The Crackin' Backs Podcast

Feet First: Dr. Courtney Conley on the Science of Shoes, Longevity, and Gait Health

• Dr. Terry Weyman and Dr. Spencer Baron

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In this episode of the Crackin' Backs podcast, we are honored to host Dr. Courtney Conley, a renowned expert in foot and gait mechanics. As the founder of Gait Happens, Dr. Conley has dedicated over 25 years to helping individuals reclaim optimal foot function. She holds a Doctorate in Chiropractic Medicine and dual Bachelor's degrees in Kinesiology and Human Biology. Her extensive clinical experience includes working with professional athletes from teams such as the Phoenix Suns, New York Yankees, Cleveland Browns, New York Giants, and San Francisco 49ers.

In this insightful conversation, Dr. Conley delves into the critical role of foot health in overall well-being and longevity. She discusses how various footwear choices can significantly alter gait biomechanics, potentially leading to musculoskeletal issues. With the plethora of footwear options available today—from minimalist shoes to highly cushioned models—Dr. Conley offers guidance on selecting footwear that promotes optimal gait and musculoskeletal health.

The discussion also explores historical changes in footwear design and their influence on modern foot ailments, providing lessons from past practices to inform current choices. Dr. Conley shares her expertise on identifying suitable running shoes amidst ever-changing information and addresses the prevalence of Achilles injuries, particularly in relation to cleats and ballet shoes, which can be detrimental to foot mechanics.

Additionally, Dr. Conley examines the practices of taping ankles and feet, known as spatting, and offers practical advice on strengthening exercises for the feet and ankles that listeners can implement immediately. She provides her perspective on the growing trend of barefoot walking, weighing its potential benefits against the risks of injuries and infections. Drawing from various cultural practices, she offers insights into optimal foot function and health.

The conversation also touches on the use of toe spacers as a tool for addressing foot alignment issues. Dr. Conley evaluates their effectiveness and discusses whether they are a valuable tool or merely a passing trend.

For more information on Dr. Courtney Conley and her work, visit Gait Happens. To schedule a consultation or learn more about her clinical practice, contact Total Health Solutions in Lakewood, Colorado.

Tune in to this episode to gain a comprehensive understanding of foot health and its profound impact on your overall well-being.

We are two sports chiropractors, seeking knowledge from some of the best resources in the world of health. From our perspective, health is more than just “Crackin Backs” but a deep dive into physical, mental, and nutritional well-being philosophies.

Join us as we talk to some of the greatest minds and discover some of the most incredible gems you can use to maintain a higher level of health. Crackin Backs Podcast

Dr. Spencer Baron:

Welcome to the cracking backs podcast, where we walk through the foundations of health and wellness. Literally, today, we're joined by one of the world's leading authorities on feet, well gait analysis and the science of footwear, Dr Courtney Conley, from how your shoes shape for your own longevity, to the Barefoot movement and even some controversial issues like fashion versus function, Dr Connolly will challenge what you think you know about your foundation, which is your feet. Get ready to walk away with insights that could change your health from the ground up. Let's face up and step into it. Dr Courtney Connolly, welcome to our show. You are considered one of the top experts when it comes to feet and gait analysis. To start it off, well, to start it off, we want to ask you about feet, but I do gotta preface a few things. I go, you know this, this whole program is going to be talking about feet and footwear, and I'm not going to call footwear sneakers, because my co host and I have been battling as to what the do you call? He says, Go ahead. Dr, Terry, what's your deal with the word sneaker? He

Dr. Terry Weyman:

wrote me something about sneakers. I go, I don't think anybody on the west coast or especially in California, has used the term sneakers in 20 years. And then he sent me an article today this that quoted, well, the guy was wearing sneakers, and I'm like, Who the hell uses the term sneakers? So we've been Valley back and forth thinking that's the East Coast term now, because they haven't caught up to the 24th century and and California is ahead of the curve. We have a better word than sneakers that my father used. So you're in Colorado. What do you think is you're on the west side of the Mason Dixon Line. So what do you say is, do we they still use the word sneakers in Colorado? Well,

Dr. Courtney Conley:

I actually grew up in Pittsburgh, so we call them tennis shoes. Everything was a tennis shoe, right?

