The Foot Expert: Your Toes Can Predict If You’ll Die Early! This Will Fix Plantar Fasciitis!

The Diary Of A CEO • May 29, 2025

TLDR

Steven Bartlett interviews Dr. Courtney Connley on The Diary Of A CEO, about foot health and its impact on overall well-being. Dr. Connley highlights that foot pain affects physical and mental health, while increasing daily steps reduces risks of cardiovascular issues and dementia. Modern footwear compromises foot function, and functional shoes with wide toe boxes and minimal heel elevation are better. The key involves transitioning gradually to barefoot shoes and strengthening feet for long-term mobility. She offers practical foot exercises and actionable advice, emphasizing foot health's crucial role.

Timeline

The Impact of Foot Pain on Overall Health

Many individuals experience foot pain, which can negatively impact physical, emotional, and mental health, making it difficult to perform daily activities and potentially leading to depression.

The Benefits of Walking and Step Count

Increasing daily steps can significantly reduce the risk of cardiovascular mortality, all-cause mortality, and dementia, highlighting walking as an easily accessible activity with substantial health benefits.

The Negative Impact of Poor Footwear

Footwear choices, especially narrow shoes, can negatively affect foot structure and function, leading to various foot problems, with children being particularly vulnerable.

Foot Problems and Their Impact on Balance

Foot issues like bunions, neuromas, and hammer toes can increase the risk of falls and decrease balance, indicating the importance of addressing these problems to maintain stability.

Common Foot Injuries and Treatments

Common foot injuries include plantar fasciopathy (heel pain) and Achilles tendonopathy, which can be addressed by strengthening the tissues in the foot and lower leg.

The Personal Significance of Movement and Foot Health

Movement was a crucial coping mechanism for Dr. Connley, and foot pain, by limiting movement, can lead to dark places, emphasizing the importance of maintaining foot health for mental well-being.

The Importance of Walking

Walking is an underrated and underutilized activity, with research showing that even small increases in daily steps can significantly improve health outcomes.

The Importance of Movement in Treating Foot Pain

Treating chronic foot pain requires addressing the underlying issues and promoting movement rather than simply resting the foot, as inactivity can worsen the problem.

The Conflict Between Fashion and Foot Health

Fashionable shoes often compromise foot function, with narrow toe boxes, heel elevation, and excessive cushioning all contributing to foot problems.

Characteristics of Functional Footwear

Functional shoes should have a wide toe box, minimal heel-to-toe drop and be thin and flexible to allow the foot to function naturally and strengthen over time.

The Benefits of Toe Spacers

Using toe spacers can improve foot alignment and spllay, which leads to better strength and function and can prevent issues like bunions and neuromas.

Effective Foot Exercises

Foot exercises, including toe exercises and ankle mobility exercises, can improve foot strength, mobility, and overall function, helping to prevent injuries and improve balance.

The Impact of Running Form on Foot Health

Overstriding while running can increase the risk of injury, highlighting the importance of striking the ground closer to the center of mass.

The Importance of Gradual Transition to Functional Footwear

The key to improving foot health involves transitioning gradually to functional footwear, performing regular foot exercises, and prioritizing foot strength and mobility.

Audio Summary

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Transcript

I want people to start thinking about

their feet because the implications it

will have for longevity is massive. But

there is plenty of things we can do for

foot strength and performance. And you

can actually do this at home. And I'm

going to educate you here. There's a lot

we could talk about here. That didn't

sound like a compliment. Dr. Courtney

Connley is a worldrenowned foot doctor

who's making people rethink everything

they know about their feet and the

shocking truth about their shoes. One in

three people will experience foot pain

and it really starts to deter your

physical health, your emotional health,

your mental health because you can't do

most things. And I know this because as

a ballet dancer and then a triathlete, I

had all of the diagnoses, bunions,

nuromomas, heel pain, and not being able

to walk and not being able to move. You

can go to some pretty dark places. But

when you look at the statistics, 5,000

steps a day can reduce the risk of

having symptoms of depression and also

reduce your risk of all-c causeed

mortality by 15%. Wow. Here's a bigger

wow. 9800 steps can reduce the risks of

dementia. So it's the most underutilized

easily accessible activity that most of

us are not doing. What about footwear

choices? Footwear has such a big

implication on our function. For

example, around 70% of children are

wearing shoes that are too narrow. I've

got a range of footwear here that most

people wear. So, what do you think of

these shoes? You shorten the muscles in

the back of the leg. What is the issue

with wearing these? So, they change the

structure of the foot. What about this

one here? You're going to make me start

sweating. So, let's talk about some good

shoes then. Okay, so these are the

things you want to look for in a

functional shoe. First,

this has always blown my mind a little

bit. 53% of you that listen to this show

regularly haven't yet subscribed to the

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that you want me to speak to and we'll

continue to do what we do. Thank you so

much.

What are we getting wrong? And at what

stage in our life do we get it wrong? It

feels

like you have a little bit of beef with

shoes. A little bit. A little bit of

beef. I've got a range of different

shoes here. But what is it that we're

being sold or told that is fundamentally

not aligned with what it is to be a

healthy, strong, happy human? I always

say that if we started with our children

and put them in the right footwear, I'd

be out of a

job because that's when it starts.

That's when the foot starts developing

and that's when we start to build

strength and you know structure to the

foot and from a very young age we start

interfering with what goes on the foot.

And when you think about all of the

things that the foot can do, it's why

I'm obsessed with it. I mean, there's

bones and ligaments and the foot should

be designed, it's designed to move.

The arch recoils, so it should lengthen,

and then it should contract. There's

four layers of muscles in

here. So, when we look at the function

of the foot, we have to respect that.

And I think

footwear can deter the function of the

foot. So is the is the biggest risk just

make sure I'm super clear that I will

fall when I'm older. Is that the key

risk? I mean I don't I think that is one

of the squella of what's going to happen

if we don't start paying attention. But

when you look at function as a whole,

things like walking, one in three

people and probably over the ages of 45

will experience foot pain. Yeah. So,

other than low back pain, there's really

no other

diagnosis that you'll see those types of

numbers. And here's the here's the issue

with foot

pain. You can't do much.

You can't go for a

walk. You can't go for a hike. You can't

do most things. You can't walk to the

mailbox when you have severe foot pain.

So, it really starts to deter your

physical health, your emotional health,

your mental health. So, it's one of

those things I'm extremely passionate

about because it's not just about pain.

It's about what happens when you can't

walk and you can't use your foot. And is

it is the foot connected to the ankle

which is connected to the correct half

which is connected to the back. Is

there sort of a whole body um holistic

issue here? Is it all interconnected?

Yes, 100%. Especially when I see you

know patients that have

bilateral symptoms of their feet. So

that would be both sides. Okay. So, for

example, if I see someone with bilateral

bunions, okay, which would be the bump

on the inside of the big toe. Yeah.

Okay. You have to ask

yourself, where is this abnormal load

coming from? Let me just check my

bunions.

Yeah. Check. Check. Yeah. Right. Where

is it coming from? Is it, you know, is

it a something that has to do with the

pelvis? Right. Because when I'm

standing, if I tilt my pelvis forward, I

should feel my arches drop. Mhm. So

there's a direct correlation between

what's happening at your hips and your

pelvis and what happens at your foot.

And when I were to tuck my pelvis, you

should feel the arches

lift. So when we start to see things

happen at the foot, it's a window. It's

a window to what's going on, not only at

the foot, but everywhere else in the

kinetic chain. When patients come to

you, what kind of symptoms do they have

that are connected to the foot?

Bunyions, nuromomas, hammer toes. What's

a nuroma and a hammer? So, a nuroma

is a nerve irritation. Yeah. In between

the toes. So, the mo the most common you

will hear of is a Morton's nuroma, and

that's typically in between the third

and fourth toes. Okay. And it can be

very painful. Remember we talked about

when you go to push off when you're

walking? Yeah. The wider and the

stronger the forefoot is, the more

stable it is. So, if I have a foot that

doesn't have spllay or that looks like

this and you're trying to push off of

it, you can irritate the nerves within

the forefoot. Okay. And you can develop

these nerve symptoms at the forefoot.

Very painful. What are the are the other

types of sort of injuries or symptoms

that people come to you with that you

then root back to the feet? Hammer toes.

Hammer toes, which is the clawing of the

toes. Oh, okay. Yeah. Right. And this is

what's cool about the foot because it's

the only place in the body where you can

see aarent loads. What does that mean?

