Foot Doctor: “Before You Do Cardio… Walk Like THIS To Live 10 Years Longer” | Dr. Courtney Conley

Key Takeaway

Start with micro walks—just 5 minutes or 500 steps. Even adding 1,000 steps to your daily baseline (if you're at 2,500+) can reduce all-cause mortality by 15%, potentially adding 10 years to your life. The key is consistency over perfection. Walking isn't optional exercise—it's a physiological necessity like breathing and sleeping. Don't wait for pain-free movement; build confidence through gentle, progressive steps. Your body needs this daily biological input to function optimally.

Episode Overview

Physical therapist Dr. Kelly Starrett debunks the 10,000-step myth and reveals how walking is a fundamental physiological necessity, not optional exercise. She explains how even small increases in daily steps provide measurable health benefits, from reducing dementia risk by 25% at 3,800 steps to alleviating depression symptoms at 5,000 steps. The conversation covers walking efficiency, footwear transitions, building confidence through micro walks, and reframing pain to restore movement in chronic pain patients.

Full Transcript

Transcript of Foot Doctor: “Before You Do Cardio… Walk Like THIS To Live 10 Years Longer” | Dr. Courtney Conley from Feel Better, Live More. Auto-generated from episode audio; may contain minor errors.

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

But when you look at the science, it's it's actually much less. So, what does the science tell us about the amount of steps we need to gain certain health benefits? So, it's very individualistic. So, depending upon where you start, what your baseline is. But if you were to look at just an overall number, where are we going to maximize longevity benefit? You're looking anywhere from 7 to 8,000 steps. So, what's interesting as I sort of think about the walking literature, and of course in Walk Your Life Depends on It, which is certainly the UK name of your latest book.

What I What I really like about it is that you make it very accessible, right? So, we'll come back to 10,000 steps in just a minute cuz I [clears throat] I actually have quite liked that as a guideline, but I I totally understand totally understand totally understand where you're coming from, which is that can be can be can be off-putting to people. And some people might go, "Well, oh, I can't reach 10,000, so what's the point?" And I think you've quoted research in the book saying that even going from what, 2,500 to 3,800 steps a day gives you some benefits.

benefits. benefits. Reduces all-cause mortality by 7%, which is, you know, I have plenty of patients that have been in chronic pain, where these are the conversations that we're having, having, having, where anything is better than nothing. So, I I that's very encouraging for people that live on that end of the spectrum where they've been in chronic pain for a while. Um they're afraid to put their foot on the ground and it's okay. We're going to take what we've termed a micro walk, which is 5 minutes, which gives you about 500 steps.

And it builds confidence in people's movement. They start to trust their body again and I think it that level, that really is priority. So it's not that you have a problem with an individual doing 10,000 steps a day. You're not saying that's negative that individual. You're saying as a public health um guiding principle, we should be making it more accessible. Yes. And you know, when you look at the research, it does seem to plateau from a longevity perspective at about 10,000, 12,000 steps. Mhm. Mhm. Mhm.

So on the other end of the spectrum, if my patients will say, "I'm walking 15, 16,000 steps per day." Wonderful. Wonderful. Wonderful. Are you also strength training? Are you doing these other things that are necessary for um living well as you age? And if the answer to that question is no, because some of my patients will say, "Well, I just don't have time because I'm walking 15, 16,000 steps a day." Then we have the conversation of what if we dialed it down? Let's bring you down to 10.

Now I give you some time back. Now we can get you in the gym. We can strength train and start making your fitness a little more well-rounded. well-rounded. well-rounded. Yeah. Yeah. Yeah. I think that's a great case study in the book of Jane who calls herself a cardio queen who was doing 15,000 steps a day, right? And you had to actually bring her down so that she could add in strength. And you know, I think you added in nasal breathing while she was walking and all kinds of stuff.

Maybe we can talk about her a bit later. In terms of making walking more accessible, because I very much agree with you that you know, the central message in this book is that walking is very much very much very much one of the most under appreciated elements of health and longevity. You were on the Chris Evans radio show yesterday. He described your book as as a love letter to walking, which I thought was a beautiful way of describing what's in the book. Let's let's make it super accessible for people.

If you add a thousand more steps to your daily step count, count, count, what could that potentially do for us? So, if you were if we were going to throw out some numbers, if you were to get to 3,800 steps per day, day, day, you can reduce your risks of getting dementia by 25%. If you were to jump to 5,000 steps per day, day, day, this is a big one, I think. You can reduce the symptoms of depression. depression. depression. And I just want to pause there for a second because my patients that live below 5,000 steps, below 2,500 steps, steps, steps, there is very often this mental health challenge that they are also facing.

It's almost like the lack of step count goes hand-in-hand with with with feelings of sadness and depression, and I think that makes sense because of the lack of movement, the lack of this core biological input that our brains need. Yeah. Yeah. Yeah. And so, depending upon where someone is along the spectrum, adding in a thousand steps, for example, which is about 10 minutes, minutes, minutes, can really bump you into different categories. When you get to 7,000 steps, you reduce your risks of getting dementia, and I think it's this stacking of behaviors.

So, I start walking more, then I'm sleeping better, then I'm breathing better, then I'm eating better. So, it's building this foundation that then our health can expand upon it with something that is so easily accessible and underutilized. Yeah. It really is incredible. It reminds us something that we spoke about when you were first on the podcast a couple of months ago. This idea that yes yes yes exercise, uh movement, walking is good for us and you know, can reduce your risk of dementia. It can help you live longer.

I mean, some research suggesting maybe 10 years you can live longer, right? right? right? Reduce your risk of depression, all that kind of stuff. And the flip side is that maybe it's not that the movement is good for us, it's that the lack of movement that many of us have in the modern world is devastatingly bad for us. Yeah. Yeah. Yeah. I think, you know, after we spoke last time, I was thinking about that quite a bit. And if we were to flip the script Mhm.

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

Yeah. Yeah. Yeah. In your experience, what are the common reasons why people don't get their steps in each day? I think I think I think with modern convenience comes responsibility. comes responsibility. comes responsibility. We have to think about it more now. Mhm. Mhm. Mhm. You know, when you are working from home, for example, and you're sitting in front of your desk for 8, 9 hours a day You have to consciously be aware and take breaks. Or else you could just could just could just flow right through your day without getting much movement at all.

So, it has become more of this awareness. You have to really be diligent about saying, "Okay, it's time for me to go for a 5-minute walk. It's time for me to get up and move around." In the book, we have all those movement snacks in there. You could do 10 air squats, you could do walking lunges, you could get outside and take a 5-minute walk. You just have to interrupt prolonged activity. prolonged activity. prolonged activity. And it's become very easy to forget to do that. do that.

do that. Mhm. Mhm. Mhm. So, that's where I think it's important. I think the other conversation there is when people get their morning workout in, so I ran for an hour, I went to the gym for an hour before my workday. workday. workday. That hour of activity doesn't excuse you from movement throughout the day. Yeah. Yeah. Yeah. It doesn't take away prolonged activity like sitting all day long. So, there has to be this interjection of movement that people need to be consciously aware of because it just doesn't happen easily anymore.

Yeah. Yeah. Yeah. I love this idea that with modern conveniences comes a responsibility. Yeah. Yeah. Yeah. And this may not be the perfect analogy, but I guess you know, if you were someone who liked vintage cars, for example, okay? Maybe this comes to mind because we just spoke about Chris Evans. Chris does like vintage cars, right? You don't just leave that car, I think, and if there's an enthusiast listening who wants to correct me, please do, but I guess the point I'm making is if you just kept that not moving at all for like 4 months at a time, there would probably be an issue.

Now, we're not cars, I understand that, but that whole idea of a responsibility to our body that it has to be moved, otherwise it won't function. It needs the lubrication, right? It needs to the oil change or whatever it is. It's like you know, that's kind of what happens when we move, right? You know, it it everything works better when we move and in particular when we walk. There's something quite different about walking, isn't there? It's this core biological input that stimulates every system in our body.

Um think about strength training for example, which is very good. I'm very obviously a very big proponent of that. Um strength training happens a couple times a week. There's needs a There's a recovery that has to occur. Walking is something that happens every single day, like breathing and like sleeping. It should be viewed as this physiological necessity that is non-negotiable. non-negotiable. non-negotiable. Um it's this low-to-moderate repetitive activity. repetitive activity. repetitive activity. So, it's an from an intensity perspective. perspective. perspective. So, there's less loads per se than running.

running. running. We get our heart rate up, but we're not maxing our heart rate. So, it's this kind of constant churn that can stimulate our metabolic system, our musculoskeletal system, our nervous system, our circulatory lymphatic system, our brains. So, it's just kind of the Yeah. Yeah. Yeah. You know, it ignites our our bodies. It says of unexpected benefits of walking. One thing I used to see a lot of in practice is people who didn't walk enough or or move enough, I should say in general, I would find that sometimes when their movement increased, their gut function better, right?

Their their their constipation went, right? Without changing their diet because you know, there is I think we touched on this in the first conversation. There is this kind of contralateral movement going on, you know, this change the upper body's going right, lower body's going left, and it almost twists the middle and your gut and your bowel, right? So, it can massively help with gut function as well. well. well. Yeah, I think that when you look at that cancer research, which is really fascinating, fascinating, fascinating, um um um I think the the mechanism behind some of that cancer research that when you get to to to X amount of steps, 7 to 9,000 for example, you reduce your risks by 16% when you're walking with at a brisk pace.

You're improving your insulin sensitivity. sensitivity. sensitivity. Mhm. Mhm. Mhm. You're improving your gut biome. So, I think those factors are why we're seeing these really exciting um um um findings with this cancer research. One of the things I've done recently, um I've been walking more and more over the last few years. I I've recognized that, you know, how important it is. And we're currently recording this conversation in the British spring. So, we're having light mornings now, okay? So, currently it's maybe getting light around 5:20. And I'm an early riser, okay?

I always have been. I go to bed early, I get up early. early. early. And in the winter, I'll probably meditate first thing. And then at some point when it's light, sometimes after the kids have gone to school and depending on what's going on with work, I'll try and walk. But I've actually changed my pattern recently because I know the number one thing I want to get in each day is a walk. Now, I personally am trying to get 10,000 steps a day. You know, I say that understanding that not everyone is going to be able to do that.

But But But it's been transformative. You know, I I get up, I have a coffee, and I'm out. Yeah. Yeah. Yeah. And then I'm back to make the kids' breakfast or whatever it might be, right? right? right? And even if I play paddle later on in the day, like I I remember the other day I was like, "Rangan, paddle, great, okay, no problem, have fun, lot of coordination, lot of sprinting on the court, but it's not a substitute for your daily walk. You still need to get the daily walk in when you can.

you can. you can. That's if there's one message that is that is it. That that is so important and it cannot be missed. And there's something very special about that morning walk. It just kicks off your day. You have sunlight, you get your body moving. I mean, it is it it does kind of I do the same thing and if I were to miss it, it does change change things. things. things. Yeah. So, we want to make this super accessible, okay? So, I totally recognize that people may not have the same level of autonomy that I have around my work, okay?

They may have a lot of family commitments or family pressures. pressures. pressures. So, one of the things that we didn't talk about in our first conversation that I wanted to and I I think we should talk about it today is your build program. program. program. Yeah. Yeah. Yeah. Right. So, towards the end of the book, you you really sort of break it down like we might do strength training or something else where it's like, "Okay, here's where you are." And there were sort of three different categories, weren't there?