Dr. Terry Weyman:

We still say sometimes tennis shoes, or say shoes or athletic shoes or footwear. Yeah, we don't use the term sneakers. Do you use? I've

Dr. Courtney Conley:

never said sneakers. Ah. Never said, All right, all right. All right.

Dr. Spencer Baron:

Hold on now. I mean, I came up with a I've heard them called trainers. I heard some of my my my thugs, guys call them kicks, yo bro. What about your kicks, man. And then there's high tops, low tops, pumps, sneakers, which I call and the tenant tennis is, I've heard tennis, yo, those are nice. White tennis is, man. So I

Dr. Courtney Conley:

it is. It is very interesting. And actually it brings up a very good point, because in our world right now, there's, I'm part of a research study that's actually defining what the word maximalist shoe means, versus minimalist shoe. And so it's, it's really the terminology with everything is, is getting quite specific, because they are two very different animals when it comes to footwear. Well,

Dr. Terry Weyman:

we're also meant, well, we're also mentioning, there's a difference in in language, you know, East Coast, West Coast, north and south. So they all have, yes, they all have cultural words that are used. And, you know, it's not universal, you know, you go into other parts of the country and provinces have different terms. And it may be English, but it's they use different words, different phrases. So it's kind of a cultural world, world, and we're just laughing because the West Coast doesn't use that the East Coast does, and we I thought that was kind of cool, actually,

Dr. Spencer Baron:

footwear. Are we going to call it footwear? Or sure

Dr. Terry Weyman:

you're wrong. So you just have to move on.

Dr. Spencer Baron:

Tell me what we call what the covering over a foot footwear.

Dr. Courtney Conley:

Thank you. Whatever you guys want to call it, I'm fine with because we'll probably redefine anything anyway.

Dr. Spencer Baron:

What we're doing is all right, well, back to the regularly scheduled program. I Dr Connolly, I, my, my girlfriend, Karen slota. Dr, Karen slota Is is a huge fan of yours after watching you on Peter Attia, such a great educator. You're so affluent with the are fluent with the biomechanics of foot, and we couldn't wait to to get you on. So how did it all get started? And your your your approach to feet and foot, I mean, shoot, or whatever you want to call it,

Dr. Courtney Conley:

you know, I think when there's a. An interest, a passion about something. It always comes with a personal quest. On the back end of it, I was a ballet dancer for many, many years, and then I converted to becoming a triathlete, and I had a lot of foot issues, and I went to chiropractic school, and I was searching for ways that, you know, I could help myself, and I loved movement was always a very big part of my life. And then I went to chiropractic school, and I think we had about maybe a semester, a half a semester on foot and ankle mechanics, and I got out of school, and we worked. I worked in several orthotic labs, and we were making a lot of orthotics for our patients. And you know, that's kind of how this whole thing got started. My My pain, per se, I was always kind of chasing it around, and then I kept thinking to myself, we treat everywhere else in the body differently than we treat the foot, and why are we doing that? And I was very intrigued by that, considering that our foot is the only interface we have with the ground that keeps us upright and balanced, it's basically what you know, enables us to be a biped. So I was very interested in that and why we weren't looking at it from how can this part of our bodies get stronger? How can it become more mobile, and how that can impact the rest of the kinetic chain? So I started searching, and here we are.

Dr. Spencer Baron:

You know, I read one many years ago that the moment your foot hits the ground, everything could go wrong, or it could go right, you know. And you know, there's, there's a lot of talk about how, you know, footwear has evolved over the years. Oh, I called it footwear, all right, natural. I love it all right. So, like you said, from minimalist shoes to highly cushioned option. How do you advise individuals on I mean, I want to just write out a starting block. Yeah,

Dr. Courtney Conley:

