Mark Sisson (2:34)

Thanks for having me. Josh, good to see you again.

Dr. Axe (2:35)

Well, you too. I know we just saw each other a few weeks ago in Austin, Texas, at the Great Health Optimization Summit. That was a lot of fun and so many great people there, but it was great just catching up there. I walked up behind you when I saw you, and I'm like. Well, I was like, who's the guy with the giant traps? And, man, you're still. It's unbelievable what great shape you're still in. You're just only 71 years old. I mean, what has been your biggest secret to being able to be this fit and healthy? I mean, I will say I'm trying to think of. I don't know Anyone who is 71 years old who's in as good a shape as you are. I don't know anybody.

Mark Sisson (3:10)

I would argue there's different metrics that we could use to define that, but sort of overall fitness, I'd probably go up against anybody. And when I say overall fitness, I mean, I can't run a 10k like I used to run, and I can't bench press like I used to bench, and I can't. But I. But, you know, as a combination of all those things, at my age, I put together my own sort of decathlon, if you will. That includes how much I can deadlift, how fast I can run, how long I can hang from a bar, how long I can hold a plank, how long I can stand on one leg with my eyes closed and my arms crossed. I mean, all these different metrics that we use to sort of define not just longevity, but robustness, robust vitality. So. Thank you. And I live. So you say. What do I attribute it to? I mean, I can't overlook genetics. Right. I had some parents that contributed a pretty good predisposition toward kind of ectomorphic, mesomorphic body type. But I've been consistent. I mean, that's really. Since the age of 12, I've lived this sort of healthy lifestyle with an eye toward, you know, being strong and lean and fit and happy and healthy and uninjured for as long as I can.

Dr. Axe (4:23)

Well, the last thing you mentioned there, I think this is just huge with so many people. I know quite a few people who have tried to do what you've done in terms of. They've been really conscious about working on mobility and stability and strength. And some of those things. Yeah. A lot of times they still get injured. I mean, that's one of the biggest single things, is injury. That was huge. Yeah. What are some of the biggest things you've done to Both prevent injuries, but if. Also, if you've had them, to overcome and heal them as completely as possible.

Mark Sisson (4:53)

Well, I think the biggest thing to preventing injuries is paying attention. And that's also my biggest drawback. When I look back at the times I've been injured is sort of right on the cusp of an injury. I sort of knew. I should have known intuitively not to do the one more rep or the one more lap or whatever it was. So I'm a collection of injuries. I was in the gym the other day showing somebody the hamstring that I tore off the bone. Inline skating accident. I used to be a pretty good distance skater for inline skates. Tripped one night, did a split with my skates on, tore the hamstring. You know, should have had a surgery to repair it, but I didn't. Tore my lat. At the age of 35, doing some gymnastic moves. Tore my lat. Right. You know, I have, like a. My lat was torn. I've torn my patellar tendon. I mean, I've got all these injuries that I've had. That, again, in retrospect, we're stupid. And, you know, I come from an ancestral point of view. I come from a very sort of Darwinian background of, like, what did our ancestors do to get us to here? How did they evolve over, you know, millions of years of behaviors that. That sort of favored certain gene expressions and things like that? And if you look back at our ancestors, they didn't get injured. I mean, if they did, they died. It was. It was pretty simple. I mean, maybe they got a little bit of an injury, but they weren't, like, out lifting weights and trying to do one more repetition for a personal record or something like that, and then tear a bicep tendon or whatever. They didn't do one more set of 2002 on the track and tear a hamstring. So we have within us this ability to recognize when things are about to go wrong. And every time I've been injured, I've sort of consciously overridden that. That, you know, that sense of, like, maybe it's maybe. Maybe your workout's done. Maybe it's time to stop this workout and live to fight another day.

Dr. Axe (6:52)

Yeah. Yeah. You know, I think, like my wife and I, Chelsea, we generally have had very few injuries, but when we got injured, the biggest injuries that I know iced. It still affects me today, still affects my wife. Today is when we were doing CrossFit, and, you know, it was like this sort of competitive nature sort of started Overriding what I think we knew was wise in terms of pushing ourselves. And I will say this too, the way that I, if I could go back in time, I would exercise differently than I did, especially in my early 30s, late 20s, because I look at, I look at my body and there are things like I herniated two discs in my back and my, my wife had an ACL tear from high school that she re injured. And you know, if we wouldn't have those injuries, if we would have been doing other things, I don't think we would have had those same problems. I mean, how much of that is true for you where maybe you'd exercise differently as you would in the past?

Mark Sisson (7:45)

No, 100%. 100%. I mean, look, I am where I am today because of not just what I did and how I did it, but also the mistakes I made and the learnings that I had from those mistakes. So I would say in the last 15 years, my primary drive for exercise is to have fun, to enjoy what I'm doing, to play as much as possible, and to prepare for play by doing things that contribute to the play in very. So a little bit of weightlifting, a little bit of sprints, a little bit of, a lot of long distance training, a little bit of mobility work and then once in a while in a competition, a friendly competition like I play ultimate Frisbee, right? Put it all together so that all those component parts that I built in the gym or on the track now come together in a functional pattern that allows me to have fun, to play, to get a tremendous workout out of it, and most importantly, not get injured. So what I would do is probably, and again, over this last 15 years, the big thing for me is what's the minimum effective dose of exercise that I need to achieve my result? Not what's the most I can do, bust my ass, leave the gym exhausted. I think people don't pay attention to how much central nervous system stress there is in certain workouts. And so you'd say, well, my muscles are tired and I'm, you know, I'm out of, I have delayed onset muscle soreness or I have all these things many times you also have a central nervous system overload that's going to take days to recover. And if you don't pay attention to that and you come back the next day and the next day and the next day. Much like, you know, not to call out CrossFit for this, but a lot of the CrossFit protocol was, you know, you know, get kept going and going and going, yeah, yeah, you know, as much as possible over time. And I think back on those, on those sorts of workouts that I did and said, well, you know, I would have been a better athlete. I would have, my career would have lasted longer as a competitive endurance athlete, for instance, if I'd stepped off the track two sprints before the workout was over. You know, I said it was over. So those are minimum effective dose. What's the least amount of work I need to do to look fit? Because clearly we want to look fit, but also to be fit as a result of that, to be robust, to be resilient, to come back from that workout stronger, not beat up, but stronger, given enough rest and nutrition to be able to go into and live my life the rest of the day and then play a game two days later or go to the gym and get stronger three days later.