Abnormal lo dysfunction because you

can't see it at the knee. You can't see

it at the hip unless you were to take

imaging where you'd start to see

structural change. But you can see it at

the foot. So, you should be asking

yourself, man, why am I developing

hammer toes? And maybe I should pay

attention to that because bunyions and

hammer toes

also will increase your risk of falling

and also decrease balance. That's a

problem. I had um planttoitis, which

meant that I struggled to walk for a

couple of weeks uh a few years ago when

I was training for a football match. And

that's really what started me on my

journey of understanding the foot and

trying to understand how to strengthen

it. Yeah. So that I could be more

active. Cuz if you've never experienced

planttoitis, which I'm sure some of my

listeners have, it really is a awful

awful thing. What are what's the the

rest of the list of those kinds of

injuries that people can get from having

a weak foot? Is there anything else that

we haven't covered? Well, plantar

fasciopathy is probably the most common.

That's your heel pain. Okay. And I do

think that that is a

diagnosis that we need to look at a

little bit differently. Achilles

tendonopathy also very very

common. Um other tendon diagnoses

posterior tibialis tendon. So that's the

tendon that runs along the inside of the

foot and it's one of the biggest

stabilizers of the medial column of the

foot. It's a powerhouse that in the

soius which is your calf lower the calf

muscle powerhouses of the lower leg and

all of these tissues can be strengthened

and produce

power and we need to start looking at

the foot just like we look at every

other part of the body. So what do you

do for a living and who are you?

Um well I'm a chiropractor by nature. Um

I went to chiropractic school.

Um, you know, I knew that I wanted to

get into some type of medicine that was

proactive, you know, not reactive. I

didn't quite have interest in surgeries

or pharmaceuticals. Movement has always

been a very big part of my life. And so,

I knew I needed to stay in that in that

arena.

So, what did you do? When I was younger,

I was a dancer. I was a ballet dancer

and then I shifted gears into being a

runner and then a

triathlete and I didn't know at the time

why movement was a necessity for me. You

know, I certainly wasn't thinking, oh,

you know, I need to do this because of

longevity or because I'm going to have a

better V2 max, you know. And now in

hindsight, when I think about it, it was

a means of survival. Mhm. Uh movement

was survival for me. And in my teens and

into my 20s, you know, I had some

personal demons that I fought.

And the one thing that was consistent

that I felt I could control was making

sure that I stayed moving. And the

problem is is when you have foot pain,

you can't do that. And because movement

was a was a lifeline for me. It was a

mode of survival. There were days where,

you know, I was a dancer. I had all of

the diagnoses we just talked about,

bunions, and nuromomas, heel pain, and

when you tag on day after day of not

being able to walk and not being able to

move, you can go to some pretty dark

places.

And so I just it was a mission of mine

to figure this out and figure out how I

can personally be able to continue to

move but then also be able to hopefully

help other people. It got tough for you,

didn't it? I can see it in your face.

Yes.

Because for this to matter this much to

you, then it's it's personal to say the

least.

It changed my life. when you're, you

know, I think whenever we have a

passion, there's always this quest

personally behind it. And so I

saw what it did for me and then over the

past 20 years being able to see what it

has done for my patients is why I'm even

more hardpressed to get this information

out there. Walking, yes,

we don't do much of that these days. It

seems to have gone out of fashion with

all the Ubers and the other ways to to

get around and all the sedentary uh

behavior that we do living in living and

working in offices. What what should we

know about walking and how important it

is? Because I'll be honest, I don't walk

that much. Yes. It's um I always say

it's the most underrated, underutilized,

easily accessible activity that most of

us are not

doing. If you think about if you look at

the research on average step count that

most people globally are taking, it's

about 45 to 4,900.

Okay? Which means that there's a lot of

us that are taking less than

that. So when I'm working with my

patients, we always look at baseline

numbers. What's your baseline?

So, for example, if you had a person who

was walking 2500 steps a day, I mean,

some of us would be like, "Wow, that's

not a lot." But for a lot of us, it

is. If you were to walk an additional

500 steps in a day, your baseline's

2500. You can reduce your risk of

cardiovascular mortality by 7%.

Wow. Here's a bigger wow. If you have a

thousandst step

increase, you can reduce your risk of

all-c causeed mortality by 15%. Dying of

anything, all-c causeed mortality,

15%. That's a big number for a thousand

steps.

So, I I have a story for you. This is a

patient of mine and it just, you

know, it warms my heart to talk about

him because when I saw him, he was 2

years into a diagnosis of heel

pain, 27 years

old. So, he had um gone to see a bunch

of people and the last doctor that he

had seen told him to limit his step

count to 2500 steps a day. Why?

to rest to rest the foot. Now, this is

chronic pain. Now, we're not talking

acute heel pain. We are two years into

this song and dance and he's being told

at 27 years old to take 2500 steps a

day. So, he comes into my office, we're

talking about all of this, and he's also

quadruplet. So, it was one of the first

quadruplets I think I've ever treated.

So he has

um you know which why I think pain is so

difficult. It's so complicated because

now you have this 27-year-old who's

seeing his siblings who are at 27 like

enjoy their life and doing all these

things and he's being told he can take

2500 steps a day. So he's now living in

his father's

basement and he's

afraid to go above 2500 steps.

And he used to tell me, he's like, "I

cry a lot. I'm

depressed." And wouldn't you be if

Yeah.

So there wasn't any magic exercise that

I was going to give him two years into

this. There wasn't any magic orthotic or

magic shoe. He had done all of that.

Shame on me if I would have done the

same thing.

So, we had a

conversation

and I knew I needed to get him outside

and I needed to get him walking. That

was my goal. Forget about the heel pain.

We didn't even focus. We didn't even

talk about the heel pain. I knew I

needed to get him outside and start

loading his

foot. Two years. This foot, by the way,

when you're walking, four to six times

your body weight. It can handle four to

six times your body weight when you're

walking. but you don't load it

appropriately and muscles

atrophy. So I told him, we had a long

long conversation and I said, "We're

going to slowly start to introduce

steps." And if you think about this, if

we were to say add a thousand steps a

day, to some people that might not sound

like a lot, but to someone who's taking

2500 steps, that's almost 50% of what

they're doing.

So we introduced the concept of a micro

walk which is a five minute

walk. So a five minute walk is about 500

steps. Okay. A 10-minute walk is about a

thousand about a thousand steps. Okay.

Right. So that makes it like a little

more digestible. Right. So you're

talking to him. And you're like,

"Listen, all I need is 5

minutes." And so we started five minute

walks. And for the first couple weeks,

it was, you know, there were good days,

there were bad days, and there still

are, but we were starting to build his

confidence in movement. We were starting

to get him comfortable on his foot

again.

And it was, you know, it was one of

those cases where I just like I I

really enjoyed working with him and

watching what had happened

because if you look at step counts, I

knew what number I was trying to get to

because if you look at um depression,

for

example, 5,000 steps a day can reduce

the risk of having symptoms of

depression. Mhm.

If you get to 7,500 steps per day, it

can reduce the prevalence of the

diagnosis of depression. So that was in

the back of my head. I'm like, we just

got to keep working towards these

numbers.

So while we were doing that, we were

strengthening his foot. I had him in

different

footwear. And at the end of each week,

we were also talking

about three good things. tell me three

good things that happened to you this

week. And in the beginning of treatment,

it was it was a struggle, Stephen. It

was a struggle for him to think about

good things happening in his

life. And

um I I spoke with him probably about a

month

ago and his email is like my why. He was

um on average he's walking between five

and 6,000 steps a

day. He still has good days or still has

bad days, more good days than bad days.

But he said to me, he's like, "I haven't

I can't tell you the last time I cried.

He's going to church. He's spending time

with his dad, you know,

and it's not it's not the step count,

it's the person behind the step count.

And that's why I think this stuff is so

powerful. I saw it change my life. I saw

what it does to my patients. I mean, it

has the capacity to improve not just

your physical health, but how you

interact with the world.

you

it has a completely different meaning

when you understand the real sort of

human consequences it can have on

someone's life for better or for worse.

[Music]

Um and it's and it's not often until we

have some kind of injury or issue that

we yes realize that our feet and ankles

were were there. Yes. And that certainly

been the case in my life. It wasn't

until I got planticitis that I was like

oh my god I should have been doing

something about this sooner. And then as

I told you before we started recording

I've currently got a high ankle sprain.

So, I've pulled some ligaments in my the

top of my ankle training for this game

called Soccer Aid. So, I'm now going

through the whole process once again of

like figuring out what I did wrong and

what what I should have been doing as a

preventative measure to try and

strengthen my feet. One of the things I

think most of us get wrong is our

footwear choices. Yes. And I've got a

range of footwear on this table in front

of me here. These are the types of shoes

that most people wear. Um, from a very

young age, I think we all wear shoes

like this.

Yes. Narrow shoes with a big heel. If

anyone can't see our conversation at the

moment, it's like the the typical

trainer. What is what is the issue with

wearing these from an early age?

