osteopenia. Whatever your current level of health or mobility, I'm quite certain that there will be something in this conversation that deeply resonates, and my hope is that it inspires you to move forward in life one small step at a time. In your brand new book, you talk about the 10,000 step urban legend.

[A]

Yes.

[B]

You describe it as a persistent myth that has actually had a deleterious effect and discouraged many people from because this daily step goal feels out of reach to many. Is 10,000 steps a myth?

[A]

It is. It's actually based on a we call it a marketing hangover. So in the 1960s there was a Japanese company that produced a pedometer called a mampoke, which actually means 10,000 step meter. So it was more designed just as a marketing campaign. And then what's really wild is that that has been adopted as the step count that we should all be trying to reach, when in fact there is no science behind that number. And I think when people think 10,000 steps, it can be very daunting. But when you look at the science, it's actually much less.

[B]

So what does the science tell us about the amount of steps we need to gain certain health benefits?

[A]

So it's very individualistic. So depending upon where you start, what your baseline is. But if you were to look at just an overall number, where are we going to maximize longevity benefit? You're looking anywhere from seven to 8,000 steps.

[B]

Seven to 8,000 steps. So what's interesting, as I sort of think about the walking literature, and of course in Walk your life depends on it, which is certainly the UK name off your latest book. What I really like about it is that you make it very accessible. Right. So we'll come back to 10,000 sets in just a minute. Cause I actually have quite liked that as a guideline. But I totally understand where you're coming from, which is that can be off putting to people. And some people might go, well, I can't reach 10,000, so what's the point? And I think you've quoted research in the book saying that even going from what, 2,500 to 3,800 steps a day gives you some benefits, reduces all cause

[A]

mortality by 7%, which is, you know, I have plenty of patients that have been in chronic pain where these are the conversations that we're having where anything is better than nothing. So I think that's very encouraging for people that live on that end of the spectrum where they've been in chronic pain for a while, they're afraid to put their foot on the ground and it's okay, we're gonna take what we've termed a microwalk, which is five minutes, which gives you about 500 steps. And it builds confidence in people's movement. They start to trust their body again. And I think at that level that really is priority.

[B]

So it's not that you have a problem with an individual doing 10,000 steps a day. You're not saying that's negative for that individual. You're saying as a public health guiding principle, we should be making it more accessible.

[A]

Yes. And you know, when you look at the research, it does seem to plateau from a longevity perspective at about 10,000, 12,000 steps. So on the other end of the spectrum, if my patients will say, I'm walking 15, 16,000 steps per day, Wonderful. Are you also strength training Are you doing these other things that are necessary for living well as you age? And if the answer to that question is no, because some of my patients will say, well, I just don't have time because I'm walking 15, 16,000 steps a day, then we have the conversation of what if we dialed it down? Let's bring you down to 10 now. I give you some time back. Now we can get you in the gym, we can strength train and start making your fitness a little more well rounded.

[B]

Yeah. I think that's a great case study in the book of Jane, who calls herself a cardio queen, who was doing 15,000 steps a day. Right. And you had to actually bring her down so that she could add in strength. And, you know, I think you added in nasal breathing while she was walking and all kinds of things. So maybe we can talk about her a bit later in terms of making walking more accessible, because I very much agree with you that, you know, the central message in this book is that walking is very much one of the most underappreciated elements of health and longevity. You were on the Chris Evans radio show yesterday. He described your book as a love letter to walking, which I thought was a beautiful way of describing what's in the book. Let's make it super accessible for people. If you add 1000 more steps to your daily step count, what could that potentially do for us?

[A]

So if you were. If we were gonna throw out some numbers, if you were to get to 3,800 steps per day, you can reduce your risks of getting dementia by 25%. If you were to jump to 5,000 steps per day, this is a big one. I think you can reduce the symptoms of depression. And I just want to pause there for a second, because my patients that live below 5,000 steps, below 2,500 steps, there is very often this mental health challenge that they are also facing. It's almost like the lack of step count goes hand in hand with. With feelings of sadness and depression. And I think that makes sense because of the lack of movement, the lack of this core biological input that our brains need.

[B]

Yeah.

[A]

And so depending upon where someone is along the spectrum, adding in 1,000 steps, for example, which is about 10 minutes, can really bump you into different categories. When you get to 7,000 steps, you reduce your risks of getting dementia. And I think it's this stacking of behaviors. So I start walking more, then I'm sleeping better, then I'm breathing better, then I'm eating better. So it's building this foundation that then Our health can expand upon with something that is so easily accessible and underutilized.

[B]

Yeah, it really is incredible. It reminds me of something that we spoke about when you were first on the podcast a couple of months ago. This idea that, yes, exercise, movement, walking is good for us and, you know, can reduce your risk of dementia, it can help you live longer. I mean, some research suggesting maybe 10 years you can live longer. Right. Reduce your risk of depression, all that kind of stuff. And the flip side is that maybe it's not that the movement is good for us, it's that the lack of movement that many of us have in the modern world is devastatingly bad for us.

[A]

Yeah, I think, you know, after we spoke last time, I was thinking about that quite a bit. And if we were to flip the script, because I think people take walking for granted.

[B]

Yeah.

[A]

Until they can't. Because if you were to ask someone, how would you feel if you couldn't walk? It's almost like a panic, like, well, that would be terrible. I mean, think about it. You couldn't, you know, walk to your mailbox, walk around your block, walk with your friends, play with your grandkids. I mean, everything really is surrounded by and for human propulsion and gait. And so when we take that away, whether it's because we choose to by a sedentary lifestyle or we're in pain, it really compromises our health.

[B]

Yeah. In your experience, what are the common reasons why people don't get their steps in each day?

[A]

I think with modern convenience comes responsibility. We have to think about it more now. You know, when you are working from home, for example, and you're sitting in front of your desk for eight, nine hours a day, you have to consciously be aware and take breaks or else you could just flow right through your day without getting much movement at all. So it has become more of this awareness. You have to really be diligent about saying, okay, it's time for me to go for a five minute walk. It's time for me to get up and move around. In the book, we have all those movement snacks in there. You could do 10 air squats, you could do walking lunges, you could get outside and take a five minute walk. You just have to interrupt prolonged activity. And it's become very easy to forget to do that. So that's where I think it's important. I think the other conversation there is when people get their morning workout in. So I ran for an hour, I went to the gym for an hour before my workday. That hour of activity doesn't excuse you from movement throughout the day. It doesn't take away prolonged activity like sitting all day long. So there has to be this interjection of movement that people need to be consciously aware of because it just doesn't happen easily anymore.

[B]

Yeah, I love this idea that with modern conveniences comes a responsibility. And this may not be the perfect analogy, but I guess if you were someone who liked vintage cars, for example. Okay, maybe this comes to mind because we've just spoken about Chris Evans. Chris does like vintage cars. Right. You don't just leave that car, I think. And if there's an enthusiast listening who wants to correct me, please do. But I guess the point I'm making is if you just kept that not moving at all for like four months at a time, there would probably be an issue. Now we're not cars. I understand that. But that whole idea of a responsibility to our body that it has to be moved otherwise it won't function. It needs the lubrication. Right. It needs to the oil change or whatever it is. It's like, you know, that's kind of what happens when we move. Right. You know, everything works better when we've moved and in particular when we've walked. There's something quite different about walking, isn't there?

[A]

It's this core biological input that stimulates every system in our body. Think about strength training, for example, which is very good. I'm very obviously a very big proponent of that. Strength training happens a couple times a week. There's a recovery that has to occur. Walking is something that happens every single day, like breathing and like sleeping. It should be viewed as this physiological necessity that is non negotiable. It's this low to moderate repetitive activity. So it's from an intensity perspective. So there's less loads per se than running. We get our heart rate up, but we're not maxing our heart rate. So it's this kind of constant churn that can stimulate our metabolic system, our musculoskeletal system, our nervous system, our circulatory lymphatic system, our brains. So it's just kind of the. Yeah, you know, it ignites our, our

[B]

bodies in terms of unexpected benefits of walking. One thing I used to see a lot of in practice as people who didn't walk enough or move enough, I should say in general, I would find that sometimes when their movement increased, their gut functioned better. Right. Their constipation went Right. Without changing their diet. Because, you know, there is. I think we touched on this in the first Conversation. There is this kind of contralateral movement going on. You know, this change. The upper body's going right, lower body's going left, and it almost twists the middle and your gut and your bowel. Right. So it can massively help with gut function as well.

[A]

Yeah. I think that when you look at that cancer research, which is really fascinating, I think that the mechanism behind some of that cancer research, that when you get to X amount of steps seven to 9,000, for example, you reduce your risks by 16% when you're walking at a brisk pace. You're improving your insulin sensitivity, you're improving your gut biome. So I think those factors are why we're seeing these really exciting findings with this cancer research.

[B]

One of the things I've done recently, I've been walking more and more over the last few years. I've recognized how important it is. And we're currently recording this conversation in the British spring. So we're having light mornings now. Okay. So currently it's maybe getting light around 5:20. And I'm an early riser. Okay. Always have been. I go to bed early, I get up early. And in the winter I'll probably meditate first thing. And then at some point when it's light, sometimes after the kids have gone to school and depending on what's going on with work, I'll try and walk. But I've actually changed my pattern recently because I know the number one thing I want to get in each day is a walk. Now, I personally am trying to get 10,000 steps a day. You know, I say that understanding that not everyone is going to be able to do that, but it's been transformative. You know, I get up, I have a coffee and I'm out.

[A]

Yeah.

[B]

And then I'm back to make the kids breakfast or whatever it might be. Right. And even if I play paddle later on in the day, like, I've. I remember the other day I was like, rongan, paddle great. Okay, no problem. Have fun. A lot of coordination, a lot of sprinting on the court. But it's not a substitute for your daily walk. You still need to get the daily walk in when you can.

[A]

That's if there's one message that is that is it that that is so important and it cannot be missed. And there's something very special about that morning walk. It just kicks off your day. You have sunlight, you get your body moving. I mean, it is. It does kind of. I do the same thing. And if I were to miss it, it does change. Change things.

[B]

Yeah. So we want to make this super accessible. Okay. So I totally recognize that people may not have the same level of autonomy that I have around my work. Okay. They may have a lot of family commitments or family pressures. So one of the things we didn't talk about in our first conversation that I wanted to, and I think we should talk about it today, is your build program. Right. So towards the end of the book, you really sort of break it down like we might do strength training or something else where it's like, okay, here's where you are. And there was sort of three different categories, weren't there? So can you kind of talk us through some of those general principles?

