Yes.
We don't do much of that these days.
It seems to have gone out of fashion, with all the Ubers and the other ways to get around and all the sedentary behavior that we do living and working in offices.
What should we know about walking and how important it is?
Because I'll be honest, I don't walk that much.
Yes, I always say it's the most underrated underutilized, easily accessible activity that most of us are not doing.
If you think about, if you look at the research on average step count that most people globally are taking, it's about 45 to 4900.
Which means that there's a lot of us that are taking less than that.
So when I'm working with my patients, we always look at baseline numbers.
What's your baseline?
So, for example, if you had a person who was walking 2500 steps a day, I mean some of us would be like wow, that's not a lot.
But for a lot of us, it is.
If you were to walk an additional 500 steps in a day your baseline is 2500 you can reduce your risk of cardiovascular mortality by 7.
Wow.
Here's a bigger wow.
If you have a 1,000-step increase, you can reduce your risk of all-cause mortality by 15%.
Dying of anything?
All-cause mortality.
15%.
That's a big number for 1,000 steps.
Hmm.
So I have a story for you.
This is a patient of mine and it just, you know, warms my heart to talk about him because when I saw him he was two years into a diagnosis of heel pain, 27 years old.
So he had gone to see a bunch of people and the last doctor that he had seen told him to limit his step count to 2500 steps a day.
Why? to rest, to rest the foot.
Now, this is chronic pain now.
We're not talking acute heel pain.
We are two years into this song and dance.
And he's being told at 27 years old to take 2,500 steps a day.
So he comes into my office.
We're talking about all of this.
And he's also a quadruplet.
So it was one of the first quadruplets I think I've ever treated.
So he has...
You know, which why I think pain is so difficult.
It's so complicated because now you have this 27-year-old who's seeing his siblings, who are at 27, like enjoy their life and doing all these things.
And he's being told he can take 2,500 steps a day.
So he's now living in his father's basement.
And he's afraid to go above 2,500 steps.
And he used to tell me, he's like, I cry a lot.
I'm depressed.
And wouldn't you be, if So there wasn't any magic exercise that I was going to give him two years into this.
There wasn't any magic orthotic or magic shoe.
He had done all of that.
Shame on me if I would have done the same thing.
So we had a conversation.
And...
I knew I needed to get him outside and I needed to get him walking.
That was my goal.
Forget about the heel pain.
We didn't even focus.
We didn't even talk about the heel pain.
I knew I needed to get him outside and start loading his foot.
Two years, this foot, by the way, when you're walking, four to six times your body weight.
It can handle four to six times your body weight when you're walking.
But you don't load it appropriately and muscles atrophy.
So I told him.
We had a long, long conversation.
And I said, we're going to slowly start to introduce steps.
And if you think about this, if we were to say, add 1000 steps a day, to some people that might not sound like a lot.
But to someone who's taking 2,500 steps, that's almost 50% of what they're doing.
Hmm.
So we introduced the concept of a micro walk, which is a five-minute walk.
So a five-minute walk is about 500 steps.
Okay.
A 10-minute walk is about 1,000 steps.
Okay.
Right?
So that makes it like a little more digestible, right?
So you're talking to him.
You're like, listen, all I need is five minutes.
And so we started five-minute walks.
And for the first couple weeks it was.
You know, there were good days, there were bad days and there still are.
But we were starting to build his confidence and movement.
We were starting to get him comfortable on his foot again.
And it was.
You know, it was one of those cases where I just like I really enjoyed working with him and watching what had happened, because
If you look at step counts, I knew what number I was trying to get to.
Because if you look at depression, for example, 5000 steps a day can reduce the risk of having symptoms of depression.
If you get to 7,500 steps per day, it can reduce the prevalence of the diagnosis of depression.
So that was in the back of my head.
I'm like, we just got to keep working towards these numbers.
So while we were doing that, we were strengthening his foot.
I had him in different footwear.
And at the end of each week, we were also talking about three good things.
Tell me three good things that happened to you this week.
And in the beginning of treatment, it was a struggle, Stephen.
It was a struggle for him to think about good things happening in his life.
And I spoke with him probably about a month ago.
And his email is like my why.
He was like, um, on average, he's walking between five and 6,000 steps a day.
He still has good days or still has bad days, more good days than bad days.
But he said to me, he's like, I haven't, I can't tell you the last time I cried.
He's going to church.
He's spending time with his dad, you know, and It's not the step count.