When I was doing research to have this

discussion with you, it was fascinating

to me when you look at the statistics of

especially with um children, with girls,

around 70% are wearing shoes that are

too narrow. Too narrow. The end part.

Yes. Yeah. Remember we talked about the

widest part of the foot should be the

toes. Mhm. So when you look at a shoe

like that, that is not the widest part.

It's tapered. See how the toe box looks

like it's tapered? Yeah. It's point like

correct. Yeah. So when you put your foot

in there, it's doing this. Mhm. It

changes the structure of the foot. It's

like the lowest hanging fruit for me is

just wear a shoe that fits your

foot because when it's in that

position, it changes the structure. If I

walked around with uh my arm in a sling

for 10 years, would my bicep get weak?

Yeah. Your mo you'd lose your mobility

as well. Correct. If you don't use it,

you're going to lose it. And so that's

why I think footwear has such a big

implication on our function.

Men's dress shoes. Men's dress shoes. I

mean, that is crazy. The point on that.

Yes. It's funny. My um brother lives in

New York City and we have this

conversation all the time and he's like,

"Look at this one. It's wide." I'm like,

"Nope, that's not wide." Right. And

they're stiff and they're, you know,

again, changing the structure of the

foot. A lot of those shoes also have a

little bit of a heel to toe drop. Yeah.

Yes. So that is when the heel to toe

drop, so the heel and the toes sit in

one plane. But when you have a higher

heel to toe drop, it's like you have a

mini high heel on. Yeah. And what's the

problem with that? Well, if my foot is

supposed to sit

flat, I have tissues in the back of my

leg that are in a good length tension

relationship. I have even pressures

across my foot. Yeah. The second I go

and change those things where I go into

a heel, you put additional pressure on

the front of the foot, you shorten the

muscles in the back of the leg. So you

start changing the the function and the

structure of not only the foot, but

everything that sits above it, your your

calf, your hamstring, your back.

Do you see a lot of back injuries that

are relating to things like heels and

Yes, you do. Mhm. It's all, you know, I

see mostly people come in for foot pain

and I always say to my patients, I wish

it was just about the foot. I wish I

could just look at your foot and say,

"This is what it is. It's all right

here." But it's not because there's a

body that sits on top of the foot.

The strength of the hip, for

example, controls the foot. It controls

how the foot unlocks.

So, you have to take that into account

when you're looking at patients with

foot pain.

But this this is the shape because it's

fashionable, right? Yes. It's my

biggest, you know, I always tell my

daughter cuz my daughter, you know,

she's like, "You make me wear these

platypus shoes." And I'm like, "Listen,

it's function over fashion." But I get

it. That is my biggest challenge is

making, you know, is looking for shoes.

But they've come a long way. They're

they've come a very very long way and I

think that uh we're getting there. Is

there an issue with the thickness of the

heel on these shoes? This big When I say

the thickness of the heel, I really mean

the thickness of the sole. So the

cushion and the the cushion. It's I mean

it's really really soft soft and

cushiony and there's about you know an

inch at the back here of soul. Yeah. Um

the cushion conversation is always very

interesting.

Um, there's always a trade-off. So,

there's a lot of popular shoes right now

that have a lot of cushion on them.

Yeah. And it's hard to argue when

someone goes into a store and they're

given this shoe that has this pillow on

it and they're standing on it for 3

seconds and they're like, "Man, this

feels really

good." The problem with

cushion is that the more stuff

that's between your foot and the ground,

the less you feel. So, there's a loss of

sensory acuity. There's a loss of

sensory perception. Remember, the foot

is, imagine the foot's a sensory organ.

And it is because there's thousands of

receptors that are, you know, screaming

for information to help keep us upright

in a biped. So, when we start

interfering with how that foot feels,

you can expect there to be problems.

Now, if you have someone that's standing

in place all day long, right, on

concrete, on man-made surfaces, there's

a time and a place. But my

non-negotiable is at least keep the foot

in its functional position, which means

a wide toe

box. So, you want to stand on concrete

all day long, fine. Put a put some

cushion underneath your foot. Help

yourself out. That's okay. But at least

allow those toes to spllay so that you

can have balance. You can have your foot

in a position that can propel you

forward. I was just thinking about my

foot as you're talking and I'm pretty

sure like my I'm pretty sure like my

pinky toe

looks I'm not going to be able to sell

pictures on only fans of my feet because

my pinky toe is kind of like crumpled

in. It like curls under, right? Yeah.

It's like curled under, right? Kind of

looks like a shoe. like you had a shoe

there like Excuse me. No, no, but you're

right. It is. It is like that. Um it's

kind of like been pushed pushed in and

underneath and I guess that's not

natural. No, it is not. How does a

natural foot look like? Have you been to

see a tribe who who don't wear these

cushion shoes? Have you seen what like a

un cushioned foot looks like? I'm

obsessed. I watch people's feet all the

time. I was just in Bise with my mother

and daughter for spring break. It's

slightly creepy. Sorry. It is, isn't it?

And you're looking at people's feet on

holiday. I'm always looking at people's

feet. Uh because it tells a story. It's

like someone's gate, you know. Watching

someone walk tells a story. you can tell

if they just got fired or if they just

got promoted, you know. But when you

look at someone's foot, I was in Bise

and with my mom and daughter and um

there were these two guys building a

house a little bit off the beach

barefoot and I'm looking at their foot

and I'm going, "Wow, it was wide. It

looked

thick. It looked flat."

And you know, I think in our society, if

you will, when we think of a flat foot,

we think, "Oh, this is bad news. We

better go get an orthotic." An orthotic

is a um a device that you put underneath

the foot to help um modify loads. Uh

what do they call those in the UK? Um

insoles. Like an insole. Okay. Yes. And

so I'm watching these guys build this

house and they're like coming up on

their toes and they have all this, you

know, toe range of motion and all this

strength and power to their foot and I'm

like that's that's what our foot was

designed to do is to be strong to

support. It's like building a house on

sand. Yeah. You have to have a

foundation that you can build upon. And

it was really cool to see. It really

was. When I had that pain in my foot,

which they told me was plantificitis,

they recommended that I go to some foot

doctor person. And this foot doctor

person measured me up for insoles. Yes.

And I put the insoles in and then I took

the insoles out and instead of that, I

just wore different shoes. Yeah. A lot

of people's first sort of diagnosis and

the thing that they're told to do

whenever they have foot pain or back

pain or whatever is go get some insoles.

Is this what you think we should be

doing? Because it's really really

common. It's like it seems to be the the

like in medicine they throw pills at you

if you have certain symptoms. It seems

to be the first thing that we do when

someone has a foot problem or an ankle

problem. First line of intervention is

that's why I I you want to change how

we're viewing the foot. It's either if

your foot hurts, here's an orthosis,

which is a a foot orthotic, an insert.

Yeah. or if it hurts worse get

surgery. If you look at the research on

planner fascitis, okay, so itis being

acute, it will tell you that putting an

orthosis or something to modify the load

underneath the foot can be

beneficial

initially because you want to offload

something that hurts. Yeah. But if you

don't use it, you're going to lose it.

So what they're not the part of the

conversation that's being missed is the

and

conversation. It's wear this insert

and strengthen your

foot because the goal should be to have

an exit strategy for the insert and get

your foot back on the ground. Because I

have

patients, Stephen, they will come in

with 20 pairs of orthotics, 20 pairs of

inserts. They've tried this one, they've

tried that one, they've tried different

shoes, higher heel totoe drops, more

cushion, and I'm sitting there going,

we're missing the boat

here. Let's have the and conversation.

One of the muscles that is a good

predictor of having heel pain, okay, is

it runs parallel to the planar fascia.

So it's flexor digtor and brevis. It

basically takes the four toes and

presses them down.

There's ways you can assess for

this. So we'll look at their toe

strength and then it almost always

correlates with the side that has the

heel pain on because it it shouldn't be

one of those conversations. You're like,

man, I wonder where this came from. No,

your foot is weak. Your foot is weak.

There's a lot of load going through it

and the structures are, you know,

getting beat up. There's something

Daniel Lieberman said to me which I've

never forgotten. He said, "If you took a

child and you put them

in 2in thick gloves from the day that

they were born and then you took those

gloves off at 30 years old, can you

imagine how deformed their hands would

be?" Right? And that's like very much

the way that we live our lives. We spend

pretty much all day wearing these big

cushioned shoes that sometimes have

these heels on. So, it's no wonder that

so many people are getting foot

problems, ankle problems, back pain.

Yeah. So, one in three people, one in

three people. Foot pain. I mean, it

is it really is a statistic that we need

to be paying attention to. We use this

word planttoicitis, but we didn't

explain what it is and what the symptoms

of it are. Is it essentially like pain

in the the heel of your foot? Pain in

the heel. So yes, and they've played

around with, you know, the terminology

being it plantar fascitis, so more of an

acute issue versus plantar fasciopathy

because often times these cases will

turn into, you know, having heel pain

for very long periods of time. Yeah. So

then you have to treat it differently.