[A]

Yeah, there's. When we decided how we wanted to outline these programs. You have to meet people where they are. So in the base program, this is for someone who has been in chronic pain, who is less than about 2,500 steps. And in that program, we encourage these microwalks. And again, we're building confidence in their movement, getting their foot on the ground. The build program is where we think most people are going to live. This is when you get to that 7,000 sweet spot range. This is eight weeks. So throughout the program, we talk about starting at your daily walk happening four times a week. Then we increase by 500 steps to 1,000 steps. So it's this very digestible program that is very focused. That's when we had talked about earlier what has happened. We forget that we need to incorporate this into our daily lives. So it's outlined in an easy way for people to understand. The other key thing with that program is working on cadence and speed, because that's where the magic happens.

[B]

Well, we'll come to speed in just a minute. This idea that we need to build slowly is something that runners are familiar with.

[A]

Yes.

[B]

Right. People know if they get into running or they sign up for a half marathon and they look at any training plan. One of the things many of the plans will say is, don't suddenly increase your volume. Correct. But I think we intuitively understand that with running because it feels like. Yes. High load on the body. Right. You're applying this similar principle, I think, to walking. Whereas some people might go, yeah, but walking doesn't have the same loads on the body as running. Why do we need to build it slowly? Why can't I just go from 1,000 steps a day to 7,000 steps a day? For example?

[A]

Some people might be able to.

[B]

Okay.

[A]

It's their bottom line level of fitness. You know, maybe the reason that they're just not getting their step count is. Is not because they can't. More of a time factor. So some might be able to. So that program outlines more of a time inventory for them. That might be how they focus. But then there's other people who actually need slow, progressive loads. And that's where that becomes important. It is still a load through your body. It's just less than running. The other conversation is if someone is working on that program and transitioning into different footwear.

[B]

Yeah.

[A]

Because that is where we really wanted to highlight that those things take time and they need to be transitioned safely because those are definitely different loads.

[B]

Yeah. We spent a lot of time last time talking about footwear and foot health and the difference between cushioned shoes, functional shoes, and minimalist shoes. So we don't need to re. Go into that. People can listen to that first one if they want to get all that information. But I think later on today we should absolutely cover how to transition from cushioned shoes to minimalist shoes. Because we've had a ton of questions about that. Okay.

[A]

It's probably the most frequent question I get in my clinics. How to do it, how to do it.

[B]

Cause people want to do it. I think these days they hear about the research on minimal issues, they go, yeah, kind of. It makes sense. I want to be in that. But how do I do that when I've spent the last 30 years in cushion shoes? Right. So we'll come to that. But in terms of this kind of build program. So you're saying at the moment, start small, anything is better than nothing. You know, getting from two and a half thousand steps a day, I think, to 3,800 steps a day. You know, I think. Actually, I'm not sure you mentioned this one yet. I think you said in the book that if you can do that, if you add 1000 steps per day on top of an existing baseline of at least 2,500 a day, that decreases all cause mortality by 15%. And so you surmise that actually if you're 70 years old, that could potentially extend your longevity by 10 years. Right. So, hey, listen, if you want to get to 10,000 sets, I mean, great. But if you're stuck at two and a half, even getting to 3, 8, 4000 will give you measurable benefits, which is amazing. Foot pain, of course, is one of the things that stops people walking. Right. And there was an example in the book of, I think, a firefighter called Christian. Yes, right. Do you remember the story?

[A]

Oh, yeah.

[B]

Can you explain it? Because I think it's Quite useful here to explain, to really talk about the new model of why pain doesn't always mean stop moving.

[A]

Yes. You know, when I first got into clinic, that was what I used to tell people, you know, come see me. We'll get you pain free. And I have really changed my tune there. I think that's not correct. I don't think the goal is to wait to move until you're pain free. People will be waiting a very long time. Pain is this normal human body experience. It's a signal for us, and we should look at it a little bit differently. We should reframe that concept, saying, how do I live well with this? How do I continue to move with my pain? Because we know it is so very complex, rather than saying, I'm not going to move until I'm pain free. And that's exactly what happened with Christian, is he had had foot pain for three years. He was training to be a wildlife firefighter, and he got some heel pain, and it lingered. And three years later, he was in my office. And in three years, he had gone to see many people. In fact, the last person that he had gone to see said they want him to decrease his step count to below 2,500 steps. Three years into this conversation, you don't want to be telling someone to decrease their step count. Remember, the less step count, Right. That's highly correlated with not feeling too good mentally. Their mental health starts to decline. So you know that with him not getting these steps in, that that was not gonna be a good idea. So he moves into his father's basement, and now he's pretty much become, I wanna say, almost a prisoner in his house. And I do see this often with patients. So he came to see me, and we really had to have a lot of conversations about pain, about education. And we started him with the microwalk, which was five minutes, which is about 500 steps.

[B]

Would that cause him pain?

[A]

He was scared. He was scared. And his foot at this point is so sensitized. His nervous system was so sensitized to what his foot was feeling, that when he experiences people pain at his foot, it wasn't matching the tissue damage. You see, his sensitivity was high. So he's feeling his foot on the ground. He said, oh, my gosh, my foot hurts. But from a tissue perspective, they weren't lining up. So we had to encourage him. Listen, let's go for five minutes. See how you feel. See how you feel that night and the next morning, it wasn't any worse, it wasn't any better. So I said, this is good. Now, over the next couple days, you're going to add another five minute walk. So he started to adapt and he started to say, well, whether I go walking or not, it's not getting better or worse, so I might as well just keep going. And so we slowly started to build and then his confidence started to come. Then we started doing foot exercises. We got him into different footwear and it was. It's one of my favorite cases because to this day he sends me text messages when he's like, hiking a mountain or hiking on a trail. And it just warms my heart. And it's why I'm reminded of why I do this. Because when you cannot walk, it literally affects so many systems in your body. And what's most detrimental is, I think, what it does to your mental health. And it was just really encouraging to see that. And it took time.

[B]

Yeah.

[A]

And the other thing I told him was when you are experiencing pain, the recovery is not linear. It's not, one day you're gonna feel a little bit better today, and the next day it's a little better. And the next day it doesn't work like that. It's up and down and up and down, but the trajectory goes up. And that's what we really wanted to do with him. And he was just wonderful. And he's really doing well now.

[B]

It's interesting that throughout this conversation already, the word confidence has come up several times. I think it's something we don't think about enough when it comes to our wellbeing, how we feel about ourselves, our self esteem. As you said at the start, you know, walking is fundamental to who we are. Just to walk around the house, to pick something up. Let's say you even drive to the supermarket. You still gotta walk around when you're there to get the stuff right. In many ways, I sort of feel walking should be kept separate from exercise. It's like, yes, I know it is, but it's almost its own category. Right. The human body, as you beautifully say, you know, walking is a physiological necessity on a par with breathing and sleeping. Yes, right. Very provocative statement for so many people. But the other thing Courtney there you said, which I think is really important, is that Christian was scared. Yeah. And I recently had Howard Schubineau on for the second time. The podcast has not come out yet, but I think you would love his work. He's a consultant MD in pain science and he has published lots of research and quotes many other researchers demonstrating how fear makes our pain worse.

[A]

Yes.

[B]

Right. So the cycle starts, doesn't it? You've got pain, you might have had an injury, but then the fear of moving on, it starts to create this vicious cycle where you have even more pain. And then someone like Christian, three years later, he's still not walking. You know, I think he was in his twenties when this happened. So I can't imagine what that does to you in your 20s in terms of how you feel about yourself.

[A]

I think that's the biggest factor, especially three years into a diagnosis. You know, if this was, if he had seen me three months prior after the injury, we're having a different conversation. But three years, this is a layered. There is a big, beautiful person behind that diagnosis of heel pain. And you cannot just treat the heel, you have to treat their emotions, how they feel, their confidence. You have to build this trust so that they can start to trust their bodies again. And that's what I think is so important because the brain rules the rooster and you have to really listen to people.

[B]

We previously spoke about this idea that all of us will have a different walking signature. It's unique, very much like a fingerprint. But despite that, what you're hoping to help your patients and therefore us with is improving our walking efficiency.

[A]

Yes.

[B]

What does walking efficiency mean? Foreign. I am really excited to share that I am bringing my Thrive tour, transform your health and happiness to Canada and Europe this September and November. It's a live, interactive, uplifting show that over 20,000 people came to last year across the UK and Australia. I'll be sharing powerful stories, life changing insights and simple tools that will inspire you to feel better, think clearer and live with more intention and joy. To get your tickets right now and see all of the dates and venues, go to Dr. Chatterjee.com forward/live. I really hope that you can join me. Today's episode is sponsored by AG1, a daily health drink that has been in my own life for over seven years now. This is the time of year when our immune systems are under the most pressure. Between spending more time indoors, travel and seasonal bugs, it's natural to look for extra ways to support our immune defenses. But most people don't want to juggle multiple pills. They want something simple, effective and easy to stick with. AG1 is a daily health drink that provides key immunity supporting nutrients, vitamin C, vitamin A, zinc and selenium, all of which contribute to the normal function of the immune system. These nutrients are included in highly bioavailable forms, meaning they are much easier for the body to absorb and use. Backed by clinical research, expert formulation and continuous improvement. AG1 has been in my own life for around 7 years now and each batch is independently tested for quality and safety. That's how they guarantee what's in your scoop and what's not. And the best thing, of course, is that all this goodness comes in one convenient, tasty daily serving. For a limited time only, get a free AG1 flavour sampler and AGZ sampler to try all the flavors. Plus free vitamin D3 and K2 and AG1 welcome kit with your first AG1 subscription order. That's $87 in free gifts for first time subscribers. See all [e-mail] LiveMore.

[A]

So as human beings, we were designed to walk upright, balanced for long distances. It should be. When you see someone walk, I love it. It's like it's a window to their soul. It's like this neurological window and you can tell when they're happy or sad or in pain, if they just got fired, if they just got promoted. All in this signature of how they carry themselves and how they walk. I don't think we want to take away the uniqueness of someone's individual gait. It could also come with traumas or what have you. But what we do want to create is this efficiency because we should be able to very easily get to that magic step count number and feel well doing it. So when we look at efficiency, it's, you know, when I first look at someone, when I'm assessing their gait, do they look comfortable? Do they look relaxed? Are they holding their breath? Are they stepping into a pothole on one side where they kind of look like they're tilting, Are they swinging their arms? Those are the, you know, big things that I take a look at to see how comfortable they are in their walking gait. And then I break it down into, if they aren't, where's the stone in the river? What's preventing this efficiency? Is it a range of motion issue? Is it a strength issue? So that's how we kind of go deep there.

[B]

So all of us could potentially think about our walking and think about some of those concepts and think about improving our efficiency. No matter how we currently walk, we could, we could change the way in which we walk. There's a lot of practical guidance for how to do this in the book. I wonder if we could go through some of those steps, right? Roll the earth away. What does that mean?

