The Art of Manliness - Built to Walk — How Modern Shoes and Weak Feet Are Holding You Back

00:00:00.000 One of the things I've learned after running AOM for nearly two decades is that the fun part is

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00:00:57.500 That's shopify.com slash manliness. That's shopify.com slash manliness. If you've been

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00:01:58.820 Brett McKay here, and welcome to another edition of the AOM Podcast,

00:02:02.180 which since 2008 has featured conversations with the world's best authors, thinkers, and leaders

00:02:06.820 that glean their edifying, life-improving insights without the fluff and filler.

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00:02:29.180 Now on to the show.

00:02:38.400 Walking is one of the most powerful health tools we have.

00:02:40.820 It improves cardiovascular fitness, boosts mood, sharpens cognition, and can even be a predictor of how well you'll age.

00:02:46.240 but all those benefits depend on something we rarely think about until it starts hurting,

00:02:50.520 our feet. For many of us, walking is so automatic that we never consider the mechanics that make

00:02:55.180 it possible. Yet the way we move, the shoes we wear, and the strength of the muscles in our feet

00:02:59.640 can have a profound impact on how comfortably and efficiently we walk. When something goes wrong at

00:03:04.500 our physical foundation, the effects can ripple upward, leading to pain not just in the feet,

00:03:08.760 but in the knees, hips, and back. My guest today is Dr. Melissa McDowell, a physical therapist and

00:03:14.580 co-author of the new book, Walk. Today on the show, Melissa explains why walking speed may be

00:03:18.980 a hidden vital sign, what gives you your signature walking style, and how to spot and address injury

00:03:24.260 inducing inefficiencies in your gait. We then talk about feet, whether you should worry about

00:03:28.240 pronation, how to rehab plantar fasciitis, and no, it's not stretching, the best kind of shoes to

00:03:33.340 wear, and much more. After the show's over, check out our show notes at aom.is slash walk.

00:03:44.580 All right, Melissa McDowell, welcome to the show.

00:03:53.860 Hi, Brett. Thanks for having me.

00:03:55.220 So you are a physical therapist and you've recently co-authored a book all about the benefits of walking.

00:04:02.400 Why is a physical therapist so into walking?

00:04:06.340 Well, it's one of the things that we spend a lot of time in our careers helping people restore.

00:04:11.800 When you've had an injury, a surgery, an unexpected accident, walking is one of the

00:04:16.700 things that we push immediately.

00:04:19.280 You know, you have a baby, guess what we do?

00:04:20.760 We take you for a walk right afterwards.

00:04:22.280 You have a total knee replacement. 0.93

00:04:23.960 Some chipper physical therapist is going to come popping into your hospital room and say, 0.99

00:04:27.860 hey, let's get you sorted out. 1.00

00:04:29.020 Let's take you for a walk.

00:04:30.080 So walking is really one of our fundamental movements that demonstrates balance.

00:04:35.580 It demonstrates coordination.

00:04:37.040 It demonstrates, can you follow directions?

00:04:39.580 And so it is really one of those things that is a vital sign for your human existence.

00:04:44.800 And it's something we take for granted until we have those moments in our lives where walking

00:04:50.160 becomes painful and then you become painfully aware that, oh man, I got to think more about

00:04:55.280 this.

00:04:55.540 Like I can't take this for granted anymore.

00:04:57.980 Absolutely.

00:04:58.380 I mean, you can not get up and make yourself a cup of coffee or use the washroom easily

00:05:03.320 if walking is limited.

00:05:05.160 And for me, that was an experience I had in high school. I had a sports injury that was

00:05:11.340 misdiagnosed. I spent almost a year out of sports, six months not walking. And it was

00:05:18.100 absolutely eye-opening as a 16-year-old who was hoping to play sports in college

00:05:22.080 that having a foot injury and not being able to walk just completely changed my entire paradigm.

00:05:28.040 So we're going to talk about some of the things that prevent us from walking effectively.

00:05:31.160 injuries, how to prevent those, how to rehab injuries. But before we do, let's just talk

00:05:36.080 about the benefits of walking. We had Manusha Marodi on the podcast a little while ago who

00:05:40.780 talked about the benefits of walking, even in short bouts. But let's do a little refresher.

00:05:44.600 Why is walking so good for both our bodies and our minds?

00:05:49.000 If you don't walk, it's kind of similar to sleeping like trash or breathing poorly.

00:05:53.920 So if you aren't getting enough walking in your daily life, you aren't accumulating that rhythmic

00:05:59.320 movement, your health from a physical side and a mental side can just absolutely go down the drain.

00:06:05.860 And so we really want to emphasize and remind everybody that this is just at your fingertips.

00:06:12.320 A little bit goes a long way. So when we think about the physiological health benefits,

00:06:17.160 if you even go for a five minute walk, so we call that a micro walk. Usually that's about 500 steps

00:06:23.880 for most individuals. We're strengthening your bones. We're contracting your muscles. We're

00:06:28.740 reducing your blood pressure. We can help with blood sugar. It helps with mood. And so as we

00:06:34.020 think about our ability to take control of our health, walking is just so readily available.

00:06:40.140 It's at our fingertips at all times. And then on the mental health side, when we think about

00:06:45.240 the psychological and cognitive benefits of walking, as soon as you go for a walk,

00:06:50.040 it boosts your cerebral blood flow. So you're getting all sorts of healthy oxygen and hormones

00:06:57.440 and temperature change to your brain that not only helps reduce your cortisol, it boosts your

00:07:03.340 dopamine and serotonin. So it's like kicking in those happy hormones that we're all looking for.

00:07:08.260 And it actually promotes something we call neurogenesis, which is activating neurological

00:07:12.960 growth factor in your brain. So walking strengthens and improves the health of your brain.

00:07:18.440 It improves the function as well. Typically, when we think about walking for health,

00:07:23.700 a lot of people focus on the number of steps we should get in a day. And, you know, I think

00:07:28.080 people probably heard it by this time. It's like, it's not 10,000 steps. That was a marketing thing

00:07:32.720 by some pedometer company. You know, it's a Japanese company said, oh yeah, I get 10,000

00:07:36.300 steps. But it's like, if you get 7,000 to 8,000 steps, you're probably good. But I thought it

00:07:41.560 was interesting. You guys in this book talk about a walking metric that seems to tell us more about

00:07:47.980 our overall health and robustness more than the number of steps we walk in a day. And that's

00:07:52.300 walking speed. Tell us about this research. I thought that was really interesting.

00:07:56.660 Yeah. So walking speed was identified more than 10 years ago as quote unquote, the sixth vital

00:08:02.720 sign. And when we think about vital signs, if you go to the doctor today, they're going to poke you,

00:08:08.180 prod you, talk to you, and they're going to take your heart rate. They're going to take your blood

00:08:11.100 pressure. They're going to look at your respiration rate. We might take your blood oxygen, right? So

00:08:14.940 we have a series of vital signs that are predictive. They tell us if you've got an elevated heart rate

00:08:20.780 and you've got elevated blood pressure, as a healthcare provider, I need to dig deeper.

00:08:26.260 And it was almost 15 years ago now, actually, that walking speed was characterized as another

00:08:32.320 vital sign, meaning it has high predictability for problems down the road. The slower you walk,

00:08:40.280 the higher your risk of dying. And it sounds dramatic, but it is one of those things that

00:08:46.220 then when you start to connect the dots and think, okay, do I have a friend or a family member or an

00:08:50.160 elder or someone I know who, gosh, they do walk really slowly. Why is that? Are they afraid of

00:08:55.480 falling? Do they have a balance issue? Are they starting to have a neurocognitive issue where

00:09:00.460 it's hard for them to coordinate the movement? Do they have musculoskeletal problem? Do they

00:09:04.840 have a systemic disease? What the heck is going on? And so when we think of vital signs, this is 0.84

00:09:10.540 one that should be held in high regard. And it is definitely something that when you go to a rehab

00:09:16.240 pro, a PT, a chiropractor, some of the general practice physicians are kind of in on the secret.

00:09:22.060 This is definitely something that we want to pay attention to.

00:09:25.460 Do we know what an optimal walking speed is?