Dr. Axe (10:32)

Yeah, I kind of had a similar. Well, I had a revelation recently where I, I was taught when weight training that you go until failure, until you're just, you know, and then, you know, and then afterwards you, then you go to failure again, you know. And one of the things I realized is like once your muscles fatigue your ligaments, your tendons have to take up more of the, the stress. And you know, I don't know, a whole lot of people were long term. They what's actually causing them pain or lack of being able to go out and do what they want. It's typically less muscle related. It tends to be more joint and connective tissue, ligament tendon related.

Mark Sisson (11:13)

Or fascia.

Dr. Axe (11:13)

Or fascia, exactly. So I much more now when I go to the gym and lift weights, I'm not going until I just can't do the last rep. I'll kind of go until that one's hard. That's okay, I'm done.

Mark Sisson (11:25)

No, that's the metric everyone should use. And it's a, you know, you train that to be intuitive about it so that some days I get to the gym and I'm literally two or three sets into a workout. Like, you know, it's not. Today is not my day to train. Yeah, I didn't look at my HRV or anything. I just sort of intuitively two or three sets in, I'm like, no, today I should have taken another day off, which I will again. Central nervous system overload, which happens if you do the workout right. Sometimes that gets as involved as just the rote contracting of the muscle tissue.

Dr. Axe (11:59)

Yeah. You know, I think a lot of people think that in order to lose weight, maybe the number one thing they can do is exercise. One of the things I've heard you talk about is, no, that's not the case. That's not the number one way you should lose weight. And sometimes the way you exercise is different. I know you and I both used to be triathletes, so throughout my 20s and early 30s, in fact, in college I was on the triathlon team. I know that you were a really high level triathlete. So we both came out of that world and I used to think, hey, this is the ultimate way to, you know, lose weight and be lean. But I know your philosophy is pretty, pretty different now.

Mark Sisson (12:35)

Totally. First of all, exercise is a horrible way to lose weight. I just wrote an entire book, Born to Walk, which the first hundred pages talks about how running in particular is a horrible way. It's a horrible weight loss strategy for most people who engage in it, thinking that it is a good weight loss strategy. So where I'm coming from is your body composition is determined probably 80% by diet. So when you become metabolically flexible, when you're able to burn your own stored body fat at rest, at low levels of aerobic output, even sometimes at high levels of aerobic output, when you're able to access your own stored body fat, you burn off that fat that you want to lose. That's the weight you want to lose. You don't want to lose muscle. So orchestrating a diet so you become metabolically flexible is the holy grail of weight loss. And that has nothing to do with exercise. Now, once you've achieved that metabolic flexibility and you're able to extract energy from whatever substrate the activity that you're engaged in requires, whether it's the fat from your plate of food or the fat stored in your body, whether it's the glycogen in your muscles or the glucose in your bloodstream, or the ketones that your liver makes in the absence of glucose, this metabolic flexibility gives you, because now you're trending toward your ideal body composition. The good news is, number one, your appetite and cravings and hunger sort of dissipate or disappear in many cases. The other good news is you don't need to do that much in the way of exercise to get toned and strong and powerful and lean. So I tell people, once you've achieved this metabolic flexibility, then the minimum effective dose of exercise becomes walk a lot, as much as you can. Walking is the quintessential human movement, human exercise. Our bodies crave walking. We benefit from it. We get stronger as a result. A result of walking. Go to the gym twice a week and lift weights. Not four, five, six times, twice a week, go to the gym and lift weights, lift heavy things. And once a week, sprint. Find some way to get to do a maximal effort. Doesn't have to be running, it can be on the assault bike, could be on the, on the elliptical trainer, could be swimming, could be whatever it is, but. But once a week, find a way to get a couple of sprint sessions in there. And that's all you need to then tone up that body that you have already carved as a result of losing the stored body fat that you have on you. It's an amazing revelation, it's freeing, it's empowering. And yet too many people fight and they struggle and they want to suffer. They want to go out and run six miles a day and then get back from the run and they're exhausted. And because the run was so stressful to their body, they secreted all these stress hormones, this cortisol. The brain said, we've done way too much, we need to sort of compensate and overeat. And so people who start running as a weight loss strategy find that they never really lose the weight. And what happens is their body composition shifts because running is catabolic. Running tears muscle tissue down, there's no doubt about this. Running hard tears muscle tissue down. Not sprinting, we'll talk about that. But running metronomically, six, seven, eight minute miles, you know, all of that is catabolic. And then the stress hormones are, they promote fat storage. And so over time, you lose a little bit of muscle, you gain a little bit of fat, even though you weigh the same and you haven't lost any weight.

Dr. Axe (15:52)

Well, you know, one of the keys, and this is why having the right diet and exercise together so powerful, is when you can get your hormones at their optimal levels. And this is why, I mean, this is. You know, I did an episode on the testosterone crisis and I've done another episode on just women's hormones, thyroid hormones, cortisol, estrogen, progesterone, just being so off. And how when you have those issues, you're just getting less bang for your buck with everything you do. But diet is one of the greatest things to fix this. In Chinese medicine, they would recommend eating a lot more yang building foods, which is pretty much really lean red meat, lots of lean red meat. And then other things, they have other things like deer antler and panax, ginseng and fenugreek and other herbs that are somewhat helpful. But it's primarily almost all diet in these ancient forms of medicine of how you fix your hormones.