You don't treat something that's acute

the same as you would treat something

that's chronic. And so you have to look

at how can I build the resiliency to the

foot. How did it happen?

How did all of this happen? How did

planticiitis happen? Like, how did I get

it? So, I'll tell you what I was doing.

I was living my life as normal. Yeah.

And then I started training to play for

this soccer game and I started training

several maybe twice a week. And then

maybe by week four or five or six, I get

this horrific ongoing pain which lasted

throughout the entire day. Yeah. where I

couldn't walk easily. It was especially

bad in the mornings and uh yeah, I

thought I'd like broken something or

ripped something in my foot. And when

they told me that it was planttoicitis,

I'd never heard that term before. But

understanding what I did there, how did

I get it? When I see I hear very similar

stories with that diagnosis, there's

always there always seems to be some

impetus of I I added load too fast too

soon. Mhm. I went on a longer hike. I

This was one of my favorites. Um I went

barefoot during COVID around my house

and everybody wanted to blame the fact

that, you know, don't ever go barefoot.

And I was like, maybe it's just cuz your

foot was weak and you weren't ready to

handle these loads. You add loads too

fast, too

soon, and the foot just says, "You know

what? You weren't ready to give me this

amount of load this quickly." Okay. And

that's, you know, when you asked me

earlier about

um why do we need to pay attention to

our foot strength? Is it just because,

you know, we're going to we want to

prevent falls when we're 70? This is the

why. Because we want to have healthy

feet, strong feet, so you can say, "Hey,

I want to go play a soccer game and I

don't want to worry about having planner

fascitis in my 30s." Mhm. Or I mean, now

with this this ankle sprain that I have,

Yes. pulling my ligaments which takes

you out of activity for so long which is

horrific. That's like a big part of this

which is if you get an injury if you get

a bad injury if you get like an Achilles

tendon issue or the you tear a ligament

like I have or even planttoitis

the inactivity that stems from that

causes a bunch of downstream issues. So

my muscles are going to atrophy. I'm

going to lose muscle over this next

couple of weeks in my lower half. I'm

going to get probably a little bit

lopsided because the injury is on my

right side. So now my left side's having

more of the burden. Uh my my lower legs,

my upper legs, my lower back is probably

susceptible now to some kind of injury

as well. And it feels like, you know,

this down downward spiral of injury just

because I didn't strengthen my foot.

What do you think of these shoes? These

are women's heels, but listen, anyone

can wear them. It's 2025. Um what do you

think of these shoes?

Well, it doesn't look like a foot. Your

foot in that position is not the

position it is supposed to be in. Now,

with that being said, there is a time

and a place. You know, I don't think I'm

going to win the battle of, you know,

you need to wear, you know, functional

footwear 24 hours a day, 7 days a week.

Time in those shoes should be

limited just like with, you

know, other things.

It's moderation. Do you see a lot of

women getting injuries because they

spend too long wearing heels? I don't

know if acute injury but but a weakening

of tissue. Yes. Because, you know, I

live in Colorado now, so I don't have

that uh there's not too many women in

Colorado that are wearing heels.

However, when I go to New York City,

it's a different conversation, different

environment. M so you know I have to say

I have to use the that is not the

position that you want to keep your foot

in. It's changing the structure of your

tissues changing the pressures in the

foot. Not to

mention that those aren't I don't I

don't care what anybody says that's not

comfortable to walk around in. People

will be like I'm really comfortable in

heels. I'm like are you really though?

The lengths we go to to look good

though. Right. That's right. Okay. So

let's talk about some good shoes then.

Okay. I've got two pairs of shoes here.

Okay.

One of them is Vivo Barefoot, who are

actually a sponsor of mine ever since I

s started talking about feet. Um and

then I don't know this brand. What is

this brand? That is Ultra Running.

So, let's talk about um the things you

want to look for in a functional

shoe. My non-negotiable is the wide toe

box. The toes have to be able to play.

When you think of all the diagnoses that

we talked about, bunyions, nuromomas,

hammer toes, when the forefoot can

spllay, the foot's going to function

better. So that's number one. Number two

is having the heel and the toe in the

same

plane. And number three is having a shoe

that is thin and flexible.

When you wear this type of

footwear, I call this a workhorse shoe

because there is more loads going

through all of your tissues, through

your bones, through your ligaments,

through your tendons, through your

muscles. So, your foot gets stronger

when you wear this type of footwear.

There's research on that.

Now, you have to earn your right. This

is the plantar fasciopathy conversation.

You can't go from wearing a um

aggressive high cushion shoe like this

one here with and yes with an insert for

example and say oh this stuff makes

sense I'm going to go take that off and

I'm going to go wear this 24 hours a

day. You won't like me. Why? Because

you'll say hey my heels hurting because

you haven't done the work. It's hey

let's do these foot exercises. Let's

wear this for 10 minutes a day. And then

people are like, "Wow, that does feel

better." And then it's a transition into

wearing this more

often. Now, when you have patients that

have had a a very weak foot or clients

that have had a very weak foot with

different

diagnosis, this is a hard, you know,

shoe to walk around in for extended

periods of time. So, that's when we'll

talk about footwear that still puts the

foot in a wide position. wide toe box. I

love this shoe. And I also like the mesh

upper because you can the toes can

expand in

here. I still have zero

drop, right? Where the heel and the toe

sit in the same plane, but you'll notice

the difference between the two shoes is

the amount of stack height or the amount

cushion. There's more stuff. Yeah. So on

this on this shoe

the it does look like the you call it

plane looks level. Yes. Okay. And it's

got a good toe box. You can see from

this side that the toe box is wide so

you can play. But it is elevated.

It's elevated off the ground. Yeah. But

the heel and toe are in the same plane.

Okay. Fine. But it it's it's still

elevated though. They're still like

quite a thick Yes. That's not too much

of a problem because it's still depends

on what your goals are. If I'm running,

that is that is a I think a great shoe

to run on, to run with, right? If you're

running on concrete, if you're running

on asphalt, you want a little something

underneath the foot.

What

about

the Nike Alpha Flies, which is my You

make me start sweating. Really? Uh uh

this is my current running shoe and I

bought it because it looks great. Yes. I

mean, you know, it is it's I have torn

the the ligaments in my in my ankle, but

but I look good. Here's the super shoe,

right? So, here's this shoe, right? And

here's your super shoe over here. Yeah.

Okay. When you look at that shoe,

there's certain characteristics to that

shoe that you definitely do not see in

this shoe. One of them being the toe

spring. So, see how it kind of lips on

the front of the shoe? Yeah. Okay. This

part here. Yeah. Yes. So, if I had that

shoe on this table and I went like this

to the front of the shoe, it would

literally rocker for me. Mhm. So, it

facilitates the rocker of the foot.

Sounds great. You put that on, you're

like, "Man, this is great. I can fly."

If you don't use it, you're going to

lose it. So, there is research that

shows when you put your foot in a

position with toe spring, you will

weaken the intrinsic muscles of the

foot.

So, I'm not

saying don't have race day and wear that

shoe, right? You get the research will

tell you two to four% running economy.

People run faster because the shoe has

the technology to facilitate gate. But

if you train in that all the time and

you never let your foot get stronger,

it's just a matter of time. You're going

to say, "My hamstring, my foot, my this,

my that." And it's like we that's why

the conversation has to happen is this

is the shoe that you're going to get

stronger in. Spend time in your training

shoe. And then that's your speed day.

That's your race day. So it's having the

shoe spectrum, knowing when to dance

along the spectrum.

I feel like I can bounce in these.

I mean, you probably can. I literally

when I put it on, I was like, "Wow, I

can bounce." I think it has like a piece

of metal going through the middle of it.

carbon in there. You know what another

fun fact is though? Certain plyometrics,

so plyometric is training the spring of

the body. So think like

jumping. There's research that will show

you that plyometrics also increase

capacity in running by 2 to 4%. So my

conversation I have with my patients is

listen, what if we stacked therapies,

right? What if you did plyometric work

which is uh jumping? Yeah. you know,

once or twice a week and we worked on

your strength and I had you in these

shoes the majority of the time and then

on race day you want to throw that shoe

on. It's like you're you're a running

you're like a running fairy. You're like

running and things look beautiful and

everything is, you know, because you

have a strong body on top of the shoe.