[A]

I love this. So when you're walking and your foot can feel the ground, a walking gait is different than a running gait. So when you're walking the heel, you graze the heel. And this is what initiates the. The foot to lengthen or to pronate. So this is when we start absorbing shock. And then we absorb shock, we roll through the foot, we get to the big toe and then we push the earth away. You're kind of rolling through your foot, pushing the earth behind you. It's a beautiful thing and you should be able to feel it.

[B]

So even just that take home message to people, next time they go for a walk, they can start to think about rolling the earth away as they walk.

[A]

When the heel strikes, it's this. Think of just this almost like a wave. And this foot is. It adapts, it's the central nervous system is causing this foot to change shape and to adapt to terrains, for example, and that's important. We need to be able to absorb shock and the foot needs to be able to stiffen for propulsion.

[B]

Yeah. And as you say, roll the earth away. I'm just feeling in my head, I can just almost feel this beautiful stretch on the fascia at the bottom of the, you know, on your soul, you know, almost like a massage every time you roll through. Right. Having said that, I know we covered footwear last time. We will definitely in this conversation as well. But one of the things she writes about in the book is if you have one of these modern stiff soled shoes, it's hard to roll the earth away, isn't it?

[A]

Oh, yes. If you look at some footwear and you try to bend it, just take the shoe and try to bend it in half. If that shoe can't bend, you can't roll anything. You can't roll your foot through there, you can't get big toe extension. So if you were to take the shoe and bend the front of it to see how well the tip of the shoe were to bend, some shoes are very stiff and you can't extend your big toe. And here's the problem with that. If I can't extend my big toe, it's not just a big toe problem. It's going to affect what happens at my ankle, at my knee and at my hip. When I see people walk in that type of footwear, there isn't any. There isn't this efficiency or there's three rockers to the foot.

[B]

There's no fluidity, is there?

[A]

There's no fluidity to the foot at all. And so you'll see them start to pick up their foot and place it down, pick up their foot and place it down. That is inefficient. So we can't take advantage of joint range of motion and strength when we can't actually feel what our foot is doing. And the foot is moving like a block instead of dissociating.

[B]

Yeah. I spoke to Helen yesterday, my movement coach, who I spoke to you a little bit about last time, and Helen loved our first conversation together. And she's got this incredible piece of technology that I think there's only 10 in the world now where she can measure everything in your body as you're walking on a treadmill, all your spinal movements. It's phenomenal. And she has measured for several years now. I'm talking about walking here, not running. Okay. Walking that when people wear cushioned shoes and walk, there is more impact going through on every joint. They don't feel the impact because they think, oh, you know, I'm on a clouds. Right. But actually there's more impact going. So almost our feeling is misleading because we think, yeah, I'm not putting any pressure on my joints at all. But we're actually over pressuring them. Because it's inefficient walking.

[A]

Yes, it's very counterintuitive.

[B]

Exactly.

[A]

Because when someone has knee pain, for example, they think, I'm gonna go wear this cushioned shoe and it's gonna help shock absorb my joints. When, in fact, when you take your shoes off, one of the things we talk about is how you adopt a softer gait because you're getting feedback from your foot. The receptors in the foot are going, hey, you're landing too hot and heavy. Lighten up a little bit. Bring your foot closer to your center of mass. So that's one thing that happens when you can feel the foot is you start to change how you're striking the ground. Not to mention with cushion, there's changes in the forces of how that foot hits the ground. And that's those forces that she's referring to there.

[B]

Yeah. It's kind of interesting. This is so obvious when you are used to minimalist shoes, right?

[A]

Yeah.

[B]

I think we both had experiences recently. Well, not that recently, but where we wear minimalist shoes. But for a wedding, for example. Yeah, but this was seven, eight years ago now where I wore these Italian dress shoes. And you don't realize how they're restricting your movement until you're used to barefoot shoes or minimal shoes and you go in a stiff sole shoe. You're like, what? You know, it's, I can't move my feet. They're like, they're almost being. They're in prison here, basically. So I think it's obvious when you go the other way, it's probably not so obvious. If you're used to these shoes, which most people are wearing, you're like, they almost have to take our word for it, don't they? But I guess you could experience it by walking. If you're lucky enough to have a garden and you walk barefoot on the grass, you can start to feel that fluidity in the sole, can't you?

[A]

My favorite thing my patients will say after they've been introduced to this type of footwear is, I just kind of keep my mouth shut. I educate on the front end, and I said, this is what we're going to try. They come back and they're like, my foot feels better. My back feels better. Their gait changes because that's how we were supposed to walk, is allowing our foot to feel. And so when you get on the other end, when your foot starts to change shape, your toes might splay some more. Your foot gets stronger. Trying to put that foot, that healthy foot, into most traditional footwear, now you really got problems.

[B]

Yeah.

[A]

Because you put your foot in there, like, man, this thing is tight. How was I wearing this before? My toes are going numb.

[B]

Yeah.

[A]

So I'll always. Which I don't know why I do this, but I have a couple old shoes that I used to wear, and I'm talking, like 15 years ago, and I'm like, let me just see what it feels like. And I'll go out my door for three minutes. And I'm like, nope, I'm coming right back. Because it does. It just feels so different.

[B]

Yeah. Walk taller is something else you write about when it comes to walking efficiency. What does that mean and why is it so beneficial when we give people

[A]

gate cues, you don't want them to think about too much. We can't have people thinking about, well, what's my heel supposed to be doing? Should I be pushing through my big toe? Should I be rotating my pelvis? Should I be internally rotating my hip? All of those things are true. There's a lot of beautiful things that happen in a walking gait, but it's complex, and you cannot have people overthinking this. Walking should be enjoyable.

[B]

Yeah. You can't micromanage it in the moment.

[A]

That's right. So the cue of walking taller, just trying to get your head towards the clouds. So many things happen with just that cue. For example, one of them is the use of your diaphragm. So it changes our posture and we can start utilizing one of the most important core muscles, which is our diaphragm, to keep us upright. It enables better breathing. The other thing that can happen is it changes our strike. So when I have a tall posture, my foot is going to strike closer to my center of mass. That's what we want. It's this grazing of the heel. So when I say walk taller, there's all these biomechanical things that are occurring just from that cue that they don't. That someone doesn't need to think about other than walk taller.

[B]

This is great, Courtney, because I imagine there's going to be a lot of people listening who are very health conscious and have managed to create time in their day to walk more. But you're not necessarily saying you have to increase yourself. Let's say someone is getting 7,000 steps a day. It may be that. Hey, keep doing that. You found the time for that. You've got that in a rhythm. Great. Now, during those 7,000 steps a day, try and roll the earth away. Try and walk a bit taller. So you're actually getting more out of those 7,000 steps.

[A]

That's right. Nasal breathing is one.

[B]

So why is nasal breathing so important?

[A]

We interviewed Brian McKenzie, who's really specialized in.

[B]

I love Brian.

[A]

Yeah, he's great. And he said one of the lowest hanging fruits from human metabolism and human function is to be able to walk nasal breathing for 60 to 90 minutes. When you're nasal breathing, it does. It changes your inputs. It kind of calms your nervous system, how you're utilizing and using your diaphragm. So it becomes a challenge for a lot of people. When you start increasing your speed and your heart rate goes up, we need more oxygen so our mouths open. So if we can start to play around with this nasal breathing, we can also create efficiency. And I really like that as a little challenge for people. But, you know, be smart about it.

[B]

Well, interestingly enough that you said when you walk taller, your diaphragm is able to work more efficiently. When you nasal breathe, as opposed to mouth breathe, your diaphragm is able to work more efficiently. Right. Because, of course, everything's connected. But I guess you can take that cue and go walk taller and try a nasal breathe.

[A]

That's right.

[B]

And you'll get all of these incredible benefits.

[A]

Yes.

[B]

And I just want to highlight. This is free.

[A]

Yeah, Right.

[B]

You don't have to buy anything here. This is completely free of charge.

[A]

When we look at what that does to our posture, for example, one of the things I'll notice when people are walking and they're either in pain or they are not efficient is they'll suck in their bellies. So they'll be sucking everything in. Okay. It is hard to breathe, period, when you're sucking in your stomach, it's very hard to nasal breathe. So when someone's walking taller, it's also just relaxing. I will often give the cue of do the opposite of suck in. You know, we have this. You know, we'll see people walking around and they'll want to suck in their bellies. It's the opposite of sucking in. It's relax so that you can breathe, so that you can rotate your body and swing your arms. When you have this tension in your belly when you're walking, the gate becomes very stiff, and that's not what it should look like. It's calm.

[B]

Yeah. I want to get to some more of these walking cues, but I had a thought relating to the start of our conversation, Courtney, and that is we're mentioning all the incredible benefits of walking a little bit more, and if we can walk more efficiently as well, even better. There's quite a lot of people out there who have grown up with the idea that intensity, intense cardio is really, really important for health, for weight loss, for fitness. I know you have to assess each individual, right. Because we're all going to be different. But as a general principle, would you say that, you know, as people get older over the age of 40, over the age of 50, over the age of 60, that in many ways the focus should be more on walking than intense cardio?

[A]

That's a tough question.

[B]

I know it is.

[A]

That's a tough question.

[B]

Cause it depends.

[A]

It does. And I think it's the. And conversation. Yeah, I think you need both. I think you need to be able to walk at a brisk pace for 30 minutes, 135 steps per minute. But I also think that we need to train VO2 max and get into the other end of the spectrum, regardless of age. I think that's very important. But this daily input of walking at that intentional walk with 30 minutes at that brisk pace, the health benefits there, this happens every single day. This is an input that occurs every single day. And I think also as we age, the other conversation I like to have there is about power. We lose power faster than we lose strength.

[B]

So what's the difference?

[A]

Power is reactivity. So, for example, it would be, can I get up and off of a chair if I'm walking across the street? And a car Comes. Can I quickly move?

[B]

Some people may think, well, isn't getting up off a chair strength? So I'm just trying to make sure people understand the difference between strength and power.

[A]

I think when we look at power, some people look as training power only for athletes, for example.

[B]

Okay.

[A]

But power is being able to move loads with speed. So if I were going to get up off this chair. Okay. And I had to, like, slowly get up off the chair and use my hands, this is not power. I need to be able to get up off of the chair. Pushing load at a certain speed, it's quite.

[B]

I didn't think about it like that. But getting up off a chair,

[A]

in

[B]

some ways it's quite an explosive movement. But you wouldn't use the term explosive to really think about getting up off a chair. But in some ways it is, well, how about walking?

[A]

If we look at walking, would you say walking is a power movement?

[B]

Until I read your book, no.

[A]

Think about speed. If I wanted to walk at a fast pace to really reap the benefits of what happens when we can push through our foot, that's power. That's foot and ankle power. Being able to roll through the foot to propel through the ball of the foot, that's foot and ankle power that we lose quickly. So not only do we strength train, but we also have to power train, which is basically taking the same movement and moving it quicker.

[B]

Yeah.

[A]

So, for example, if I was going to do a lunge, I would go down for three counts. Right. Slow and up for one. So I'm just moving faster under load.