Mark Sisson (16:42)

Right. And to that point, running metronomically, you know, lots of, lots of high end aerobic stuff either to triathlon training lowers testosterone. And you know, the reason that the guys in the Tour de France used to supplement with testosterone and try not to get caught was not because they wanted to build huge muscles. They wanted to have enough testosterone to wake up the next morning and feel like they're alive. Testosterone levels were so low as a result of the inordinate amount of work they were doing. So that is another aspect of what happens to men in particular who are long term distance runners is testosterone tends to lower. Conversely, if you're a weight trainer or you do occasional sprints, it raises testosterone, it raises growth hormone. So once again, we're talking about a complex system here where we're talking about testosterone, we're talking about estrogen for women, we're talking about leptin and ghrelin and insulin and glucagon and all these different things that are literally controlling how the genes in our bodies upregulate or downregulate, how they, how they tell our bodies to build this protein or store that fat or do it's, it's all about this hormone control. And you know, orchestrating the, a diet that optimizes for that is part one. And then orchestrating a training program that optimizes for the building of muscle, the increase of power and speed but doesn't become catabolic is another part of that.

Dr. Axe (18:09)

Have you ever done a biological age test?

Mark Sisson (18:12)

I'm sorry, I don't believe in those things.

Dr. Axe (18:13)

You know what, you don't need to. Here's what I would say. If you did, it would be much younger than your age. And I think part of that is what you just said is really dialing in what the ideal foods are, what the ideal movement is in order to optimize your hormones biologically. I mean, you've probably seen this data on, I mean, men in their late 20s today have the same level of testosterone that men did 50 years ago in their 60s. And so, I mean it's dropped 33% over the last 50 to 70 years. I mean, male testosterone levels. So I mean, it is really, really an issue yet again. One of the things, and then I see all these men, the first thing they're doing is running and getting testosterone replacement therapy versus using movement medicine, food medicine, all these things that they could do to optimize your hormonal levels.

Mark Sisson (19:01)

Yeah. Now let's be clear. I've been doing TRT. I've been doing testosterone replacement therapy for about 10 years. I started my mid-60s and I, I make no, you know, apologies. You know, it's. I'm not doing, you know, trend. I'm not doing, you know. Yeah, I mean, clearly I'm not, I'm not a bodybuilder type, but it's, it's been a very integral part of my, you know, being able to keep up with my schedule that I set for myself, which is, you know, it's aggressive for someone my age. Clearly, when I say a minimum effective dose of exercise, I've still tightened it to the things that I want to achieve. I still want to go out and play ultimate Frisbee with 20 something.

Dr. Axe (19:37)

Yeah. Yeah. And again, I'm not trying to put down hormone replacement therapy. I will say my philosophy is put it off. As long as you can use herbs, even use things like peptides, let's do some things to put it off. Because right now, I don't know how many men are getting on them in their 30s already and sort of relying on those. It's just too early. In fact, in Chinese medicine, they recommend start doing stuff typically in your mid-60s, you know, and it's a lot of. But all that being said, you know, one of the other things that I love that you talk about, and by the way, I just want to kind of show off my shoes here. So these are my paluvas. This is your awesome shoe company. So I got to tell you a quick story. My wife and I literally met because of barefoot shoes. So my wife was online watching videos of, of, of people of this barefoot running trend. And I posted a video forever ago on YouTube of barefoot shoes. Now, at the time, those were Vibrams. These are ten times better.

Mark Sisson (20:32)

Yes.

Dr. Axe (20:32)

And I want to share why, but Chelsea sort of, you know, learned about me. Then she came to visit my clinic and we, we met, we hit it off because of, because of barefoot shoes. But I, I've been wearing some form of barefoot shoes for. See, that would have been in 2011. I mean, probably 2010, 20 2009. I mean, a long time ago. And I, part of me, I read a study on how much traditional shoes cause torque in your knees, in your hips, and all the issues related to that. Talk to me a little bit about one other thing. I just want to mention these shoes, why I love them. Most of the shoes today, they have far too much. A lot of the barefoot shoes, they have no cushioning. I Found that really bothered my joint.

Mark Sisson (21:12)

Yes.

Dr. Axe (21:12)

If I wore them too much or when you're wearing regular shoes, most of them have the cushioning is too soft. So then that was causing issues. The thing I love about these is it's a good amount of cushioning, yet it's a barefoot shoe. Yet the, the actual, it's a very, very high level rubber cushioning to where you're not kind of, it's not throwing off your running gate. It's not causing other issues there. So I mean, the way that they've been, these have been designed are just kind of extraordinary.

Mark Sisson (21:40)

I appreciate that. I mean, that's two years of R and D before we even launched our first product. But going back to my experience, I started running with these same 5 toed sh in 2007 and I was an immediate adopter. I'm like, this is amazing. I get this. I've hated shoes my whole life. As a career runner, I did not like the shoes I ran in. I got injured as a result of the thick cushioned shoes because my knees. Feet need to feel the ground. Feet need to feel what's underneath. So that by the time you weight that front foot when you're walking or running or jumping or whatever, the brain has all the information it needs on how to orchestrate the entire kinetic chain. How much to scrunch the arch, how much to allow the toes to articulate individually around, around that rock or that stick, how much to roll the ankle outside to accommodate the tilt or the texture of the ground you're walking on so that it does not tweak the knee, how deeply to be able to bend the knee, to upset some of the jump that you're making or whatever, all that information instantaneously hits the brain by the time you weight that front foot if you're barefoot, which is how we spent millions of years as humans evolving, we evolve with these feet as a primary sensory organ. It's our connection with the universe as our feet. Then only in the last couple of hundred years have we had these thick, cushioned, padded shoes that negate all of that input, all of that sense. So understanding how feet work, the fact that there's thousands, tens of thousands, hundreds of thousands of nerve endings in the feet that want to feel the ground. We had to create a shoe that allows for individual toe articulation. So even though you can get a shoe that has a wide toe box, for instance, if you've been scrunched up in a shoe your entire life and your feet are deformed, misformed as there's overlapping toes, sometimes bunions, Feet don't then automatically find this wonderful display outward when you take off those shoes. It's a reason tens of millions of toe spacers have been sold over the last couple of years. People recognize their feet are messed up. So we create a shoe that has these individual toe slots that allows for the ground feel. So just enough, just enough padding. Like an extra 3 millimeters of padding beyond what the previous shoes had to give you the sense of like, walking. Like if you're walking on a sidewalk or concrete, it feels like you're walking barefoot on a putting green. Yeah, okay. Just enough, but also thin enough that you can still feel every cobblestone you walk on, every hole you step in, the dimples on the manhole covers, you can feel all that, and it feels wonderful. It feels amazing. The foot wants to feel that. So we combined this ground feel with toe splay, toe articulation. The big toe wants to be out. It wants to be away from the other toes because it is the primary driver of every push off. Whether you're walking or running or sprinting or jumping or dancing, it's the primary driver. It's the last thing to hit the ground, and you want that to be there. You don't want it folded up against the other toes. And then over time, have your feet become more duck footed because you're trying to roll off that big toe and you can't because it's not there. So we're now two years into this experience, you know, many tens of thousands of customers who are like, oh, my God, this is the greatest. You know, I had no idea I was messing my feet up this way until I put these on.