00:09:28.320 So we like to say that about a hundred steps a minute is pretty typical. And between 120 and

00:09:33.480 130 is what we consider to be brisk. So if you and I are in an airport and we are not late for a

00:09:38.660 flight, we're probably going to be walking around a hundred steps a minute. But if we're like,

00:09:42.780 I think they're boarding. Let's go. Most people can kick it up to that 120 to 130. And a good way

00:09:49.920 to test that is if you have access to a treadmill is hop on and just do a step count, right? So

00:09:55.840 you're counting each strike, right, left, right, left, right, left. And you want to just sort of

00:10:00.260 see what feels comfortable to you. Most normal sized adults. So if you're not like six foot 10

00:10:05.760 or four foot 10, most of us that are kind of in that normal center of the bell curve are going to

00:10:10.660 be walking at about three and a half to just under four miles per hour if we're walking at

00:10:17.000 that 120 to 130. So if you've ever walked on a treadmill at that pace, you're kind of cooking a

00:10:21.300 little bit. Gotcha. All right. So walking speed, I love that. So that's the sixth vital metric that

00:10:27.040 we should focus on. This was interesting. You had this whole section. I thought this was really a

00:10:30.820 lot of fun about us having a signature walking style or signature walking pattern. I didn't

00:10:38.680 think about that, but it's true. I think everyone has their own unique way of walking. I mean,

00:10:43.420 one of the things that I can do with my family, if we're at the airport, for example, or out in a

00:10:48.440 crowd, I can recognize people or recognize the people in my family by the way they walk.

00:10:54.340 So how do we develop this signature walking style that we have?

00:10:57.920 Well, it's a culmination of our good habits and our bad habits. And so I love a good airport,

00:11:03.340 I travel a ton for work and I am an absolute creeper. I watch people walk. I judge anyone

00:11:09.280 wearing a stiletto. If you're wearing a stiletto in an airport, I've got my eyes on you. And I'm

00:11:13.540 just going to say it here and now. I know this audience is mostly guys, but maybe you can

00:11:17.760 influence your gals in your life. Stilettos are the new smoking. They are terrible for your health. 0.89

00:11:24.140 They are absolutely something that, you know, do not buy the women you love stilettos, 0.99

00:11:28.540 please. And thank you. So who's wearing stilettos to the airport? 0.54

00:11:32.140 Oh my gosh.

00:11:33.040 The next time you're there, you just take a look, my friend, and you will be as appalled

00:11:36.460 as I am.

00:11:37.060 Wow.

00:11:38.400 Because what happens if you need to go 120 to 130 steps a minute?

00:11:41.480 Because they're boarding.

00:11:42.240 You're going to miss your flight, girl.

00:11:43.900 But at any rate, I love being in an airport.

00:11:46.100 I love observing other humans.

00:11:47.820 You know, as a physical therapist, that's just a big part of my curiosity as a human.

00:11:52.220 And so, yes, people have signature walking patterns.

00:11:55.160 And they are a culmination of all the good things and all the bad things and all the

00:11:58.440 old injuries and everything that kind of brings you to waking up this morning, all that accumulation

00:12:04.820 of your life. Think about this. If I'm your boss and you come into my office and I give you a raise

00:12:10.000 and I give you another 20% bonus, how are you going to walk out of my office? Head held high,

00:12:15.440 confident, probably brisk, you know, a little bit of a spring in your step, right? Not quite

00:12:19.780 Conor McGregor walking into the octagon, but you're going to have a pep in your step. But if

00:12:23.900 you come in my office and I say, look, Brett, like this isn't going well. I'm really disappointed in

00:12:28.280 your performance and, you know, you're missing your KPIs and I've got really significant concerns

00:12:32.540 about your future at this company. When you walk out of my office, things are going to look very

00:12:37.200 different, right? Your posture will look different. Your speed might look different. Your, you know,

00:12:42.160 pace is going to be different. And so walking tells us a lot about what happened to you in the

00:12:46.840 past and it tells us a lot about how you're doing today. Another part of walking signature is it

00:12:53.180 kind of tells us a little bit about your health history. So if you've had a leg fracture, if you've

00:13:00.440 sprained your ankles 77 times, if you've got a leg that's shorter or longer than the other, if you've

00:13:05.320 got low back pain or a limitation in how your pelvis moves, I mean, a physical therapist can

00:13:11.440 certainly tell. That's what we're trained in. But if you're a lay person, you know, an average Joe,

00:13:16.920 and you're in the airport and you see someone walk by and you're like, huh, that doesn't quite

00:13:20.640 look right. You're not necessarily able to diagnose or pinpoint the problem like I could,

00:13:25.580 but what you're seeing is a lack of efficiency. And when you see somebody that maybe swings an

00:13:32.260 arm a little differently, or they're wobbling side to side, or you can hear one foot scuffing

00:13:37.460 differently, oftentimes what that means is there's something imbalanced and an imbalance typically

00:13:43.580 belies an inefficient gait. Okay. I want to talk more about having an efficient versus inefficient

00:13:50.260 gate. But one more thing about walking style. So I was listening to Pandora the other day

00:13:55.200 and the Frankie Valli and the Four Seasons song came up, Walk Like a Man. This is the Art of

00:14:00.600 Manliness podcast. We got to talk about this. Do men and women walk differently? Absolutely.

00:14:05.600 Absolutely. You know, men and women, if I saw a skeleton, I'd be able to tell you if it was a man

00:14:10.420 or a woman, right? And we have significant anatomical differences and those differences

00:14:16.700 then influence our movement patterns, our postures. And so absolutely, you know, I think too,

00:14:25.060 especially in the US, you know, men tend to be taller, men tend to be heavier, men tend to have

00:14:29.620 more muscle. And so you're moving a different machine than a woman is. And so yes, the gait 0.99

00:14:36.060 pattern, an efficient gait, so an ideal gait is going to be similar regardless of gender, age,

00:14:43.080 height, weight, you name it. But overarchingly, you could probably de-identify a person for me

00:14:50.300 and most clinicians, and we'd be able to tell you roughly height, weight, and gender just by

00:14:55.280 watching their walking pattern. Yeah. One thing I've read is that men tend to move their shoulders

00:15:00.940 more while walking than women do. Yeah. So when you think about what's sort of acceptable 1.00

00:15:07.280 posture-wise in America. And if you lined up a group of guys and gals, most people are going to

00:15:13.840 lift up their shoulders and kind of get tall and suck in their belly because of some sort of 1.00

00:15:19.080 arbitrary beauty standard. And what you'll tend to notice is women tend to minimize some of that 1.00

00:15:27.380 sway. We tend to really suck in that belly to try to look snatched, if you will. And the guys are 1.00

00:15:34.280 like, I'm just trying to get from point A to point B, right? And I'm trying to do it with some level

00:15:38.820 of style. And so when you see more shoulder movement in a guy or in a gal, what's happening

00:15:44.060 is they're creating more rotation. Rotation makes you more efficient. And so a man typically is

00:15:49.560 going to walk a little faster than a gal. A man's typically going to have a longer stride length 1.00

00:15:53.420 unless he's significantly shorter than a comparable woman. And so men are generating more force and 0.98

00:16:00.040 more momentum, partially because of the anatomy, partially because of muscle and partially because

00:16:04.820 of culture as well. Yeah. That's interesting. So yeah, culture, the way we think about sex and

00:16:09.400 gender in a culture can influence even the way we walk, which is interesting. All right, let's go,

00:16:14.320 but I want to talk more about this efficient and inefficient walking. So you mentioned there's

00:16:19.260 some things you can look at when someone's walking to figure out whether or not they're

00:16:23.380 walking efficiently or inefficiently. If you're seeing arm movement kind of off, maybe they're

00:16:27.800 not moving one arm, that could be a sign. What are some other signs of inefficient walking?

00:16:32.820 The best place to assess this is if you have access to a treadmill. And what's kind of fun

00:16:37.540 about walking on a treadmill is you can not only hear the walking pattern, you can see the walking

00:16:42.420 pattern. And inefficiency is coming about a billion different ways. I had a good friend who

00:16:48.700 I was training for a marathon with, and he kept complaining of shoulder pain. And this guy was

00:16:52.820 like an all-American track athlete, total stud. He's jacked. He's fit. He's smart. He's one of

00:16:57.700 those people that's like an ideal patient. They do anything you ask him to do. I've got this

00:17:01.460 shoulder pain. It's killing me. It's killing me. So I was like, all right, you know, you're the

00:17:04.400 stud athlete. Let's bring you into the office and see what's going on. So I put this guy on a

00:17:09.360 treadmill, right? And he's a marathoner. He's an all-American. He's a total stud when it comes to

00:17:13.060 running. I get him walking on the treadmill and I'm standing behind him. And if you have a physical

00:17:17.540 therapist in your life, we're always watching you with love, but we are. And so I put this friend

00:17:21.820 of mine on the treadmill and I'm standing behind him and I whip out my camera. I start videotaping

00:17:25.280 him. All he's doing is walking. And I take him up to running speed and then I take him off the

00:17:30.580 treadmill and I'm like, well, how do you feel? Well, my shoulder hurts. I go, all right, well,

00:17:33.200 look at this video. Oh, you were taping me? I'm like, yeah, of course. I'm a physical therapist.