But if you put a weak body and a weak

foot in that

shoe, you got to earn your right. Should

we be standing more often? Because most

of us work and live in offices now and

we sit at desks and I I you know I do

this podcast sat down. Do you think much

about standing desks or how often we

should spend bipedal or I think that's

what you refer to as I think that it's

more about movement. Okay. I don't know

if standing in one place is any better

than sitting in one place other than

when you're standing you can actually

like you know move around and you know

make it more active standing but it is a

matter of taking movement breaks like

that's I call them you know movement

snacks all of us spend a lot of time

either sitting all day long or you know

standing at our

desks if we were to take micro walks a

five minute walk a couple times a day.

The system stays moving. You're staying

active and you're slowly, you know,

inching up that step count that we know

is so important for not only physical

health, but emotional and mental health.

That's what I like about it. I think you

mentioned there was an association with

movement, walking, and dementia,

Alzheimer's risk. What What does the

science say there? You

know, when you look at step counts, if

that was going to be our

baseline,

9,800 steps per day can reduce the risks

of dementia. But what I think is the

cool part with that is

3,800 steps, you get 50% of the maximal

benefit.

So, if you were to, let's just call it

4,000, shoot for 4,000 steps, you're

going to get a benefit,

a 50%

benefit. And some of my favorite

research on looking at that

population with walking is relationship

walking. There's really cool studies um

looking

at walking in groups for the elderly

population and how that has a social

connection and it improves their

emotional health and it combats

loneliness and feelings of

isolation and that is the beauty of a

walk. Run clubs are getting incredibly

popular at the moment, aren't they? All

around the world. Are you seeing more

and more people come to you as a result

of that? Yes, I think also um you know

it was interesting. I was working at the

running event in Austin, Texas, and I

was teaching there. And so, a lot of the

shoe stores were there, and one of the

bigger shoe stores had said that the

majority of their clients now are

actually walkers and not

runners. And I thought that was pretty

interesting. And I'm thinking to myself,

I wonder why that is. Like, are more

people reverting to walking because

they're getting injured when they're

running? Are they, you know, I'm making

all these conclusions in my head. I'm

like, well, is it because we're going in

the wrong direction with footwear

because we're creating this shoe that is

basically doing the work for us and it

feels so good and, you know, people

aren't putting the work in

anymore. I don't know, but I'm certainly

going to do my best to change that.

You brought me a box which I have Yes.

here in front of me.

Foot health kit. Yes, that's what it

says on the front of the box. Um, a foot

health kit. I mean,

what is in this box? It's like my little

like bag of treats. You know, when I

started doing this, it was funny. Um,

this is what you give people as a bag of

treats. That's right. For their

birthdays and stuff.

I want people to start thinking about

their feet because I I think there's

such um implications for their health.

And I wanted to make it easy because

when we think about all the things we

need to do to stay healthy, it's like I

have to strength train, I have to, you

know, eat this. I need to V2 max. I need

my cardiorespiratory fitness. There's a

lot. So, I wanted to make it easy. So I

um first what one of the things that

that is in there are toe strengtheners.

So I'll pull them out the box. So

those are toe spacers. Toe spacers. Yes.

So is this all the same thing, right?

Yes. So these are toe spacers. Correct.

And then there's this. Yes. What's this?

Those are toe strengtheners. Toe

strengtheners. Okay. So that's my toe

workout. There is this thing, a band.

And

then there's this ball. Yes. So this is

like this is my foot gym. That's right.

Can you show me how this stuff works?

Absolutely. Okay. So um these are my

feet and these are my ankles. So I had

planttoitis in I believe it was this

foot actually and then right now I've

got a high ankle sprain which is some

kind of ligament here has been torn and

they told me that it's torn on all three

sides. So, I've been in a boot for the

last couple of weeks, but I've taken it

off over the last week or two, and I was

on crutches as well. Um, what are you

The minute I took my socks off, you

became fixated on my feet. Yes. What

What do I need to be thinking about? And

what can you see just by looking at my

feet? You know, when you're looking at

this foot here, you can start to see

this little see this little bump here.

You can start to see bumps on the top of

the big toe. Mhm. Okay. And the

diagnosis is a hex limitus or a hex

rigidus. And basically what that means

is that you have formed um

arthritis on the top of the toe. So it

prevents you from getting that full

range of motion that we need when we

walk and run. Okay.

Okay. If the bump goes out to the

side, that's what we call hex valgus.

That's the bunion. The bunion. Okay.

Okay.

So that's what why the foot is a window

to mechanics because you can see loads

aarent loads right why is this forming

here so you know one of the first things

I want to look at is how much range of

motion the big toe it's all about the

big toe when we're walking we put a lot

of loads and force that go through the

big toe when we walk you should have

about 40 to 45 degrees to walk out of

that big toe. So, here's Eddie. Here's

45 degrees up. Up. Okay. Okay. So, yes.

So, what I'll want to see is how much

range of motion. Can you see how he's

off the ground, though? I want the ball

of the big toe on the ground.

That's a good amount of range. That's

the first nice thing you've said about

my feet.

We're just getting started. I'll find

something else. And then you want to

look at toe dexterity. So in other

words, can you isolate your toes? So can

you lift just your big toe on the right?

Good.

And then on the left.

That's actually quite hard. Like I've

never had to do that before.

It's funny because when you'll see

people that have poor awareness to their

feet, when they try to lift their toes,

you'll see them like their hands and

like your back isn't going to extend

your toe. Okay. Okay. And then put your

big toe down and then extend your four

toes. Yes.

No, that pinky is not that's not

listening. There you go. And

here. Okay. And then what I want you to

do is you're going to lift up all of

your

toes and spread

them. And you can see two, three, and

four, right? They don't want to spread

as much. Mhm. Earlier we talked about

those nuromomas. The nuromomas live

within the toes here, right? Within

right in between the toes.

So if we have issues with nerve problems

here, you got to be able to spllay.

So you wear vivos. You know, when you

allow your foot to be in a shoe where

the feet can actually spllay, you'll

start to see changes. Mhm. But imagine

if you, you know, were in a shoe where

your foot I mean I had a I was at an

expo working a couple weeks ago and this

woman came up to me and she's like,

"Man, I can't figure out why my foot

hurts." And I took her shoe off and I'm

telling you, her foot looked like this.

It look like a shoe. And I took a

picture and I showed it to her and I was

like, "Does your foot look like a foot

or does it look like a shoe?" We don't

really know the difference these days.

No, because remember the widest part of

the foot should be the toes.

So that's what we want to look for in

the front of the foot. We also talked

about that muscle. What side did you

have the heel pain on?

I believe it was the right side. So one

of the things we'll do um and you can

actually do this at home. You could use

like a a credit card. So in my office we

can actually measure that. But if you

were to do it at home, you just take a

card and put it underneath the toe.

Okay. Okay. And make sure you're lined

up here. Yep. And some people will also

do that. See how you're like holding

your leg just the toe. Mhm. And then

I'll try to pull the card out from under

you. And I shouldn't be able to do that.

I should feel some tension.

And then I'll ask the patient, "Where do

you feel this? What's

working?" And if they say my hip, my

quad, it's wrong guy. We're talking

about the foot. So you should feel that

in the arch of the foot and maybe into

the calf.

Okay. Big toe flexoralis longus. This

guy by the way, this muscle starts over

here. It's very important to strengthen

this muscle when you have a history of

ankle sprains. Starts on the fibula,

which is the outside of the leg. It

comes down the foot, crosses under, and

inserts into the big toe. Then I'm going

to take the card and I'm going to put it

underneath the four

toes. The muscle that we're looking for.

Yes, that's beautiful. See how you got

that little See, that's the second comp

compliment I gave you

about. I'm going to put this underneath

your toes.

Yeah.

Right. Little. Yep. And then don't let

me pull the card

out. And you should feel that in the

arch of your foot. patients that have

I'm not really feeling it to be honest.

I'm not feeling it anymore. Okay. Oh,

what? Okay, there you go. Roll the roll

the bottom of the foot like this. Yes.

Just wake it up a little bit. There's a

bunch of receptors on the bottoms of the

foot. So, when we can't feel things and

it shouldn't surprise us, you know, if

we've been walking around in footwear

that compromises the function of the

foot or we've had injuries, you start to

lack what we can feel. So, just wake it

up a little bit. And how long would you

do that for in the morning?

60 90 seconds. Do you do this every day?

Uh, I do. I'll tell you when I like if

I'm standing at my desk, I'll keep the

ball there. Okay. When I come back from

a run, I do this whole little setup. But

I wear these all day.

What is that that you're wearing,

though? So, these are toe spacers. So,

they do exactly that. They spllay the

foot. And why are you wearing that?

Okay. Remember when I was telling you

about my years of being a ballet dancer?

Okay. Um, inpoint shoes. Uh, I wore

orthotics for a long period of time. I

wore ill-fitting footwear and my foot

was weak and things hurt. Okay. And we

talked about why I needed to fix all of

that. Um, you can

see my bunion here.