[B]

And we lose power faster than strength as we get older.

[A]

Yes. And how am I supposed to walk fast if I can't produce power at propulsion? You don't. I was having this conversation with my father. He's like, you know, Courtney, he's like, you know, I was walking the other day and I just felt like I had to pick up my leg and drop it down. And pick up my leg and drop it down. He was losing power because he couldn't push through his foot and ankle. And I said, dad, we need timeout conversation here.

[B]

So do we train power whilst walking or do we train power separately, which then enhances our walking?

[A]

I think both. I think we have to train power separately. So, for example, calf raise, we could work on same concept. Going down slow, pushing up fast, little vibrations. If you don't want to jump, there's always somewhere that you can fit along that. I'll have some patients put their hands on the wall and just bounce their Heels.

[B]

Why?

[A]

You can train double leg hopping, single leg hopping, depending upon what you're comfortable with.

[B]

It's the speed that we're looking for.

[A]

It's the speed and that's react. We need that reactivity, you know, we need to be able to be aware of our surroundings, be able to move with speed as we age.

[B]

It's really interesting thinking about power in the context of walking. I've been thinking about it recently since I've taken up paddle, which is really only maybe eight months ago now, but I'm playing more and more.

[A]

It's pretty fun. I played for the first time a couple months ago. I was like, man, this is pretty fun.

[B]

It's pretty fun. And as you advance through the levels and played a higher level, which I'm now starting to compared to a few months ago, it really is quite intense. You know, you can have, you know, long rallies which are all about patience, a lot of moving back and forward and waiting for your moment. And literally in the last two weeks, I've realized, wow. Because I used to play a lot of squash when I was a teenager, I would do lots of sprint training. I was very quick on the squash courts. And I realized for the last three years, I've not really trained speed. I've been moving a lot, but I haven't trained speeds. And I'm like, rockin. You know what's gonna really help you on the paddle court?

[A]

That's right.

[B]

It's being faster. So I got these jumping blocks out of the shed in the garden a few days ago. I was jumping on and off. But again, I just wanna highlight the point that I was thinking about power as, you know, in terms of an athletic movement to help me on the paddle courts. But it's not just that, is it? You're saying as you get older, you may not be playing intense paddle like I am, but you still need that power to, you know, to help prevent a fall when you're actually stepping down from the curb.

[A]

I think I wanna like scream that that's very. Regardless of decade, regardless of decade of life, there is a way that you have to intervene with that type of training. It's very important for not only activity like you're doing, but just interacting with your environment. Fall risk in walking, speed, in being able to catch yourself, you know, if you were to stumble.

[B]

Yeah.

[A]

So that's a very important conversation. And I don't think we should shy away from having these conversations as we age, saying, okay, well, we're just going to do, you know, chair yoga. For example, which I am not. Like there's a time and a place for all of that, but I also think it should be the and conversation challenge our systems a little bit. Regardless, like I mentioned of decade, there is always some way for that stimulus to occur.

[B]

It comes back to what you're saying before about with modern conveniences comes a responsibility. If you want this body of yours to work well for the duration of your life, there are certain inputs it requires. Yes, so I love what you said before about intensity and walking. You're saying it's not an either or, it's an and. You also made an Instagram reel very recently where you were addressing the same question when it came to walking or strength. Yes, and I think you specifically said, excuse me for the lack of clickbait here, but this is an and conversation, right? So talk to us a little bit about walking v Strength. Today's episode is sponsored by the way, have you tried to meditate before? Perhaps you've heard about some of the benefits like reducing stress and increased focus, and you've given it a go and thought it's not the practice for you. Well, I believe that may well be because you have not yet tried the right approach. You see, the Way is the only meditation app with a single long term pathway. You're not forced to make loads of choices each day. Instead, you're guided on an enjoyable and progressive journey that deepens your practice step by step. Now, I've been using this app for many months now and I absolutely love it. 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. Since I partnered with the Way, I have had so much positive feedback. One listener said, Dr. Chatterjee, I came to the Way through your podcast. I've tried other meditation apps with limited success and likes the idea of following a single guided path. I'm nearly two months in now and loving it. Henry's gentle and concise approach is very calming and the Way is now a regular part of my morning routine. That's the sentiment that many people report when they start meditating with the Way. And for listeners of my show, the way is offering 30 free sessions to help you establish your meditation practice. All you have to do is go to thewayapp.com livemore to get started.

[A]

Well, people ask me that all the time. What would you choose? Would you walk or would you strength train? And like I said in that post, I'm like, I don't really like that question because it's the. And conversation, they're two very different inputs. Just because you strength train one day does not excuse you from not walking. They're different biological inputs.

[B]

Might one argue. Again, I think we should be doing all of them as well. But if we were just gonna play the game of walking, be strength for a minute, just as a thought experiment might want to argue that walking is this fundamental human movement, it's very unique to humans, and that you could, if you were time pressured, you could walk uphill to, you know, make your walking, you know, have a strength component to the lower limbs at least.

[A]

Yep.

[B]

You could get a weighted vest or a backpack or, you know, we all get to rucking shortly. But again, I agree with you, it should be both. But if you were time pressured, if you, for example, let's say did, I dunno, a 30 minute walk each day, but you wore a weighted vest while you were doing it and you went uphill, you're kind of getting the best of both, aren't you?

[A]

Well, welcome to the boost program. Welcome to the boost program because that's exactly what you can do. So if you wanted to amp up your walking, let's say time was a factor. There's lots of things you can do. You can throw on a weighted vest, you can add in walking lunges. Some of my favorites for the foot and ankle are heel to toe walks. So you just walk heel to toe. And this is also producing power because you're powering up onto the ball of your foot. So I'll have patients do that, you know, 20 steps on each side so you can incorporate those things into that walk.

[B]

I think now's a good time to talk about Jane, who we mentioned before, because I think she beautifully illustrates the potential problems with being one dimensional with our movement. So she was getting 15,000 steps a day, which I think most of us would go, man, you're crushing it, right? In the modern world, to get 15,000 steps a day, you're probably doing way more than most people. But she came in to see you with lower back pain and osteopenia. So tell us a little bit about Jane and what you recommended to her.

[A]

She was, she was, you know, for her, when she came to see me, she was in pretty good health. I mean, she was moving, she was walking, but she did have some low back pain and osteopenia. Now we know when we're walking, we can maintain bone health. It is a load to bones.

[B]

Can you just explain what osteopenia is actually for people who don't know the term.

[A]

So osteopenia and osteoporosis, it's when you start to see changes in your bone health. So a decrease in the density. Density of the bone. So it's a precursor, if you will, to porosis. So it should be one of those. I need to start paying attention.

[B]

Exactly.

[A]

So while she was maintaining bone health with her walking, I knew we needed to start loading her more. So we had the conversation of we're gonna decrease some of your step counts and we're gonna get you in the gym a couple times a week for resistance training. This also helped with her low back pain. She was building up her strength around her spine. We changed her programming around. I also had her get on a rower, which she now loves. So we were doing more intense VO2 max work on the rower. So I was taking her picture of fitness and making it more diverse, creating more movement variability. And that's what I think is very important in her case in particular, because she was just walking and we needed to broaden that picture a little bit. A lot of the things that we did were able to change that picture for her.

[B]

We spoke about efficiency when it comes to walking, but what we're talking about here is efficiency when it comes to time.

[A]

Yeah.

[B]

You know, I think she beautifully illustrates, as I say, the problems with one dimensional movements. But I think there's gonna be many people who are listening to us right now thinking, oh, I sort of. I go to the gym four times a week and lift, but I don't really walk much. Or the converse. People are saying, hey, I walk 45 minutes every morning and then I crack on. I'm sat down at work all day. I don't go to the gym, but I feel pretty good. I'm getting my morning light and my nature. And I think that just illustrates that. You know, what I love when you were describing the Jane story is that by taking her down from 15,000 steps, I think, to 9,000 steps, you freed up time in her week. And it's not that that time went to just watching television. You freed up that time so she could strength train and do other things. And I think that's a really interesting one for us all to think about. You know, once you've met the base requirements, are you better off increasing your step count to 12,000, 13,000, or are you better off doing something else?

[A]

We talk about taking a time inventory in the book.

[B]

Yeah.

[A]

And it was really interesting because I did that as well when I was writing the book and my workouts Happen in the morning. That's when I'm like, I get my strength training in or whatever's on the docket for the day. It happens in the morning. And then on the days I'm in clinic, I'm typically not sitting down. I'm constantly like, with patients, I'm moving around. And once I started monitoring my step counts, I'd get home from my days in the clinic, and I'm thinking, I have to be 7 to 8,000. And I would look at my wash, and, man, I only hit 5,000 steps today, even though I was moving around all day long. And then I would get home and I'd say, okay, you got 20 minutes. So it really would make me monitor my time, what I needed to get done, and I made time for it. So that's a good thing to think about, because I think sometimes we think we're getting more movement in during the day, and it's. The day goes by fast.

[B]

That relates to one of the questions I've had when I announced that you're coming back on the show, Courtney, where someone said, I move around a lot during the day for work. Why do I need to walk as well? I guess you've semi answered that to a degree. But there's a flip side, isn't there? It depends on, well, what kind of movement are you doing? Right. Because there is something about the kind of metronomic, rhythmic texture to walking that perhaps you're not getting if you're just moving around the office.

[A]

Yeah. There's a difference between ambient walking and intentional walking. Ambient is what I get around my house, for example, which is still activity. But that intentional walk is exactly what you said. It's that repetitive motion, the rotation, the stimulation to the systems in our body. That is what's important. And so those intentional walks, we have to make time for those.

[B]

Yeah. Back to cues for walking efficiency. We did roll the earth away, walk taller. We did swing the arms, or swing those arms and walk softer. Can we talk a little bit about those two?

[A]

I think we can all probably know someone in our families where you can hear them coming from a mile away. You hear that really heavy strike, and

[B]

what does that mean? What does it signify?

[A]

So I'll often see that with people that have very stiff feet, for example. So remember, when the foot hits the ground, it has to elongate. It's our first opportunity for shock absorption. So we want the foot to pronate. We want to absorb shock as soon as that foot hits the ground. So someone who has very rigid Feet, for example, or very stiff feet, they have an inability, or it's difficult for them to absorb shock. So when they hit the ground, it's just hot and heavy, very loud. So we'll work on kind of dialing their nervous system down. I want you to try to walk softer. For some people, that happens a little bit easier than others. When you have footwear on where you cannot feel your heel, for example, you don't know how heavy you're walking or how soft you're walking because you're not getting any feedback.

[B]

Yeah.

[A]

That's the beautiful thing about the calcaneus, about the heel, is you have this bone, and then there's also this fat pad with a bunch of receptors in it, and it's designed to tell you information.