So, can you kind of talk us through some of those general principles? principles? principles? Yeah, there's when we decided how we wanted to outline these programs, you have to meet people where they are. So, in the base program, this is for someone who has been in chronic pain, who is less than about 2,500 steps. And in that program, we encourage these micro walks. And again, we're building confidence in their movement, getting their foot on the ground. The build program is where we think most people are going to live.

This is when you get to that 7,000 sweet spot range. Um this is 8 weeks. So, throughout the program, we talk about starting at your daily walk happening four times a week. Then we increase by 500 steps to 1,000 steps. So, it's this very digestible program that is very focused. That's when we had talked about earlier, what has happened? Uh we forget we forget we forget that we need to incorporate this into our daily lives. So, it's very it's outlined in an easy way for people to understand that.

The other key thing with that program is working on cadence and speed. and speed. and speed. Because that's where the magic happens. When it comes to speed in just a minute, um um um this idea that we need to build slowly is something that runners are familiar with. with. with. Yes. Yes. Yes. Right? People know if they get into running or they sign up for a half marathon and they look at any training plan, one of the things many of the plans will say is don't suddenly increase your volume.

Correct. Correct. Correct. But I think we intuitively understand that with running because it feels like yes, high load on the body, right? You're applying this a similar principle, I think, to walking, whereas some people might go, "Yeah, but walking doesn't have the same loads on the body as running. Why do we need to build it slowly? Why can't I just go from 1,000 steps a day to 7,000 steps a day, for example?" Some people might be able to. Okay. Okay. Okay. It's their bottom line level of fitness.

You know, maybe the reason that they're just not getting their step count in is not because they can't, more of a time factor. factor. factor. Mhm. Mhm. Mhm. So, some might be able to. So, that program outlines more of a a time inventory for them. That might be how they focus. But then there's other people who actually need slow progressive loads. progressive loads. progressive loads. Mhm. Mhm. Mhm. And that's where that becomes important. It is still a load through your body, it's just less than running.

Um the other conversation is if someone is working on that program and transitioning into different footwear. Yeah. Yeah. Yeah. Because that is where we really wanted to highlight that those things take time and they need to be transitioned safely because those are definitely different loads. loads. loads. Yeah. Yeah. Yeah. We spent a lot of time last time talking about footwear and foot health and the difference between cushion shoes, functional shoes, and minimalist shoes. Yeah. Yeah. Yeah. So, we don't need to re-go into that. Um people can listen to that first one if they want to get all that information, but I think later on today we should absolutely cover how to transition from cushion shoes to minimalist shoes because we've had a ton of questions about that, okay?

It's probably the most um frequent question I get in my clinics. Yeah. Yeah. Yeah. How to do it. How to do it cuz people want to do it, I think, these days. They hear about the research on minimalist shoes. They go, "Yeah, it kind of it makes sense. I want to be in that, but how do I do that when I spent the last 30 years in cushion shoes?" Right? So, we'll we'll come to that, but in terms of this kind of build program, so you're saying at the moment start small, start small, start small, anything is better than nothing, um you know, getting from 2,500 steps a day, I think, to 3,800 steps a day, you know, I think actually, I'm not sure you mentioned this one.

Yeah, I think you said in the book that if you can do that, that, that, if you add 1,000 steps per day on top of an existing baseline of at least 2,500 a day, that decreases all-cause mortality by 15% and so you surmise that actually, if you're 70 years old, that could potentially extend your longevity by 10 years, right? So, hey, listen, if you want to get to 10,000 steps, that'd be great, but if you're stuck at 2,500, even getting to 3,800, 4,000 will give you, you know, measurable benefits, which is amazing.

amazing. amazing. Foot pain, of course, is one of the things that stops people walking, right? And And And there was an example in the book of, I think, a firefighter called Christian. Yes. Yes. Yes. Right? Do you remember the story? Oh, yeah. Oh, yeah. Oh, yeah. Can you explain it cuz I think it's quite useful here to to explain Do you want me to talk about the the new model of, you know, why pain doesn't always mean stop moving? Yes. Yes. Yes. You know, when I first got into um clinic, that was what I used to tell people, you know, come see me.

We'll get you pain-free. And I have really changed my tune there. Um I think that's not correct. I don't think the goal is to to to wait to move until you're pain-free. People will be waiting a very long time. Pain is this normal um human body experience. It's a signal for us. And we should look at it a little bit differently. We should reframe that concept saying, how do I live well with this? How do I continue to move with my pain because we know it is so very complex.

Rather than saying, I'm not going to move until I'm pain-free. And that's exactly what happened with Christian is he had had foot pain for 3 years. years. years. Um he was training to be a wildlife firefighter and he got some heel pain. And it lingered. And 3 years later, he was in my office. And in 3 years, he had gone to see many people. In fact, the last person that he had gone to see said they want him to decrease his step count to below to below to below 2,500 steps.

2,500 steps. 2,500 steps. 3 years into this conversation, you don't want to be telling someone to decrease their step count. Remember, [snorts] the the less step count, right? That's highly correlated with not feeling too good mentally. Their mental health starts to decline. So, you know that with him not getting these steps in, that that was not going to be a good idea. So, he moves into his father's basement. father's basement. father's basement. Um and now he's pretty much become I want to say almost a prisoner in in his house.

And I do see this often with patients. patients. patients. So, he came to see me and we really had to have a lot of conversations about pain, pain, pain, about education, about education, about education, and we started him with the micro walk, which was 5 minutes, which is about 500 steps. Would that cause him pain? Um he was scared. Mhm. Mhm. Mhm. He was scared. And his foot at this point is so sensitized, his nervous system was so sensitized to what his foot was feeling that when he experiences experiences experiences pain at his foot, it wasn't matching the tissue damage.

You see, his sensitivity [clears throat] was high. So, he's feeling his foot on the ground, he said, "Oh my gosh, my foot hurts." But from a tissue perspective, perspective, perspective, they weren't lining up. So, we had to encourage him, "Listen, let's go for 5 minutes. See how you feel. See how you feel that night and the next morning." morning." morning." It wasn't any worse. It wasn't any better. better. better. So, I said, "This is good. Now, over the next couple days, you're going to add another going to add another 5-minute walk." So, he started to adapt, and he started to say, "Well, whether I go walking or not, it's not getting better or worse.

So, I might as well just keep going." And so, we slowly started to build. And then his confidence started to come. Then we started doing foot exercises. We got him into different footwear. Um and it was it's one of my favorite cases because to this day, he sends me um text messages when he's like hiking a mountain or hiking on a trail, and it just warms my heart, and it's why I'm reminded of why I do this, because when you cannot walk, it literally affects so many systems in your body, and what's most detrimental is I think what it does to your to your mental health.

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

It's interesting that throughout this conversation already the word confidence has come up several times. times. times. And I think it's something we don't think about enough when it comes to our well-being, how we feel about ourselves, our self-esteem. As you said at the start, you know, walking is fundamental to who we are. Just to walk around the house, to pick something up. Let's say you even drive to the supermarket, you've still got to walk around when you're there to get the stuff, right? In many ways, I sort of feel feel feel walking should be kept separate from exercise.

It's like Yes. Yes. Yes. it is, but it's almost its own category, right? The human body As you beautifully say, you know, walking is a physiological necessity on a par with breathing and sleeping, right? Very provocative statement for so many people, but the other thing, Connie, that you said, which I think is really important, is that Christian was scared. Yeah. Yeah. Yeah. And I recently had Howard Schubiner on for the second time. The podcast has not come out yet, but I think you would love his work.

It's he's a, you know, consultant MD in in pain science, pain science, pain science, and and and he has published lots of research and and quotes many other researchers demonstrating how fear makes our pain worse. worse. worse. Yes. Yes. Yes. Right? So, you know, that the cycle starts, doesn't it? You've got pain, you might have had an injury, but then the fear of moving on it starts to create this vicious cycle where you have even more pain, and then someone like Christian, 3 years later, he's still not walking.

You know, when I think he was in his 20s when this happened. So, I can't imagine what that does to you in your 20s in terms of how you feel about yourself. yourself. yourself. I think that's the biggest factor. Mhm. Mhm. Mhm. Especially 3 years into a diagnosis. You know, if this was if he had seen me 3 months prior after the injury, we're having a different conversation. Yeah. Yeah. Yeah. But 3 years, this is a layered there's a uh big beautiful person behind that diagnosis of heel pain and you cannot just treat the heel.

the heel. the heel. Mhm. Mhm. Mhm. You have to treat their emotions, how they feel, their confidence. You have to build this trust so that they can start to trust their bodies again. And that's what I think is so important because the the brain rules the roost. And you have to, you know, really listen to people. We previously spoke about this idea that all of us will have a different walking signature. You know, it's unique very much like a fingerprint. But despite that, that, that, what you're hoping to help your patients and therefore us with is improving our walking efficiency.

walking efficiency. walking efficiency. Yes. Yes. Yes. What does walking efficiency mean? So, as human beings, we were designed to walk upright, balanced for long distances. It should be when you see someone walk, I love it. It's like it's a window to their soul. It's like this neurological window and you can tell when they're happy, or sad, or in pain, if they just got fired, if they just got promoted, all in this signature of how they carry themselves and how they walk. I don't think we want to take away the uniqueness of someone's individual gate.

It could also come with traumas or what have you. But what we do want to create is this efficiency because we should be able to very easily get to that magic step count number and feel well doing it. So, when we look at efficiency, it's you know, when I first look at someone when I'm assessing their gait, do they look comfortable? Do they look relaxed? Are they holding their breath? Are they stepping into a pothole on one side where they kind of look like they're tilting?

Are they swinging their arms? arms? arms? Those are the you know, big things that I take a look at to see how comfortable they are in their walking gait. And then I break it down into if they aren't, aren't, aren't, where's the stone in the river? What's preventing preventing preventing this efficiency? Is it a range of motion issue? Is it a strength issue? Um, Um, Um, so that's how we kind of go deep there. So, all of us could potentially think about our walking and think about some of those concepts and think about improving our efficiency.

No matter how we currently walk, we could we could change the way in which we walk. There's a lot of practical guidance for how to do this in the book. Um, I wonder if we could go through some of those steps, right? Roll the earth away. What does that mean? that mean? that mean? Um, I love this. So, when you're walking and your foot can feel the ground, a walking gait is different than a running gait. running gait. running gait. So, when you're walking, the heel you graze the heel, and this is what initiates the foot to lengthen or to pronate.

So, this is when we start absorbing shock. shock. shock. And then we absorb shock, we roll through the foot, we get to the big toe, and then we push the earth away. You're kind of rolling through your foot, pusing the earth behind you. Um, it's a beautiful thing and you should be able to feel it. So, even just that take a message to people that next time they go for a walk, they can start to think about rolling the earth away Yes. Yes. Yes. as they walk.

I'm going to bring out Eddie again. Ah, brilliant. Ah, brilliant. Ah, brilliant. Um Um Um when the heel strikes, it's this Think of it just this almost like a wave where it goes on the outside of the heel, the outside of the foot, and then rolling through the first and second toe. second toe. second toe. Yeah. Yeah. Yeah. And this foot is it adapts. It's the central nervous system system system is causing this foot to change shape and to adapt to terrains, for example. And that's important.

We need to be able to absorb shock, and the foot needs to be able to stiffen for propulsion. It really is just beautiful seeing Eddie again because you just see the complexity complexity complexity and the magnificence that exists within the human foot. And as you say, roll the earth away, I'm just feeling in my head, I can just almost feel this beautiful stretch on the fascia at the bottom of the earth. Yes. Yes. Yes. I think you know, on your sole. You know, almost like a massage every time you roll through, right?