Okay. So, I work on all of this stuff

all the time and toes play is a big part

of that. So when I have these toe

spacers

in, they spllay the foot for me. Every

pair of shoes that I wear um is

compatible with a toe spacer. Okay. So

you don't wear any narrow shoes. Yeah.

Non-negotiable.

Okay. And this is

important. There is a difference between

a wide toe box and a wide shoe. So

people will say, "Well, I ordered the

wide." The width will come

here. That's where they change the

width. But if the toes are still

tapered,

the width has to extend into where the

toes are. Mhm. So that's where you got

to be careful. It's a wide shoe is not a

wide toe box shoe. And if you try to

wear these in just a wide shoe, you're

not going to be comfortable. So if I

wore this for one year, what promise

could you make me or what could you tell

me the benefit and the upside would be?

You would definitely see improvement of

display of your foot. Yeah.

And when you have the tissues the the

spllay, you can start to improve the

strength of the foot. And what's

downstream from strong foot? Go up the

chain. You have better toe strength.

You're going to build a better platform.

You're gonna have a jet engine on a jet

engine. So, your ankle mobility, then

your knee extension, your hip extension,

because your foot is doing what it was

designed to do, which is be mobile and

be strong.

Okay? We need to pay attention. If you

if things go south from

here, you can expect there to be changes

up the chain. I see it all the time.

This one change has transformed how my

team and I move, train, and think about

our bodies. When Dr. Daniel Lieberman

came on the diio, he explained how

modern shoes with their cushioning and

support are making our feet weaker and

less capable of doing what nature

intended them to do. We've lost the

natural strength and mobility in our

feet. And this is leading to issues like

back pain and knee pain. I'd already

purchased a pair of Viva barefoot shoes.

So I showed them to Daniel Lieberman and

he told me that they were exactly the

type of shoe that would help me restore

natural foot movement and rebuild my

strength. But I think it was planticitis

that I had where suddenly my feet

started hurting all the time. And after

that I decided to start strengthening my

own foot by using the Vivo Barefoots.

And research from Liverpool University

has backed this up. They've shown that

wearing Vivo Barefoot shoes for 6 months

can increase foot strength by up to 60%.

Visit

vivarefoot.com/doac and use code diary

20 from my sponsor for 20% off. A strong

body starts with strong feet.

Is there anything else that we need to

be aware of? What is what is this other

stuff here? You've got like toe

strengtheners as well. So before we get

to those with you know the big toe and

the four toes, this is when you can use

that band. Okay. Right. So you just put

your heel on there. Okay. You grab your

four

toes. Right. It's like you're doing a

bicep curl, but you're doing it with

your

toes. And you press into the band. Then

you lift up and you press it into the

band. There is research, four sets, 12

reps. I mean, these are some of the

things that they work on to improve

function of the foot that helps with

planer fascitis.

Okay? And then you go around the house

and you grab the big toe. Keep that ball

of the big toe on the floor and then

press.

Yes.

Right. And it's it's a good place to

start. You're building strengths in your

foot.

And if you want to if you want to really

get after it, go for just the little

guy. Oh my gosh. Little piggy. Let's

have a look.

It's really wild because the abductor

digit, the muscle that abducts the

little toe is just as big as the big

one. And we like just are like, "Oh,

that toe is just there to, you know, hit

furniture.

It stabilizes the outside of the foot.

What is the difference between someone

that does this and doesn't do this?

Well, let's start with pain. Yeah, they

and I I use the word prevent injury.

That's tough for me. You want to create

environment where you can have the best

opportunity for function. Mhm. So when

people strengthen their foot, they are

going to have a foundation that's going

to have resilience to the rest of their

system. This is what we we walk

on. You cannot um build a jet engine on

a paper

airplane. I'm working with a lot of, you

know, athletes right now are getting

bigger. They're getting stronger.

They're getting faster. And if you look

at the rates of injuries at the foot,

they're going up because we know the

amount of loads that go through the foot

when we walk and when we run. So if we

want to do a bunch of squats and do a

bunch of deadlifts and do all the sexy

stuff, but not pay attention to the

foundation on which we're putting all of

this on, you're going to run into

problems. So from a function

perspective, you're improving your

function from the ground up. You're

providing a better environment for your

body to decrease pain. And when we get

older, it's, you know, you don't want to

be chasing your tail with this stuff.

How does this dovetail into mobility and

flexibility? Because that's something

I'm thinking a lot about at the moment.

Uh I I realize that as I do a lot of

upper body workouts and stuff like that.

When you watch me like pick up the

weights and stuff, put them back down. I

look like I'm I've got the mobility of

someone that you would think was double

whed if it a lot of it starts with our

feet. So, we talked about the big toe.

When you're

walking, the big toe has to extend a

certain amount. Okay, I'm going to show

you here. Okay, so when I'm walking, I

have to have a certain range of motion

out of my toe. And that gives me range

of motion out of my knee and out of my

hip. If I cheat the system, so let's say

this is the only amount of range I have.

Let's say I have a big toe that's only

going to extend 20 degrees.

you're going to

compensate. You might shorten your

stride. You might take shorter steps.

You might not get access to hip

extension because your toe isn't going

into full extension. So, you will see

some type of

compensation. You know, the other one I

think about is ankle mobility. You know,

I was listening to one of your podcasts

and you were talking about

um the story of rafting in Bali, I

think. Oh yeah. And how you were, you

know, walking down the stairs and how

it's something that you want to be able

to do.

And I was thinking to myself, I'm like,

if you were to ask

someone, if you wanted to continue to be

able to do that as you age, what would

you wear?

Probably V2 max. Endurance. Yeah. Your

hip strength, maybe. Yeah. Right. Your

core strength, your hip mobility. I

think very few people would say ankle

mobility and toe strength. But here's

the

deal. If you don't have good toe

strength, where are you going? You could

be falling. If you don't have good ankle

mobility, same

thing. So ankle mobility is a big one.

Also, it gives us access when we squat,

when we go up and down a stair, even

walking. So what do you mean by ankle

mobility? Do you mean my ability to go

like this? This dorsif

flexion. The ankle also plantar flexes

and it inverts and eververts. But the

the one I'm talking about when you're

you know this ankle dorsif flexion is

something I look at with all of my

patients.

And I it's not stood up is it? Sorry,

it's not sat down. Is it stood up? Like

you would if you you can do it. You look

at it seated. Yes. But you want to keep

that heel on the ground.

Okay. I mean, that's that's all we've

got there. Okay. And we're looking for

about, you

know, between 20

30°, but this range of motion is very

restricted. Remember the high heel

conversation. Yeah. You walk around in a

high heel for a long time, ankle dorsif

flexion is affected.

And what can I do to improve my ankle

mobility to prevent myself getting

injured or getting pains or issues with

my lower leg, upper leg, back?

Um, you know, I think joints, you have

to look at joints from two perspectives.

Both mobility and stability. How well

does it move and how well can you

control that motion? Yeah. Right. So you

can work on static stretching, dynamic

stretching. The other thing I would be

looking at here though is the strength

of one of my favorite muscles, which is

the solius, this big calf muscle back

here. Okay? Because it's the solius,

right, that helps control this motion.

And you know, if you had a seated calf

raise machine here,

And we wanted to look at baseline like

what can you do with your single single

leg seated calf raise which is this one

right? Yes.

The capacity that the solius can produce

is you it can put eight times your body

weight going through your forefoot.

That's a

lot. So there was a study that looked at

return to run.

So, um, they were looking at how much

strength, if you will, can we produce

out of a seated single leg calf raise?

Yeah. One and a half times your body

weight six times. Well, six reps. Yes.

Single leg. Okay. So, you would put one

and a half times your body weight plates

six times. That's a

lot. If you were to do it standing,

holding half your body weight, six

reps. But we don't train the lower leg

like we do everywhere else. No.

Especially men. Yes. And don't care

about legs. Yeah. It's I always say

it's, you know, the the machine at the

gym that should have the longest weight

line is the seated calf raise machine.

And it's always open.

What what do you see the biggest

mistakes that runners make outside of

the alphs issue wearing those big

cushion shoes? Is there a certain way

that we run that is causing us problems?

And also it are we running too much

because some people they really get

hooked on running. I mean I love it. I

think running is one of the best forms

of activity. I think if we wanted to

keep it very simple overstriding is the

enemy. Overstriding. Yes. What's an

overstrike? So, if I'm running, right,

here's my foot. Yeah. I want my foot to

strike as close to my center of mass as

possible. As in as close to your body as

possible. Yes. Okay. So, overstride

would be as if I landed with my foot all

the way out here. Okay. Yes. Got you.

So, our calccanous, this heelbone was

beautifully designed to absorb shock.