[B]

Yeah. People just don't realize enough. I think that if your foot can't feel the ground, it doesn't know where you are in space. Right. In that chat with Helen yesterday, she was talking to me about research in the 1970s showing that gymnasts, when they land on a cushioned pad, as opposed to on the ground, there is way more force going through their entire system because they don't know where they are. The foot's trying to find some sort of. Some kind of metric to say, oh, here you are. Here's the ground. You're much better off just landing straight on the ground where your feet can actually. Oh, they know what they're doing there.

[A]

The foot prepares you. It knows. It's like, hey, I'm about to hit something hard. Soften up.

[B]

Yeah.

[A]

You know, it can change the fascial compartments can change their pressures, and that's what it was designed to do. But we have to be able to

[B]

feel that swinging those arms. You mentioned that. That's really important.

[A]

Yes.

[B]

I'd love you to talk about why that's important. But also, you know, a modern thing you will see a lot is people walking with coffee cups. Yeah. Right. And we'll get to relational walking shortly. Right. So I'm not criticizing that. I'm just commenting on that. Clearly, when you're walking with a coffee cup in one hand, you're not swinging your arms. So why is it important? And is there an issue here that we need to think about?

[A]

I'm gonna preface this conversation with saying something is better than nothing. So if you're walking with Coff, if that is what is going to get you walking, great. But I have a story for you. So this is an interesting story. I was treating this gentleman who was an FBI agent, and he was always my last patient of the day. And so when he would come in, he had changed out of his work attire. So I would only see him in his sweatpants and gym clothes. And his gait, he had this little, you know, hiccup to his gait, as I call it. So he was kind of stepping in a pothole on his right side, and he wasn't swinging his right arm. And so we started working on these things, and he started getting better, but I wasn't nailing it. It was one of those cases, if you get on my list that I'm thinking about at night when I'm laying in bed, that's not the list you want to be on. So I'm obsessing about this. I'm like, what am I missing? What am I missing? And one day he was running late, and he didn't have time to change his clothes. And so I watched him walk back into my office, and I said, what side do you keep your gun on? And he goes, my right side. And I was like, oh. So he had his gun in his holster on the right side.

[B]

Wow.

[A]

So he. When he was walking, his arm wasn't swinging like it should. It was almost like there was this barrier there, and it was really this wild kind of thing that I noticed. And I said, oh, my gosh. I said, we need to. I was like, what are your thoughts on moving that to the other side? He's like, you know, that's his. This has been years.

[B]

Yeah. He's conditioned to know how to pull it, how to use it.

[A]

Yeah, it's actually a term called a gunslinger's gait, but it was really very interesting. So once I kind of determined that at least we had a mechanism for the why. But I think it's interesting when you see these patterns for people who walk their dogs. For example, I'm like, can you switch the leash into the other side? Just switch up the input. Because when you're walking and you're only moving one side, that's not efficient. We have to be able to rotate. We have to be able to move our bodies from side to side. And there's a very big reason for that when it comes to the foot. You know, that's. The foot has to be able to pronate and supinate, and it's the rotation of our bodies, our arm swing, that facilitates what happens in the foot.

[B]

Yeah, I hate carrying something in one hand when I'm walking. I'll always take a back if I need to take something, but, you know, Just to reassure people. I presume you agree with this, but if you're out for an hour's walk and for five minutes of those or 10 minutes of those, you're drinking something, then you pitch it. I don't think that's. I think we're robust, aren't we, as humans? We can deal with stuff. It's just if every walk you're doing, you've got a water spot in your right hand and you're repeating that over and over again, there may be a consequence in terms of your gates.

[A]

It certainly would be something to look into.

[B]

Exactly. You may also be fine. But. Yeah, exactly. I mentioned relationship walking. I know that you have said that this is one of the funnest bits of research you did when writing this book. Yeah. What is it?

[A]

When I was writing this book, my daughter is now 15. And for anybody who has a teenager out there, it's fun times. You know, we certainly have had our challenges, but when she comes home from school, I can always tell what kind of mood she's in. Is she happy? Is she sad just by her gait? Right. Like, is she, you know, excited to walk through the door? And I always will ask her, how was your day? Fine. How are your friends? Fine. What about your schoolwork? Fine. And I don't get a lot of. I don't get the answers that I'm quite looking for there. And even if we have dinner and I ask her these same questions, fine, fine. Can you take me to Starbucks? That's usually what I get. And I started doing the research for this book, and I said, gosh, Courtney, take your kid for a walk. And so I told her, I said, addie, just give me 10 minutes. Just give me 10 minutes, and then we won't have to, you know, we don't have to go through these questions. And I will tell you what, we started doing that after dinner, within five minutes. This is no joke. That kid couldn't keep her mouth shut. She's telling me about her friends and about the boys and about her classes, and I'm like, it touched my heart so much. I was like, okay. Because when you get outside and there's this change of environment, you know, there's some research looking at. Maybe with the teenagers, it's eye contact, where she can still be looking around, being stimulated by different things, but the activity, the increase in heart rate, the increase in blood flow, she really, really opened up, and it was mimicking exactly what I read in the research, which was relationship walking. You start to communicate a little Bit differently. There's bonds that are created. Walking with your spouse, walking with your grandparents. There's just fascinating research on this, which sounds. It makes sense, doesn't it?

[B]

Like, it totally makes sense. And it kind of. It feeds back into this central idea that walking is a physiological necessity. You could even expand that and go, walking is a social necessity, a relational necessity. Because that research, I think what you just described with your daughter, I think many people will have experienced, and there is, in your book, there's some really good research on relationships and as a romantic couple, what going for a walk together a couple of times a week will do for your relationship. And again, it's pretty simple.

[A]

It's free.

[B]

It's free. You just gotta do it.

[A]

That's right.

[B]

Yeah.

[A]

I read once that it's hard to have anxiety when you're looking out at an ocean at the horizon. And I kind of think about that with walking, too. It's hard to sustain being in a bad mood or to sustain being cranky when you're outside walking. It's hard because, again, it's this input our brain is starting. We have neurotransmitters. We have all this action happening in our systems. And I think that's a really special thing that we have forgotten about.

[B]

Yeah. Let's talk about walking with weight or rucking. What are the benefits?

[A]

So amping up your walking. So if you want to. Again, that time conversation, it's going to burn more calories, it's more loads. So you can also increase your heart rate depending upon how much load you're putting on your back, what type of terrain, and it can get difficult. So it can be very beneficial for people. I also want to preface the importance of the gear, the correct type of vests, because you don't want anything that's constricting your neck and shoulders, where your breathing becomes altered.

[B]

Yeah.

[A]

So those are things to consider. I think also it can be really good for your foot and ankle, but

[B]

you have to build up.

[A]

That's right. That's right. Because if you're walking in a minimal shoe, for example, that is more loads going through your foot and ankle. It's a harder environment, but that's also the environment where you can get stronger.

[B]

If you were in a cushioned shoe already and you had a choice of either adding weight and going what is called rucking or moving to minimalist shoes, what would be the better step to take first?

[A]

I would go minimal shoes first and build up there.

[B]

Get comfortable there before you start adding weight. Yeah, me too.

[A]

You know, you definitely don't want to do those at the same time. So you wouldn't want to grab a minimal shoe and put weight on your back. It's too many variables. So, you know, if your choice would be, hey, I want to get my steps in, I want to amp up my walking, and I want to add weight, and I'm not in minimal shoes. That's one option, but you don't want to do those things at the same time.

[B]

Yeah. Is there something to consider? You mentioned the equipment. If I think about me walking and all the kind of improvements in efficiency I've made over the years, I've realized and experienced how important that lateral rotation is when you walk. You know, you swing your arms. You know, there's that counter rotation in the body. I imagine some brands, I haven't tried it yet. It's on my list to try as, you know, having a waisted vest, for example. But I imagine some brands are going to maybe restrict that lateral movement, whereas some are probably a bit more.

[A]

Yeah, I don't think there's enough people talking about the equipment for weighted walking because that rib cage expansion is crucial. You have to have rib cage expansion not only for what's happening at, you know, from a breathing capacity, but that rib cage and the rib cage expanding also is what dials in rotation.

[B]

Yeah.

[A]

It has a direct correlation to what's happening at your pelvis. So you do not want anything that is going to be compressing that rib cage. So that's where I think the gear is very important. I made. This is a funny story. When I first started weighted walking, I had a backpack, like my hiking backpack in my garage. And I was like, you know, this makes sense. I'm gonna add some weight. So I didn't have a sandbag or anything, but I had a 25 pound kettlebell. So I just threw it in my backpack and I'm walking around. I'm like, all right, I'm an hour in. And the next day I woke up and I was like, man. I was like, I can't believe I'm telling you this. This is very embarrassing. But my low back was so sore. And it was because every time I was walking, the kettlebell was smacking into my low back. And then I was like, okay, this is a good concept, but I need the right gear.

[B]

Yeah. It's not a failure. It's a learning opportunity. Right. Don't have something heavy knock against your lower back whilst you walk.

[A]

It just doesn't make any sense.

[B]

You should have done A chapter on that in the book. Yeah. But I think it all plays into this idea that walking's amazing. There's so many benefits. And it depends on your starting point. Right. If you currently not even hit two and a half thousand steps a day. Okay, no worries. Let's get you there first. And you've got a program in the book to help people get there. If you're at two and a half thousand, you want to get to 5,000. Okay, well, that program's gonna help you build up. And if you want the boost program to really max your walking, you know, I think that's fantastic as well. So, you know, you're never gonna run out of things to do if you're trying to improve the way that you walk.

[A]

Yeah. I mean, when I was writing this, I consider myself a pretty active person. My whole career is built around movement. The changes in my life, in my lifestyle from researching this and writing it, I'm so grateful for, because walking has taken on a whole new kind of meaning for me. Even though activity has always been a part of my life, it continues to be this calming measure for me, this bringing me back to baseline when I was writing and I'd get into, you know, I'd be challenged. Right. Things weren't flowing, I'd go take a walk. You know, my creativity would improve when I was stressed out. Go take a walk, you know, so I was able to really think about the benefits and what it was doing for me. And it was really cool to see. To see what happened and to see how important it has become.

[B]

Today's the final day of your, you know, book promo trip to the uk. Right. And interestingly, you've come with your mother.

[A]

Yes.

[B]

Right. So you've been in London for a few days doing all kinds of cool stuff.

[A]

Yes.

[B]

The weather has been great.

[A]

Yes.

[B]

Have you two been managing to walk a lot while she'd been here?

[A]

I'm so proud of her. She, first of all, this is very exciting. She got her a pair of vivo barefoots. She's 76 years old.

[B]

Love it.

[A]

She put in 13,000 steps yesterday in her vivos. In her vivos.

[B]

Put it there. I know, Fantastic.