I love this conversation. Yeah, it's so interesting. I'm doing a lot of research now. I'm writing a book on walking, and when you look at how our footwear has changed over the years. It was initially used for just a protective covering so from the elements, from weather, and it was just like a moccasin type piece of footwear. And then over the years, it's transitioned. And in the 14th and 15th centuries, I find this really interesting. It was the introduction of cacaos and poulins, those really pointy medieval kind of boots, and those were worn by people that were higher in the socio economic areas. So everyone kind of wanted to emulate that. And there's really cool research looking at they dug up the remains of the skeletal remains of these people that wore their shoes, and they noticed an intro, an increase in hallux valgus, or bunions with the introduction of that footwear, very interesting. And so we were getting all of these, you know, indications that footwear can impact the structure of our foot, but we've let fashion kind of override function, and I really think that's had an impact on what's happening. So when I'm advising patients on what type of footwear, the simplest thing I say to them is, look at a foot that's healthy, which is hard to find these days, by the way, that's what the shoe should look like. It should be widest at the toes. I'm going to bring out Eddie. This is Eddie.

Unknown:

Hello, Eddie. I'm a

Dr. Courtney Conley:

very big Pearl Jam fan, so I named my

Dr. Terry Weyman:

is feather the tibia.

Dr. Courtney Conley:

Yeah, that's good point. I should start naming the bones after everyone. My dog's name is my I have a little golden doodle too, and my dog's name is hallux. So there's a lot of we got a lot of skin in the game going on. That's great. But when you're looking at a shoe, it should be widest at the toes right? It should be flat and flexible, so the heel and the toe sit in the same plane, and the shoe should move. Our foot moves. Our big toe moves 65 degrees, 40 in the walking gait cycle. So. So the footwear should allow for the foot to do what it was designed to do, which is display and to move. And if you look at the majority of footwear out there, and I think we have a lot of work to do, the footwear does not look like a foot.

Dr. Terry Weyman:

I gotta inject something really quick Spence. How do you because this is right down my alley. I always say that you need to pay attention to below the knee, so above the knee is healthy. But how I all the time I will say exactly what you're saying to a woman, and they're like, Yeah, but those shoes aren't cute. How do you how do you get past that? That something that's been around since, like you just said that the 12th century. I mean, they still wear those pointed shoes, and I call them cockroach killers, because you can get into the corner of but how do you how do you get past that, that thought process where, if a woman's going out for a nice evening, or a man that they totally throw out that, and they think that is cute and this is ugly.

Dr. Courtney Conley:

I think this is where why I'm so passionate about education, because I think if people understood the consequences of what happens, we don't really think about it in our 20s and 30s. We're walking around in heels. We're, you know, doing all the things. And this doesn't exclude men. You know, my brother lives in New York City, his shoes are pointier than some of the women that I work with, right, right? You don't think about those things then, but the majority of my patients in their 40s, in their 50s, I hear it all the time. I wish I knew what wearing that type of footwear, then would have done to what is to my feet, because it alters their walking gate. It causes changes in the structure of the foot. So bunions hammer toes, from a longevity perspective, that is a problem, because once you have bunions or hammer toes, your increases of falls, the your fall risk increases, your balance changes. So there's a lot of implications from this. And I think if we educate, and this is, I call it a shoe spectrum, right? Dr, Terry, it's, I'm not asking people to wear, as my daughter would say, platypus footwear all the time. Okay, it's just have a shoe spectrum. If you have to wear high heels because you want to go on a date or you want to, you know, get dressed up, fine. But if you know that for the rest of the day or when you get out of those shoes, do the right things and just balance it. And I think that, you know, when I started doing this, there was one company that was making functional footwear. Now, 15 years later, there's got to be, I mean, there are 1000s now, right? So the education is getting out there. People are getting smarter. When you start wearing footwear that feels good, right? You want more of it, so it's not a hard sell. And the fashion is is coming. It's coming

Dr. Spencer Baron:

interesting. You mentioned about fashion. I for many years, I lectured on some of the bad habits that we have during simple bad habits we have during the day, like high heel shoes. And in delving into the history of the high heel, where did that come from? But of course, a man and you mentioned about socioeconomic levels, but I saw images of the toe coming to a point, and the longer the shoe, the more status you carried along with the heel. And I thought, that can't be possibly comfortable. And at that point in, you know, in that century, it was they would, they would suffer where, and they couldn't walk because it wasn't functional, you know. So how would you tell somebody now, you did mention about the forefoot and how the toe box needs to be, you know, needs to allow the foot to conform to its natural position. But what about the rest of the shoe? And how would you tell somebody that needs to get a running shoe to look what to look for.