Dr. Axe (24:59)

Yeah, it's really the first time that I've worn barefoot shoes and actually said, these are. These are perfect in terms of the cushioning, in terms of the ground feel, you know, I'm currently working on a book on cellular healing and reversing biological age and a number of things. And in this book, one of the things I've discovered in writing this is that the first breakdown that happens in the body physiologically is cellular communication. And then so like circadian rhythms is a great example of this. If you're getting too much blue light at night or not getting enough light in the morning, there's this sort of confusion by the body. And there's this sometimes this communication issue that happens also when you eat toxic food or lack nutrients and you lack nutrient signaling. So communication, it's key for relationships. You Know, if you want to have a great marriage or a great break, you gotta have great communication, I think, about walking barefoot or wearing barefoot shoes in a very similar way. If you can't feel the ground, there's a lack of communication there. Your body really, from the feet up now, doesn't know what to do. And so now your feet aren't communicating with the ground. So then that's now going to disrupt your knees, your hips, your low back, all the way up through your entire spine. And so that's one of the reasons, just looking at the science or the philosophical idea behind why walking barefoot is so important, is that if you don't, if your feet aren't right, your whole body's not going to be right. I mean, it's really the ground floor of the foundation.

Mark Sisson (26:24)

Absolutely. We talk about the, you know, the entire kinetic chain, the posterior chain, and again, all of it depending on this communication with Earth. Now, clearly, we can't go barefoot all the time, by the way. I would prefer everyone go barefoot all the time. So if we could get away with that and if we had the surfaces to walk on that we could do that, then I would be barefoot most of the time. But we've created this environment that is pavement and concrete and hardwood floors and marble floors and tile floors and all this other stuff, not to mention all the stuff we could be stepping in. So we need some kind of footwear. So my design was, okay, I want to come up with the optimal footwear, the optimal shoe that allows the foot to do what the foot wants to do, what the foot is designed to do, without compromising the ground feel, without compromising the toe splay, and have it be a good looking shoe, because that was also important.

Dr. Axe (27:16)

What is your view on this? Because there are a lot of practitioners that have pushed for or pushing for now, like things like orthotics. You know, I remember all the way back in college when I was doing triathlons, I started getting just terrible shin splints. And so, I mean, I tried orthotics first off. It might have helped by like 5 or 10%. It never really helped fix the issue. But what's your view on orthotics?

Mark Sisson (27:41)

Oh, so let me tell you, I go back to my original adoption of the Nike, the thick Nike trainers. And I went from running 50 miles a week in Chuck Taylor's because that's all we could do with those minimalist shoes, to 80, 90, 100, 110 miles a week in the thick training shoes. And I got horrible knee pain I got chondromalacia, okay? And that's from lack of ground feel. So I couldn't run for almost a season. And I was miserable walking around with a cane because of this. I go to see this guy, one of the first guys, Stephen Sabotnik in Hayward, Miracle Cure made these hard acrylic orthotics for me that prevented over pronation of my feet and kept my feet always in a slight supinated position. Okay. My knee pain went away and I ran for three more years until my hips went out. So this is a perfect example of not fixing the original issue, but putting a shim in one part of the kinetic chain and then having the kinetic chain having the weakest link be the next thing to break, which in my case was my hips, which ultimately ended my career. So my hip tendinitis was so bad that I went from qualifying for the US Olympic trials in the marathon 1980 to not being able to run. And as a result of that, I wound up learning how to cycle and swim a little bit, and that started my triathlon career. But it was the shoes that ultimately caused me all these problems. And it was the orthotics that just put a band aid on one of the problems and then forced put it further up the kinetic chain.

Dr. Axe (29:18)

It's almost like taking medication, right? You get one symptom, but over time, it's going to cause a whole nother symptom. You're not getting to the root of the issue. You're just.

Mark Sisson (29:26)

You're just creating. So feet want to pronate. You know, our foot is this multiplanar device that lands in a certain way and then folds and rolls and, you know, supinates, pronates and does all these amazing things that involve torque, that involve loading of certain coiled. The Achilles is one of the greatest loading mechanisms there is. And the people who are sprinters have this great ability. They don't use their calf muscles when they sprint. They're always coiled, right? They're always just landing and pushing and landing and pushing. So feet are the integral part of that. And if you start to mess with that structure by scrunching the big toe over and forcing. Forcing the foot to kind of compensate for how it wants to pronate off the big toe. Well, when you can't pronate off the big toe, you sort of roll inward and now your arch becomes a little bit flatter, maybe. And because you've been wearing supportive shoes that don't allow your arch to even work, because most of the footwear that we Wear today has an arch support in it. Your arch gets weak, weaker and weaker. So. So you lose all of this. Like, I know runners who run 50, 60 miles a week have the weakest foot muscles I've ever seen because they're always locked into this, encased in this supportive springy box like trampoline. And yeah, their lungs are fit and they're whatever, you know, their quads are fit and whatever, but they're not functioning appropriately as a total human being. Using the entire kinetic chain. And then you put them in minimalist shoes, train them appropriately, and I go, oh my God. I found a whole new lease on life. My running improved immensely because now I finally learned how to run. The way the foot is involved, the foot should be absorbing most of the impact of the landing. The foot muscles should be absorbing most of the impact of a landing of every time you stride, if you're a mid foot strider, but if you're a heel striker, you wear these thick cushioned shoes and the shoes forgive this bad form and then you get injured. 50% of runners get injured every year. Like that's worse than the NFL. 50% of all runners get injured every year. The so called high tech running shoes of the running boom of the last 50 haven't altered that one iota.