Okay. When I overstride and I can feel

it, what am I going to do? That's going

to hurt. So, you're not going to do it

anymore. You're going to overstride and

be like, "Ah, that hurts." So, I'm going

to adopt my gate pattern and I might not

overstride and bring that foot closer to

me. So, you strike differently. You want

the foot to hit in line with your body a

little bit in front of the body. Okay.

It's the heavy overstride you want to

avoid. Okay. Okay.

But if I can't feel

anything, you don't know. That's the the

more stuff on the shoe. You can

overstride hot and heavy and because you

have all this cushion there, you're

like, well, yeah. So, that's, you know,

the argument of allowing your foot to be

able to feel things. What about this

whole thing with gates and stuff?

Because sometimes when when I was

videoed from the back and someone in the

comment section was like, "Your like

gate is wrong or something." when you

run Steve. So, I don't know what he

meant. I didn't say qualifications, so I

kept it moving. But everybody has a

certain gate. What is a gate? You have a

running gate or a walking gate. It's

just your what happens when your foot

strikes the ground to the time it hits

the ground again. So, you have certain

um stride lengths and step lengths.

Okay. So, when I'm if you were if we had

a treadmill here, Yeah. and I would have

you start running,

that would be your running gate. I'd be

looking at you from the back, from the

side, from the front and seeing what

happens when your foot hits the ground

when it comes back up into swing phase.

What's happening above the foot? So,

what are your hips doing? What is your

pelvis doing? So, you're really looking

at the person. And then you're also

looking at, you know, what am I seeing

that I think could be um, you know, a

factor in either pain or poor

performance.

And then you see those things and you're

like, "Okay, let's start working on

this." But this is the interesting thing

with gate,

right? Someone will see something and

they'll say, "Okay, you need to start

doing calf

raises." If they also don't

cue gate, right? Or let's work on your

cadence. Let's work on some type of

skill. Strength and skill light up

different parts of your

brain. So, you can get really good at

calf raises and great, but if you want

to be a good runner, you have to look at

different things.

So, what what's the most common issue

with someone's gates? The overstride.

Overstride. And then also kind of the

crossover. Why is that a bad thing?

It takes away some of that efficiency.

So, often times you can see, you know,

if someone's crossing over, when they

land, they'll have more of this kind of

collapse through the extremity. if you

will. Okay. Okay. We want to control the

foot when it hits the ground. That's why

the hip conversation, right? The hip

controls what happens at the foot. Are

we supposed to be barefoot?

We are supposed to let our foot function

how it was designed. And that is letting

the foot feel the ground. Now, we live

on man-made surfaces and we walk around

on concrete. So, for me to say yes, we

should all be walking around barefoot.

That's a conversation that's difficult

to have.

But the stronger that your foot becomes

and the more resilient that it becomes,

you can handle these things a lot

better. And it makes interacting with

your environment so much more fun and

easy.

What are these?

Okay, my daughter was a rock climber and

she was up in her room one day and she

had the bands around her fingers and she

was like strengthening her hands and I

was looking at it. I was like, man, I'm

like, I want one of those for the foot.

And I'm looking for them and I couldn't

find them. So, I said, well, here we go.

So, I designed these and they're

different resistances.

So, it's the same concept as you would

with your hands. You just put them

around your toes. Okay. Okay. Give me

the easy one. Which one's easy? That's

the easy one. Okay. Here we go. Are they

all the same size, which you need

different sizes for different size feet?

Nope. So when your toes

spllay, you can slide those on a little

easier. My little piggy is completely

redundant. It's doing nothing. It feels

like it feels like it's disabled. Well,

we're going to change that. Okay. Yeah.

So when you lift up all your

toes, try to get your big toe to touch

my finger. Yes. That's abductoralysis.

That's this muscle right here. So people

that have like bunions, it's like just

strengthen that muscle. Right. So you

that guy goes in and you hold right

there. So now you're

strengthening inside of the foot. You're

strengthening the muscles

inside the arch of the foot. If you can

get that little guy to go out, you're

going to strengthen this guy. So you're

just going to lift all your toes. Good.

And then spread reach him forward. Try

to keep the tripod of the foot, though.

Okay. So I'm trying to lift all your

toes, but keep that tripod. One to

center of the heel. So, lift.

Yes. Yes.

Yes. And split. Yes. Now, press those

toes to the ground as you spread them.

Lift. Spread. Reach. Oh, that's pretty.

Thank you.

Okay. So, and that gets you've got ones

that get incrementally harder. So, this

would be harder. This would be hardest.

Okay. So, we're doing like 30 40 reps a

day. That's how you'll know someone

needs to work on this because they can't

keep those points. So they're kind of

like it looks like their foot's on an

ice skate. Yeah. So that's the front of

the foot. Yeah.

When you get into this part of the foot,

the rear

foot, there's certain things you want to

pay attention to.

We already talked about mobility at the

ankle, but you also want to look at what

happens when that heel comes off the

ground because this is when all the

magic happens because the foot engages.

The intrinsic muscles engage. It's

basically like I'm getting ready to to

propel

forward. So, there's certain muscles

that you want to have some good capacity

to be able to get your foot in this

ready position.

So two we can talk about is one that

runs along the inside

and then this is posterior tibialis one

of the very big stabilizers of the arch

of the

foot and his best friend which is the

solius. Those guys help do this to the

foot help invert the foot.

Okay. So go ahead and stand up for me.

Put your foot in

here. I'm going to put this around your

ankles. Oh,

there you go. Okay. Spread your feet a

little

bit. Toes pointing straight

ahead. Which, by the

way, we want to talk about

gates. When I'm moving from point A to

point B, my feet should also look like

they're moving in this direction. If

someone's walking like this with their

feet pointed out, correct? Yeah. I want

to know why,

do they have a a bone in their lower leg

that's rotated out, which could happen,

but if

not, you don't get to you don't get to

walk like

that. So, we want the toes pointing

straight ahead as long as there's no

compromise

structurally. Okay. Okay.

So, what I want you to do here is you're

going to keep the ball of the foot on

the floor

and I want you to drive your ankles

almost like you were going to sprain

your ankle. Right? So, you're going to

push into that

range out. So, you're going to take your

ankles and drive them into the band.

Into the band. Yep. Watch right

here. Okay. So,

here. This way.

Yes. Now, keep that big toe on the

ground.

Yes. See, there's your other compliment.

That didn't sound like a compliment.

But what you should feel here is that

when you increase the arch of the foot,

you should feel it also in the hips. I

feel like I just don't have an arch in

my foot. I don't know. It's weird. I

don't feel like I can. How about this?

Put your hands on your chest. Rotate to

your left as far as you can. Keep your

feet on the ground. See, that's pretty.

See that arch?

Yes. Now go this way. So that's another

way to work on how the foot feels

because the foot should change shape. It

should lower and it should increase the

arch. So you recommend people do these

types of exercise frequently. Oh yeah. I

mean you're standing at your desk, you

know, here's your movement break. You

rotate 20 times. Let your foot change

shape.

Do your toe yoga. Big toe, four toes.

Lift all your toes, spread them, and

reach them forward.

[Music]

My physio gave me a towel and he put it

on the floor and he said I have to like

grab it and pull it up and grab it and

pull it up as part of my recovery from

my injury. Have you do you do you ever

tell people to do that? You know that

towel thing where you grab I don't. You

don't. What?

I don't want to get anybody in trouble

here. No. Call them out. Okay. When do

you ever do this? Never. Correct. So

unless you were, you know, and maybe in

your initial phases of rehab, where you

are just trying to wake up the foot, you

want to, you know, towel scrunch, pick

up marbles like they, you know, that's a

very common foot exercise.

But from a functional perspective,

that never happens in the gate cycle.

When you're walking and you're running,

your toes never do this or they

shouldn't. Most people when their foot

is weak, that's one of the biggest

compens compensations that you will see.

They toe grip. You'll see them walking

and it's like, you know, they start

gripping the ground because they feet

are weak. Feet are weak to compensate

for something. Yes. Okay. I made the

biggest investment I've ever made in a

company because of my girlfriend. I came

home one night and my lovely girlfriend

was up at 1:00 a.m. in the morning

pulling her hair out as she tried to

piece together her own online store for

her business. And in that moment, I

remembered an email I'd had from a guy

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new sponsor and a company I've invested

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And I believe in it so much that I'm

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Your next move could quite frankly

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daccircle.com.

I will speak to you then.

Do you wear socks? Uh, I do not wear

socks. Why? I just haven't found any

that I, you know, love. My second and

third toes, personal information here.

Mhm. Are webbed. So, basically, there's

skin that comes up in between two and

three. Mhm. So, as far as socks are

concerned, most of the socks out there,

like if you look at a compression

sock, when someone puts it on their

foot, it literally like with my bunion,

you'll see my foot look like this

because it's just suctioning my foot

together and it's so uncomfortable.