00:17:37.100 So I show him the video and I say, what do you see? And he's like, well, I'm not, I'm not swinging

00:17:42.040 my arm. And this guy was a 400 meter runner in track, right? He's not a long distance guy. He's

00:17:47.160 a track runner, runs around in circles, indoor track, 200 meter track, outdoor track, 400 meter

00:17:50.940 track. I was like, bro, you are carrying a purse in your left arm, right arm, super duper huge arm

00:17:59.100 swing, torso rotation, hip rotation. It's like unlocking his foot. He's doing amazing on the

00:18:03.520 right side of his body. And it looked like he was carrying a lady's handbag on the left. And I was

00:18:07.480 like, what are you doing? And he's like, I don't know. Putting people in an environment where they

00:18:12.000 don't know they're being observed, where you can control speed and you can get some video is sort

00:18:16.360 the ideal place to assess efficient walking or running. A treadmill is a perfect spot.

00:18:21.920 And if you have somebody that can set up a camera, then you can sort of look at your own pattern.

00:18:25.800 You can sort of be your own detective. I love that kind of stuff, right? You don't have to go to a

00:18:30.320 pro, like a PT, personal trainer, chiropractor, whomever, to do some assessment. And so the first

00:18:36.800 thing you're looking for is, does anything look off, right? Do you see a wobble? Are you dipping

00:18:42.260 side to side? Do you see your hip dropping, your shoulder dropping? Does it look like you're

00:18:46.820 limping? You know, most of us, even if you don't have formal training, can identify those sorts of

00:18:51.000 things. And then the other thing I love about putting someone on a treadmill is you can hear

00:18:55.260 the pattern. You can hear if they scuff. You can hear if one foot lands harder than the other.

00:19:00.980 An efficient walking gait should sound like this. An inefficient walking gait will sound like

00:19:07.800 or you hear like a scuff. And so pattern is huge. And these are the types of things that those of

00:19:14.900 you that are listening to the podcast today, go be your own detective. Like you can play with

00:19:18.900 this stuff. You're like, man, you know, I've got, I've got this nagging Achilles thing and I haven't

00:19:22.560 been to a pro to help me. Well, go get on a treadmill and have somebody hold a phone

00:19:26.200 and see if you can tell, right? A treadmill is a great place to look for inefficiencies.

00:19:31.160 The other place that you can find inefficiency today, you don't even have to go anywhere,

00:19:35.260 is go pick up your walking shoes or your running shoes and flip them over.

00:19:39.120 Look at the sole of the shoe.

00:19:41.100 Now, if you have brand new shoes, this isn't as effective.

00:19:43.360 So the dirtier, the older the shoes, the better.

00:19:46.020 The more mileage you have in the shoes, the better.

00:19:47.940 Because what will happen is the shoes are going to tell you a story

00:19:51.420 of what your pattern looks like.

00:19:54.380 Do you have more wear on the heel?

00:19:55.880 Do you have more wear on the toe?

00:19:57.100 Is the wear different on your right versus your left?

00:19:59.700 If you look at your shoe from the top, does it look twisted?

00:20:02.760 These are the things that clinicians will do if you come into our office.

00:20:05.260 But this is the kind of stuff that anybody can do at home to start thinking about, am

00:20:10.600 I efficient when I'm walking or if you're a runner, when you're running.

00:20:14.600 Some of the things you recommend to develop a more efficient walking pattern, walk faster.

00:20:18.620 We naturally start walking more efficiently when we have to walk a bit faster instead

00:20:22.360 of just puttering around.

00:20:23.800 Walk taller, have good posture when you walk.

00:20:26.140 That improves your walking efficiency.

00:20:28.220 Swing your arms.

00:20:29.000 You talked about that.

00:20:29.860 And then you talked about, you have this great diagram in the book that shows a foot and

00:20:34.560 how a foot should land on the ground for an efficient walk. What does that look like?

00:20:39.920 Yes. So traditional gait mechanics start at lateral heel. So pinky toe side of your foot.

00:20:46.640 And then as you move your body forward, you're going to load through the middle of the foot.

00:20:51.800 You load the outside of the pinky toe, the ball of the foot. And then your final part of contact

00:20:57.340 is pushing off the big toe. So it essentially goes from the back to the front and from the

00:21:02.840 outside to the inside. And that's an ideal pattern, right? There's all sorts of reasons

00:21:08.280 people have inefficiencies or they can't achieve that pattern or it's difficult or what have you.

00:21:12.660 But in a perfect world, if we were trying to get you to an ideal efficient gait pattern,

00:21:17.800 it's outside of the heel and then you push off with the inside of big toe.

00:21:22.980 And let's say you have a patient, you're looking at them like, okay, someone's off here.

00:21:26.840 We need to focus on improving your foot strike. How do you do that? How do you rehab that?

00:21:32.540 Because someone might have been walking inefficiently where they're maybe walking on the inside of their foot first for their entire life.

00:21:39.760 So how do you train somebody to be like, okay, you're going to walk, start on the outside of your heel, and then kind of rotate on your foot to the big toe?

00:21:47.860 Right. Yeah. I listened to when you interviewed Matt Fitzpatrick, and I thought it was really interesting in his episode with you how he talked about being a pro runner and having coaches who didn't try to mess with his gait mechanics, right?

00:21:59.180 So it's a slippery slope for sure, and it is definitely something where I always have said in my career, 20 plus years as a PT, if you don't have pain, if you aren't having problems, I'm not messing with your mechanics.

00:22:13.660 It's clearly working for you, and if you're somebody who has some sort of an anatomical difference or you've had an injury or surgery, like I had an injury in high school, I still have screws in my foot from when I was 16.

00:22:24.960 that changes my loading mechanics for sure but i've done 13 ironman triathlons a 50k like i ultra

00:22:32.060 run i have no mechanical issues but i've got hardware in there and there's a lot of people

00:22:36.820 who do right so if you don't have any problems don't mess with it but if you're somebody who's

00:22:42.320 like i have a chronic plantar fascia problem i've got chronic heel pain i've got a chronic achilles

00:22:46.660 thing i've got this bite in my hip i've got achiness in my low back that's definitely sort

00:22:52.860 of your body trying to tell you, hello, is there something going on down below at your foot?

00:22:57.660 Now, couple that, if you're a guy who wears dress shoes, if you have to be kind of fancily

00:23:03.500 dressed for work, if you wear shoes that are perhaps not the right size, over 60% of adults

00:23:08.980 in the US are wearing the wrong sized shoe, wrong length. There's a lot of factors that can

00:23:14.080 contribute to that. But to answer your question, if somebody has interest in assessing their gait

00:23:21.300 mechanics, and identifying if their pattern is optimal, you can play with it with some very

00:23:28.700 basic drills. You can play with it with drills if you've got access to a gym that has a mirror,

00:23:33.560 you know, walking toward a mirror barefoot can tell you a lot. Again, video analysis is priceless.

00:23:39.480 And so even just throwing your iPhone on the ground and videotaping yourself walking toward

00:23:43.560 and walking away, you can start to get that idea of how do you land. If you feel like you aren't

00:23:49.800 landing lateral and then pushing off big toe medial. You can play with just that strike pattern

00:23:55.920 in standing. So if you go up to standing and almost stand like you're going to go into a lunge

00:24:00.340 and then you load the lateral foot, roll through, push off the big toe and just see how your body

00:24:05.900 feels when you do that, that can sometimes be a good indicator. If you don't have the range of

00:24:10.400 motion to do that or you've got a mobility restriction or kind of like I said, you've got

00:24:14.820 old screws in your foot or have had old fracture, injury, whatever, it might be a good time

00:24:19.720 to ping a pro, you know, get ahold of your local PT, chiropractor, foot person and be like, Hey,

00:24:24.600 can you take a look at me? Because you don't want to mess with gait mechanics unless you have

00:24:28.980 issues. But if you do have issues, it is a low hanging fruit to try to correct.