Dr. Axe (31:46)

Yeah, you know, one other thing that happens a lot of shoes and another reason why I love these is that there is such a dramatic heel to toe drop on a lot of these shoes today. And that's going to disengage your posterior chain, right? As there were a lot of people that are walking around. And I always had this issue. I played soccer and I did triathlons and cycled a lot. So I became incredibly quad. It was like everything I do, my quads want to just take over for the rest of my body. And so I've really focused on in terms of and one of the reasons why I believe even doing CrossFit, I ended up herniating two of those discs in my back was my posterior chain was weak. So now I've spent the last 10 years since then really focusing on rehabbing, healing my posterior chain. But one of the last things, things to really click for me was realizing, oh well, I'm wearing shoes where I'm at this massive disadvantage. When you know, you shortened your calf muscle, right.

Mark Sisson (32:39)

Which is a strong component of that kinetic chain. And in shortening the calf muscle, you put more pressure on the Achilles and it wraps around then the plantar fascia. And then because you squish the big Toe against the other toes. If you've been wearing regular shoes to train in. People talk about plantar fasciitis because it's an itis. It's an inflammation, but it's been been rediagnosed in many cases as plantar fasciosis, a lack of blood flow as a result of scrunching that big toe over. And that plantar fascia area does not have much blood flow to begin with. And now you've cut it off even further. So many people who are trying to roll out plantar fascia problems or stretch them out, that's not the issue. The issue is let the big toe abduct away. Let that area give more blood flow to that area.

Dr. Axe (33:27)

Yeah, yeah. So one of the biggest things I've done, like, now if I have somebody with plantar fasciitis now, the first thing I'm gonna have them do is get barefoot shoes. And then for a period of time, I typically have them. Don't know if you know what softwave is, but you know, something to kind of help get blood flow and break up some of the, you know, that. That fascia.

Mark Sisson (33:42)

It is blood flow.

Dr. Axe (33:43)

Yeah, yeah, yeah.

Mark Sisson (33:44)

Very cool.

Dr. Axe (33:45)

Yeah, that's great. Well, again, you know, I think just. And if everybody's. Everybody who's listening or watching this, I want to encourage you, consider going barefoot. The health benefits are numerous. I'm going to have Mark talk about that now. But I just want to say, for me, it's been so good for my back. It's been so good for engaging my butt, my hamstrings, my entire posterior chain. I can tell my feet are much stronger. Improved balance and stability. So there's loads and loads of benefits here of going barefoot. Listen, you don't have to be barefoot all the time if you don't want. You know, if you're on a hospital floor for 12 hour shifts, you might need some cushioning a little bit there. I don't know. Mark probably has an opinion on that. But overall, I wear these, you know, probably 50% of the time. You know, I wear them when I'm working out every time. And just when I'm going around the house or running errands or doing a lot of stuff. But, I mean, these are the shoes I wear most of the time.

Mark Sisson (34:38)

Yeah.

Dr. Axe (34:40)

You know, most people don't think twice about what they put on their feet, but they should. Conventional shoes with raised heels squishing your toes and these thick soles can actually cause pain. Think things like plantar fasciitis. Bunions and more. In fact, 83% of Americans suffer from chronic foot related issues. And the biggest remedy I could ever recommend is paluva. That's why I wear Paluva. Piluva is a five toe minimalist shoe that mimics barefoot movement, restoring natural alignment while looking stylish. With just enough cushioning for daily life and athletic training, paluvas let each toe move independently, the way God intended us to walk. When I wear mine, which is almost every day, I feel grounded, connected, and like I'm actively supporting my body's healing. Your feet are your foundation. Start taking care of them with Paluva shoes. Ready to take the first step towards better movement and foundational health? Visit paluva.com and use the code AXE at checkout for 15% off your first pair.

Mark Sisson (35:46)

Well, again, if you can't go barefoot, I would say wearing a five toed shoe is the next best thing. To your point about in the hospital, people on their feet 12 hours a day, a lot of nurses are now wearing paluvas and singing the praises.

Dr. Axe (35:58)

Wow.

Mark Sisson (35:58)

I've got a couple of surgeons who are doing stir and when you do surgery, you are standing in one place for hours. Right. And I've got surgeons wearing shoe. Yeah, this is, this is a little bit thicker version. It's a leather, it's called the Napa, the Paluva Napa. It's a five toed shoe. Even though it looks like it's really thick, it's still only 12 millimeters total stack height.

Dr. Axe (36:22)

Wow.

Mark Sisson (36:22)

But just enough so that when you're standing on concrete all day long. So, so benefits of going barefoot, first of all, you know, from Chinese medicine, the big toe is wired directly to the brain. Okay. So I want to do an experiment with pre dementia, you know, people, early, early onset dementia, barefoot and minimalist footwear to see if there's any connection there. That's, that's one of my goals. In the gym, you'll hear all the bodybuilders go, great toe. The big toe is called the great toe. Great toe, great ass. The great toe is directly connected to the glute. And so the reason guys and girls will train barefoot in the gym on leg day, they want that big toe to be abducted away to plant into the ground, to press it into the ground to fully activate the glute when they're doing squats or lunges or even deadlifts, Romanian deadlifts or whatever. So there's a tremendous benefit to engage. You've felt it. The increased, increased engagement of muscles in the leg, just by having the feet splay outward.

Dr. Axe (37:22)

Well, and think about how important this is for men, because your glute is probably your largest muscle, and it's probably the most important for building testosterone. I mean, we know that building up these muscles is going to support testosterone. And so men, if you have low testosterone, going barefoot, especially on butt day and leg day, that's important for women. Very same thing. If you want to build healthier, a better backside, again, you know, going barefoot's gonna help.