So, my option would be a toe sock.

Mhm. So, a sock that you know just fits

over your toes. But because my toes are

webbed, I can't wear them. What what do

you think is the most important thing

that we haven't talked about yet that we

should have talked about as it relates

to foot health and everything downstream

from foot health?

I mean I think you know big picture like

what I hope to do like my passion is to

bring awareness to the foot because when

we start doing that and we pay attention

from getting stronger from the ground up

things life gets easier and I mean that

not just physically but just like we

talked about wellness because you're

able to move and get out there and walk

and run and move like you want to. So

that's kind of the big the big picture

here. I think we talked about the

importance of foot strength and foot

mobility and driving home the importance

footwear. I think the

biggest, you know, or maybe the lowest

hanging fruit for people is if this kind

of work seems overwhelming like I have

to strengthen my toe and do all this

stuff, just wear a shoe where your foot

can feel the ground and your foot can be

in its functional position. start there

because the research will tell you just

doing

that you will start to improve the

strength of your

foot and I think that's that's key and

start small transition. It's so

interesting listening to so many of

these um the comments from some of your

previous work, people of all ages, but

often people that are slightly older

talking about how transformative finding

out more information about their feet

has been and changing their footwear in

particular.

Reading this one comment here from this

guy says he's 65 years old and when he

discovered the zero drop wide box toe

shoes, he lost all the pain in his feet,

ankles, knees, and hips within a couple

of months. I hear it all the

time. I hear it all the time. And it's

it seems so counterintuitive to us

because I think we've been, you know,

trained to think that our foot needs

stuff. It needs support. It needs

cushion. It needs spring. And that

changes the dynamics of how your foot

interfaces with the ground. So when you

bring it back to what it was designed to

do, those comments you'll hear you will

hear all the

time. And it's it's a wonderful thing.

It's literally why I do this. Is there

anything else we should have talked

about that we didn't that you think is

pertinent to anyone that's trying to get

control of um their foot health? I mean,

I think, you know, I just want to make

sure the we highlight the conversation

of transition because I think that's

where we lose people is this when people

listen to this, there's bells going off

in their brains going, man, this makes

sense. This makes sense. They want to go

home, burn all their shoes, and like go

buy a pair of barefoot shoes and call it

a day. You got to earn your right. So,

there has to be that transition. There

has to be that I'm going to step. I'm

going to build. I'm going to have a shoe

spectrum. And that that conversation of

a shoe spectrum, there's a time and a

place. You have your workhorse shoe. You

have your cheat

shoe. And you know when to wear what.

Where am I now? I'm I think I'm in the

workhorse shoe. I'm trying not to wear

any cushion shoes as much as I possibly

can. Well, when you think about it with

ankle sprains, this is what I find

fascinating,

right? When that thing heals, when your

ankle

heals and you say, "Well, I'm going to

go into a cushion

shoe." Some of these shoes are getting

getting high. Mhm. So you put the sole

of your foot on a shoe that has a high

cushion. You see the distance you have

from your foot to the ground. Yeah. So

let's say you step on a rock and you

have poor propriception because your

foot can't feel real well because you

have a history of ankle sprains and you

step on a rock and you have this far to

go. Where do you think that ankle's

gone?

So my ankle sprain patients, I want them

close to the ground. I want them to

feel right. Right. So, it's it's pretty

wild when people are like, I want to

wear, you know, all this

stuff, you know, hiking boots. Another

conversation. What's wrong with hiking

boots? Well, people will say, "I need a

hiking boot cuz I I want my ankles to

feel

stable, and that's not what they do. It

might be a and there will be research

coming out on this. When you wear a

hiking boot, it's like a neurological

hug. It kind of feels like, you know,

I'm gonna have this thing around my

ankle. It's going to protect me. It's

going to protect me. It

doesn't. And when you walk down a

mountain, this foot has to do, remember

we talked about this, ankle dorsif

flexion. If you have something that's

going to restrict ankle dorsif flexion,

you have transfer

loads. So, you end up transferring load

to the knee. Mhm. So, you know, when my

patients say to me, "I need a hiking

boot." I say to them, listen, why don't

we just work on getting your ankle more

stable, improving your

mobility. So then you won't need to feel

like you need this thing around your

ankle and that takes

time, but in the long run. Is there an

issue if I'm wearing the barefoot shoes

at the moment and then I start wearing

like football boots again or I think you

guys call them cleats? Yeah. Is there

chance of me getting injured because I

spent so long in the barefoot shoes. Now

I'm No, it's Sometimes you can't do

anything about the environment of the

shoe. So, think of a cleat, um an ice

skate, a ski boot. There's certain um

you know, sports that require the

stiffness. And so when you pay attention

to your foot

health and then you put that foot in the

cleat, you just make sure that when you

get your foot out of the cleat, you do

all the stuff. You take that kit, you

roll the bottom of the foot. When I get

out of my cycling

shoes, even though they are wider now,

they have wide toe box cycling shoes.

I'm always doing stuff for my

foot because it's a the cleat is an

environment for the sport. So, you know,

you pay attention before and you pay

attention after. Courtney, we have a

closing tradition on this podcast where

the last guest leaves a question for the

next guest, not knowing who they're

going to be leaving it for. And the

question that has been left for you Oh,

this is going to be good, huh? It is a

good one. What do you fear you will most

likely regret 10 years from now?

This is a battle that I have um in my

head pretty much all the time. I love my

work so much. It

is it's just the reason that I feel that

you know there's so much I want to do.

There's so much I want to learn. There's

so many ways I want to help people. Um

and I work a lot but I don't look at it

as work. I I enjoy it.

Um, but I I'm also a

mother and I need

to find

that work life balance where I I don't

want to fear in 10 years that I look

back and said, "Man, I worked a lot, but

I really wished I would have gone to her

soccer game."

So, I've created this life for me where

I can

say, "I'm not going to do that. I'm

going to her soccer game." And she gets

mad at me all the time, but I tell her,

I'm like, "This is what happens when you

own your own business." She's like,

"Mom, quit saying that." I mean, she

knows I work my ass off, but at the same

time, she also knows that I can drop

anything and go be there for her at any

time.

And so that's what I really want to work

on and make sure that in 10 years I

don't look back and say,

"Gosh, I missed some of that."

As I'm often told, you don't get that

time back either, do you? So yeah, it's

not something that's very easy to

correct. Yeah. Courtney, thank you so

much for doing what you're doing. I I'm

very much looking forward to your book

because it's been a bit of a black box,

I think, my feet, my foot health. um up

until more recently when I discovered

your work, but also just from this

conversation today. It feels like I now

have a better understanding of how this

thing that I thought was largely

irrelevant is having a big downstream

impact on a bunch of things that I

really really care about. But also,

maybe most importantly, is just having a

set of actions that I can take on a

daily basis, on a weekly basis to

prevent finding myself in a situation

where I'm older and I fall or where I

lose my mobility or movement or the

meaning in my life because I have

something wrong with my

foundations. Hopefully, next time we see

each other, I will have the strongest

feet you've ever seen. I was just

thinking the next time we see each

other, there's going to be so many more

compliments. On my feet. On your feet.

Yeah. One can only hope. Courtney, thank

you so much. Thank you so much. An

honor. Thank you.

This has always blown my mind a little

bit. 53% of you that listen to the show

regularly haven't yet subscribe to the

show. So, could I ask you for a favor?

If you like the show and you like what

we do here and you want to support us,

the free simple way that you can do just

that is by hitting the subscribe button.

And my commitment to you is if you do

that, then I'll do everything in my

power, me and my team, to make sure that

this show is better for you every single

week. We'll listen to your feedback.

We'll find the guest that you want me to

speak to and we'll continue to do what

we do. Thank you so much.

[Music]

Detailed Summary

In this episode of The Diary Of A CEO, Steven Bartlett interviews Dr. Courtney Connley, a foot and gait mechanics specialist, about the critical role of foot health in overall well-being and longevity. Dr. Connley emphasizes that foot pain significantly impacts physical, emotional, and mental health, often leading to inactivity and depression. She advocates for increased daily steps to reduce the risk of cardiovascular issues and dementia, highlighting walking as an easily accessible yet underutilized activity. The discussion covers the detrimental effects of modern footwear, such as narrow shoes and excessive cushioning, which compromise foot function. Dr. Connley promotes functional footwear with wide toe boxes and minimal heel elevation, along with practical foot exercises. She underscores the necessity of gradual transition to barefoot shoes, emphasizing the importance of strengthening feet for long-term health and mobility. The conversation also explores running form, the benefits of toe spacers, and dispels myths about hiking boots and insoles, offering actionable advice for maintaining foot health.