Having said that, I know we covered footwear last time. Well, we will definitely in this conversation as well, but one of the things you write about in the book is if you have one of these modern stiff-soled shoes, shoes, shoes, it's hard to roll the earth away, isn't it? it? it? If you look at some footwear, and you try to bend it, just take the shoe and try to bend it in half. If that shoe can't bend, you can't roll anything. You can't roll your foot through there.

You can't get big toe extension. So, if you were to take the shoe and bend the front of it to see how well the tip of the shoe were to bend, some shoes are very stiff. very stiff. very stiff. And you can't extend your big toe. And here's the problem with that. If I can't extend my big toe, it's just a big toe problem. It's going to affect what happens at my ankle, ankle, ankle, at my knee, and at my hip. I'm delighted to announce that AG1, the daily health drink that has been in my own life for over 6 years now, have updated and improved their formulation based upon the latest science.

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See all details at drinkag1.com {slash} livemore. When I see people walk in that type of footwear, there there isn't any um there isn't this efficiency or these there's three rockers to the foot. There's no fluidity to see is there? There's no fluidity to the foot at all. And so you'll see them start to pick up their foot and place it down. Pick up their foot and place it down. That is inefficient. Mhm. Mhm. Mhm. So we can't take advantage of joint range of motion and strength when we can't actually feel what our foot is doing and the foot is moving like a block instead of dissociating.

Yeah. I spoke to you Helen yesterday, my movement coach who I spoke to you a little bit about last time and um, having loved our first conversation together and um, she's got this uh, incredible piece of technology that I think there's only 10 in the world now um, where she can measure everything in your body as you're walking on a treadmill there. All your spinal movements. It is it it's phenomenal. And she has measured for several years now that I'm talking about walking here, not running, okay?

Walking. That when people wear cushion shoes and walk walk walk there is more impact going through on every joint. They don't feel the impact cuz they think, oh, you know, I'm I'm on a cloud, right? But actually there's more impact going so almost our feeling is misleading cuz we think yeah, I'm I'm not putting any pressure on my joints at all, but we're actually over pressuring them because it's inefficient walking. inefficient walking. inefficient walking. Yes. It's very counterintuitive. Exactly. Exactly. Exactly. Because when someone has knee pain for example, they think, I'm going to go wear this cushion shoe Mhm.

Mhm. Mhm. and it's going to help shock absorb my joints. When in fact when you take your shoes off one of the things we talk about is how you adopt a softer gait. softer gait. softer gait. Mhm. Mhm. Mhm. Because you're getting feedback from your foot. The receptors in the foot are going, hey, you're landing too hot and heavy. heavy. heavy. Lighten up a little bit. Bring your foot closer to your center of mass. mass. mass. So that's one thing that happens when you can feel the foot as you start to change how you're striking the ground.

Not to mention with cushion, there's changes in the forces of how that foot hits the ground. Yeah. Yeah. Yeah. And that's those um forces that she's referring to there. Yeah. Yeah. Yeah. It's kind of interesting. This is so obvious obvious obvious when you are used to minimalist shoes, right? right? right? Yeah. Yeah. Yeah. I think we both had experiences recently, well, not that recently, but where we wear minimalist shoes, but for a wedding, for example. Yeah. Yeah. Yeah. Uh but this was 7 8 years ago now, where I wore these Italian dress shoes, and you don't realize how they're restricting your movement until you're used to barefoot shoes or minimalist shoes, and you go in a stiff sole shoe, you're like, you're like, you're like, Yeah.

Yeah. Yeah. You know, it's I I can't move my feet. They're like they're almost being they're in prison here, basically. So, I think it's obvious when you go the other way, and it's probably not so obvious if you're used to these shoes, which most people are wearing. You're like, they almost have to take our word for it, don't they? But but I guess you could experience it by walking. If you're enough to have a garden, and you walk barefoot on the grass, you can start to feel that fluidity in the sole, can't you?

can't you? can't you? My favorite thing my patients will say after they've been introduced to this type of footwear, is I just kind of keep my mouth shut. I educate on the front end, and I said, "This is what we're going to try." They come back, and they're like, they're like, they're like, "My foot feels better. Yeah. Yeah. Yeah. My back feels better. Their gait changes because that's how we were supposed to to walk is allowing our foot to feel. And so, you know, when you get on the other end, other end, other end, um when your foot starts to change shape, your toes might splay some more, um your foot gets stronger, trying to put that foot, that healthy foot into most traditional footwear, now you really got problems.

Yeah. Yeah. Yeah. Because you put your foot in there, you're like, "Man, this thing is tight. How was I wearing this before? My toes are going numb." Yeah. Yeah. Yeah. So, I always um I don't which I don't know why I do this, but I have a a old shoes that I used to wear, and I'm talking like 15 years ago. And I'm like, "Let me just see what it feels like." And I'll go out my door for 3 minutes, and I'm like, "Nope. I'm coming right back." Because it does, it just feels so different.

different. different. Yeah. Yeah. Yeah. [clears throat] [clears throat] [clears throat] Walk taller is something else you write about when it comes to walking efficiency. efficiency. efficiency. What does that mean, and why is it so beneficial? beneficial? beneficial? When we give people gait cues, um you don't want them to think about too much. too much. too much. Mhm. Mhm. Mhm. We can't have people thinking about what What's my heel supposed to be doing? Should I be pushing through my big toe? Should I be rotating my pelvis?

Should I be internally rotating my hip? All of those things are true. There's a lot of, you know, beautiful things that happen in a walking gait, but it's complex, and you cannot have people overthinking this. Walking should be enjoyable. Yeah, you can't micromanage it in the moment. moment. moment. That's right. So, the cue of walking taller, taller, taller, just trying to get your head towards the clouds. clouds. clouds. Mhm. Mhm. Mhm. So many things happen with just that cue. For example, one of them is the use of your diaphragm.

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

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

Yeah. Yeah. Yeah. Try and walk a bit taller. So, you're actually getting more out of those 7,000 steps. steps. steps. That's right. Nasal breathing is one. So, tell Why why is nasal breathing so important? important? important? We interviewed Brian MacKenzie who has really specialized in Brian. Brian. Brian. Yeah, he's great. And he said one of the lowest hanging fruits from human metabolism uh and human function is to be able to walk nasal breathing for 60 to 90 minutes. Mhm. Mhm. Mhm. When you're nasal breathing, it does it changes your inputs.

It kind of calms your nervous system down. It changes how you're utilizing and using your diaphragm. So, it becomes a a challenge for a lot of people. Uh when you start increasing your speed and your heart rate goes up, we need more oxygen. So, our mouths open. So, if we can start to play around with this nasal breathing, we can also create efficiency. And I really like that as a little challenge for people. But, you know, be smart about it. Well, then interestingly enough that you said when you walk taller, your diaphragm is able to work more efficiently.

efficiently. efficiently. When you nasal breathe as opposed to mouth breathe, your diaphragm is able to work more efficiently, right? Cuz of course, everything's connected. But, I guess you can take that cue and go walk taller and try and nasal breathe. And you'll get all of these incredible benefits. benefits. benefits. Yes. Yes. Yes. And I I I just want to highlight this is free. free. free. Yeah. Yeah. Yeah. Right? You don't have to buy anything here. This is completely free of charge. of charge. of charge. Um Um Um [gasps] [gasps] [gasps] when we look at what that does to our posture, for example, one of the things I'll notice when people are walking and they're either in pain or they um are not efficient is they'll suck in their bellies.

bellies. bellies. So, they'll So, they'll So, they'll be sucking everything in. Okay? It is hard to breathe, period, when you're sucking in your stomach. It's very hard to nasal breathe. So, when someone's walking taller, it's also just relax. I will often give the cue of do the opposite of suck in. You know, we have this You know, we'll see people walking around and they want to suck in their bellies. It's the opposite of sucking in. It's relax so that you can breathe, so that you can rotate your body and swing your arms.

When you have this uh tension in your belly when you're walking, the gait becomes very stiff. Mhm. Mhm. Mhm. And that's not what it should look like. It's It's It's calm. calm. calm. Yeah. Yeah. Yeah. I want to get to some more of these walking cues, but I had a thought related to the start of our conversation, Courtney, and that's is we're mentioning we're mentioning we're mentioning all the incredible benefits of walking a little bit more. Yeah. Yeah. Yeah. And if we can walk more efficiently as well, even better.

There's quite a lot of people out there who have grown up with the idea that intensity, intense cardio, is really, really important for health, for weight loss, for fitness. I know you have to assess each individual, right? Because we're all going to be different. But as a general principle, would you say that you know, as people get older, over the age of 40, over the age of 50, over the age of 60, that in many ways the focus should be more on walking than intense cardio?

intense cardio? intense cardio? You're That's a tough question. I know it is. That's a tough question. Cuz it depends. It it does. And I think it's the and conversation. conversation. conversation. Yeah. Yeah. Yeah. I think you need both. I think you need to be able to walk at a brisk pace brisk pace brisk pace for 30 minutes, 135 steps per minute. but I also think that we need to train VO2 max and get into the other end of the spectrum, regardless of age. I think that's very important.

But this daily input of walking at that intentional walk with 30 minutes at that brisk pace, the health benefits there, this this happens every single day. day. day. Mhm. Mhm. Mhm. This is an input that occurs every single day. single day. single day. And I think also as we age, the other conversation I like to have there is about power. about power. about power. Uh we lose power faster than we lose strength. strength. strength. So So So What's the difference? Power is reactivity. So for example, it would be can I get up and off of a chair?

If I'm walking across the street and a car comes, can I quickly move? move? move? Some people may think, well, isn't getting up off a chair strength? So what what I'm just trying to make sure people understand the difference between strength and power. I think when we look at power, some people look as training power only for athletes, for example. Okay. Okay. Okay. But power is being able to move loads with speed. with speed. with speed. So if I were going to get up off this chair, okay, and I had to like slowly get up off the chair and use my hands, this is not power.

I need to be able to get up off of the chair pushing load at a certain speed. It's quite I didn't think about it like that, but getting up off a chair in some ways is quite an explosive movement. But you wouldn't know you wouldn't use the term explosive to really think about getting up off a chair, but in some ways it is. Well, how about walking? If we look at walking, would you say walking is a power movement? Until I read your book, no. Think about speed.

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

Yeah. Yeah. Yeah. So, for example, if I was going to do um a lunge, a lunge, a lunge, I would go down for three counts, right? Slow. And up for one. So, I'm just moving faster under load. under load. under load. And we lose power faster than strength as we get older. Yes. And how are How am I supposed to walk fast walk fast walk fast if I can't produce power at propulsion? at propulsion? at propulsion? You don't you I was having this conversation with my father.

He's like, "You know, Courtney." He's like, "You know, I was walking the other day and I just felt like I I had to pick up my leg and drop it down and pick up my leg and drop it down." He was losing power. Mhm. Mhm. Mhm. Because he couldn't push through his foot and ankle. And I said, "Dad, we need time out conversation here." So, do we train power whilst walking or do we train power separately, which then enhances our walking? both. both. both. I think we have to train power separately.

So, for example, a calf raise. raise. raise. We could work on same concept, going down slow, down slow, down slow, pushing up fast. Um little vibrations if you don't want to jump. There's always somewhere that you can fit along that. I'll have some patients put their hands on the wall and just bounce their heels. Why? Why? Why? You can train double leg hopping, single leg hopping, depending upon what you're comfortable with. comfortable with. comfortable with. It's the speed that we're looking for. And that's react We need that reactivity.

reactivity. reactivity. You know, we need to be able to be aware of our surroundings, be able to move with speed with speed with speed as we age. It's really interesting thinking about power power power in the context of walking. walking. walking. I've been thinking about it recently since I've taken up paddle, which is really only really only really only maybe 8 months ago now, but I'm playing more and more. fun. I played for the first time a couple months ago. I was like, "Yeah, this is pretty fun." It's pretty fun.