[A]

And, you know, I'm sitting there going, mom, bring your other shoes. You know, I'm like, just in case, you know, let's, you know. But she walks every day at home. She's in the gym a couple times a week. And so her transition, you know, and of course, the next morning I was like, how's your feet, Mom? She's like, I feel great.

[B]

Do you know which one she wore?

[A]

She had the Primus Flex, I believe.

[B]

Yeah.

[A]

But she really did. She really did very well. And, you know, now she has three pairs of them. But I was really proud of her. Cause she put the steps in. And not to mention, the place that I'm staying in is on the fourth floor, which I didn't. I missed the. I missed the little fine print. And not only that, but the staircase is about a third of the size of this table.

[B]

An old traditional British staircase.

[A]

So God bless her, she's had to walk up and down these stairs a million times. I carried her 50 pound suitcase up those stairs, by the way.

[B]

So she's on a fitness holiday.

[A]

Yeah, but, yeah, so she was able. And she said to me, she goes, if some of her friends were here, and in fact, she said most of them, she's not sure they would be able to get to our flat because they wouldn't be able to navigate the staircase or have the power or have the strength to do so. And that, like, broke my heart. I was like, oh. I literally looked at her and I said, that's why I wrote this book. That is one of the reasons why I wrote this book, so that people don't have to have those conversations when they get older. I can't go on this trip with my grandma, with my daughter. I can't go on this trip with my grandkids because I'm afraid or I won't be able to do things like walking up a flight of stairs.

[B]

But that is happening, Courtney. It's happening all over the shop. And there'll be people listening right now who that story, like it a little bit. Did for me. Makes you a bit tearful because, you know, I can't remember the last time I was able to do stuff like that with my mum.

[A]

Yeah.

[B]

And it just highlights why the message in this book is so important. Because so many people, they neglect their health throughout their life. They end up in their 70s wondering, why can't I do that stuff anymore? Why can't I enjoy my grandchildren or play with my children? And it didn't start in your 70s. It started many decades before that. That doesn't mean, you know, you can't undo problems. You can. It's never too late, but it's never too early. Also,

[A]

when I was at the radio show yesterday, there was a gentleman there that ran the marathon and I asked him when he started running, he was older. And he goes, I didn't start running until I was 60. And he had just finished the marathon. So that was also like. I love having that conversation, that it's never too late. It's never too late. Yes. Is it easier the earlier I start? Yeah. We want to avoid some of these problems. We want to take a proactive approach, not a reactive approach. And so I think it's hopeful on both ends. Like, there's no better time to start than now.

[B]

Yeah. Courtney, since you came on last time, that episode was so well received, I can't tell you. We've had one of our most popular episodes of the year. The amount of questions I've had, the amount of people who said, I've got minimal issues. But next time Courtney comes on, can you go through in detail how to transition? Right. So I have a list of questions from many people in my audience. I don't think we'll get through them all, but I thought it might be quite good to try and get through a few of them, if possible.

[A]

Yes.

[B]

And let's start off with that one. You know, what are some practical steps for transitioning from cushioned shoes to more minimalist ones?

[A]

So when you think about the characteristics of functional footwear, we'll start there. We have a wide toe box, a low heel to toe drop. So that's defined as 6 millimeters or below.

[B]

Yeah.

[A]

And varying degrees of cushion. So if we were to start with the first one, if you're in a traditional shoe, this is the majority of footwear out there. Transitioning to the wide toe box, that's my non negotiable. That's what happens first. And that's usually pretty easy because there's not a person that says, wow, I have more space for my toes. I don't like that. What they will say is that sometimes it feels a little loose because their toes don't have the strength or the splay to fill up the toe box. But.

[B]

But they will.

[A]

But they will.

[B]

Yeah.

[A]

So they can use toe spacers, for example, as a way to help them facilitate that splay. And then they can do the exercises that we talk about. So that transition into the wide toe box, it's usually pretty easy. And people adapt to that quickly. And they like it when we move into heel to toe drop. I think a lot of people don't realize that the majority of traditional footwear, and this is trainers, what have you, the heel sits higher than the toe, so 10 millimeters, 12 millimeters. And over time, if I'm constantly in this position, it's going to affect, for example, the mobility of my ankle. It could make my calf tight.

[B]

And for people who are listening, the extreme version of that is the lady's high heel.

[A]

Yes. If you were to wear a high

[B]

heel all day long, you'd understand that. But there are many other shoes have degrees off that, just not to that extreme. Correct. Yeah.

[A]

And you know, in the book we have a high heel rehab section. So if you've worn high heels your whole life, again, have hope there's something you can do about it.

[B]

And I just want to reemphasize that. Something we covered in the first conversation is that you have a very holistic approach to this. You're not against people wearing high heels if they want to. If they feel good and they want to wear it out on a night out or to a wedding, you're like, sure, but make sure on those other times you're doing something about it. So I just want to re. Emphasize that point that you. I think one of the things people like about your approach is that it is very realistic.

[A]

You don't want to instill fear in people. That's not what we want to do. We want to encourage people. We want to empower people. You don't want to have the always or never conversation. You always have to wear these shoes. You never can wear those shoes. People don't want to hear that. And it's not realistic. If you feel good in a high heel, going out to dinner with your husband and that makes you want to wear that shoe, go for it and feel good and enjoy it. What I'm saying is, when you get out of that heel, don't wear the heels all day long. Pay attention to your foot. Do some exercises. So that's where that conversation becomes much more digestible. You meet people where they are. Okay, so with the heel to toe, the higher heel to toe drop, if you were to transition into a functional shoe, so that would be 5 millimeters or 6 millimeters. We're not taking you all the way down to zero. It's like a nice halfway point. And then we talk about doing ankle mobility exercises, for example, working on your foot and calf strength. That is one of the things that we'll hear when people transition into a zero drop. They'll say, well, my calves got sore. And then they'll want to blame the shoe. And it's not the shoe. It's just a signal saying, you probably didn't have the capacity in your calf or the range of motion to drop down as quickly as you did.

[B]

Yeah, you're working your muscles and tendons in a different Way, if you went to the gym and did bicep curls, and the next day you had a sore bicep, you'd be like, yeah, great. Okay. I really worked those biceps great. They're gonna grow back stronger. But somehow, when it comes to minimal shoes. Oh, there's something wrong with the shoes. It's like, no, no, no. You're just using your muscles in a different way, in the way that they're probably meant to be used once you start training them.

[A]

It's like if you were squatting and you were squatting £100 one week and £200 the next week, and you were like, man, I am. People wouldn't say, well, stop squatting. They would just say, hey, Maybe only squat 10 more pounds than you were.

[B]

Yeah.

[A]

It's a very different conversation at the foot. It's, well, there must be something wrong.

[B]

So we take this gradual transition. Okay. And again, I just want to emphasize we went in detail in our first conversation into the difference between functional shoes and minimalist shoes. And functional might be considered a transitional.

[A]

Yeah.

[B]

Sort of phase as you get to true minimalist shoes. As I mentioned in that comment, I just want to repeat this. I have been wearing Vivo barefoot shoes for almost 14 years now, pretty much exclusively. So I know they're arranged very well. The show is also sponsored by them. So I want to make that very, very clear. But it's not about that for me. It's about, you know, choose your brand that you want. Right. I will say for Vivo Barefoots that the. I think it's the Primus Knit. A, it's my favorite shoe, but B, the people who I have transitioned or helped transition over many years, friends or, you know, family or patients who wanted to. I found the Primus Knit to be a really good shoe because there is a bit of. I wouldn't call it cushioning, but there is a bit of substance under it. So you don't. I love the Primus Flow as well, which is very, very barefoot. But I think the Primus Knit is a great transitional shoe for people if they're looking for something there.

[A]

If you look at the sole of that shoe. So we talked about wide toe box, heel to toe drop, and then the last thing is the sole of the shoe.

[B]

Yeah.

[A]

The difference between a functional shoe and a minimal shoe is minimal has a thin and flexible sole, so you can feel more of the ground. This is probably the hardest part that takes people to transition into that shoe. If you were to look at the sole, it has these lugs on them. It's almost like a trail shoe. So it gives a little bit of space between the sole of the foot and the ground. So that is a great shoe for people to transition into a more minimal shoe, but their foot still has a little bit of.

[B]

Yeah, yeah. Okay. So. And once people have chosen the shoe that they want to transition, if we put it through the lens of walking. So we're not talking, you know, you know, running in minimalist shoes can be done. It's a separate conversation. We're not addressing that here at the moment. Okay. And I think if you go from three decades of cushion shoes into buying some barefoot shoes and going for a, you know, a one hour run on a road in them when you're not used to it, don't blame the shoe afterwards. It's like that was the wrong thing for you to do. Right. Let's get people walking in these shoes first.

[A]

Yes.

[B]

Once they've got this, let's say this new shoe, let's say someone walks 30 minutes a day, is it just a case of like, I don't know, you do some of the walk in those and some of them in your old shoes or. Yeah, that's literally what. I'll take them in a backpack with you.

[A]

Yeah. I'll say either walk five minutes away from your house, come back 10 minutes, put your old shoes on, do the

[B]

rest of your walk, do the rest

[A]

of your walk, walk around your house barefoot, 5, 10 minutes, slowly transition and then see how you feel that night. And the next morning, if you're feeling pretty good, add a little bit of time. Some people make that transition quickly. They're like, this isn't a problem. My mom, but she's, you know, she's a walker. She's, you know, she is healthy and she's your mom.

[B]

So I imagine there's been some full exercises in her life for some time

[A]

that would not be very good if we had some problems there. But yeah, so that's. Some people transition quicker and that's okay.

[B]

Okay. So basically, take it easy, listen to your body and as you get more comfortable, start to increase. And I guess if you go to a functional shoe and you get to the point where you can walk 30 minutes a day, no problem, you're wearing them the whole time and you're walking to the shops and the office in them, then you could, you know, go to a minimalist shoe and apply the same principles again.

[A]

Yep.

[B]

Yeah.

[A]

Like in the build program, for example, when we talk about these different walks per day, you could start with taking one of those walks or a portion of one of those walks with your minimal shoes, you know, and then start to build up, build the capacity of the foot and ankle. I mean, it took me, you know, I got into this because I had some pretty significant foot pain for a very long period of time. Bunions, neuromas, stress fractures. It took me years to be able to walk in minimal shoes for long periods of time, for all day long. I mean, it took a long time, and I would still. That's why I'm this big. You know, shoe spectrums are important.

[B]

Yeah.

[A]

I want to spend the most of the time that I can in footwear that is going to improve my overall function. It's going to put my foot and ankle in the position that it was supposed to be in. I'm going to be in an environment where I can get stronger. Now, there are times where I'm like, I want to go hike 10 miles in Colorado. You know, I like to have a little more stack height. It's like the least amount of cushion necessary to complete the job. But if you look at the footwear out there now, that's not least amount of cushion of anything that is. You're walking on a cloud and you're walking on a pillow, and you're interfering with sensory acuity, and that is a problem.