Mark Sisson (37:47)

So, you know, you walk barefoot in your house and you walk up the stairs. Let's say you have some hardwood floors or whatever, and you walk up. Notice that you step on the metatarsal head and your feet splay. That's probably the most your feet will ever splay outward is when you are stepping up onto a step or if you're sprinting down the beach at low tide on the. On the wet sand, you go back and look at your. Your footprints. That's the greatest amount of splay your toe will get. Your feet want to splay. They're designed to splay outward, not just to improve stability, because that's a greater. A more stable platform, but to enhance the strength of each of the component parts of that foot. So every toe should be strong and independent on its own. Clearly, the great toe, the big toe, should be the most. Courtney Conley. Do you know Courtney?

Dr. Axe (38:33)

No.

Mark Sisson (38:33)

Okay. She's a chiropractor. She's probably, I think, one of the most knowledgeable people about feet and foot health and foot strength in the country. And she will tell you that one of the greater predictors of mortality in people over 65 is foot strength and particularly big toe strength, that ability to not trip and fall because of either balance and. Or the strength that you have in your foot to recover if you do trip. Because, you know, if you trip, you don't have to fall. It's not obligatory that you fall and break a wrist or break a hip. The number of times I triple hiking, for instance, you know, over the years with a backpack on, but never fall. I catch myself, you know.

Dr. Axe (39:13)

Yeah.

Mark Sisson (39:14)

So I think the ability to engage that big toe to build the foot strength so that your feet are stronger, they're more mobile, they're more resilient, your balance is better. You want to go barefoot for that, to get that toe splay. I encourage people to do that test where you're maybe barefoot in your living room and close your eyes, cross your arms, and then stand on one foot and see how long you can hold that. Well, some of that's balanced in the brain. Most of that is foot dexterity, the ability to recognize the brain, to recognize exactly how much off you are, and then to be able to apply pressure to either the heel or the toe or the little toe, and to be able to maintain that stability, it's a great. I do that between sets when I'm in the gym. It's a. It's a easy way to recover and yet do another sort of form of exercise while you're waiting for the next set to come up.

Dr. Axe (40:06)

Yeah. You know, one of the things that I'm very, very thoughtful of now is not just exercise. You know, when I was in my 20s and even a good part of my 30s, I was. I was much more thoughtful about how do I look good, I mean, you know, and feel good. But overall, I wanted to feel good in the short term. It wasn't. I wasn't thinking about. About as much. Hey, in my 60s and 70s and 80s and 90s, and how can I be at my. My height of my, you know, be very fit and active.

Mark Sisson (40:36)

Right.

Dr. Axe (40:36)

During those times? And so a lot of times, you know, today, people have maybe one form of exercise they do, and they've only focused on that. It might just be weight training, it might just be running. But I think having a real sense now about things like stability. Right. Balance, like you're talking about, is just so important. I know that when I think about the people that I know that are the most fit in their 70s, 80s, and 90s, those people, there's a couple things in mind. One, they tend to walk a lot, you know, and a lot of times they hike. They do a lot of uphill and downhill.

Mark Sisson (41:09)

It's the best.

Dr. Axe (41:10)

And then the next thing is sometimes I'll see these guys at the gym. I remember I walked up to this guy, he's actually a doctor who's in his 70s, and he gets on one of those kind of half balls, you know, in the gym, the Bosu balls. And he's always doing appropriate balance stuff. And he says, this is what keeps me from injury. It's what's. He attested that as being a big part of him being so fit, you know, at that. At that point in life.

Mark Sisson (41:32)

Yeah, I mean, one of my. I used to have a slack line in my backyard in Malibu. I'm trying to figure out where to put it in my house in Franklin right now. But a slack line is a great way to develop that sort of balance. And it becomes fine motor skills, because a Slack line isn't about, isn't about, you know, like a trap, a tightrope walking kind of balance. With a slack line, everything happens below the waist and you're trying to bring the line back underneath you. You're not trying to stand on top of say a metal pipe or something like that. So slack lining is a great way to do that. Again, those, those, those one leg exercises, the balance exercises. But I mean so, so many of the, of the little things that we used to not think were valuable, like planks or whatever, they're incredibly valuable. And so I throw. We do a lot of these mix and match. A lot of these different workouts these days. Like, like part of one of my, my other routines in between sets at the gym is just a dead hang from a pipe, from a, you know, from a, from a bar. Because grip strength is another way of, another metric for longevity.

Dr. Axe (42:37)

And as I said, interesting foot strength and grip strength, your hands and feet.

Mark Sisson (42:41)

So hands, I mean feet are just hands that we developed in a different way. But many people who don't have. This is the, I mean it's the best example. People who don't have arms use their feet with very much dexterity. They can do lots of things with their toes. Most of us never have that occasion to do that. And so we wrap them up in these attractive pointy Italian fashion wear, you know, and try to attract the opposite sex and use that as a means of passing the genes along to the next generation. But we evolved, surviving as a result of using that contact that we have with the ground as the primary focus. Like everything we do, whether you walk or sprint or jump or dance or get out of a chair or get out of a sofa or get up off your desk. Everything you do starts with contact with the ground and why you would not optimize that like athletes. I just, I'm blown away by how little attention world class athletes and you know, NBA players, NFL players, baseball players don't pay attention to their foot health and their foot strength. Strength.

Dr. Axe (43:48)

Can I tell you one of the next big things I think we're going to see in pro sports in the future is customized shoes for athletes. And they're going to be barefoot. I mean they're actually going to be customized for the individual in that way.

Mark Sisson (44:00)

Yeah, no, I mean, so you mentioned two things that I find fascinating. So you played soccer and you did triathlons. So soccer, a soccer cleat wants to mold your foot into a bat so you can strike the ball for whatever reason. A cycling cleat wants to do the same thing. Cycling cleats are some of the most uncomfortable shoes you'll ever wear. Certainly going back to the days of you and I competing in triathlons, me even before you. And I remember those days when I would get back from 100. So you know the term the brick, right?

Dr. Axe (44:33)

Yeah.

Mark Sisson (44:33)

All right, So I coined that phrase. I don't know if you know that.

Dr. Axe (44:35)

No, that's my.