And as you advance through the levels and play at a higher level, which I'm now starting to compared to a few months ago, it really is quite intense. You know, you can have you know, long rallies, which are all about patience, a lot of moving back and forward and waiting for your moment. And literally in the last 2 weeks I've realized, "Wow." Cuz I used to play a lot of squash when I was a teenager. I would do lots of sprint training. I was very quick on the squash courts.

And I realized for the last 3 years I've not really trained speed. Yeah. I've been moving a lot, but I haven't trained speeds. And I'm like, "What can You know what's going to really help you on the paddle court?" paddle court?" paddle court?" That's right. That's right. That's right. It's being faster. So, I got these jumping blocks out of the shed in the garden a few days ago. I was jumping on and off. and off. and off. But again, I just want to highlight the point that point that point that I was thinking about power as, you know, in terms of an athletic movement to help me on the paddle court.

But it's not just that, is it? You're saying as you get older, you may not be playing intense paddle like I am, but you still need that power to, you know, to help prevent a fall when you're actually stepping down from the curb. I I think I want to like scream that. That's very regardless of decade, regardless of decade of life. There is a way that you have to intervene with that type of training. It's very important for not only activity like you're doing, but just interacting with your environment.

Mhm. Mhm. Mhm. Fall risk and walking speed and being able to catch yourself, you know, if you were to stumble. Yeah. Yeah. Yeah. So, that's a very important conversation and I don't think we should shy away from having these conversations as we age saying, "Okay, well, we're just going to do, you know, chair yoga for example." Which I am not like there's a time and a place for all of that. But, I also think it should be the and conversation. conversation. conversation. Challenge our systems a little bit, regardless, like I mentioned, of decade, there is always some way for that stimulus to occur.

It comes back to what you were saying before about with modern conveniences comes a responsibility. If you want this body of yours to work well well well for the duration of your life, there are certain inputs it requires. Yes. Yes. Yes. So, I love what you said before about intensity and walking. You're saying it's not an either or, it's an and. You also made an Instagram reel very recently where you were addressing the same question when it came to walking or strength. Yes. Yes. Yes. And I think you specifically said, "Excuse me for the lack of clickbait here, here, here, but this is an and conversation, right?" So, talk to us a little bit about walking versus strength.

Well, people will ask me that all the time. If you what would you choose? Would you walk or would you strength train? train? train? And like I said in that post, I'm like, I don't really like this that question because it's the and conversation. They're two very different inputs. Just because you strength train one day does not excuse you from not walking. They're different biological inputs. Might want to argue. I I again, I I think we should be doing all of them as well. But, let's we we were just going to play the game of walking versus strength for a Just as a thought experiment, thought experiment, thought experiment, might want to argue that walking is this fundamental fundamental fundamental um um um human movement.

It's very unique to humans. humans. humans. And that you could if you were time pressured, you could walk uphill to to to you know, make your walking, you know, have a strength component to the lower limbs at least. Yep. Yep. Yep. You could get a weighted vest or a backpack or, you know, we all get to rocking shortly. rocking shortly. rocking shortly. But But But again, I I agree with you. It should be both. But if you were time pressured, if you, for example, let's say did I don't know, a 30-minute walk each day, but you wore a weighted vest while you were doing it and you went uphill, you're kind of getting the best of both, aren't you?

aren't you? aren't you? Well, welcome to the boost program. Welcome to the boost program. Because that's exactly what you can do. So, if you wanted to amp up your walking, let's say time was a factor. There's lots of things you can do. You can throw on a weighted vest. You can add in walking lunges. Some of my favorites for the foot and ankle are heel-to-toe walks. So, you just walk heel-to-toe. And this is also producing power. Cuz you're powering up onto the ball of your foot.

So, I'll have patients do that, you know, 20 steps on each side. So, you can incorporate those things into that walk. I think now's a good time to talk about Jane, who we mentioned before, because I think she beautifully illustrates the potential problems with being one-dimensional with our movement. So, she was getting 15,000 steps a day, which I think most of us would go, "Man, you're crushing it." Right? In the modern world, to get 15,000 steps a day, you're probably doing way more than most people.

But she came in to see with lower back pain and osteopenia. So, tell us a little bit about Jane and what you recommended to her. She was. She was, you know, for her when she came to see me, she was in pretty good health. I mean, she was moving, she was walking, but she did have some low back pain and osteopenia. Now, we know when we're walking, we can maintain bone health. It is a load to bones. Can you just explain what osteopenia is actually for people who don't know the term?

term? term? So, osteopenia and osteoporosis is when you start to see changes in your bone health. So, a decrease in the density of the bone. the bone. the bone. So, it's a a precursor, if you will, to porosis. porosis. porosis. Yeah. Yeah. Yeah. So, it should be one of those I need to start paying attention. Exactly. Exactly. Exactly. So, So, So, while she was maintaining bone health with her walking, I knew we needed to start loading her more. So, we had the conversation of we're going to decrease some of your step counts and we're going to get you in the gym a couple times a week for resistance training.

training. training. Um this also helped with her low back pain. She was building up her strength around her spine. Uh we changed her programming around. I also had her get on a rower, which she now loves. Um so, we were doing more uh intense VO2 max work on the rower. So, I was taking her picture of fitness and making it more diverse. diverse. diverse. Mhm. Mhm. Mhm. Creating more movement variability. And that's what I think is very important in her case in particular because she was just walking and we needed to broaden that picture a little bit.

Um a lot of the things that we did were able to change that picture for her. We spoke about efficiency when it comes to walking, but what we're talking about here is efficiency when it comes to time. time. time. Yeah. Yeah. Yeah. You know, You know, You know, I think she beautifully illustrates, as I said, the problems with one-dimensional movements, but I think there's going to be many people who are listening to us right now thinking, "Oh, I I sort of I go to the gym four times a week and lift, but I don't really walk much." Yeah.

Yeah. Yeah. Or the converse, people saying, "Hey, I walk 45 minutes every morning and then I crack on. I'm sat down at work all day. I don't go to the gym, but I feel pretty good. I'm getting my morning light and my nature." my nature." my nature." And I think that just illustrates that, you know, what what I love when you were describing the Jane story is that by taking it down from 15,000 steps, I think to 9,000 steps, you freed up time in her week and it's not that that time went to just watching television.

watching television. watching television. You freed up that time so she could strength train and do other things. And I think that's a really interesting one for us all to think about, you know, you know, once you've met the base requirements, requirements, requirements, are you better off increasing your step count to 12,000, 13,000, or are you better off doing something else? It's We talk about taking a time inventory in the book. Yeah. Yeah. Yeah. And, And, And, you know, I it was really interesting because I did that as well when I was writing the book and my workouts happen in the morning.

That's when I'm like I get my strength training in or whatever's on on the docket for the day, it happens in the morning. morning. morning. And then on the days I'm in clinic, I'm typically not sitting down. I'm constantly like with patients, I'm moving around and once I started monitoring my step counts, I'd get home from my days in the clinic and I'm thinking I'm thinking I'm thinking I'm you know, I have to be 7 to 8,000. And I would look at my watch and man, I only had 5,000 steps today.

Even though I was moving around all day long. And then I would get home and I'd say, "Okay, you got 20 minutes." So, it would it really would make me um monitor my time, what I needed to get done and I had and I made time for it. So, So, So, that's a good thing to think about because I think sometimes we think we're getting more movement in during the day and and and it it it the day goes by fast. That relates to one of the questions I've had when I announced that you're coming back on the show, Courtney, where someone said someone said someone said I move around a lot during the day for work.

work. work. Yeah. Yeah. Yeah. Why do I need to walk as well? I guess you've semi-answered that to a degree, but there's a flip side, isn't there? It depends on well, what kind of movement are you doing? Right? Because there is something about the kind of Yeah. Yeah. Yeah. metronomic, rhythmic um texture to walking that perhaps you're not getting if you're just moving around the office. the office. the office. Yeah, there's a difference between ambient walking and intentional walking. Ambient is what I get around my house, for example.

for example. for example. Um which is still activity, but that intentional walk is exactly what you said. It's that repetitive motion, the rotation, the stimulation to the systems in our body. That is what's important. And so, those intentional walks, we have to make time for those. Yeah. Yeah. Yeah. Back to uh cues for walking efficiency. We did uh roll the earth away. Uh walk taller, we did. Um Um Um swing the arms or swing those arms and walk softer. walk softer. walk softer. Yeah. Yeah. Yeah.

Can we talk a little bit about those two? two? two? Uh I think we can all probably know someone in our families where you can hear them coming from a mile away. Uh Uh Uh you hear that really heavy strike. What does that mean? What what what does it signify? it signify? it signify? So, I'll often see that with people that have very stiff feet, for example. So, remember, when the foot hits the ground, it has to elongate. It's our first opportunity for shock absorption. So, we want the foot to pronate.

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

Yeah. Yeah. Yeah. That's the the beautiful thing about the calcaneus, about the heel, is you have this bone, and then there's also this fat pad, with a bunch of receptors in it, and it's designed to tell you information. information. information. Yeah, people just don't realize enough, I think, that if your foot can't feel the ground, the ground, the ground, it it doesn't know where you are in space, right? And that chat with Helen yesterday, she was talking to me about research in the 1970s showing that gymnasts, gymnasts, gymnasts, when they land on a cushioned pad, as opposed to on the ground, there is way more force going through their entire system, because system, because system, because they don't know where they are.

The foot's trying to find some sort of, you know, some kind of metric to say, "Oh, here you are. Here's the ground." Yes. Yes. Yes. You're much better off just landing straight on the ground, where your feet can actually, oh, they know what they're doing there. doing there. doing there. It it It the foot prepares you. Yeah. Yeah. Yeah. It knows. It's like, "Hey, I'm about to hit something hard. Soften up." Yeah. Yeah. Yeah. You know, it can change the the fascial compartments can change their pressures, and that's what they it was designed to do, but we have to be able to feel that.

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

Um, I want to preface this conversation with saying something is better than nothing. So, if you're walking with coffee, great. If you're not great if that's if that was what it is going to get you walking, great. Um, but I have a story for you. So, this is an interesting story. interesting story. interesting story. Have you tried to meditate before? Perhaps you've heard about some of the benefits like reducing stress and increased focus. increased focus. increased focus. And you've given it a go and thought it's not the practice for you.

Well, I believe that may well be because you have not tried the right approach. The Way is the only meditation app with a single long-term pathway. You're not forced to make loads of choices each day. Instead, you're guided on an enjoyable and progressive journey that deepens your practice step-by-step. Since I partnered with The Way, I have had so much positive feedback. One listener said, "Dr. Chatterjee, I came to The Way through your podcast. I have tried other meditation apps in the past with limited success and like the idea of following a single guided path.

I'm nearly 2 months in now and loving it. Henry's gentle and concise approach is very calming and The Way is now a part of my morning routine." You see, that's the sentiment that so many people report when they start meditating with The Way. For listeners of my show, The Way is offering 30 free sessions to help you establish your own meditation practice. All you have to do is click on the QR code on screen or go to the way app.com/livemore to get started. I was treating this gentleman who was an FBI agent.