00:24:33.700 So we talked about things that can cause issues in your walking gait or gait mechanics. Injuries

00:24:37.900 are a big one, just your life history. What about your anatomy? Like what if your ankles or your

00:24:43.800 feet naturally cave in or turn in? Can that mess things up for you down the line?

00:24:48.060 So this is one of those things we definitely myth bust in the book. You alluded to the 10,000 steps a day. That is definitely a myth. You're correct. It's a leftover from a Japanese pedometer company's marketing campaign in the 1960s. Another thing we myth bust in the foot, people are terrified of pronation. Pronations become this like bad word in gait mechanics and shoe advertisements. And people who have flat feet often are told, oh, you need an orthotic. Oh, you need this. Oh, you need surgery.

00:25:16.220 And interestingly, there's a lot of science that says a flatter arch is within normal

00:25:23.120 limits.

00:25:24.120 There's a lot of data that looks at different populations who have flatter feet compared

00:25:29.340 to those who have higher arches.

00:25:31.760 And overarchingly, there isn't a significant difference in pretty large population studies

00:25:36.680 for like stress fracture risk or tendinitis risk and those sorts of things.

00:25:41.080 And so it is a little bit of outdated thinking that pronation is bad or flat feet are bad.

00:25:47.260 Pronation is a normal range of motion.

00:25:49.640 And so if you've heard that term before and you don't know what it means, that's okay

00:25:52.900 because most of you listening are probably not clinicians.

00:25:55.780 Pronation is a normal movement when your load goes from the outside of the foot to the big

00:26:01.320 toe side.

00:26:02.480 Your middle of your foot needs to pronate.

00:26:04.960 So it's just like flexion or extension.

00:26:06.620 It's a biomechanical term for the movement we're going through.

00:26:09.980 Pronation is getting the big toe down.

00:26:12.220 And so you have to pronate in order to be able to load the big toe and push off.

00:26:16.620 You're pushing off your big toes, your gas pedal and gait mechanics.

00:26:19.820 So someone who has a flatter anatomy, it used to be this idea that, oh, you know, you're

00:26:25.100 going to be really sloppy and you're not going to be able to generate force.

00:26:28.280 You're going to end up with itis and fractures and all this other stuff.

00:26:30.860 And the science has really rebutted that in probably the last almost 20 years.

00:26:34.780 So the good news is as, as all of us want to learn more and be better stewards of our

00:26:41.440 bodies, pronation isn't a bad thing and very small percentage of the population, you know,

00:26:46.760 let's say I think it's under 5%, it might be maybe like 3%, actually truly have what

00:26:51.880 we call flat foot deformity, which is a medical condition where you're super, super, super

00:26:55.600 flat and all your bones are sitting on the ground.

00:26:57.820 I actually took care of a patient a couple of years ago who had that problem and ended

00:27:01.120 up having a surgery to reconstruct his arch because he did fit into that tiny little part

00:27:05.920 of the population. But for most individuals, a flatter arch or a more pronated foot isn't

00:27:14.400 problematic if you back it up with good strength around the area. And so a lot of times people

00:27:21.420 have a flatter arch and then their foot is terribly weak and that can start to cause problems.

00:27:26.380 All right. Maybe we can talk about ways you can strengthen that. Okay. So we can't use flat feet

00:27:30.240 to get out of the draft anymore you're not going to get that that rejection that's right okay and

00:27:37.280 i think you also highlight you know they did research they've looked at we're always looking

00:27:41.100 at hunter gatherers right to figure out what does a human body look like without all these

00:27:45.860 industrial trappings around us a lot of those hunter gatherer people they have pretty flat feet

00:27:51.020 they walk around barefoot and their feet you look at their print like there's no arch hardly and

00:27:55.660 they're fine they climb trees they walk miles a day and they're okay yeah the the foot a foot

00:28:01.560 that is unobstructed by a shoe gets strong and there's this fabulous researcher her name's sarah

00:28:07.100 ridge and she is a really smart woman and she researches minimal shoes so shoes that allow you

00:28:14.840 to behave in a more barefoot manner so not a shoe with a ton of cushion not a shoe with a carbon

00:28:20.080 fiber plate not a shoe with a ton of stack all that sort of stuff so a shoe that truly is zero

00:28:24.940 drop. So meaning flat from the heel to the toe, minimal cushion with a wide toe box. And her

00:28:30.300 research has demonstrated that the more time you spend barefoot or the more time you spend in

00:28:35.500 minimal shoes, the larger cross-sectional area you get in the internal muscles in your feet.

00:28:42.140 Now, the stronger the muscles in your feet, the bigger the muscles in your feet, guess what

00:28:45.360 happens? Those feet get wider and flatter because just like if my bicep gets bigger,

00:28:49.740 the anatomy is going to change. And so these itty bitty little muscles that are in between

00:28:53.500 the long bones of your feet. When their cross-sectional area gets bigger, it gives you an

00:28:57.880 appearance of a wider, flatter foot. Guess what? Those feet are super duper duper strong. If you've

00:29:02.940 ever seen somebody with a deformed foot, horrible bunion, toes are smashed together, hammer toes,

00:29:10.240 you know, it's all like claw-like. It looks terrible. That is a weak, weak, weak foot.

00:29:14.980 That person is going to have absolutely no control of the intrinsic muscles. They're going to have

00:29:19.580 super weak toe flexors. Those are very problematic for walking and fall risk and balance.

00:29:25.840 When you see somebody with a wide, flat, thick foot, that foot is strong. And that foot has a

00:29:32.320 lot of capacity because it has been, as you said, a barefoot hunter-gatherer, people who live in

00:29:39.100 beach communities, people that are more often not in a very structured shoe. They have stronger feet.

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00:31:06.380 And now back to the show.

00:31:08.060 So one thing that can prevent people from walking efficiently or walking comfortably, and I know a lot of maybe runners have experienced this, but this can pop up in anybody, is plantar fasciitis.

00:31:20.140 What causes plantar fasciitis? 0.91

00:31:23.400 It is a, it's a bugger. 0.88

00:31:25.280 I've struggled with it myself. 0.92

00:31:26.900 So the plantar fascia is a connective tissue that runs from your heel to the ball of your foot, essentially.

00:31:33.720 And its job is just helping to transmit force.

00:31:36.940 It's an inert tissue. It's not muscle. It's not a ligament. It's similar to tendon from a

00:31:42.300 structural standpoint. It's kind of in that connective tissue category. So it has a poor

00:31:47.740 blood supply. It has a ton of nerve. It's one of those structures that when it gets pissed,

00:31:52.640 it's pissed for a while. So your plantar fascia's job is supporting the muscular structure of your

00:31:58.560 foot. So guess what? If your foot is weak, who ends up doing more of the work? Plantar fascia.

00:32:04.480 And there's a lot of ways to make it angry.

00:32:07.020 You can make it angry by ramping up your volume too quickly.

00:32:10.240 You can make it angry by having weak feet.

00:32:12.800 You can make it angry by wearing the wrong shoes.

00:32:14.880 You can make it angry by having bad gait mechanics.

00:32:17.140 There's all sorts of ways to make this thing really cranky.

00:32:20.280 And when it gets upset, it takes a lot of work to calm it down because resolution typically

00:32:28.180 involves some pretty heavy lifting.

00:32:30.780 We have to figure out why is this tissue staying inflamed?

00:32:35.520 Because tissues want to be in homeostasis.

00:32:38.400 Your body's not happy when something is chronically inflamed.

00:32:41.360 And so when somebody has chronic heel pain or chronic plantar fascia problems, it's often

00:32:47.820 because another link in that biomechanical chain is not doing its job.

00:32:55.100 Gotcha.

00:32:55.500 So that could be caused by shoes that you're wearing.

00:32:58.620 It's just you're not giving your foot the opportunity to strengthen the muscles to support the foot and so the plantar fascia has to take up the slack

00:33:06.660 Yeah, so we talk about in the book we we have a thing we call the 24-hour shoe clock

00:33:11.320 And it's assessing your day or 24 hours by the type of footwear you're wearing

00:33:15.500 So let's say you're sleeping and you're barefoot for eight hours and then you're at home for a couple hours

00:33:19.460 And are you someone who wears slippers? Are you someone who wears inside shoes?

