Transcription
Let's talk about, um, the things you want to look for in a functional shoe. My non-negotiable was the wide toe box. The toes have to be able to splay. When you think of all the diagnoses that we talked about, bunions, neuromas, hammer toes, when the forefoot can splay, the foot's going to function better. So that's number one. Number two is having the heel and the toe in the same plane. And number three is having a shoe that is thin and flexible.
When you wear this type of footwear, I call this a workhorse shoe because there is more load going through all of your tissues, through your bones, through your ligaments, through your tendons, through your muscles. So your foot gets stronger when you wear this type of footwear. There's research on that. Now, you have to earn your right. This is the plantar fasciopathy conversation. You can't go from wearing an aggressive, high-cushion shoe, like this one here, with an insert, for example, and say, "Oh, this stuff makes sense. I'm going to go take that off and I'm going to go wear this 24 hours a day." You won't like me.
Why? Because you'll say, "Hey, my heel's hurting because you haven't done the work." It's, "Hey, let's do these foot exercises. Let's wear this for 10 minutes a day." And then people are like, "Wow, that does feel better." And then it's a transition into wearing this more often. Now, when you have patients that have had a very weak foot or clients that have had a very weak foot with different diagnoses, this is a hard, you know, shoe to walk around in for extended periods of time. So, that's when we'll talk about footwear that still puts the foot in a wide position, wide toe box. I love this shoe. And I also like the mesh upper because you can, the toes can expand in here. I still have zero drop, right where the heel and the toe sit in the same plane. But you'll notice the difference between the two shoes is the amount of stack height or the amount of cushion. There's more stuff.
Yeah. So on this shoe, the, it does look like the, you call it plane, looks level.
Yes. Okay. And it's got a good toe box. You can see from this side that the,
toe box is wide so you can splay. But it is elevated.
It's elevated off the ground. Yeah.
But the heel and toe are in the same plane.
Okay. Fine. But it, it's, it's still elevated though. They're still like quite a thick.
Yes. That's not too much of a problem because it's still depends on what your goals are.
If I'm running, that is, that is a, I think a great shoe to run on, to run with. Right. If you're running on concrete, if you're running on asphalt, you want a little something underneath the foot.
What about the Nike Alpha Flies, which is my?
You make me start sweating.
Really?
Um, this is my current running shoe and I bought it because it looks great.
Yes. I mean, you know, it is, it's.
I have torn the, the ligaments in my, in my ankle, but, but I look good.
Here's the super shoe, right? So, here's this shoe, right? And here's your super shoe over here.
Yeah.
Okay. When you look at that shoe, there's certain characteristics to that shoe that you definitely do not see in this shoe. One of them being the toe spring. So, see how it kind of lifts on the front of the shoe?
Yeah.
Okay.
This part here. Yeah.
Yes. So, if I had that shoe on this table and I went like this to the front of the shoe, it would literally rock for me.
Mhm.
So, it facilitates the rocker of the foot. Sounds great. You put that on, you're like, "Man, this is great. I can fly." If you don't use it, you're going to lose it. So, there is research that shows when you put your foot in a position with toe spring, you will weaken the intrinsic muscles of the foot. So, I'm not saying don't have race day and wear that shoe, right? You get the research will tell you 2 to 4% running economy. People run faster because the shoe has the technology to facilitate gait. But if you train in that all the time and you never let your foot get stronger, it's just a matter of time. You're going to say, "My hamstring, my foot, my this, my that." And it's like, we, that's why the conversation has to happen is this is the shoe that you're going to get stronger in. Spend time in your training shoe. And then that's your speed day. That's your race day. So, it's having the shoe spectrum, knowing when to dance along the spectrum.
I feel like I can bounce in these.
I mean, you probably can.
I literally when I put it on, I was like, "Wow, I can bounce."
That's right.
I think it has like a piece of metal going through the middle of it.
There's carbon in there.
You know what another fun fact is though?
Certain plyometrics. So, plyometric is training the spring of the body. So, think like jumping. There's research that will show you that plyometrics also increase capacity in running by 2 to 4%. So, my conversation I have with my patients is, "Listen, what if we stacked therapies, right? What if you did plyometric work, which is, uh, jumping?"
Yeah.
You know, once or twice a week, and we worked on your strength and I had you in these shoes the majority of the time. And then on race day, you want to throw that shoe on, it's like you're, you're a running, you're like a running fairy. You're like running and things look beautiful and everything is, you know, because you have a strong body on top of the shoe. But if you put a weak body and a weak foot in that shoe, you got to earn your right.
Should we be standing more often? Because most of us work and live in offices now and we sit at desks and I, I, you know, I do this podcast sat down. Do you think much about standing desks or how often we should spend bipedal, or I think that's what you refer to as?
I think that it's more about movement.