And he was always my last patient of the day. day. day. And so when he would come in, he had changed out of his, you know, work attire. So I would only see him in his, you know, sweatpants and gym clothes. And his gait, he had this little, you know, you know, you know, hiccup to his gait, as I call it. So he was kind of stepping in a pothole on his right side and he wasn't swinging his right arm. And so we started working on these things.

things. things. And he started getting better. Um but I wasn't nailing it. It was one of those cases, if you get on my list that I'm thinking about at night when I'm laying in bed, that's not the list you want to be on. Um Um Um so I'm obsessing about this. I'm like, what am I missing? What am I missing? Um and one day he was running late. And he didn't have time to change his clothes. clothes. clothes. And so I watched him walk back into my office.

And I said, um what side do you keep your gun on? And he goes, my right side. And I was like, oh. So he had his gun in his holster on the right side. right side. right side. Wow. Wow. Wow. So he, when he was walking, his arm wasn't swinging like it should. It was almost like there was this barrier there. there. there. Yeah. Yeah. Yeah. And it was really this wild kind of thing that I noticed and I said, oh my gosh. I said, we need to I was like, what are your thoughts on moving that to the other side?

He's like, Yeah, that's his This has been years. Yeah, he's conditioned to know how to pull it, how to use it. Yeah. Yeah. Yeah. It's uh it's actually a term called a gunslinger's gait. gunslinger's gait. gunslinger's gait. Um Um Um but it was really very interesting. So, once we I kind of determined that at least we had a mechanism for the why, but I think it's interesting when you see these patterns. Um for people who walk their dogs, for example, I'm like, "Can you switch the leash into the other side?

Just switch up the input." Mhm. Mhm. Mhm. Because when you're walking and you're only moving one side, that's not efficient. We have to be able to rotate. We have to be able to move our bodies from side to side. Uh and there's a very big reason for that when it comes to the foot. foot. foot. You know, that's the foot has to be able to to to um pronate and supinate, and it's the rotation of our bodies, our arm arm swing that facilitates what happens in the foot.

the foot. the foot. Yeah. I hate carrying something in one hand when I'm walking. I'll always take a backpack if I need to take something. But you know, just to reassure people, I I I presume you agree with this, but if you're out for an hour's walk and for 5 minutes of those or 10 minutes of those you're drinking something, then you picture I don't think that's you know, I think we're robust, aren't we, as humans? We can deal with stuff. It's just if every walk you're doing you've got a water bottle in your right hands and you're repeating that over and over again, then may be a consequence in terms of your gait.

It certainly would be something to look into. into. into. Exactly. You may also be fine, but yeah, I I Exactly. I mentioned relationship walking. I know that that that you have said that this is one of the funnest bits of research you did when writing this book. Yeah. Yeah. Yeah. What is it? When I was writing this book, um my daughter is now 15. And And And for anybody who has a teenager out there, there, there, uh it's fun fun times. You know, it's uh we've certainly have had our challenges, but but but um when she comes home from school, I can always tell what kind of mood she's in.

Is she happy? Is she sad? Just by her gait, right? Like is she, you know, excited to walk through the door? And I always will ask her, "How was your day?" "Fine." "How are your friends?" "Fine." "Fine." "Fine." "Um what about your schoolwork?" "Fine." And I don't get a lot of I don't get the answers that I'm quite looking for there. And even if we have dinner and I ask her these same questions, "Fine. Fine. Can you take me to Starbucks?" That's usually what I I get.

And I started doing the research for this book and I said, "Gosh, Courtney, take your kid for a walk." And so I told her, I said, "Addy, um um um [clears throat] [clears throat] [clears throat] just give me 10 minutes. Just give me 10 minutes and then we won't have to, you know, we don't have to go through these questions." And And And I will tell you what, we started doing that after dinner. Within 5 minutes, this is no joke, that kid couldn't keep her mouth shut.

She's telling me about her friends and about the boys and about her classes and I'm like, I'm like, I'm like, it touched my heart so much. I was like, "Okay." "Okay." "Okay." Because when you get outside and there's this change of environment, you know, there's some research looking at maybe with the teenagers it's eye contact where she can still be looking around, being stimulated by different things, but the activity, the increase in heart rate, the increase in brain in blood flow, uh she really, really opened up and it was mimicking exactly what I read in the research, which was relationship walking.

You start to communicate a little bit differently. There's bonds that are created. Walking with your spouse, walking with your grandparents. There's just fascinating research on this, which sounds it makes sense, doesn't it? Like It totally makes sense and and and it kind of it feeds back into this central idea idea idea that walking is a physiological necessity. necessity. necessity. Yes. Yes. Yes. You could even expand that and go walking is a social necessity, a um relational necessity. Because that research, you know, I think what you just described uh with your daughter, I think many people will have experienced.

Yeah. Yeah. Yeah. And there is in your book there's some really good research on relationships and as a, you know, as a romantic couple, what going for a walk together a couple of times a week will do for your relationship. relationship. relationship. And again, it's pretty simple. It's free. It's free. It's free. You just You just got to do it. That's right. That's right. That's right. Yeah. Yeah. Yeah. I read once um that it's hard to have anxiety when you're looking out at an ocean, at the horizon.

horizon. horizon. And I kind of think about that with walking, too. It's hard to to to sustain being in a bad mood or sus- to sustain being cranky when you're outside walking. It's hard. Because Because Because again, it's this input. Our brain is starting We have neurotransmitters. We have all this action happening in our systems and I think that's a really special thing that we have forgotten about. about. about. Yeah. Yeah. Yeah. Let's talk about walking with weight or rocking. rocking. rocking. Yeah. Yeah. Yeah. Uh what are the benefits?

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

Yeah. Yeah. Yeah. Uh so those are things to consider. I think also think also think also it can be really good for your foot and ankle. ankle. ankle. But you have to build up. That's right. That's right. Because if you're walking in a minimal shoe, for example, that is more loads going through your foot and ankle. It's a harder environment. But that's also the environment where you can get stronger. If you were in a cushioned shoe already and you had a choice of either adding weights and going what is called rucking or moving to minimalist shoes, what would be the better step to take first?

first? first? I would go minimal shoes first. And build up there, get comfortable there before you start adding weights. Yeah, me too. You know, um you definitely don't want to do those at the same time. Mhm. Mhm. Mhm. So you wouldn't want to grab a minimal shoe and put weight on your back. your back. your back. It's too many variables. Mhm. Mhm. Mhm. So, you know, if your choice would be, "Hey, I want to get my steps in, I want to amp up my walking, and I want to add weight, and I'm not in minimal shoes." That's one option, but you don't want to do those things at the same time.

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

ergonomic. ergonomic. Yeah, I don't think there's enough people talking about the equipment for weighted walking. weighted walking. weighted walking. Right. Right. Right. Because that rib cage expansion is crucial. crucial. crucial. Yeah. Yeah. Yeah. You have to have rib cage expansion not only for what's happening at, you know, from a breathing capacity, but that rib cage and the rib cage expanding also is what dials in rotation. Yeah. Yeah. Yeah. It has a direct correlation to what's happening at your pelvis. So, you do not want anything that is going to be compressing that rib cage.

So, that's where I think the gear is very important. Um I made This is a funny story. When I first started uh weighted walking, I had a a backpack, like a like a like a my hiking backpack in my garage. And I was like, "Yeah, this this makes sense. I'm going to add some weight." So, I didn't have a sandbag or anything, but I had a 25-lb kettlebell. So, I just threw it in my backpack, and I'm walking around. I'm like, "All right, you know, I'm an hour in." And uh the next day I woke up and I was like, "Man, I was like, my I can't believe I'm telling you this.

This is very embarrassing. But, my low back was so sore, and it was because every time I was walking, the kettlebell was was was Yeah. Yeah. Yeah. smacking into my low back. And then I was like, "Okay, this uh this is a good concept, but I need the right gear." Yeah, it's a it's not failure. It's a it's a learning opportunity, say. All right? It's don't have something heavy knock against your lower back while you walk. It just doesn't make any sense. You should have done a chapter on that in the book, you know.

Yeah, but but but I think it all plays into this idea that you know, walking is amazing. There's so many benefits, and you know, it depends on your starting point, right? If you currently not even hit 2,500 steps a day, okay, no worries. Yeah. Yeah. Yeah. Let's get you there first. And you've got a program in the book to help people get there. If you're at 2,500, you want to get to 5,000, okay, well, that program's going to help you build up. And if you want the boost program to really max your walking, you know, you know, you know, I think that's fantastic as well.

So, you know, you're you're never going to run out of things to do if you're trying to improve the way that you walk. Yeah, I mean, when I was writing this, I'm I consider myself a pretty active Yeah. Yeah. Yeah. person. My whole career is built around movement. movement. movement. The changes in my life, in my lifestyle, from researching this and writing it, I'm so grateful for because walking has taken on a whole new kind of meaning for me. Even though activity has always been a part of my life, it continues to be this calming calming calming measure for me.

This bringing me back to baseline. When I was writing and I'd get into, you know, I'd be challenged or I things weren't flowing, I'd go take a walk. Mhm. Mhm. Mhm. You know, my creativity would improve. Um when I was stressed out, go take a walk. You know, so I was able to really think about the benefits of what it was doing for me, and it was really cool to see what happened, and to see what happened, and to see how important it it has become.

Today's the Today's the Today's the final day of your, you know, book promo trip to the UK, right? Yes. Yes. Yes. And interestingly, you've come with your mother. mother. mother. Yes. Yes. Yes. Right. So, you've been in London for a few days doing all kinds of cool stuff. Yes. Yes. Yes. The weather has been great. Yes. Yes. Yes. Have you two been managing to walk a lot while you've been here? I'm so proud of her. She um She um She um first of all, this is very exciting.

She got her uh pair of Vivo barefoot. She's 76 years old. Love it. Love it. Love it. Uh she put in 13,000 steps yesterday. In her Vivos. In in her Vivos. Put it that way. I know. I know. I know. Fantastic. Fantastic. Fantastic. And you know, I'm sitting there going, "Mom, "Mom, "Mom, bring your other shoes, you know, I'm like maybe just in case, you know, let's you know, but she's she walks every day at home. at home. at home. She's in the gym a couple times a week.

And so her transition, you know, and of course the next morning I was like, "How's your feet, Mom?" She's like, "I feel great." feel great." feel great." Do you know which one she wore? She had the Primus Flex, I believe. Yeah. Yeah. Yeah. Um but she really did very well. And you know, now she has three pairs of them. But I was really proud of her cuz she she put the steps in. And not to mention the place that I'm staying in is on the fourth floor.

Which I didn't I missed the uh I missed the little fine print. And not only that, but the staircase is about a third of the size of this table. An old traditional British staircase. So God bless her. She's had to walk up and down these stairs a million times. I carried her 50-lb suitcase up those stairs, by the way. So she's on a fitness holiday. Yeah. Um Yeah. Um Yeah. Um But yeah, so she was able And she was she said to me, she goes, um "If some of her friends were here and in fact she said most of them she's not sure they would be able to get to our flat." Yeah.

Yeah. Yeah. Because they wouldn't be able to navigate the staircase or have the power or have the strength to do so. And that like broke my heart. I was like, "Oh." I literally looked at her and I said, "That's why I wrote this book." That is one of the reasons why I wrote this book. So that people don't have to have those conversations when they get older. I can't go on this trip with my with my daughter. I can't go on this trip with my grandkids because I'm afraid or I won't be able to do things like walking up a flight of stairs.

But that is happening, Courtney. It's happening all over the shop. And there'll be people listening right now who that story, like it a little bit did for me, makes you a bit tearful because you know, I can't remember the last time I was able to do stuff like that with my mum. mum. mum. Yeah. Yeah. Yeah. And it just highlights why the message in this book is so important because so many people they neglect their health throughout their life. They end up in their 70s wondering why can't I do that stuff anymore?