It's the person behind the step count.
And that's why I think this stuff is so powerful.
I saw it change my life.
I saw what it does to my patients.
I mean it has the capacity to improve not just your physical health but how you interact with the world.
It has a completely different meaning when you understand the real sort of human consequences it can have on someone's life, for better or for worse.
And it's not often until we have some kind of injury or issue that we realize that our feet and ankles were there.
Yes.
And that's certainly been the case in my life.
It wasn't until I got plantar fasciitis that I was like oh my God, I should have been doing something about this sooner.
And then as I told you before we started recording, I've currently got a high ankle sprain.
So I've pulled some ligaments in the top of my ankle training for this game called Soccer Aid.
So I'm now going through the whole process once again of like figuring out what I did wrong and what I should have been doing as a preventative measure to try and strengthen my feet.
One of the things I think most of us get wrong is our footwear choices.
Yes.
What do you think of these shoes?
These are women's heels, but listen, anyone can wear them.
It's 2025.
What do you think of these shoes?
Well...
It doesn't look like a foot.
Your foot in that position is not the position it is supposed to be in.
Now, with that being said, there is a time and a place.
I don't think I'm going to win the battle of you need to wear functional footwear 24 hours a day, seven days a week.
Time in those shoes should be limited.
Just like with other things it's.
Do you see a lot of women getting injuries because they spend too long wearing heels?
I don't know if acute injury, but a weakening of tissue, yes.
Because you know I live in Colorado now so I don't have that – there's not too many women in Colorado that are wearing heels.
However, when I go to New York City, it's a different conversation, different environment.
So you know, I have to say – I have to use the – that is not the position that you want to keep your foot in.
It's changing the structure of your tissues, changing the pressures in the foot, not to mention –
I don't care what anybody says.
That's not comfortable to walk around in.
People will be like, oh, I'm really comfortable in heels.
I'm like, are you really though?
The links we go to to look good though, right?
That's right.
Okay, so let's talk about some good shoes then.
Okay.
I've got two pairs of shoes here.
Okay.
One of them is Vivo Barefoot.
Yes.
Who are actually a sponsor of mine.
Ever since I started talking about feet.
And then I don't know this brand.
What is this brand?
That is Ultra Running.
So...
Let's talk about the things you want to look for in a functional shoe.
My non-negotiable is the wide toe box.
The toes have to be able to 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 loads going through all of your tissues, through your bones, through your ligaments, through your tendons, through your muscles.
So your foot gets stronger when you wear this type of footwear.
There's research on that.
Now, you have to earn your right.
This is the plantar fasciopathy conversation.
You can't go from wearing an aggressive, high-cushioned shoe.
Like this one here?
Yes, with an insert, for example, and say, oh, this stuff makes sense.
I'm going to go take that off, and I'm going to go wear this 24 hours a day.
You won't like me.
Why?
Because you'll say, hey, my 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 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 a plane, looks level.
Yes.
Okay.
And it's got a good toe box.
Yes.
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, but the heel and toe are in the same plane.
Okay, fine.
But it's still elevated, though.
They're still quite thick.
Yes.
That's not too much of a problem because it's still flat.
It depends on what your goals are.
From running.
That is, 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're going to make me start sweating.
Really?
This is my current running shoe, and I bought it because it looks great.
Yes.
I mean, you know, it's... I have torn the ligaments in my ankle, but I look good.
Here's the super shoe, right?
So here's this shoe, right?
And here's your super shoe over here.
Yeah.
Okay.
When you look at that shoe...
There's certain characteristics to that shoe that you definitely do not see in this shoe, one of them being the toe spring.
So see how it kind of lips on the front of the shoe?
Yeah.
Okay?
This part here, yeah.
Yes.
So if I had that shoe on this table and I went like this to the front of the shoe, it would literally rocker for me.
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?
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 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.
Yeah, 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 two 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 jumping, 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 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 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 referred to as
I think that it's more about movement.
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 move around and make it more active standing.
But it is a matter of taking movement breaks.
I call them movement snacks.
All of us spend a lot of time either sitting all day long or 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 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 does the science say there?
You know...
When you look at step counts, if that was going to be our baseline, 9800 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 4000 steps, shoot for 4000 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 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, 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 the 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.
What you just listened to was a most replayed moment from a previous episode.
If you want to listen to that full episode, I've linked it down below.
Check the description.
Thank you.