00:33:22.820 Are you someone who pads around the house barefoot? Do you wear socks?

00:33:25.260 And then when you go outside the house, what do you put on your feet? You know, are you somebody

00:33:28.960 that we interviewed a flight attendant for the book and for men and women, they are required to

00:33:34.860 wear specific uniform shoes in all the major Delta, United, American, like they all have a uniform shoe

00:33:40.780 requirement. And that uniform shoe does not allow optimal biomechanics of the foot. And that's a

00:33:49.140 problem. So if I was a flight attendant and I'm spending eight hours a day sleeping, and then I'm

00:33:53.080 spending two or three hours at home barefoot, but then I'm going into a shift of, you know,

00:33:57.300 let's say 10 or 12 hours in a shoe that has an elevated heel that has a narrow toe box and is

00:34:02.700 stiff. My foot musculature is being compromised while I'm in that shoe. My biomechanics are

00:34:09.980 compromised. My mobility is compromised. And so when you run into individuals who have chronic

00:34:15.440 inflammatory problems, foot, toe, heel, Achilles tendon, plantar fascia, we use that 24 hour shoe

00:34:22.660 concept to assess, all right, well, how much time of the day are you spending in shoes

00:34:26.900 that are maybe not a healthy choice? Yeah, we'll get more into shoes here in a minute.

00:34:31.180 And changing your shoe type can help not just plantar fasciitis, but other issues as well.

00:34:36.240 But what else can you do to rehab plantar fasciitis? Because I know there's a lot of

00:34:40.060 devices out there, training protocols that people use that, you know, these involve stretching

00:34:46.140 programs that you can do. What actually works for rehabbing plantar fasciitis?

00:34:50.660 So similar to a couple of the other myths we busted today, stretching is not typically the

00:34:56.660 solution for plantar fascia problems. Generally speaking, we need to get people strong. And

00:35:03.160 there's two areas of culprit when you have a plantar fascia problem. A lot of people have

00:35:08.260 weak foot intrinsics and a lot of people have weak calves. And oftentimes, and this is sort of where

00:35:16.720 the science points us for sure. There's tons of research right now that's like in the last probably

00:35:20.900 five years that's really trying to drive clinicians away from thinking that plantar fascia problems

00:35:28.340 are a mobility problem and trying to help educate us so we can do a better job taking care of you

00:35:34.100 guys saying it's not a stretching problem, it's a strengthening problem. And so if you're somebody

00:35:40.420 who's struggling with plantar fascia issues, I would say there's two things I would immediately

00:35:44.680 tell you to do. The first is assess your shoes because you're probably wearing A, the wrong

00:35:49.660 length and B, something with a narrow toe box. And then the second thing I would suggest you do

00:35:55.180 is assess your foot intrinsic strength and assess your ability to do a single leg calf raise.

00:36:02.980 Okay. And then if it's not, your calf raise is not good, maybe add some more calf raises in your

00:36:08.180 strength training program. So what's interesting about single leg calf raise is it is normalized

00:36:14.300 for gender and age. And there are very clear thresholds that you should be able to do.

00:36:23.040 This is something that you can try at home to assess if you have a calf imbalance right side

00:36:30.840 to left, or if you are weaker than your age matched peers. So for guys, if you're between 30

00:36:37.500 and 40, you should be able to, and this is real science. We can put it in the show notes if we

00:36:42.760 need to. You should be able to do 32 single leg calf raises with just fingertips on the wall. So

00:36:49.180 not holding onto a counter, full excursion and full excursion means going through all the full

00:36:53.860 range of motion. And that's like with a cadence. That's not like one, take a rest, two, take a

00:36:58.600 rest, three, check your email. It's one, two, three. So if you're between 30 and 40, 32. If

00:37:04.880 you're between 40 and 50, 28. If you're 50 to 60, 23. If you're 60 to 70, 19, 70 to 80, 14.

00:37:12.760 this is demonstrating your single leg propulsion endurance.

00:37:19.680 And so if you aren't even close to that,

00:37:22.180 or if you have one side where you aren't close to those metrics,

00:37:25.700 what that's telling us is you are overloading other tissues.

00:37:30.360 And if plantar fascia is the problem, most likely that's who,

00:37:33.500 because your calf isn't doing its part of the job.

00:37:36.900 And then another thing I thought was interesting that you can do to rehab

00:37:40.120 is maybe one run a week if you're a runner or you can do this if you just walk to make sure you're

00:37:46.300 doing it barefoot on grass yeah the data on that is really fun and if you don't have access to safe

00:37:52.160 grass barefoot on a treadmill is fantastic but yeah that's one that i think a lot of people are

00:37:56.400 very surprised by that because generally when people have plantar fascia pain or they have

00:38:00.920 heel pain they go oh i should get into a huge cushion shoe all that's going to do is make

00:38:05.400 things worse. So that's actually counterproductive if you have arch pain or heel pain. Cushion shoe

00:38:12.300 is not the solution. Less shoe is more solution. And think about it like this. If I'm in less shoe,

00:38:18.160 am I going to land harder or softer? You're going to land softer, right? Because you don't want to

00:38:22.980 bang your foot into the surface. If I'm in a super cushioned shoe, it actually makes us strike the

00:38:28.980 ground harder because there's so much cushion. We're not getting that sensory input into the

00:38:34.280 hundreds of thousands of receptors in the bottom of your foot, you have to land harder to get that

00:38:38.860 information to your brain. So it's counterintuitive, but one of the recommendations, you're exactly

00:38:44.440 right, is barefoot on grass, or if you don't have access to safe grass, barefoot on treadmill.

00:38:49.760 And then the other strengthening piece that I would highly recommend if you're somebody that's

00:38:53.460 struggling with this type of problem is assessing the intrinsic muscle endurance and muscle

00:39:00.860 performance in your foot. And so in order to do that, and we demonstrate this, this is a drill,

00:39:05.620 we call the movement snacks in the book. And this is something we teach in the book. In our book,

00:39:10.180 we have a whole assessment chapter. So you can kind of see where you're at. And, you know,

00:39:14.320 my coauthor, Courtney Conley of Gate Happens, she's a chiropractor. I'm a physical therapist.

00:39:18.580 If you come to see either one of us, the first thing we do is assess you, right? So in our book,

00:39:23.100 we're saying, hey, assess yourself. Here, we're giving you the tools, do this at home.

00:39:27.340 So if you want to assess the internal strength of your foot after you've done that calf assessment,

00:39:33.260 you take off your sock, you put your foot on the floor.

00:39:36.040 And the first thing you do is you try to lift up big toe without lifting up everybody else

00:39:39.660 and without clawing the ground of toes four or five, one, two, three, four, five.

00:39:44.840 So you're just going to try to lift up big toe.

00:39:46.820 Then you put big toe down and relax it and you try to lift up toes two, three, four, five.

00:39:51.980 And this is an assessment of your intrinsic foot strength.

00:39:56.020 another way you can look at this is called lift spread and reach and this is actually one of the

00:40:00.480 exercises we recommend where you are sitting in a chair foot is barefoot heels on the ground toes

00:40:06.720 are on the ground you start by lifting up all your toes and big toe as high as you can get them

00:40:12.100 and your arch so your ball your foot is off the ground so your heels the only thing contacting

00:40:16.140 then you spread out all your toes like little frogs so you have space between every single toe

00:40:20.340 and then you try to reach them out like you're some sort of a gecko so you lift the foot up

00:40:25.240 spread out the toes, reach out like a gecko. And that activates all those little bitty foot

00:40:31.400 muscles, the intrinsic muscles in between your long bones. If that is hard for you,

00:40:35.640 if your foot cramps, if you can't do that, it's telling you those guys are weak. And guess what?

00:40:41.060 If they're weak and your calf is weak, who's doing all the work? Your plantar fascia.