[B]

Yeah. I would just add there. The vivobarethot tracker hiking boots are insanely good. You've got incredible grip, which you often want if you're hiking trails, but so comfortable, you can really feel your foot flexing with every footfall.

[A]

So when you think about that hiking shoe, too, you still have to have the boots to be flexible at the ankle.

[B]

You don't want a stiff boot where you suddenly can't move your feet and ankle anymore.

[A]

If you were walking down a mountain and you don't have ankle dorsiflexion, so your ankle is not allowed to move. Those loads have to go somewhere. So what we'll see is that people will transfer that weight or load from the ankle up into the knee. So you don't want to interfere with those types of ranges of motion. I think people think those hiking boots are like this. It's going to provide all of this stability, and I have to have it there. Guess what? Your ankle was beautifully designed to be a very good stabilizer. There are muscles that sit on the inside and outside of the ankle that when trained, are better than any stabilizing boot you could buy.

[B]

Yeah.

[A]

So rather than avoid it, we train it, we use it, we introduce the Foot to varying positions, various terrain, and get stronger and more resilient.

[B]

That leads on to the second question on this sheet. How can we restore full mobility and confidence in our ankles, especially after previous ankle injuries?

[A]

Yeah, when we think about the ankle, we don't want to avoid ranges of motion. I think for someone who had a history of ankle sprains, for example, the thought of putting their foot on a slant board, that's kind of tilting them into that position of the ankle sprain sounds very frightening to people. So we kind of adopt this. Well, I'm just not gonna do it. You have to train the ankle. We have to train for movement variability. You don't want to avoid these ranges. You want to work into them. So when we're working on, especially patients that have had ankle instability, we're working on all these different ranges. Pointing the foot, flexing the foot, inverting and everting the foot. In training in all those different positions, those muscles, the intrinsic muscles of the foot and ankle are very good stabilizers. And so rather than I need a boot, I need all of this stability around the ankle, we can train the body to do that.

[B]

Are you a fan of those Bosu balls or those. Is it those half Bosu balls where it's an unstable service to stand on?

[A]

It's a great question. You have to know what you're doing before you get on one of those. And a lot of people have a difficult time. So why put someone's foot in an environment that's going to challenge them more when they're having just as much of a difficult time with their foot on the ground, the foot on the ground is more. We want to train for function. Now, if you can put your foot on a Bosu ball and you look like you can control those motions, that's one conversation. But when you see people all over social media and they're, like, on a Bosu ball and they're wobbling all over the place, how functional is that? What is your intent? What is your goal?

[B]

Yeah, I just want to add there that the first time you came on the show a couple of months ago, we mentioned a lot of the things in your book, but the book wasn't out. The book is now out. Okay. And there are so many exercises, practical ones, in the book. So for someone who's had a previous issue, I would say get the book and take a look. Cause at the start at the back, there's all kinds of things that are gonna help people build that up, aren't there? Yeah.

[A]

And I love Treating the foot and looking at this part of our body that can get stronger. We haven't treated the foot like that. When we have the conversation of arch support, for example, people say, well, does the foot need arch support? And I say to them, do you know how well your foot is designed? It has the best arch support you can imagine. When we talk about the medial arch of the foot, so that's the inside arch. There are so many muscles there that are designed to help your midfoot and stabilize your architecture and stabilize your big toe. So, no, the foot doesn't need arch support. Now, if we shove it into a shoe where the toe box is tapered or the anatomy is changed, then, yes, yeah, you need arch support because you're compromising the integrity of the foot and ankle. But when that foot is doing what it's supposed to do, and I have toe splay and I have a strong foot and I have capacity and I can push off through my toes, then, no, that foot does not need arch support. It's well designed to handle many times our body weight when we walk and run.

[B]

I just want to highlight that 12, 13 years ago, people would have said I had a flat right foot. Now I've got an arch in it. Because I've been using my foot for the last 12, 13 years, I've not been putting it in deforming footwear. You know, that's quite a provocative term, but it is. If your shoe is literally squeezing the front of your feet and it's narrow, you are literally deforming your feet. We just have to be honest about that. That's what is happening. And since I stopped wearing those kind of shoes and I've been in minimalist shoes, my feet have changed. They're stronger, they're meatier. There's an arch. Now. This isn't just one thing. Oh, I've got a flat four. Or I don't. It's like, okay, you might do at the moment, but maybe with the right inputs, it will change.

[A]

When I started doing this, my foot looked atrophied.

[B]

Yeah.

[A]

It was just. There was no muscle in the foot. And, yes, those things do change. And I would encourage people that conversation of flat feet. I think we've been really trained, if you will, to think that flat feet are bad. And if I have a flat foot, then I have to have some type of support and I need this very aggressive shoe. That is not the case. I have plenty of patients whose flat feet are very strong. So it's more in how the foot functions. And if you have a flat foot that is weak, do what you did, which is strengthen your foot. Because here's where the problem is going to be. If you have a flat, weak foot and you don't do anything about it, over time, where that foot may have been flexible, right, you're still able to move, will start to become stiff and rigid. So now, instead of having a flexible, flat, weak foot that I can strengthen, I now have a rigid, stiff, flat foot. And that is a very different conversation. And those are the people that have a very difficult time with walking gait as they age because their foot has lost the ability to adapt. Those are the ones we have the conversations with. I need a specific type of foot orthosis. We need to get in some type of rockered shoe to help them do something that we as human beings were very born to do, which is to walk for long distances upright.

[B]

Some of the questions that have come in relate to this idea that people are listening to me talk about this, you talk about this, and they're thinking, okay, I wanna start paying attention to my foot and my foot health. But I've neglected it for several years. Is it too late? Can you undo 20, 30 years of being in incorrect footwear?

[A]

Yes, you can. Your foot needs to be. When you look at someone's foot, and this will be a good example of. With a bunion, for example. A bunion is when the big toe starts to dive in, you'll see that bump on the inside of the foot. If you can move that, if that's flexible, it's a muscular imbalance. There's a muscle that straightens the big toe. I'm a perfect example of that. So when the foot is still flexible and I can work on it and I can train it, then by all means, yes, that foot gets stronger. If the foot has become, like I said, stiff and rigid, where you have toes overlapping one another, the conversation becomes more difficult because now you're getting structural change, and that can be difficult to address.

[B]

Can toe spaces sometimes help with that?

[A]

With the more rigid.

[B]

Well, no. When toes are starting to overlap each other.

[A]

If I can get a toe spacer on someone, we're doing it. I wear them every day. I've been wearing them for, gosh, years.

[B]

Do you wear them in your shoes?

[A]

I wear them in my shoes because I was a little late to the foot party here. I wish I would have started doing this work much sooner, but my bunion, for example, has improved significantly. It is no longer painful. I run, I walk with these spacers on it Helps keep my toes in alignment. And it's a low hanging fruit. It's easy. It's like, just wear it around the house. Start with a couple minutes a day. It can be difficult for people to break in too, because people aren't used to having their toes splay at gate happened.

[B]

You have this box, don't you, with lots of goodies, which you kindly bought me a few months ago, which has been amazing. If they've got toe spacers, I think toe strengtheners. What else have you got in there?

[A]

There's bands, a ball. I wanted to keep it simple.

[B]

Where can people get that if they choose to get one?

[A]

Amazon. Right here.

[B]

Just on Amazon?

[A]

Yep.

[B]

On the website they just look at your name or gates. Happens. G A I T happens. Okay. Okay, back to the questions. What do you think about barefoot shoes or minimalist shoes for people with osteopenia? And I'm guessing they're talking about osteopenia in the foot, although I don't know that from the question.

[A]

Yes. So think about what happens when you're walking from a bone perspective. It's all about dosage. That's why the dosage is very important, because when you're walking barefoot or say in a minimal shoe, there's more loads going through the bone. This can be stimulatory, so you get this osteoclastic and blastic activity and it's this, it can be this environment that is good for your bone health. Now, if I go too fast too soon. Right. My dosage is too much, then that positive bone response can turn into a stress reaction because I went too fast too soon. So from a bone perspective, when done correctly, we can stimulate tissue and when done incorrectly, we can cause problems. So again, it's that conversation. Start small. If you're transitioning into minimal footwear and you haven't walked for long periods of time, don't start running in them yet.

[B]

Yeah.

[A]

Because there's many more times your body weight going through your foot in a running gait than in a walking gait. So start with this slow transition in a walking gait.

[B]

Yeah. Okay. Now there's been a lot of questions around two common issues, plantar fasciitis and Achilles tendinopathy. Okay, so let's start with plantar fasciitis. How do you treat and cure it is one of the questions.

[A]

It's one of those diagnoses that I really think is this evolutionary mismatch. Because when you look at the foot, there's tissues, we share loads. So when I'm walking, for example, we have two muscles, tibialis anterior and posterior, that help absorb force when the foot hits the ground. So. So they're friends with the plantar fascia when I go to push off. So when I'm pushing off of my gait, I have my toe flexors in my calf that facilitate propulsion. They're also friends with the plantar fascia. If they're not doing their jobs, the plantar fascia gets pissed. Because now instead of having this foot that was designed to share loads of the plantar fascia has to take on more of it. And so when we look at treatment for these types of things, it's not just keep deloading. It's not just, here's a foot orthosis and here's a shoe that's gonna rocker for you. It is. Why wouldn't I look at bringing the friends back to the party? Yeah, start strengthening the foot so that we can actually make change here. You know, one thing I think is very interesting, and if I had time to go back to school, I would for this. But when you see bilateral heel pain. So people that have plantar fasciitis, fasciopathy on both sides, I'm more and more convinced that this is a up the chain conversation, that there is a very big correlation between the pelvic floor, hypertonicity of the pelvic floor and what we're seeing at the feet. If you think about it, if I was under high stress, for example, right. I get into this like fight or flight, everything's tense. That also happens at the pelvic floor, and it also happens at someone's foot. That's what's so cool about the foot.

[B]

Yeah.

[A]

You look at it and you can tell if someone is like, why are they gripping their toes so much? It's like, do they have an inability to actually relax their entire system? Yeah. So it's been really some interesting work to do a lot of breath work, pelvic floor work, with my patients with biological heel pain. And it helps them quite a bit. It's really pretty neat.

[B]

It also makes me think about even higher up because, you know, when you've got a forward head posture that goes, you know, as we said last time, the feet are the foundation of the body. So you want a strong foundation. And, and to add to that, you know, they also respond to what's going on up the chain. Right. It goes both ways. So if your head's jutting out forward, well, that is gonna have an impact on your feet. And of Course, if it's bilateral, it indicates there's something a bit more central going on than something local in that foot. What about Achilles tendinopathy? Is that something you see a lot of.

[A]

Yes.

[B]

For people who don't understand the term tendinopathy, what are we talking about here?