Why can't I enjoy my grandchildren or play with my children? children? children? And it it didn't start in your 70s. Yeah. Yeah. Yeah. It started many decades before that. That doesn't mean, you know, you can't undo problems. You can. It's never too late, but it's never too early also. also. also. Yeah. Yeah. Yeah. I was when I was at the radio show yesterday, there was a gentleman there that ran the marathon. marathon. marathon. And I asked him when he started running. He was older and he goes, "I didn't start running till I was 60." And he had just finished the marathon.

So, that was also like I love having that conversation that it's never too late. late. late. It's never too late. Yes, do you think is it easier the earlier I start? Yeah. Yeah. Yeah. We want to avoid some of these problems. We want to take a proactive approach, not a reactive approach. And so, And so, And so, I think it's hopeful on both ends. Like there's no better time to start than now. now. now. Yeah. Yeah. Yeah. Courtney, since you came on last time, um um um that that episode was so well received.

I can't tell you. You know, we've had one of our most popular episodes of the year. year. year. The amount of questions I've had, the amount of people who said, "Rangan, I've got minimal shoes, but next time Courtney comes on, can you go through in detail how to transition?" Right? So, I have a list of questions from many people in my audience. I don't know if we'll get through them all, but I thought thought thought it might be quite good to try and get through a few of them if possible.

Yes. Yes. Yes. And let's start off with that one, you know, what are some practical steps for transitioning from cushioned shoes to more minimalist ones. So, when you think about the characteristics characteristics characteristics of functional footwear, we'll start there. there. there. We have a wide toe box, a low heel-to-toe drop, so that's defined as 6 mm or below. Yeah. Yeah. Yeah. And varying degrees of cushion. So, if we were to start with the first one, if you're in a traditional shoe, this is the majority of footwear out there.

there. there. Transitioning to the wide toe box, that's my non-negotiable. That's what happens first. And that's usually pretty easy because there's not a person that says, "Wow, I have more um space for my toes. I don't like that." If that." If that." If Yeah. Yeah. Yeah. You know, what they will say is it sometimes it feels a little loose. Yeah. Yeah. Yeah. Because their toes don't have the strength strength strength or the splay to fill up the toe box. But But they will. Yeah. Yeah. Yeah.

So, they can use toe spacers, for example, as a way to help them facilitate that splay. And then they can do the exercises that we talk about. So, that transition into the wide toe box, it's usually pretty easy and people adapt to that quickly and they like it. [snorts] [snorts] [snorts] When we move into heel-to-toe drop, I think a lot of people don't realize that that that the majority of traditional footwear, and this is trainers, what have you, the heel sits higher than the toe. the toe.

the toe. So, 10 mm, 12 mm, and over time, if I'm constantly in this position, it's going to affect, for example, the mobility of my ankle. my ankle. my ankle. It could make my calf tight. I mean, the for people who are who are listening, the extreme version of that is is is the ladies' high heel. Yes, if you were to wear a high heel all day long. day long. day long. You you'd understand that, but that there are many other shoes have degrees off that, just not to that extreme.

Correct. Correct. Correct. Yeah. Yeah. Yeah. And, you know, in the book we have a high heel rehab section. So if you've if you've worn high heels your whole life, again, you have help. There's something you can do about it. just want to re-emphasize that. Something we covered in the first conversation is that you have a very holistic approach to this. You're not against people wearing high heels. If they want to if they feel good and they want to wear it out on a night out or to a wedding, a wedding, a wedding, you're like, "Sure, but make sure those other times you're doing something about it." So I I just want to re-emphasize that point that you I think I think one of the things people like about your approach is that is that it is very realistic.

realistic. realistic. It's It's It's you don't want to instill fear in people. people. people. Yeah. Yeah. Yeah. That's not what we want to do. We want to encourage people. We want to empower people. people. people. Um you don't want to have the always or never conversation. never conversation. never conversation. Yeah. Yeah. Yeah. Always have to wear these shoes. You never can wear those shoes. People don't want to hear that. And it's not realistic. not realistic. not realistic. If you feel good in a high heel going out to dinner with, you know, your husband and that that makes you want to wear that shoe, go for it.

And feel good and enjoy it. Yeah. Yeah. Yeah. What I'm saying is when you get out of that heel, that heel, that heel, don't wear the heels all day long. Pay attention to your foot. Do some exercises. So that's where that conversation becomes much more digestible. You meet people where they are. are. are. Okay. Okay. Okay. So with the heel-to-toe, the higher heel-to-toe drop, um if you were to transition into a functional shoe, so that would be 5 mm or 6 mm. It's We're not taking you all the way down to zero.

It's like a nice halfway point. point. point. Mhm. Mhm. Mhm. [clears throat] [clears throat] [clears throat] And then we talk about doing ankle mobility exercises, for example. Working on your foot and calf strength. That is one of the things that we'll hear when people transition into a zero drop, they'll say, "Well, my calves got sore." And then they'll want to blame the shoe. And it's not the shoe, it's just a signal saying you probably didn't have the capacity in your calf [snorts] [snorts] [snorts] or the range of motion to drop down as quickly as you did.

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

training them. training them. It's like if you were squatting and you were squatting 100 lb one week and 200 lb the next week and you're like, man, I am so sore. You people wouldn't say, well, stop squatting. They would just say, hey, maybe only squat 10 more pounds than you were. Yeah. Yeah. Yeah. They It's a very different conversation at the foot. It's well, there must be something wrong. something wrong. something wrong. So, we take this gradual transition, okay, and I again, I would just like to emphasize we went in detail in our first conversation conversation conversation into the difference between functional shoes and minimalist shoes.

And functional might be considered a a transitional transitional transitional Yeah. Yeah. Yeah. sort of phase as you get to true minimalist shoes. minimalist shoes. minimalist shoes. Um Um Um as I mentioned in that conversation, I just want to repeat this. Um I have been wearing Vivo Barefoot shoes for almost 14 years now, pretty much exclusively. So, I know their range very well. well. well. The show is also sponsored by them. So, I want to make that very very clear, but it's not about that for me.

It's about, you know, choose your brand that you want, right? want, right? want, right? Um I will say for Vivo Barefoot that the I think it's the Primus Knit. It's my favorite shoe, but be the the people who I have transitioned or helped transition over many years, friends or you know, family or patients who wanted to to to I found the Primus Knit to be a really good uh shoe because there is a bit of I won't call it cushioning, but there there is a bit of substance under it, so you don't I love the Primus Flow as well, which is very very barefoot, but I think the Primus Net is a is a great transitional shoe for people if they're looking for something there.

If you look at the sole of that shoe, so we talked about wide toe box, heel to toe drop, and then the last thing is the the sole of the shoe. Yeah. Yeah. Yeah. The difference between a functional shoe and a minimal shoe is minimal has a a thin and flexible sole, so you can feel more of the ground. This is probably the hardest uh part part part Yeah. Yeah. Yeah. that takes people to transition into. Um that shoe, if you were to look at the sole, it has these lugs on them.

It's almost like a trail shoe. So, it gives a little bit of space between the sole of the foot and the ground. So, that is a great shoe for people to transition into a more minimal shoe, but their foot still has a little bit of bit of bit of Exactly. Exactly. Exactly. Yeah. Yeah. Yeah. Yeah. Okay, so and what once people have chosen the shoe that they want to transition, transition, transition, if we put it through the lens of walking, so we're not talk, you know, you know, running in minimal shoes can be done, and that's a separate conversation.

We're not addressing that here at the moment, okay? And I think if you go from three decades of cushion shoes into buying some barefoot shoes and going for a you know, a 1-hour run on a road in them when you're not used to it, don't blame the shoe afterwards. It's like that was the wrong thing for you to do, right? Let's get people walking in these shoes first. Yes. Yes. Yes. Once they've got this, let's say this new shoe, new shoe, new shoe, um let's say someone walks 30 minutes a day.

day. day. Is it just a case of like I don't know, you you do some of the walk in those and some of them in your old shoes or or yeah. That's literally what them in a backpack with you. Yeah, I'll say either walk 5 minutes away from your house, come back, 10 minutes, put your old shoes on. Do the rest of your walk. Walk around your house barefoot 5-10 minutes. Slowly transition. And then see how you feel that night and the next morning. If you're feeling pretty good, add a little bit of time.

Some people make that transition quickly. quickly. quickly. They're like, this isn't a problem. My mom. But she's, you know, she's a walker. She's, you know, she um is healthy. healthy. healthy. And she's your mom. And And And so I know She's had There's been some foot exercises in her life for some time. That would not be very good if we had some problems there. Um but yeah, so that's some people transition quicker. And that's okay. Okay, so basically take it easy, listen to your body, and as you get more comfortable start to increase.

And I guess if you go to a functional shoe and you get to the point where you can walk 30 minutes a day, no problem, you're wearing them the whole time, and you're walking to the shops and the office in them, then you could, you know, go to a minimalist shoe and apply the same principles again. principles again. principles again. Yep. Yep. Yep. Yeah. Yeah. Yeah. Um like in the build program, for example, when we talk about um these different walks per day, you could start with taking one of those walks or a portion of one of those walks with your minimal shoes.

Mhm. Mhm. Mhm. You know, and then start to build up, build the capacity of the foot and ankle. I mean, it took me, you know, I got into this because I had some pretty significant foot pain for a very long period of time. Bunions, neuromas, stress fractures. Um it took me years to be able to walk in minimal shoes for long periods of time, for all day long. I mean, it took a long time. And I would still That's why I'm this big, you know, shoe spectrums are important.

important. important. Yeah. Yeah. Yeah. I want to spend the most of the time that I can in footwear that is going to improve improve improve my overall function. It's going to put my foot and ankle in the position that it was supposed to be in. I'm going to be in an environment where I can get stronger. stronger. stronger. Now, there are times where I'm like, I want to go hike 10 miles in Colorado. You know, I like to have a little more stack height. It's like the least amount of cushion necessary to complete the job.

But, if you look at the footwear out there now, that's not least amount of cushion of anything. That is you're walking on a cloud and you're walking on a pillow and you're interfering with sensory acuity and that is a problem. Yeah. I would just add that the Vivo barefoot Tracker hiking boots are insanely good. You've got incredible grip, um which you often want if you're hiking trails, but so comfortable. You can really feel your foot flexing with every every every uh with every footfall. So, When you think about that a hiking shoe, too, too, too, you still have to have the boot to be flexible at the ankle.

You don't want a stiff boot where you can suddenly can't move your feet and ankle anymore. ankle anymore. ankle anymore. If you were walking down a mountain and you don't have ankle dorsiflexion, so your ankle is not allowed to move. You those loads have to go somewhere. So, what we'll see is that people will transfer that weight or load from the ankle up into the knee. Yeah. Yeah. Yeah. So, you don't want to interfere with those types of ranges of motion. I think people think those hiking boots are like this, you know, it's going to provide all of this stability.

And it I have to have it there. Um guess what? Your [snorts] ankle is beautifully designed to be a very good stabilizer. There are muscles that sit on the inside and outside of the ankle that when trained are better than any stabilizing boot you could buy. could buy. could buy. Yeah. Yeah. Yeah. So, rather than avoid it, we train it. We use it. We introduce the foot to varying positions, various terrain, and get stronger and more resilient. resilient. resilient. That leads on to the second question on the sheet.