00:40:46.020 So the three of those structures are a team. And if one or two of the team members are not

00:40:52.320 holding up their end of the job, not doing their work. That's when plantar fascia has to do more

00:40:58.120 work and it gets grumpy. Okay. And then I think something to point out if you're rehabbing

00:41:02.600 plantar fasciitis, this could take a while. It could take once, a long time. And that's the same

00:41:08.380 thing with other foot injuries. And I'm sure as a physical therapist, one of the hardest things you

00:41:13.060 have to deal with is managing people's expectations on recovery. It could take a while, but you just

00:41:18.640 got to keep going on with it and keep doing the protocol, stick with it because the rehab will

00:41:23.740 work eventually. And I think you'd say to get going on that rehab as soon as possible. If

00:41:28.460 something's hurting, don't just ignore it. That's correct. I will speak for the entire

00:41:32.400 community of medical professionals everywhere. It is easier for us to solve your problem more

00:41:37.320 recently to when you were injured than three months, six months, a year down the road. So

00:41:41.840 please, please, please make it easier on us and you. If you tweak something and it doesn't get

00:41:47.060 better in a week and a half, go grab a professional to help you. It will make us getting you better

00:41:52.140 faster. It will reduce how much compensation you start to create in your life to be gimping and

00:41:58.540 limping around something that's acute. The longer you wait, the more compensation, the more bad

00:42:03.980 habits, the more that inflammation gets to hang around and the harder it is for our teams to help

00:42:09.320 support you on that journey, getting back to what you love to do. So yes, don't let it hang out

00:42:14.160 there because it, these, some of these types of problems really do require a professional

00:42:18.400 to help you. And I think that goes back to the shoe conversation. Like if you're wearing a shoe

00:42:23.860 that isn't the correct length or has a narrow toe box or is a pronation control shoe, and you

00:42:28.660 actually don't need that, it's helpful to get a professional's eyeball on there. You know, it's

00:42:32.760 like, I don't work for a shoe company. I have no skin in the game to tell you what shoe to go wear.

00:42:36.480 Right. But I am a professional who can say, gosh, Brett, you know, that shoe seems like it's not

00:42:41.780 helping you. Here's some video analysis. That shoe has a wear pattern. I think it's a problem.

00:42:46.720 Let's actually measure your damn foot. You know, 60% of adults are wearing the wrong length of 0.99

00:42:52.160 shoe. That's a big deal. And that contributes to these types of problems. Well, let's talk about

00:42:56.640 shoes because we've been talking about it throughout this conversation because shoes can

00:43:00.320 cause a lot of foot problems that can affect your foot health. I feel like 15 years ago,

00:43:05.500 barefoot running was all the rage. They even had these shoes, the Vibram five fingers,

00:43:10.000 just like it's like a thin piece of rubber under your foot and like a place for each toe that was

00:43:15.240 big but then i feel like in the you know past five years or so all the running shoes are they look

00:43:21.980 like these you know space age moon shoes with lots of cushioning but it sounds like you're saying

00:43:28.360 like those types of shoes might not be good for our feet so what is the ideal shoe for foot health

00:43:34.840 not just for running, but like for everyday wear for walking.

00:43:38.700 Yes. Unpopular opinion. I was in London recently and there was a Hoka store right next to,

00:43:45.220 it was right next to like the Breitling store. And I was like, wow, Hoka's got quite a budget for,

00:43:51.120 for where they're putting these stores with their, their real estate, my friends.

00:43:55.140 Yeah. You know, it, it is interesting and you're correct, right? There was the,

00:43:58.280 Chris McDougall wrote the book Born to Run. He's a friend of Courtney and mine and

00:44:02.260 his conversation changed how people looked at footwear. There was this tribe that was able to

00:44:06.720 run at high performance and super long distances barefoot. And then the five-finger shoe came out

00:44:11.500 and everyone said, oh my gosh, let's all get those and go run, you know, long distances.

00:44:14.960 And what happened? There was an epidemic of bone stress, injury, stress fracture,

00:44:19.280 plantar fascia pain, whatever, because people hadn't earned the right to wear a minimal shoe.

00:44:25.060 So here's how I like to characterize shoes. And a lot of this is the work from Courtney and her

00:44:31.080 research over the years. So there's three categories of shoes. Traditional shoe, which

00:44:35.580 is what most of you are probably wearing. That's where I would put a Hoka, a Brooks, a Nike, an

00:44:38.880 Adidas, a dress shoe, a high heel shoe, you name it, a wing tip, whatever. Then there's a functional

00:44:44.940 shoe. And a functional shoe is a shoe that has the following criteria. Wide toe box, low heel

00:44:51.700 to toe drop. So that's the difference between how much foam is under your heel versus ball of the

00:44:56.040 foot and lower cushion. And you're correct, Brett, in that most shoes nowadays look like

00:45:03.180 a moon shoe. There's cushion everywhere. The heels are stacked up super high. And that is

00:45:09.560 a big shift in the pendulum of shoe technology. So we've got our traditional shoes, which are

00:45:14.400 normal shoes, like your New Balance, that would be a traditional shoe. Then you have a functional

00:45:18.440 shoe. And then you have like that five fingers category, minimal shoes. And not all the minimal

00:45:23.100 shoes have the, you know, articulating toes like a five fingers does. A minimal shoe is going to

00:45:28.880 be classified as a shoe that has a wide toe box, zero heel to toe drop. So that means your heel

00:45:34.840 is not stacked up above ball of foot and then minimal to no cushion. So if I was going to tell

00:45:40.600 you a brand that meets the criteria for functional, a brand I use personally is called ultra running.

00:45:47.940 So they have wide toe box. They do have cushioned shoes, but there are a lot of shoes in their

00:45:52.240 spectrum that are in that functional category for us, which is like less than six millimeters of

00:45:57.140 heel to toe drop, and then lower cushion. So when their company was created, and I think they're

00:46:02.540 about 2009, maybe 2013, somewhere in there is when they were launched. Their first feature was our

00:46:09.520 shoe is shaped like a foot. And if you look down at your foot, the widest part of your foot should

00:46:14.080 be your toes. But because most of us wear traditional shoes, or, you know, we've had to

00:46:18.480 wear a uniform shoe, we've gotten trapped in wearing dress shoes or whatever. A lot of times

00:46:22.400 the ball of the foot is the widest part and the toes are pinched together. But like you mentioned

00:46:26.620 earlier, people that spend more time barefoot, you know, our ancestors, the widest part of the

00:46:31.620 foot was the toes. And so what Altra did is they said, it's non-negotiable for us. Our shoes are

00:46:36.640 going to be foot shaped. They're going to respect the anatomy. Courtney says that all the time. I

00:46:41.300 love when she says that respect the anatomy with your shoe choices. So if you look at Altra's

00:46:46.520 website or kind of check out their shoes. They've got things from that more minimal shoe, right? So

00:46:52.440 very low cushion, zero heel to toe drop. And then they have more introductory shoes that do have a

00:46:58.080 little bit of stack height and a little more cushion. And then a shoe company that does a good

00:47:02.680 job in the minimal space is Vivo Barefoot. And if you've ever picked up a Vivo Barefoot, it's minimal.

00:47:08.620 Like there is very little cushion. Your heel and toe are on the exact same plane. It has a wide

00:47:13.140 toe box. But here's the thing with minimal shoes. You have to earn the right. If you just go buy a

00:47:19.820 Vibram Five Fingers, you go buy a Vivo Barefoot and you've been in a traditional shoe and you

00:47:24.960 haven't gained the mobility or the strength, it's like going to the gym and trying to throw a 300

00:47:30.840 pound snatch above your head. It's like going to the gym and trying to bench press your body weight

00:47:34.460 if you haven't done that. It's like going to the gym and trying to do 100 pull-ups if you're not

00:47:38.120 conditioned to do it. You haven't earned the right. And so the challenge with shoes is this,

00:47:43.500 because there are gigantic marketing budgets, right? And everyone's got fancy features and

00:47:49.180 they've got pro athletes wearing XYZ shoe. As a consumer, it's super hard to understand

00:47:54.940 kind of where you fit along that spectrum. So here's my takeaway. Most of you are in

00:47:59.660 traditional shoes. I would encourage you to consider a shoe with functional criteria.

00:48:04.800 And if you want to go even further, you could consider a minimal shoe, but you have to think

00:48:10.220 about that comparison of, can you go in and bench press your body weight? Can you go in and snatch

00:48:15.060 300 pounds? Like you have to earn the right to get into that minimal shoe or you can cause problems.

00:48:20.020 Yeah. For my everyday shoe, which I do all my walks in, I wear limbs. They're a company mix.