Okay. I don't know if standing in one place is any better than sitting in one place, other than when you're standing, you can actually like, you know, move around and, you know, make it more active standing. But it is a matter of taking movement breaks. Like that's, I call them, you know, movement snacks. All of us spend a lot of time either sitting all day long or, you know, standing at our desks. If we were to take micro walks, a five-minute walk a couple times a day, the system stays moving. You're staying active and you're slowly, you know, inching up that step count that we know is so important for not only physical health, but emotional and mental health.
That's what I like about it.
I think you mentioned there was an association with movement, walking, and dementia, Alzheimer's risk.
What, what does the science say there? You know, when you look at step counts, if that was going to be our baseline, 9,800 steps per day can reduce the risks of dementia. But what I think is the cool part with that is 3,800 steps, you get 50% of the maximal benefit. So, if you were to, let's just call it 4,000, shoot for 4,000 steps, you're going to get a benefit, a 50% benefit. And some of my favorite research on looking at that population with walking is relationship walking. There's really cool studies, um, looking at walking in groups for the elderly population and how that has a social connection and it improves their emotional health and it combats loneliness and feelings of isolation. And that is the beauty of a walk.
Run clubs are getting incredibly popular at the moment, aren't they? All around the world. Are you seeing more and more people come to you as a result of that?
Yes, I think also, um, you know, it was interesting. I was working at the running event in Austin, Texas, and I was teaching there. And so, a lot of the shoe stores were there, and one of the bigger shoe stores had said that the majority of their clients now are actually walkers and not runners. And I thought that was pretty interesting. And I'm thinking to myself, I wonder why that is. Like, are more people reverting to walking because they're getting injured when they're running? Are they, you know, I'm making all these conclusions in my head. I'm like, well, is it because we're going in the wrong direction with footwear because we're creating this shoe that is basically doing the work for us and it feels so good and, you know, people aren't putting the work in anymore? I don't know, but I'm certainly going to do my best to change that.
You brought me a box which I have, yes, here in front of me.
Foot health kit. Yes, that's what it says on the front of the box.
Um, a foot health kit. I mean,
what is in this box?
It's like my little, like bag of treats. You know, when I started doing this, it was funny.
This is what you give people as a bag of treats.
That's right.
For their birthdays and stuff. I want people to start thinking about their feet because I, I think there's such, um, implications for their health. And I wanted to make it easy because when we think about all the things we need to do to stay healthy, it's like, I have to strength train, I have to, you know, eat this. I need to V02 max. I need my cardiorespiratory fitness. There's a lot. So, I wanted to make it easy. So I, um, first, what, one of the things that that is in there are toe strengtheners.
So I'll pull them out the box. So,
those are toe spacers.
Toe spacers.
Yes.
So is this all the same thing? Right.
Yes.
So these are toe spacers.
Correct.
And then there's this.
Yes.
What's this?
Those are toe strengtheners.
Toe strengtheners. Okay. So that's my toe workout.
There is this thing, a band. And then there's this ball.
Yes.
So this is like, this is my foot gym.
That's right.
Can you show me how this stuff works?
Absolutely.
Okay. So, um, these are my feet and these are my ankles. So I had plantar fasciitis in, I believe it was this foot actually. And then right now, I've got a high ankle sprain, which is some kind of ligament here has been torn. And they told me that it's torn on all three sides. So, I've been in a boot for the last couple of weeks, but I've taken it off over the last week or two, and I was on crutches as well.
Um, what are you, the minute I took my socks off, you became fixated on my feet.
Yes.
What, what do I need to be thinking about? And what can you see just by looking at my feet?
You know, when you're looking at this foot here, you can start to see this little, see this little bump here.
You can start to see bumps on the top of the big toe.
Mhm. Okay. And the diagnosis is a hallux limitus or a hallux rigidus. And basically, what that means is that you have formed, um, arthritis on the top of the toe. So it prevents you from getting that full range of motion that we need when we walk and run.
Okay.
Okay. If the bump goes out to the side, that's what we call hallux valgus. That's the bunion.
The bunion. Okay.
Okay. So that's why the foot is a window to mechanics because you can see loads, aberrant loads, right? Why is this forming here? So, you know, one of the first things I want to look at is how much range of motion the big toe. It's all about the big toe when we're walking. We put a lot of load and force that go through the big toe when we walk. You should have about 40 to 45 degrees to walk out of that big toe. So, here's Eddie. Here's 45 degrees.
Up.
Up. Okay.
Okay. So, yes. So, what I'll want to see is how much range of motion. Can you see how he's off the ground, though?
I want the ball of the big toe on the ground.
That's a good amount of range.
That's the first nice thing you said about my feet.
We're just getting started. I'll find something else. And then you want to look at toe dexterity. So, in other words, can you isolate your toes? So, can you lift just your big toe on the right? Good.
And then on the left.
That's actually quite hard. Like, I've never had to do that before.
It's funny because when you'll see people that have poor awareness to their feet, when they try to lift their toes, you'll see them like, their hands and like your back isn't going to extend your toe. Okay. Okay. And then put your big toe down and then extend your four toes. Yes.