Dr. Courtney Conley:

I think if we're going to win this battle, which I've thought about often, you have to meet people where they are. So if you have been wearing, you know, a certain type of shoe, a lot of cushion, a lot of support and orthotic. You have to have the conversation where this shoe is doing a lot of the work for you. There is no doubt when you put your foot into a shoe that has toe spring or. Support that it's going to feel better. It's designed to they're often called recovery sandals for a reason. So people put them on their feet and they're like, Wow, this feels great. But I always say no one gets a free lunch, so if you don't use it, you're going to lose it. And there's a lot of research. Dan Lieberman talks about this, that when you have toe spring, for example, you lose the intrinsic strength of the foot because the shoe is doing the work for you. So I have to say to people, we're going to slowly work your way into more functional footwear. So we might start them off on a shoe that has a wide toe box that's kind of my non negotiable, and it can still have stack height. It can still have a heel to toe drop. And then we're working on things like, if they've been in a high heel for many years, their posterior compartment of their legs. So their calf muscles, for example, might be shortened. They might have weak feet. So we're going to work on all these things as I slowly transition them, so I will meet them where they are, rather than saying, you know, shoe shame people, we don't want to shoe shame people. It won't work. So we need to gradually meet them where they are, give them, you know, empowerment, empowerment, and do these things, and then they start to feel better. And then the conversation switches. It's, I really like wearing these shoes. And then we it makes the it makes the transition much easier. And it makes sense. It just makes sense.

Dr. Spencer Baron:

No, that's true in clinical practice. You would, you know, I remember, you know, seeing women tear their calf muscle, and you know, they would wonder why, and then you'd find out that they work all day in a high heel. Did you see would you see that? And how would you advise someone, a woman, to or, I mean, high heels are, you know, typical amongst women that are into that fashion. But how would you advise someone to transition from there?

Dr. Courtney Conley:

If that has been an environment that they have been in for very long, it is a slow transition. Anything worth doing takes time, so we'll put them on whatever is necessary. Oftentimes, with the calf, when you see calf strains, it's highly correlated with a weakness in the foot. So for example, if I'm walking forward, you'll often see people kind of toe gripping right as they push off. It's why I'm not a big fan of exercises like picking up a marble or, you know, grabbing a washcloth. That's a compensation pattern that most of us can do very well, unless we've had a surgery or boot or what have you. But if I'm doing this all the time, I'm changing the structure or the function and the muscle tension relationship at my foot and at my calf. So for those people that have calf issues, or, you know, calf strains, we're working on strength of the foot and then mobility and or strength at the calf.

Dr. Spencer Baron:

Whoa, yeah, that's fascinating, because that's that was a typical protocol rehab for, you know, picking up marbles. I remember Miami Dolphins. They would have a tray of marbles, and they'd roll them out on the floor, and the player would sit there and just, you know, move the marbles or bunch of a towel or or move tissues. I mean, when would you do that there?

Dr. Courtney Conley:

I there's always a time and a place. You know, there's a time and a place for orthotics. There's a time and a place for certain surgeries, and there's a time and a place for that type of rehabilitation. But if we get specific and you really start to assess what the client is doing at their foot, I think we will see that a lot of us actually have good long toe flexor strength, as it is a compensation versus long extensor strength. For example, you know, in the gait cycle, this doesn't happen. I at heel strike, everything is more in a lengthened position, right? So I always take things back to function. What are we trying to accomplish here?