00:48:25.940 Oh yeah. That's a great brand.

00:48:27.360 Yeah. Minimal shoe. It's wide toe box, no cushioning.

00:48:31.360 Yes. Zero drop.

00:48:32.620 Yeah, zero drop.

00:48:33.520 But I love them.

00:48:34.140 I wear them out.

00:48:34.780 I mean, I go through like two pairs a year

00:48:37.120 because I walk in them all the time.

00:48:38.800 I wear them all the time.

00:48:39.880 And I've been a big advocate

00:48:41.200 for looking for more opportunities

00:48:42.620 to make sure I get shoes

00:48:44.140 that respect the anatomy of my foot.

00:48:46.080 Yes.

00:48:46.440 I'm a power lifter, weight lifter.

00:48:48.200 And a lot of the weight lifting shoes,

00:48:49.660 very narrow toe box,

00:48:50.940 almost like ballerina shoes.

00:48:52.360 They just kind of scrunch your toes together.

00:48:53.740 And whenever I squat,

00:48:55.080 you got like 400 pounds on your back.

00:48:56.440 You're trying to squat and you're like,

00:48:57.640 man, my feet just feel all scrunched up.

00:49:00.040 Right.

00:49:00.260 But thankfully there's a weight lifting shoe brand

00:49:02.040 that came out, Tyr, T-Y-R. 0.54

00:49:04.760 Oh, yeah. 0.99

00:49:05.440 They come from Swim.

00:49:07.760 Yeah.

00:49:08.200 They've got a wide toe box

00:49:10.000 weightlifting shoe

00:49:10.780 and it's improved

00:49:12.300 my lifting experience

00:49:13.340 so much better.

00:49:14.700 So, yeah.

00:49:15.100 And then Limbs does make

00:49:16.820 a wide toe box 0.86

00:49:18.280 zero drop dress shoe.

00:49:20.380 They look kind of goofy, though.

00:49:21.920 I'm not ready to go

00:49:22.860 to wearing those

00:49:23.840 when I'm wearing a suit.

00:49:25.280 And you're okay.

00:49:26.000 You guys talk about this.

00:49:27.080 It's okay to wear, you know,

00:49:28.920 if you're a guy

00:49:30.240 wear some Oxfords, you know, for a couple hours, but like don't wear them all the time. And most

00:49:35.620 of the time just stay in that functional shoe. Let's talk about the shoe size. I thought it

00:49:39.140 was interesting. You said 60% of adults are wearing the wrong size shoe. What's going on

00:49:44.580 there? Like why, why are people walking around with the wrong size shoe? I imagine it's because

00:49:49.100 they probably the last time they measured their foot was when they were in high school

00:49:52.240 buying new shoes with their mom at JCPenney. It's so true. I mean, how many of us have our

00:49:58.740 high school body weight on our driver's license, let's be honest. So you're correct. Most people

00:50:03.220 have the misconception that when you stop growing vertically, and I'm, you know, I'm almost six feet

00:50:08.640 tall, right? I've been six feet tall since I was in high school. So I'm done. I've been a size 10

00:50:12.540 forever. I'm a size 10 in shoes. And another misconception is I wear a 10 in every single

00:50:17.520 brand. So there's research that came out in 2018. So we're pushing 10 years that this study

00:50:24.420 has not been refuted. And it was a big scale study looking at adults. And it was, hey,

00:50:29.840 hey, Brett, what size shoe are you? So what size shoe do you wear is your daily shoe?

00:50:34.280 Like a size 10. Size 10. Okay. How long have you been a 10? I'd say since high school. That's what

00:50:39.140 I've. Okay. Since high school. So when we think about that, and I'm not saying you're wrong,

00:50:43.000 but I would challenge you to measure that foot, my friend, feet change length for a variety of

00:50:48.220 reasons. Muscle gain, muscle loss, weight gain, weight loss, volume change, hormones,

00:50:56.500 medications. Most of us have a preconceived idea that when we stopped getting taller,

00:51:02.000 our feet stopped growing. And it's just simply not the case. So one of the ways to solve that

00:51:07.540 is, do you know the name of that device that they have at every shoe store that's black and silver

00:51:12.980 that measures your foot? I know it's named after some guy who invented it.

00:51:15.600 It is. It's called a Brannock device and it is a hundred years old this year. It has

00:51:20.300 never been changed. The features are the exact same. It was innovated in the US. It's from New

00:51:25.480 York. And that device is still kind of a gold standard of foot measurement. Now you could go

00:51:30.500 to a clinic and get some fancy foot scan or that sort of thing. And there are some companies,

00:51:35.080 Vivo Barefoot actually is starting to do a custom flip-flop where they scan your foot and they only

00:51:40.140 fit you, which is fascinating, right? It accounts for right versus left differences, those sorts of

00:51:44.940 things. But I would encourage everybody listening, if you take nothing else away, please go measure

00:51:50.900 your foot in a proper shoe store. Because if you thought you were a 10 since high school,

00:51:55.880 you may or may not still be. Your feet are not symmetrical. Neither is the rest of you. And so

00:52:01.320 you may have a foot that's creeping toward a 10 and a half. But if you're always buying a 10,

00:52:05.360 you're doing that foot that's a little larger, a disservice. Another thing to think about is

00:52:09.800 shoe brands are all made on different molds. And so a Nike, an Adidas, a Hoka, a New Balance,

00:52:15.580 whatever, a 10 is not a 10 is not a 10. And so with that, when you're switching brands,

00:52:20.580 it's very important to recognize that you aren't probably the same size in different brands.

00:52:25.900 So we talked about the ideal shoe is a wide toe box, minimal drop, heel to toe drop,

00:52:31.140 because you want your foot to just, your toes particularly to splay out as much as possible,

00:52:35.680 because that's how they naturally want to be. What do you do if your toes are scrunched together,

00:52:40.760 even when your shoes are off due to years of wearing constraining shoes? Can you get them

00:52:45.720 splaying out again? You can. There is hope. If you take your socks off and you look down and

00:52:51.620 you've got a crowded elevator in that anatomy. So there's a lot of ways to improve your toe

00:52:57.400 splay. One is being barefoot at home and just spending more time barefoot if you have the

00:53:02.680 availability to do that. The second is a device that's going to cost you 15 bucks. You can get

00:53:08.420 them on Amazon. You can get them at Gate Happens. You can get them from all sorts of different

00:53:12.800 brands. It's called a toe spacer. An important note with these, they are based on your shoe size.

00:53:18.020 So make sure that you are ordering the right size if you order a toe spacer, because if you just

00:53:22.320 order a generic one, that's not small, medium, large, it will not fit your foot. And it's silicone

00:53:27.520 that you wear that goes in between your little toes and it starts to work on restoring space.

00:53:34.080 Now, to my folks who are high fashion shoe aficionados out there that are wearing suits

00:53:39.400 and wingtips and everything else, you're not going to be able to put these on and wear them

00:53:43.140 for a long period of time if your toes were mashed together since you've been an undergrad

00:53:47.460 at Penn State. This is something you may need to wear for five or 10 minutes and then take off.

00:53:52.120 My husband is a retired professional big mountain skier and those in the ski industry

00:53:57.340 know you wear ski boots that are really tight so you have good awareness and you feel really

00:54:02.680 you know locked in when you're doing dangerous things and he's got some toe issues from it and

00:54:07.660 so when we give him toe spacers he can wear them for five to seven minutes he's gonna take them off

00:54:12.640 but over time there is hope you can wear these wear them at home wear them if you have a wide

00:54:17.640 toe box shoe you can wear them in your shoes you can restore anatomical position over time now there

00:54:25.500 are some people who have like serious deformities and they've got you know bone spurs and all sorts

00:54:30.680 of issues that may not resolve but for the majority of us who just have some sins of bad shoes in the

00:54:35.780 past wearing toe spacers is a phenomenal solution gotcha my wife's a big fan the socks she wears

00:54:43.160 when she runs these in ninja socks oh yeah toe socks she likes them she's i don't i don't have

00:54:49.340 the patience to get my toes in each little little holes but i think i can also putting it on is too

00:54:54.120 much. But I think that it does help your toes splay out because it's just keeping things

00:54:57.700 separated. And then you also talk about toe flossing. I've been doing that. It's basically

00:55:02.360 you stick your fingers between your toes, kind of creating a toe spacer with your fingers and

00:55:07.980 kind of massaging it and like working your foot. That's something else you can do when you're

00:55:12.020 watching the great British baking show. Yeah, it's a great way to restore mobility. It's also

00:55:17.180 a great way to work on creating space because if you can get your fingers in between those toes,

00:55:21.120 kind of like you're holding hands with your foot. I mean, that just is reminding them what

00:55:25.180 their neutral position was. And if we were able to be barefoot more and we were constrained by

00:55:30.300 shoes less over time, those toes are going to want to go back to that natural state.