No, that pinky is not, that's not listening.
There you go. And here. Okay. And then what I want you to do is you're going to lift up all of your toes and spread them. And you can see two, three, and four, right? They don't want to spread as much.
Mhm.
Earlier we talked about those neuromas. The neuromas live within the toes here, right? Within, right in between the toes.
So if we have issues with nerve problems here, you got to be able to splay.
So you wear Vivos. You know, when you allow your foot to be in a shoe where the feet can actually splay, you'll start to see changes.
Mhm.
But imagine if you, you know, were in a shoe where your foot, I mean, I had a, I was at an expo working a couple weeks ago and this woman came up to me and she's like, "Man, I can't figure out why my foot hurts." And I took her shoe off and I'm telling you, her foot looked like this. It looked like a shoe.
And I took a picture and I showed it to her and I was like, "Does your foot look like a foot or does it look like a shoe?"
We don't really know the difference these days.
No.
Because remember, the widest part of the foot should be the toes. So that's what we want to look for in the front of the foot. We also talked about that muscle. What side did you have the heel pain on?
I believe it was the right side.
So, one of the things we'll do, um, and you can actually do this at home. You could use like a, a credit card. So, in my office, we can actually measure that. But if you were to do it at home, you just take a card and put it underneath the toe.
Okay. Okay. And make sure you're lined up here. Yep. And some people will also do that. See how you're like,
holding your leg, just the toe.
Mhm.
And then I'll try to pull the card out from under you.
And I shouldn't be able to do that. I should feel some tension.
And then I'll ask the patient, "Where do you feel this? What's working?" And if they say my hip, my quad, it's the wrong guy. We're talking about the foot. So you should feel that in the arch of the foot and maybe into the calf.
Okay. Big toe flexor hallucis longus. This guy, by the way, this muscle starts over here. It's very important to strengthen this muscle when you have a history of ankle sprains. Starts on the fibula, which is the outside of the leg. It comes down the foot, crosses under, and inserts into the big toe. Then I'm going to take the card and I'm going to put it underneath the four toes. The muscle that we're looking for. Yes, that's beautiful. See how you got that little, see, that's the second compliment I gave you about. I'm going to put this underneath your toes.
Yep.
Right. Little. Yep. And then don't let me pull the card out. And you should feel that in the arch of your foot. Patients that have.
I'm not really feeling it to be honest. I'm not feeling it anymore.
Okay. Oh, what?
Okay.
There you go. Roll the, roll the bottom of the foot like this.
Yes. Just wake it up a little bit. There's a bunch of receptors on the bottoms of the foot. So, when we can't feel things, and it shouldn't surprise us, you know, if we've been walking around in footwear that compromises the function of the foot or we've had injuries, you start to lack what we can feel.
So, just wake it up a little bit.
And how long would you do that for in the morning?
60, 90 seconds.
Do you do this every day?
Uh, I do. I'll tell you, when I, like if I'm standing at my desk, I'll keep the ball there.
Okay.
When I come back from a run, I do this whole little setup. But I wear these all day.
What is that that you're wearing there?
So, these are toe spacers. So, they do exactly that. They splay the foot.
And why are you wearing that?
Remember when I was telling you about my years of being a ballet dancer? Okay. Um, in pointe shoes, uh, I wore orthotics for a long period of time. I wore ill-fitting footwear and my foot was weak and things hurt. Okay. And we talked about why I needed to fix all of that. Um, you can see my bunion here.
Okay. So, I work on all of this stuff all the time and toe splay is a big part of that. So when I have these toe spacers in, they splay the foot for me. Every pair of shoes that I wear, um, is compatible with a toe spacer.
Okay. So you don't wear any narrow shoes.
Yeah. Non-negotiable.
Okay.
And this is important. There is a difference between a wide toe box and a wide shoe. So people will say, "Well, I ordered the wide." The width will come here. That's where they change the width. But if the toes are still tapered, the width has to extend into where the toes are.
Mhm.
So that's where you got to be careful. It's a wide shoe is not a wide toe box shoe. And if you try to wear these in just a wide shoe, you're not going to be comfortable. So if I wore this for one year, what promise could you make me or what could you tell me the benefit and the upside would be?
You would definitely see improvement of splay of your foot.
Yeah.
And when you have the tissues, the splay, you can start to improve the strength of the foot.
And what's downstream from a strong foot?
Go up the chain. You have better toe strength. You're going to build a better platform. You're gonna have a jet engine on a jet engine. So, your ankle mobility, then your knee extension, your hip extension, because your foot is doing what it was designed to do, which is be mobile and be strong.
Okay?
We need to pay attention. If you, if things go south from here, you can expect there to be changes up the chain. I see it all the time. If you love the D CEO brand and you watch this channel, please do me a huge favor. Become part of the 15% of the viewers on this channel that have hit the subscribe button. It helps us tremendously and the bigger the channel gets, the bigger the guests.