How can we restore full mobility and confidence in our ankles, especially after previous ankle injuries? injuries? injuries? Yeah. Yeah. Yeah. Um Um Um when we think about the ankle, we don't want to avoid ranges of motion. I think for someone who had a history of ankle sprains, for example, the thought of putting their foot on a slant board that's kind of tilting them into that position of the ankle sprain sounds very frightening to people. So, we kind of adopt this, "Well, I'm just not going to do it." You have to train the ankle.

We have to train for movement variability. You don't want to avoid these ranges, you want to work into them. them. them. So, when we're working on especially patients that have had ankle instability, we're working on all these different ranges, um pointing the foot, flexing the foot, inverting and everting the foot, and training in all those different positions. The those muscles, the intrinsic muscles of the foot and ankle, are very good stabilizers. Mhm. Mhm. Mhm. And so, rather than I need a boot, I need all of this, you know, stability around the ankle, we can train the body to do that.

Are you a fan of those Bosu balls or those Is it those half Bosu balls where it's an unstable surface to stand on? a great question. Um you have to know what you're doing Okay. Okay. Okay. before you get on one of those. And a lot of people have a difficult time. So, why put someone's foot in an environment that's going to challenge them more when they're having just as much of a difficult time with their foot on the ground? ground? ground? Yeah. Yeah. Yeah. The foot on the ground is more We You to train for function.

Now, Now, Now, if you can put your foot on a Bosu ball and you look like you can control those motions, motions, motions, that's one conversation. But, when you see people all over social media and they're like on a Bosu ball and they're, you know, wobbling all over the place, how functional is that? Mhm. Mhm. Mhm. You know, what is your What is your intent? What is your goal? Yeah. Yeah. Yeah. I just want to add that that's the first time you came on the show a couple of months ago, we mentioned a lot of the things in your book, but the book wasn't out.

The book is now out, okay? And there are so many exercises, practical ones, in the book. So, for someone who's had a previous issue, I would say get the book and and take a look cuz at the start, at the back, there's all kinds of things that are going to help people build that up, aren't there? Yeah, and I I love treating the foot uh and looking at this part of our body that can get stronger. Mhm. Mhm. Mhm. It we we haven't treated the foot like that.

When we have the conversation of arch support, for example, um people say, "Well, does the foot need arch support?" support?" support?" And I say to them, "Do you know how well that your foot is designed? It has the the best arch support you can imagine." Um when we talk about the medial arch of the foot, so that's the inside arch. Mhm. Mhm. Mhm. There are so many muscles there that are designed to help your midfoot and stabilize your arch and stabilize your big toe. So, you know, the foot doesn't need arch support.

Now, if we shove it into a shoe where the where the where the toe box is tapered or the anatomy is changed, changed, changed, then yes. then yes. then yes. Yeah, you need arch support because you're compromising the integrity of the foot and ankle. Mhm. Mhm. Mhm. But, when that foot is doing what it's supposed to do, and I have toe splay, and I have a strong foot, and I have capacity, and I can push off through my toes, then no, that foot does not need arch support.

It's well designed to handle many times our body weight when we walk and run. I would just want to highlight that 12, 13 years ago people would have said I had a flat right foot. right foot. right foot. Now I've got an arch and it's because I've been using my foot for the last 12, 13 years. I've not been putting it in deforming footwear. You know, that's quite a provocative term, but it is if your shoe is literally squeezing the front of your feet and it's narrow you are literally deforming your feet.

We we just have to be honest about that. That's what is happening. And since I stopped wearing those kind of shoes and I've I've been in minimalist shoes my feet have changed. They're stronger, they're meatier, they're there's an arch now. It's you know, it this isn't just one thing, oh, I've got a flat foot or I don't. It's like, okay, you might do at the moment, but maybe with the right inputs it will change. When I started doing this, my foot looked looked atrophied. Yeah. Yeah.

Yeah. It was just you could there was no muscle in the foot. foot. foot. And yes, that those things do change. And I would encourage people that conversation of flat feet I think we've been really trained, if you will to think that flat feet are bad. And if I have a flat foot, then I have to have some type of support and I need this very aggressive shoe. That is not the case. I have plenty of patients whose flat feet are very strong. So it's more in how the foot functions.

And if you have a flat foot that is weak, do what you did. Mhm. Mhm. Mhm. Which is strengthen your foot because here's where the problem is going to be. If you have a flat weak foot and you don't do anything about it. Over time time time where that foot may have been flexible right? You're still able to move it. It will start to become stiff and rigid. So now instead of having a flexible flat weak foot that I can strengthen I now have a rigid stiff flat foot and that is a very different conversation.

And those are the people that have a very difficult time with walking gait as they age because their foot has lost the ability to adapt. Those are the ones we have the conversations with I need a specific type of foot orthosis. We need to get in some type of rocker shoe to help them do something that we as human beings were very born to do which is to walk for long distances upright. distances upright. distances upright. Some of the questions that have come in relate to this idea that people are listening to listening to listening to me talk about this, you talk about this and that thinking okay, I want to start paying attention to my foot and my foot health but I've neglected it for several years.

years. years. Is it too late? Can you undo 20 30 years of being in incorrect footwear? Yes, you can. Your [snorts] foot needs to be when you look at someone's foot and this will be a good example of for a bun with a bunion for example. A bunion is when the big toe starts to dive in. You'll see that bump on the inside of the foot. Yeah. Yeah. Yeah. If you can move that, if that's flexible that's it's a muscular imbalance. There's a muscle that straightens the big toe.

I'm a perfect example of that. So when the foot is still flexible and I can work on it and I can train it then by all means yes, that foot gets stronger. stronger. stronger. If the foot has become like I said stiff and rigid where you have toes overlapping one another, um the conversation becomes more difficult. Because now you're getting structural change. change. change. And that can be difficult to to address. Can toe spacers sometimes help with that? that? that? With the more rigid? Well, no, when there's when toes are starting to overlap each other.

If I can get a toe spacer on someone, we're doing it. Right. Right. Right. Um I wear them every day. I've been wearing them for gosh, years. gosh, years. gosh, years. Do you wear them in your shoes? I wear them in my shoes. Because I was a little late to the to the foot party here. I wish I would have started doing this work much sooner. But my bunion, for example, um has improved significantly. It is no longer painful. It you know, I run, I walk with these spacers on.

It helps keep my toes in alignment. alignment. alignment. Mhm. Mhm. Mhm. Um and it's a low-hanging fruit. It's easy. It's like just wear it around the house. Start with a couple minutes a day. It can be difficult for people to break in, too, because people aren't used to having their toes splay. At Gait Happens, you have this uh box, don't you, with lots of goodies which you kindly brought me a few months ago, which has been amazing. Um it they've got toe spacers, I think toe strengtheners.

What else you got in there? there? there? There's bands, ball. I wanted to keep it simple. simple. simple. Where where could people get that if they if they choose to get one? Amazon, right here in the United States. Yeah, and on our website. They just look at your name or Gait Happens, g a i t happens. Okay. Okay, back to the questions. Um what do you think about barefoot shoes or minimalist shoes for people with osteopenia? osteopenia? osteopenia? And I'm guessing they're talking about osteopenia in the foot, although I don't know that from the question.

yes. So, yes. So, yes. So, think about what happens when you're walking from a bone perspective. It's all about dosage. That's why the dosage is very important because when you're walking um barefoot or saying a minimal shoe, there's more loads going through the bone. This can be stimulatory. be stimulatory. be stimulatory. Mhm. Mhm. Mhm. So you get this osteoclastic and blastic activity and it's this um it can be this environment that is good for your bone health. health. health. Mhm. Mhm. Mhm. Now, Now, Now, if I go too fast too soon, right?

My dosage is too much. Then that positive bone response can turn into a stress reaction Mhm. Mhm. Mhm. because I went too fast too soon. So from a bone perspective, bone perspective, bone perspective, when done correctly, we can stimulate tissue. And when done incorrectly, we can cause problems. So again, it's that conversation. Start small. Um if you're transitioning into minimal footwear and you haven't walked for long periods of time, don't start running in them yet. them yet. them yet. Yeah. Yeah. Yeah. Because there's many more times your body weight going through your foot in a running gait than in a walking gait.

So start with this slow transition in a walking gait. walking gait. walking gait. Yeah. Yeah. Yeah. Okay, now there's been a lot of questions around two common issues. Plantar fasciitis and Achilles tendinopathy. tendinopathy. tendinopathy. Yeah. Yeah. Yeah. Okay. So let's start with plantar fasciitis. How do you treat and cure it? That's one of the questions. It's one of those diagnoses that I really think is this evolutionary mismatch. Because when you look at the foot, foot, foot, there's tissues share we share loads. So when I'm walking, for example, we have two muscles, tibialis anterior and posterior, that help absorb force force force when when foot hits the ground.

So, they're friends with the plantar fascia. When I go to push off, so when I'm pushing off of my gait, I have my toe flexors in my calf that facilitate propulsion. They're also friends with the plantar fascia. Mhm. Mhm. Mhm. If they're not doing their jobs, the plantar fascia gets pissed. Yeah. Yeah. Yeah. Because now instead of having this foot that was designed to share loads, the plantar fascia has to take on more of it. of it. of it. Mhm. Mhm. Mhm. And so when we look at treatment for these types of things, it's not just keep deloading.

keep deloading. keep deloading. It's not just here's a foot orthosis and here's a shoe that's going to rocker for you. It is why wouldn't I look at bringing the friends back to the party? Yeah. Yeah. Yeah. Start strengthening the foot. So that we can actually make change here. You know, one thing I think is very interesting and I if I had time to go back to school I would for this, but when you see bilateral heel pain, Mhm. Mhm. Mhm. so people that have plantar fasciitis, fasciopathy on both sides, I'm more and more convinced that this is a um up the chain conversation.

Yeah. Yeah. Yeah. That there is a very big correlation between the pelvic floor, hypertonicity of the pelvic floor and what we're seeing at the feet. Um Um Um it's if you think about it, if I was under high stress for example, right? I get into this like fight or flight, everything's tense. That also happens at the pelvic floor and it also happens at someone's foot. That's what's so cool about the foot. You look at it and you can tell if someone is like, why are they gripping their toes so much?

It's like do they have an inability to actually relax their entire system? Yeah. Yeah. Yeah. So it's been really some interesting work to do a lot of breath work, um pelvic floor work with my patients with bilateral heel pain Yeah. and it helps them quite a bit. It's really pretty neat. [clears throat] [clears throat] [clears throat] It also makes me think about even higher up because, you know, when you've got a forward head posture that goes, you know, as we said last time that the the feet are the foundation of the body.

So, you want a strong foundation and to add to that, you know, they also respond to what's going on up the chain, right? It goes both ways. If your your head's jutting out forward, well, that is going to have an impact on your feet and of course if it's bilateral, it indicates that something a bit more central going on than something local in that foot. What about Achilles tendinopathy? Is that something you see a lot of? Yes. Yes. Yes. Um, Um, Um, for people who don't understand the term tendinopathy, what are we talking about here?

here? here? Uh, anytime you have um, a tendinopathy or a tendinitis, it's you have to ask yourself, what happened to the tendon? Why is it starting to um, not be efficient, if you will. It's a very common diagnosis and it's also counterintuitive to people because when their heel hurts, when their Achilles tendon bothers them, the immediate reaction is, I got to get off of it. Mhm. Mhm. Mhm. I got to I'm going to do less and we know that tendons need load. And when we load our tendons, it's basically this concept of mechanotransduction.

mechanotransduction. mechanotransduction. We're loading the tendon, it's what stimulates the health of the tendon. And what helps share those loads or absorb some of those forces are strong calves. calves. calves. So, when we look at uh, treating for Achilles tendinopathies, for example, a lot of the research is heavy, slow loads. You have to improve the capacity of the muscles that insert at the Achilles tendon. tendon. tendon. Um Um Um I had a patient once that we were working on and again, several years with Achilles tendon pain.