00:55:36.020 You made such a good example when you talked about squatting heavy and wearing a narrow

00:55:39.820 toe box lifting shoe. You're not able to recruit muscles who can help you push into the floor to

00:55:46.820 get out of that hole if you're in a narrow toe box shoe. When you go to a wider toe box lifting

00:55:52.280 shoe, you get a performance boost. The science is there. It's just plain true. And so, you know,

00:55:58.940 that's not a condemnation of shoes that have a narrow toe box, but if you've got the ability

00:56:04.020 to consider something with a wider toe box, you've got the budget to try a couple different

00:56:07.500 pairs of shoes. It is definitely something where people see a performance boost and they have

00:56:12.760 better balance. You're more engaged with the floor. My favorite pet peeve, my husband and I

00:56:17.240 owned a gym for a long time. And one of my favorite pet peeves is having people come in for,

00:56:21.340 we had a CrossFit and we had a functional gym, come in for CrossFit and a Hoka or a cushioned

00:56:25.880 running shoe, a Brooks. And I'm just like, this is the wrong tool for a job. You're bringing,

00:56:30.040 you know, a gun to a knife fight or whatever. So you want to select the right tool for the job.

00:56:35.860 And if you're trying to lift heavy in a super cushioned shoe, you know, you might as well be

00:56:39.780 standing on a pillow. Yeah. You're going to just waste a lot of energy. Yeah. I noticed when I

00:56:44.140 switched to the tier lifting shoe with the wider toe box, I was having some knee pain like behind

00:56:48.700 my knee, my right knee when I was squatting, when I switched the tier that cleared up. Yeah. I mean,

00:56:54.340 it's amazing. So the thing with the toe splay does, it's going to contribute to that more

00:56:58.080 efficient walking gait, which can help clear up foot pain, knee pain, hip pain, all those

00:57:04.520 downstream effects that all starts with your foot and having that proper toe splay. Let's talk about

00:57:10.140 one last thing. Something else that might keep people from walking or make walking uncomfortable

00:57:14.480 are things like bunions, hammer toes, calluses. What causes those and what can we do to mitigate

00:57:20.340 those types of injuries? Yep. So one of the things we offer up in the book when we encourage people

00:57:26.740 to do a little self-assessment is to start with visual inspection. Take off your socks, look at

00:57:31.460 your feet. And do you have deformities? Do you have differences right to left? Are you seeing a

00:57:36.500 big bunion on your left and nothing on your right? Calluses also tell a story, right? Calluses tell

00:57:41.520 us where we're loading the weight-bearing tissue of the foot. Hammer toes are often from wearing

00:57:46.740 shoes that are too short or from having internal foot weakness where your toes start to claw the

00:57:53.380 ground for purchase. So if you do that visual foot inspection and you're seeing things that don't

00:57:59.300 look neutral. Again, bunion, hammer toe, calluses, corns, which are the bumps on the top of the foot.

00:58:05.380 What that's telling us is that your footwear is affecting the shape of your foot. Babies don't 1.00

00:58:12.000 have bunions. And there is a hot topic of debate about whether bunions are genetic or not. And

00:58:19.020 I'm happy to myth bust that for those listening. There is a very small genetic component and some

00:58:26.220 people are more predisposed, but years of wearing narrow toe boxes, shoes that are too short or too

00:58:33.980 tight, definitely accelerates the process of that big toe drift. And once you start going down that

00:58:40.920 path without, you know, counteracting it by changing your footwear, by wearing toe spacers,

00:58:46.020 by getting your feet strong, it can be a very slippery slope. So if you're somebody who just

00:58:50.800 took your shoes and socks off and you're looking down there and you're like, Oh, I definitely have

00:58:54.820 a bunion, or I have one that's bigger on one side than the other, it just becomes this opportunity

00:58:59.780 for you to say, all right, well, what's the why? You know, what's the why? Do I wear a dress shoe

00:59:05.220 to work every day? Do I wear a narrow, those Adidas trainers that are back and so popular right now

00:59:09.980 are so narrow. And I see them everywhere. I was just in New York City for a week. And it's like,

00:59:15.180 everywhere I go, people are wearing, you know, the Samba or they're wearing the Tigers or they're

00:59:20.000 wearing that a6 that's so popular right now and those are not a foot shaped shoe by any means and

00:59:25.860 if you're walking super long distances in those or spending a lot of hours in them without

00:59:30.220 counteracting it in some way it can take you down a path of those deformities getting worse

00:59:36.440 okay so it all goes back to shoes get that functional shoe and if you're ready for it

00:59:41.520 a minimal shoe yep and get strong so it's functional shoe calf and foot strength and

00:59:48.340 then if you want to keep going, start working your way into minimal. And the trick with minimal is

00:59:53.220 you kind of dip back and forth. So I, as I said, just was in New York city recently. I took a pair

00:59:58.540 of minimal shoes. I took a pair of functional shoes and I can walk around the city in minimal

01:00:02.640 shoes. I can't do it all day. I can't go take 12,000 steps or something, but I can do four or

01:00:06.800 5,000 steps in a pair of minimal shoes, which for me with a history of foot surgery and some,

01:00:12.000 you know, running injuries and those sorts of things is really saying a lot. Like I'm,

01:00:15.660 I'm pretty proud of that, that I've gotten enough mobility and gotten enough strength

01:00:19.220 that I can tolerate that.

01:00:21.200 Well, Melissa, this has been a great conversation.

01:00:22.800 Where can people go to learn more about the book and your work?

01:00:25.380 So our book is called Walk, and it is available everywhere you buy books, Amazon, Target,

01:00:30.780 Barnes & Noble, Walmart.

01:00:31.940 We are doing some live events around the US and around London in order to meet the people

01:00:37.980 and get to share our message.

01:00:40.280 My website is melissamcdowell.com.

01:00:43.680 You can find me on Instagram at DrMelissaMcDowellDPT.

01:00:47.600 And yeah, I look forward to meeting people in person.

01:00:49.940 It's one of those things.

01:00:50.600 If you ever see me in an airport watching people walk,

01:00:53.020 come tap me on the shoulder and say hello.

01:00:54.900 Fantastic.

01:00:55.360 Well, Melissa McDowell, thanks for time.

01:00:56.460 It's been a pleasure.

01:00:57.260 Thanks, Brett.

01:00:58.600 My guest here is Dr. Melissa McDowell.

01:01:00.200 She's the co-author of the book, Walk,

01:01:01.880 Rediscover the Most Natural Way to Boost Your Health and Longevity,

01:01:04.340 One Step at a Time.

01:01:05.560 It's available on Amazon.com and bookstores everywhere.

01:01:08.080 You can find more information about her work at our website, melissamcdowell.com.

01:01:11.560 Also check out our show notes

01:01:12.560 at aom.is slash walk.

01:01:14.300 We find resources

01:01:15.100 where you delve deeper

01:01:15.660 in this topic,

01:01:16.220 including links to the shoes

01:01:17.320 we recommended.

01:01:26.240 Well, that wraps up

01:01:27.340 another edition

01:01:28.060 of the AOM podcast.

01:01:29.160 If you haven't done so already,

01:01:30.040 I'd appreciate it

01:01:30.640 if you take one minute

01:01:31.360 to give us a review

01:01:32.260 on the podcast player

01:01:33.200 that you use to listen to the show.

01:01:34.660 And if you've done that already,

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01:01:36.440 Please consider sharing the show

01:01:37.560 with a friend or family member

01:01:38.680 who would think

01:01:39.160 we had something out of it.

01:01:40.340 As always,

01:01:41.220 Thank you for the continued support.

01:01:42.340 Until next time, this is Brett McKay.

01:01:43.800 Remind you to not listen to anyone's podcast, but put what you've heard into action.

The Art of Manliness - June 02, 2026

Built to Walk — How Modern Shoes and Weak Feet Are Holding You Back

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