Mark Sisson (44:36)

Yeah, yeah. So if you go back through history. So I used to coach a professional triathlon team in the late mid to late 80s and I would have him do a brick every week. And it was 100 mile run. Sorry, 100 mile ride followed by a 10 mile run. That's the original brick. But we would do these rides and I'd get off the bike and I could not feel my feet after 100 miles. And then I'd put on running shoes and be expected to hit the ground literally running and go do 10 miles. So I've always been fascinated by whoever it was that said a cycling foot is much more efficient when you scrunch it all together, bind it all together, wrap it tight, and then apply it to a cleat and start applying.

Dr. Axe (45:16)

Well, can I tell you what's interesting is one, even though that's the way it's been done, I don't know that that is actually the best way now maybe with striking a ball, because that's a little bit unorthodox in terms of a movement. We're not going to do that often. But I will say there's no doubt that if you are wearing something that's more barefoot, you should be able to cut laterally better.

Mark Sisson (45:36)

Yes.

Dr. Axe (45:37)

And the other thing I would say is the most common, from what I remember, the most common injury in soccer players is hamstring tears. Why is that? Well, you get so quad dominant that now your hamstrings are weak. And so they're just, you know, there's such an imbalance there. It's easy to, easy to tear.

Mark Sisson (45:52)

Well, and you get quad dominant. Great point. You get quad dominant because you've bypassed 30% of the forces generated from running or jumping should be created or absorbed by the muscles in the feet. 30% of that should start and be allocated to stronger foot muscles. Whether it's again a strong arch, a plantar fascia that's been coiled and pushed off the ankle, rolling a little bit. And what do we do? We tape those feet up, we tape the shoes up and we wear these thick, restricted things and then all of that force now has to be. Has to begin, has to emanate from the ankles up. And that's how we become that quad dominant. If we were able to. This is one of the things I've said for a long time, but if we were able to. To retrain the feet and develop a wide, flatter, certainly stiff cleat for athletes like that, that could absorb some of that initial shock, we would offset. We wouldn't tear the ACL because of that. We wouldn't pop the Achilles because the entire foot was taped up and the first point of release was where the calf and the Achilles come together. Boom. It totally makes sense to me. And yet that that's what's happening. And yet we're back into these trainers that are 30 years behind the scene or 35 years behind as they tape their athletes up.

Dr. Axe (47:15)

Yeah, you wrote a book here. It's called Born to Walk. So I remember reading Born to Run years ago. And I think that it's so funny because if I would have heard this in my 20s or 30s or my 20s, I would have thought, waste of time, waste of time, or that's not that exciting. But the reality is that when we go and look at these blue Z and we. And now working with people that are, you know, and really studying longevity, there's no doubt that walking is one of the optimal things you can do. And you can mix it up. You could wear a weighted vest. You can do hiking, of course, up and down. I mean, it's amazing if you go up and down some pretty steep stuff, what an amazing work that work that is. It's. It's really.

Mark Sisson (47:58)

Well, not only is it. You're right. So it's good cardiovascular work. It's good muscular work. And if you do it in minimalist footwear, it's also amazing foot strength work because every step you take on a hike lands you in a different position. Now, if you're running and you're landing in a different position, unless you're really well trained, it's a gamble. It's a gamble if you're walking again. If you're walking, as I say, by the time your foot lands, the brain already knows. I already feel this rock. I already know I should, like, slide to the outside. I should roll the ankle a little bit. I already know how deeply to bend my knee. And so one of my favorite workouts to do, I'm going to the south of France for July and August. I do every year. I do a lot of hiking there. One of the reasons I designed this shoe was to enable me to walk 10 to 12 miles a day in the south of France, because that's sort of our yearly pilgrimage. And I hike until I find a Meadow or some 200 yards, then I jog or I run or I sprint. Then I with good form and then I regain resume my hiking. And so it's a combination of hiking and a little bit of running and put it together and I think it's the ideal workout. It's what we used to call it fart lick in the old days, right?

Dr. Axe (49:10)

Oh, yeah.

Mark Sisson (49:12)

But it's, it's an incredible workout. I'm not running, I'm not met. Running metronomically 7 minute miles. It doesn't appeal to me anymore. And it, and there's no, there's no goal for me to do that. Why would I do that? I'm not. Again, horrible way to lose weight. I don't need to lose weight. I don't want to lose weight. It's catabolic to run that often, that far. If you want to run once a week, fine. But most people, the only people who should be running are ectomorphs with great lung capacity who are genetically gifted with their VO2 Max and who have a high pain tolerance. Those are the only people who should be running and they shouldn't be running. But if they want to compete, then let them compete. But our ancestors did not run. The premise of Born to Run, Christopher McDougall's book that you read and that I read, it was a great book. The premise was that we evolved as persistence hunters. Right. But a persistence hunt isn't two hours of seven minute miles.

Dr. Axe (50:04)

Yes. Not at all.

Mark Sisson (50:05)

Chasing a gazelle down.

Dr. Axe (50:06)

Yeah.

Mark Sisson (50:06)

Every day. No, a persistence hunt is crouching and stalking and jogging and sprinting and hiding and tracking for two hours until the beast is like, overwhelmed. And we have this, you know, cooling system, this evaporative cooling system. Our sweat glands enable us to go up and jab a spear in it, which we, you know, that's our weapon. And then not do it every day, you know, every once in a week. You didn't do a persistence hunt every day. So my whole premise here is lots of walking, walk, walk, walk, walk, walk, lifting heavy things. And our ancestors lifted rocks and stones and they built shelters, and they carried babies and they carried carcasses and they climbed trees, lifting heavy things and then sprinting. Once in a while, our ancestors had to sprint for their lives. Once in a while. Not every day, but once in a while, those, those component parts allowed the Men to go out and do a persistent hunt once a week, once every four days, whatever it was. And do you think that our ancestors, after they'd had a big day of hunting, were like, well, we don't have a hunt today. Let's go out for an easy 10 miler? No, it was completely antithetical to health. It was a waste of calories.