[A]

Anytime you have a tendinopathy or a tendonitis, you have to ask yourself, what happened to the tendon? Why is it starting to not be efficient, if you will? It's a very common diagnosis, and it's also counterintuitive to people, because when their heel hurts, when their Achilles tendon bothers them, the immediate reaction is, I gotta get off of it. I get a. I'm going to do less. And we know that tendons need load. And when we load our tendons, it's basically this concept of mechanotransduction. We're loading the tendon. It's what stimulates the health of the tendon and what helps share those loads or absorb some of those forces are strong calves. So when we look at treating for Achilles tendinopathies, for example, a lot of the research is heavy, slow loads. You have to improve the capacity of the muscles that insert at the Achilles tendon. I had a patient once that we were working on, and again, several years with Achilles tendon pain. And every time his foot would hurt in the morning, he would get his scooter out. He was a physician. And I said, you're going to leave that scooter at home. We're done with the scooter. Because it's not that the rest was bad per se. He was feeling better. But you can't rest a tendon. It will not. When you go to return to activity, you have now a calf that has gotten weaker. So a tendon that is not maintaining or improving its integrity or health. And so then it just becomes this cycle. So with those diagnoses, tendinopathies, plantar fasciopathies, we have to look at movement and we have to look at progressive loading.

[B]

Yeah.

[A]

And those are very, very important conversations. We cannot deload forever.

[B]

Yeah. That's a principle, I think, that has come up on multiple occasions through this conversation, Courtney, that. But you need to load the body.

[A]

Yeah.

[B]

You know, I can think back to Christian, the firefighter. Right. And how he was told to move less three years on. Right. And as you beautifully explained, you know, whether he walked on it or not, the pain was the same. Right. So you might as well walk on it then.

[A]

Living well with pain rather than having it dictate your life and saying, I'm not doing that. That.

[B]

Yeah, yeah. And if you just superimpose onto that. This idea that Howard Schubiner spoke to me about, and his research has shown that maybe even 90% of chronic pain has a neuroplastic component, I. E. It's not structural. It's. It's been created by the brain, maybe due to fear, worry, anxiety, stress. And you layer that into what you're saying. It's like, hold on a minute. If you've had pain for two years, maybe the injury's healed.

[A]

That's right.

[B]

Maybe there's something else now. It's a. You know, his book is called unlearn your pain. Right. Maybe there's a learned cycle here that, you know, actually that word confidence again, that small amounts of movements, micro walks get you going, build up that confidence, make you realize, I don't need to fear my body anymore. My body is capable of. It all starts to play in, doesn't it? I love that idea. How do you live well with pain?

[A]

My practice over the years has changed in that more recently, I think, since I've started doing more and more of this work, I'm seeing more chronic pain patients that are afraid to put their foot on the ground. And those are my. Like, these people become very, very dear to me because it's heartbreaking. And it is that conversation of, you know, the diagnosis, the musculoskeletal diagnosis is one thing, but the bigger conversation is the one of fear and getting them to trust their bodies and getting them to feel confident again.

[B]

Yeah. There's a question on gait analysis for running. Do you support gait analysis for running? And related to that was, how do we know if our running shoes are causing us issues with our posture or not?

[A]

Yeah, it's.

[B]

That's individual assessments. Yeah, that is deep. Top line.

[A]

Top line. You know, there's some very good runners out there. And you'll see on social media, these people breaking down their mechanics, and they're like, oh, my gosh, his foot's pronating and he's this. And I'm like, he just won. He just broke a world record. You know, like, the guy has clearly, you know, he's running and he has this gait. Do you really want to mess with those things? So there it gets into these kind of fine lines as far as the footwear is concerned, with the super shoes. There's actually a great podcast here in the UK with Ian Griffiths, Pod Chat live. He talks about. They go in depth about Shoe research and really looking at what's happening at the foot. But when you look at these super shoes, we know they give people economy 2 to 4%. Some studies would say more. But I think what we need to consider is these shoes work best when someone knows how to run.

[B]

Yeah, exactly.

[A]

When you have an elite runner who has a faster cadence and they're striking their foot on their midfoot or their forefoot, they have a strong posterior chain, they have an efficient gait, then these shoes provide that economy. If you put a super shoe on someone that has a weak foot and calf and they start running on their forefoot and their midfoot, you can cause problems because the demand is greater than what they have the capacity for.

[B]

That's the piece people miss. We're literally two days post one of the most iconic marathon races in history. Two people broke two hours in an official race. I mean, phenomenal. And of course, the elites are pretty much all wearing these super shoes. But these guys, I mean, a lot of them are from East Africa. A lot of them grew up barefoot. And, I mean, you know, at the formative years of their life and their running, gait work, they had exceptional mechanics. And now this is, as you put, as you said on our first conversation together, it's the icing on the cake. Right? But so many people are getting injured by thinking, I'm gonna get a 4% improvement in my 5K.

[A]

It's like, do some plyometrics. You'll get 4% improvement. You know, like, pay attention to what you're putting in the shoe. Let the shoe be the icing on the cake. I think it was really cool to see some of the. Of course, I'm obsessing over all of their gaits, but when you see these runners that have this, you know, this pronation, this excessive pronation, it's a beautiful thing to see because tissues need to lengthen before they can contract. You know, the foot has to recoil.

[B]

It's like elastic, isn't it?

[A]

So that's what. When you see a foot that's going into pronation, you know that they're getting ready to propel forward and spring forward. We don't want to eliminate arch recoil. We want to learn how to strengthen it and control it. And then you have this foot that can basically be this spring off the ground, and it's really pretty cool to see.

[B]

We've covered most of the common questions. I don't think we can get through all of them. But there is one question that came up, which I think is Quite relevant to some of the things we've been talking about today. But also at the end of our first conversation, when you spoke about how walking speed could be the sixth vital sign and predict dementia by up to seven years sometimes. And someone wrote in to say, rangan, I'm worried about my elderly mother. She used to like walking, but now she's a lot less stable. Should I really be asking her to increase her walking?

[A]

Yes. And in a safe environment, what would make her feel safe? Would that be walking with poles, for example? Sometimes my patients, if we put poles in their hands, it gives them that kind of sense of stability.

[B]

That's a great idea.

[A]

You know, it'll give them a little more real estate, if you will. So that's an option. The counterintuitive option is what kind of shoes are on her feet if she can't feel the ground and fall risk is a factor, put her foot on the ground, take smaller steps, you know, start with five minutes. Even in that. In the aging population, I think that's really important because if you can't feel the ground, then our fall risk is going to increase. So we could start with again, that transition conversation that we had. But making it in an environment, we can't say, don't walk. We can't. It's like telling someone not to sleep.

[B]

Yeah.

[A]

So we have to find ways. That's the conversation I want, really, is from a movement perspective. It's not what people can't do, it's what can we do to modify, to get someone to be able to do these things. So it's not a question of. No, it's how do we do it? Whether that's poles, different footwear, small increments, building confidence.

[B]

Yeah. I love that. I think it's such an important message and it reminds me when my mum was more active, I think I put mum In Vivos, maybe 10 years ago, something like that. And she was in her mid-70s at the time, and she just couldn't believe how much more stable she felt in them. She was like, oh. Because of course, it makes sense if you can feel the ground. If you're not on a pillow, you've got better balance. So I think sometimes when people think about, oh, minimalist shoes, they think about athletic people in their 20s and 30s. It's like I've always said, the elderly are a fantastic place to really be targeting. I think we could all benefit. But certainly the elderly get them feeling the ground and they'll probably. You'll probably find a lot of them feel A lot more stable.

[A]

I think this is a conversation that no one's having either. Let's say they were in a cushioned shoe. Those materials in the shoe break down pretty fast. And so people will have these highly cushioned shoes for a year, a year and a half. And if you watch someone walk in a highly cushioned shoe that has worn down, it can be scary. You're like, oh, my gosh. Because the materials have worn down. So it literally looks like their foot is trying to feel something and they can't. So that's another conversation is if you are. If this minimal conversation isn't making sense to you and you are in cushioned footwear, you have to change those shoes out pretty frequently. And you can't have those shoes for one year, two years. I mean, those materials break down in a minimal shoe. There's nothing to break down.

[B]

Yeah. It stays the same.

[A]

It's more stable.

[B]

Yeah. I could talk to you about feet and walking forever. I just love this topic. I'm obsessed with it. I think about it. I live it. Connie, I think you've written such a beautiful book. I know you wrote it with someone called Melissa McDowell.

[A]

Yes.

[B]

I think it's. You know, I think Chris put it beautifully yesterday when he said it's a love letter to walking. It really is something we've not spoken about, but I'll leave people to read about it. In the book is long haul walking, which you put right at the end, which I kind of feel is such a beautiful thing for us to think about, because it's easy to think about walking as physical benefits, dementia risk, lower risk of heart attack and cancer. And yes, those things are incredibly important. But walking is also who we are. It helps us understand who we are. And those long haul walks you describe at the end, these three day walks, these four day walks, these 10 day walks, that whatever it might be that people go on as a way of discovering who they are. I just love that stuff. There's a real spiritual component to walking, isn't there?

[A]

Yep. I was gonna say it's a spiritual component. And it is pretty amazing when you either cross that finish line or you challenge yourself to the point where you're making things a little uncomfortable. That sense of achievement from putting one foot in front of the other for long periods of time, I don't think it gets any better than that.

[B]

Yeah. One of the things you write about is the Camino de Santiago, you know, a long haul walk. And I think someone you guys interviewed for the book said after days of Walking. When your body is tired and your mind starts to quiet, the soul begins to speak. What unfolds is rarely just about the miles. It becomes a rite of passage, a time to let go, to reflect, to move through grief or transition, and to reconnect with what really matters. Absolutely beautiful. And that's what the book is about, right? Walk. Your life depends on it. Courtney, I've thoroughly enjoyed this conversation and my previous one with you this year. I think you're doing incredible work. I'd really encourage people to pick up the new book. I think it's wonderful and I just want to finish off by asking you. You get asked a lot about the feet and about walking and people will tell you their problems and tell you the reasons why they can't. What is the key message from all your work that you want to leave

[A]

people with, that you can, that anything is when you look at the foot and what it is capable of doing. It literally is what carries us through our lives. And to see movement deterred from the ground up, when every step is painful, those things can change. It is a hopeful conversation. It is what we as human beings were designed to do, was to keep our foot on the ground and to keep walking and to keep moving forward. There's so many, you know, analogies we could use here. One step in front of the other, just to keep going. Nothing allows that to happen more than our feet.

[B]

Well, Courtney, thank you for everything you do. Thank you for writing with your co partner Walk. It's a great book and thank you for coming back.

[A]

Thank you so much.

[B]

Really hope you enjoyed that conversation. Do think about one thing that you can 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 Bits, 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 these 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 adverts 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.