And every time his foot would hurt in the morning, he would get his scooter out. He was a physician. Uh and I said, "You're going to leave that scooter at home. We're done with the scooter." the scooter." the scooter." Uh because it's not that the rest was bad per se, he was feeling better, but you can't rest a tendon. It will not when you go to return to activity. Mhm. Mhm. Mhm. You have now a calf that has gotten weaker. weaker. weaker. So, a tendon that is not um maintaining or improving its integrity or health.

And so, then it just becomes this cycle. So, with those diagnoses, uh tendinopathies, uh tendinopathies, uh tendinopathies, plantar fasciopathies, we have to look at movement and we have to look at progressive loading. progressive loading. progressive loading. Yeah. Yeah. Yeah. And those are very, very important conversations. We cannot deload forever. Yeah, that's a principle I think that has come up on multiple occasions through this conversation, Courtney, that that that you need to load the body. Yeah. Yeah. Yeah. You know, you I can think back to uh Christian, the firefighter.

Yeah. Yeah. Yeah. Right? And how he was told to move less. Three years on. Mhm. Right? And as you you as you beautifully explained, you know, whether he walked on it or not, the pain was the same. same. same. Yeah. Yeah. Yeah. Right? So, you might as well walk on it then. then. then. Living well with pain rather than having it dictate your life and saying, "I'm not doing that." Yeah. Yeah. And if you just superimpose onto that this idea that how would Schubiner spoke to me about and his research has shown that maybe even 90% of chronic pain has a neuroplastic component, [clears throat] i.e., i.e., i.e., it's not structural, it's it's been created by the brain, maybe due to fear, worry, anxiety, stress, and you layer that into what you're saying, it's like, "Hold on a minute.

If you've had pain for 2 years, maybe the injury's healed. That's right. Maybe there's something else now." It's uh you know, his book is called Unlearn Your Pain, right? Maybe there's a learned cycle here that you know, actually that word confidence again, that small amounts of movements, micro walks, get you going, build up that confidence, make you realize I don't need to fear my body anymore. My body is capable. It all starts to play in, doesn't it? I love that idea. How do you live well with pain?

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

Yeah. Yeah. Yeah. There's a question on gait analysis for running. Do you support gait analysis for running? And related to that was, "How do we know if our running shoes are causing us issues with our posture or not?" Yeah, it's uh that's deep. assessment, yeah, that is deep. Top line. line. line. Um Um Um top line. You know, there's some some very good runners out there, and you'll see on social media these people breaking down their mechanics, and they're like, "Oh my gosh, his foot's pronating, and it's he's this." And I'm like, "He just won He just broke a world record, you know?" Like, the guy has clearly, you know, he's running and he has this gait.

It's Do you really want to mess with those things? Um so, there it gets into these kind of fine lines. fine lines. fine lines. Um as far as the footwear is concerned with the super shoes, um shoes, um shoes, um there's actually a great podcast here in the UK with uh Ian Griffiths, Pod Chat Live. He talks about He They go in depth about shoe shoe research and really looking at what's happening at the foot. But when you look at these super shoes, we know they give people economy.

2 to 4% Some studies would say more. Um but I think what we need to consider is these shoes these shoes these shoes uh work best when someone knows how to run. Yeah. Exactly. Yeah. Exactly. Yeah. Exactly. When you have an elite runner who has a faster cadence and they're striking their foot on their midfoot or their forefoot, they have a strong posterior chain. chain. chain. They have an efficient gait, then these shoes provide that economy. If you put a super shoe on someone that has a weak foot and calf, and they start running on their forefoot and their midfoot, you can cause problems because the demand demand demand Yeah.

Yeah. Yeah. is greater than what they have the capacity for. capacity for. capacity for. That's the piece people miss. We We're literally 2 days post one of the most iconic marathon races in history. Two people broke 2 hours in an official race. I mean, phenomenal. And of course, the elites are pretty much all wearing these super shoes. But these guys, I mean, a lot of them are from East Africa. A lot of them grew up barefoot, and it be I mean, you know, at the formative years of their life and their their running gait were they had exceptional mechanics.

And now, this This as you put on as you said on our first conversation together, it's the icing on the cake. Yeah. Yeah. Yeah. Right? But so many people are getting injured by thinking, "I'm going to get a 4% improvement in my 5K." It's like do some plyometrics, you'll get 4% improvement, you know? Like pay attention to what you're putting in the shoe, let the shoe be the icing on the cake. I think it was really cool to see some of some of some of course I'm obsessing over all of their gates, but gates, but gates, but when you see these runners that have this, you know, this pronation, this excessive pronation, it's a beautiful thing to see because tissues need to lengthen before they can contract.

You know, the foot has to recoil. recoil. recoil. It's like an elastic It's like elastic, isn't it? isn't it? isn't it? So that's what when you see a foot that's going into pronation, you know that they're getting ready to, you know, propel forward and spring forward. We don't want to eliminate arch recoil. We want to learn how to want to We want to learn how to strengthen it and control it and then you have this foot that can basically be this spring off the ground. Yeah.

Yeah. Yeah. And it's it's really pretty cool to see. We've covered most of the common questions. I can't I don't think we can get through all of them, but there is one question that came up which I think is quite relevant to some of the things we've been talking about today, but also at the end of our first conversation when you spoke about how walking speed could be the sixth vital sign and predict dementia by up to seven years sometimes. And someone wrote in to say, "Rung, I'm worried about my elderly mother.

She used to like walking, but now she's a lot less stable. Should I really be asking her to increase her walking?" Mhm. Mhm. Mhm. Um yes. Um yes. Um yes. And in a safe environment. What would make her feel safe? Would that be walking with poles for example? Sometimes my patients if we put poles in their hands, it gives them that kind of sense of stability. It's a great idea. You know, it'll give them a little more real estate, if you will. So, that's an option.

option. option. Um the counterintuitive option is what kind of shoes are on her feet? If she can't feel the ground and fall risk is a factor, factor, factor, put her foot on the ground. Take smaller steps. You know, start with 5 minutes. Even in that in the um aging population, I think that's really important because if they can't if you can't feel the ground, ground, ground, then our fall risk is going to increase. So, we could start with again that transition conversation that we had. Yeah.

Yeah. Yeah. Um but making it in an environment, we can't say don't walk. Mhm. Mhm. Mhm. We can't. It is it's like telling someone not to sleep. Yeah. Yeah. Yeah. So, we have to find ways. That's the conversation I want really is from a movement perspective, it's not what people can't do. It's what can we do to modify to get someone to be able to do these things? these things? these things? So, So, So, it's not a question of no, it's how do we do it?

Whether that's poles, different footwear, small increments, building confidence. building confidence. building confidence. Yeah. Yeah. Yeah. I love that. I think it's such an important message. important message. important message. And um it reminds me when my mom was more active, more active, more active, I think I put mom in Vivobarefoots maybe 10 years ago. Um Um Um something like that. And she was in her mid-70s at the time. And she just couldn't believe how much more stable she felt in them. She was like, "Oh." like, "Oh." like, "Oh." Because it it of course it makes sense.

If you can feel the ground, if you're not on a pillow, Yeah. Yeah. Yeah. you you've got better balance. So, I think sometimes when people think about oh oh oh minimalist shoes, they think about athletic people in their 20s and 30s. Like, I've always said the elderly are fantastic place to to to really be targeting. I think we could all benefit but certainly the elderly get them feeling the ground and they'll probably you'll probably find a lot of them feel a lot more stable. I think this is a conversation that no one's having either.

Let's say they wear in a cushion shoe. Those materials in the shoe break down pretty fast. pretty fast. pretty fast. And so people will have these highly cushioned shoes for a year a year and a half. And if you watch someone walk in a highly cushioned shoe that has worn down it's a it can be scary. You're like, oh my gosh. Because the materials have worn down. So it literally looks like their foot is trying to feel something and they can't. So that's another conversation that is if you are if this minimal conversation isn't making sense to you and you are in cushion footwear, you have to change those shoes out pretty frequently.

pretty frequently. pretty frequently. Mhm. Mhm. Mhm. And you can't have those shoes for 1 year, 2 years. I mean, those materials break down. In a minimal shoe, there's nothing to break down. Yeah. Yeah. Yeah. It stays the same. It's more stable. Yeah. Yeah. Yeah. I could talk to you about feet and walking forever. I just love this topic. I'm obsessed with I think about it. I live it. [snorts] Um Connie, I think you've written such a beautiful book. I know you wrote it with someone called Melissa McDowell.

Yes. Yes. Yes. Um Um Um I I think it's you know, I think I think Chris put it beautifully yesterday when he said it's a love letter to walking. It it really is. Something we've not spoken about but I'll leave people to read about it in the book is long haul walking. Yeah. Yeah. Yeah. Which you put right at the end which I kind of feel is such a beautiful thing for us to think about because about because about because it's easy to think about walking as you know, physical benefits, dementia risk, lower risk of heart attack and cancer.

And yes, those things are incredibly important. important. important. But walking is also who we are. Yeah. Yeah. Yeah. It helps us understand who we are. And those long haul walks you you describe at the end, these three-day walks, these four-day walks, these 10-day walks that whatever it might be that people go on as a way of discovering who they are. I I just love that stuff. There's a real spiritual component to walking, isn't there? there? there? Yep. I was going to say, it's a a spiritual component.

And it is pretty amazing amazing amazing when when when you either cross that finish line or you challenge yourself to the point where you you're making things a little uncomfortable. uncomfortable. uncomfortable. Uh that sense of achievement from putting one foot in front of the other for long periods of time, I don't think it gets anything I don't think it gets any better than that. Yeah. One of the things you write about is the Camino de Santiago. Yeah. Yeah. Yeah. Um Um Um you know, a long haul walk.

And I think someone you guys interviewed for the book book book said, "After days of walking, when your body is tired and your mind starts to quiet, quiet, quiet, the soul begins to speak. What unfolds is rarely just about the miles. It becomes a rite of passage, a time to let go, go, go, to reflect, to move through grief or transition, transition, transition, and to reconnect with what really matters." matters." matters." Absolutely beautiful. And that's what the book is about, right? Walk, your life depends on it.

Corinne, I've thoroughly enjoyed this conversation and my previous one with you this year. I think you're doing incredible work. incredible work. incredible work. I'd really encourage people to pick up the new book. I think it's wonderful. And I just want to finish off by asking you, you get asked a lot about the feet and about walking. about walking. about walking. And people will tell you their problems and tell you the reasons why they can't. What is the key message from all your work that you want to leave people with?

That you can. That That That anything is anything is anything is when you look at the foot and what it is capable of doing, it literally is what carries us through our lives. And to see movement deterred movement deterred movement deterred from the ground up when every step is painful, those things can change. It is a hopeful conversation. It is what we as human beings were designed to do was to keep our foot on the ground and to keep walking and to keep moving forward. There's so many, you know, analogies we could use here.

One one step in front of the other. Uh just to keep going. Nothing Nothing Nothing allows that to happen more than our feet. feet. feet. Well, Connie, thank you for everything you do. Thank you for writing with your co-partner co-partner co-partner uh Walk. It's a great book and thank you for coming back on the show. If you enjoyed that conversation, then I think you are really going to enjoy this one that I picked out especially. especially. especially. When we have an emotion, it changes our posture.

When we have an emotion, it stores somewhere in the body. And I have just seen countless times when I touch people in certain parts of their body, certain emotions release. Certain patterns are stored there.