Dr. Axe (51:17)

Well, even if we go back even 100 years ago, when most jobs. I think Maybe it's even 200 years ago, but. But 50% of jobs were agriculture related and you had blacksmiths and everything else. And it's like we were spending so much time outside, so much time in the sun, barefoot, in the sun, fresh air, very, very in the soil.

Mark Sisson (51:38)

The germ theory of all of that.

Dr. Axe (51:40)

Right, exactly. And so much of sickness today is just living out of tune with nature. It's just living out of tune. I believe that in order to optimize health, one of the things that I've taught is it's all about connection. And one of those things is on this show, we talk about physical, mental, spiritual. One is connection to God, the other is connection and love of other people having those relationships. And then it's really living in tune and connection with the earth when the sun goes up, when it goes down, just living in tune with nature. And so that's one of the reasons I've been such a big fan of your work and all the things you've done. I know that you're the founder of Primal Kitchen and some amazing, amazing food products. And then now with Paluva again, and so much of this, one of the things that. And I've been. I read your newsletter back and probably started and probably right when you. I don't know when you started. I was gonna say 2008 is when I started reading it. So I've been reading it for a long time and you're putting out great content, but a lot of it is living in tune, you know, eating things in their most natural form possible, walking in your most natural form possible. And I love that you've done this with this new shoe brand, Paluva, and it's just awesome. So I want to encourage everybody to go out and check out these shoes. And they're stylish. That's another thing, you know, I love. We've got some leather here. We've got some, you know. Yeah, yeah, yeah. I love that.

Mark Sisson (52:55)

So this is. This is a loafer. This is the Miami loafer. This is a casual shoe.

Dr. Axe (53:00)

And then the nicest slip on that's great. Thank you.

Mark Sisson (53:02)

This is a. This is our atr. This is the terrain shoe. This is a trekking shoe. I have a lot of people trekking in this, a lot of people rucking in this. A lot of people who are training for trail running. And by the way, most trail runners don't run. They just hike fast.

Dr. Axe (53:18)

Yeah.

Mark Sisson (53:18)

You know that.

Dr. Axe (53:19)

Yeah, yeah.

Mark Sisson (53:19)

I mean, the. The fast ones do, but most people just hike fast. Perfect shoe for. That's got a increased tread on it. We just launched. This is my own personal. This. We just launched a golf shoe.

Dr. Axe (53:30)

Wow. Really?

Mark Sisson (53:31)

It's gonna crush. Yeah. I mean, you know, some of the top golfers who have always felt like they need the ground feel.

Dr. Axe (53:37)

Yeah.

Mark Sisson (53:38)

Not had that with the. With the. With the shoes that they have. And I've already had. I have 600 because I wear. Test all my shoes. I've already worn some of this off just walking on concrete and pavement and stuff, like, a lot. But it's an amazing shoe. So we are so excited about the possibility of changing the way the world thinks about foot health, foot strength, and how that integrates with the entire. Again, with the entire physical body, the kinetic chain, hormonal systems, all of this. It all starts with the feet.

Dr. Axe (54:08)

Wow. It's so powerful. Well, again, I'm a huge fan here, and I wear these constantly, all the time. And again, you know, I think for so many of you, you'd be blown away at just the benefits of just wearing barefoot shoes 50% of the time and during your workouts and wearing these types of shoes. And as I mentioned, this is the best brand out there in terms of the foam is perfect, the fit is perfect. Just the way you've done is just so fantastic.

Mark Sisson (54:32)

Mark, thank you. I appreciate that. And what I'll tell people is I think this is the most comfortable shoe you've ever worn.

Dr. Axe (54:36)

Yeah.

Mark Sisson (54:37)

Once you, you know, some people, takes.

Dr. Axe (54:39)

About two weeks, I think, to fully adapt.

Mark Sisson (54:41)

Yeah.

Dr. Axe (54:41)

But overall. Yeah. Yeah.

Mark Sisson (54:43)

Within a couple of days, you go, oh, my God. Like, I can't believe. Like. Like how. How. How dexterous my toes are and how great this feels. Right?

Dr. Axe (54:49)

Yeah, yeah, yeah. It's fantastic. And especially if you've got chondromanlacia patella, if you have plantar fasciitis, if you have back pain, if you have knee pain, if you need to rehab your ankles, it's great for that. But also it's great to prevent all those things for longevity, for your health span. So I want to encourage you guys, go and check out Paluva here by Mark Sisson. These shoes are amazing. And, hey, we have a deal.

Mark Sisson (55:10)

Should we talk about that?

Dr. Axe (55:11)

Yeah, yeah, yeah, go ahead.

Mark Sisson (55:12)

Yeah, yeah, no. So we have a 15% off introductory deal for any of your viewers, listeners, and it's axe.

Dr. Axe (55:20)

Code axe.

Mark Sisson (55:21)

Code axe.

Dr. Axe (55:22)

And so go to peluva.com. okay, that's P E L U V A dot com. Use the code AXE. That's AXC. And 15% off. So, Mark, that's so kind of you to do that.

Mark Sisson (55:31)

No, it's my pleasure. I want the world to experience it.

Dr. Axe (55:34)

Yeah, yeah, I do as well. We're so grateful for you. For everybody who subscribed to the show, who shares this podcast out there, and again, everybody I bring on here, like Mark, it's because I want you to take your health to the next level. No matter what you're doing, I want you to prevent the injuries. I want you to be 90 years old, playing with your grandkids, bringing them to Disney World or rucking and hiking here, traveling through Europe or France, like Mark here is able to do. And so, anyway, just thanks so much for watching, everybody. And hey, if you're watching on YouTube, what was the biggest piece of advice that Mark shared today? Or that piece of wisdom that you thought, wow, I didn't know that. Or. Or. And have you worn barefoot shoes before? Have you worn Paluvas? Hey, we'd love to hear from you on YouTube in the comment section there as well. Hi, thanks so much for watching. We'll see you on the next episode. That's the sound of the fully electric Audi Q6E Tron and the quiet confidence of ultra smooth handling. The elevated interior reminds you this is more than an ev.

Mark Sisson (56:36)

This is electric performance redefined.