Dr. Spencer Baron:

Right? Oh, I love this. I

Dr. Terry Weyman:

got one question before we move on to going into gay cycle this, I want to kind of go back a little bit in the fashion. I had a model that come in, and she was so excited that she finally made enough money to buy these high heel shoes with a, I'm not going to say the brand name, but it's got a black shoe with a red bottom. And they're very, very, very expensive. And. And she was so excited to get these shoes, and yet, every time she burned her feet killed her and but it was such a status symbol to have these shoes, and they're so expensive. And I went, is it worth the amount of money you're I go, you either like anything, pay for health. You can pay for illness, you know. But how do we get this fashion trend to to actually, I guess you've answered that by just time. But the where these, these people aren't spending 1000s of dollars on a shoe that's killing them.

Dr. Courtney Conley:

I mean, I think with everything, it's the funding behind it, and that's why we have to get this education out there. I was just at teaching at the running event in Austin. So it's a big event that they have every year. All the footwear companies are there. And when I landed, you know, there's 1000s of people there, and I was walking around, I'm like, it's like an alien invasion of footwear. Everything was like, you know, there's springs, and there's, you know, some of these shoes were 50 millimeters off the floor. And I'm sitting there going, what is happening right now, like, or, and it's like, the the super shoe, and it's kind of the thing. But there is a time and a place. There is a time and a place to wear a super shoe. It gives you two to 4% running economy, because there's things built within the shoe. So if you want to line up to, you know, win a marathon, you're going to say to somebody, don't wear this shoe. And the guy next to you has a two to 4% increase in their economy. You have to work with them. Same with the fashion thing. If you want to wear this shoe, you can't make a functional footwear, shoe, a high heel. It just it's just never going to work. So you have to be able to have these conversations and say, This is a short period of time where the shoe to win the race, where the shoe to go out to dinner, where these other types of footwear for the majority of the rest of your day,

Dr. Spencer Baron:

and referring to a super shoot. What Is there a is there a super shoe, or you're just referring to being super, super

Dr. Courtney Conley:

so there's in the running world the super shoe are the shoes now that have the carbon plates. They have certain materials and densities to the shoe that basically can, you know, act almost as a spring to spring people forward. And it does increase. There's no question it's a performance shoe, but it does things like increases stride length. It changes gait mechanics, which, if you don't have a strong calf if you don't have a strong hamstring, for example, those are the types of injuries that pop up when you just throw those shoes on and think, Hey, I'm going to become a super runner in my super shoe. You have to earn your right. I always say that you have to earn your right to wear a super shoe, you have to earn your right to wear a high heel out to dinner, or you're going to pay for it.

Dr. Spencer Baron:

Do you love those finger shoes? The ones that were each individual. Talk

Dr. Courtney Conley:

about fashion.

Dr. Spencer Baron:

They seem, they seem biomechanically sound, but they never, they are caught on,

Dr. Courtney Conley:

yeah, the survivor and five finger the like five fingered shoes. It's, you know, it's allowing the toes to splay, to have dexterity. I don't think those will ever from a fashion perspective, I live in Colorado. We see people on the trails with those all the time. I walk

Dr. Terry Weyman:

my dog in them.

Dr. Courtney Conley:

Yeah, yeah, good idea, so, but I love, like, the fashion questions, because it is that is the biggest battle that I face. I got, I

Dr. Terry Weyman:

got another question for you on that, because I got in this discussion after the Olympics, when they were talking about the Super shoe and and how all the winners were wearing them. And I went, it's the same problem they were started having with the suits in swimming. You know, they were custom fit for these guys, and it gives them that 1% edge, while at the Olympics, 1% is the difference between a gold medal and 10th place. Well, there's a lot of countries that can't afford them because they're very expensive suits and the super shoes are very expensive. Do you ever see a problem with these other countries, these third world countries, where they can't afford them? Or do you see. That the sponsors or people will always supply at that level, those shoes for those people.

Dr. Courtney Conley:

That's a great question. I think gate is so environmentally and culturally um influenced, and, you know, at those levels, everybody's getting sponsored, everybody's getting sponsored by, you know, certain companies. I do think that there are companies out there now that are realizing the impact, and I like working with these companies because they realize the impact of what they're doing today is going to have a result of what they're doing in the future. And I like having that awareness. And those are the companies that care, right? You know, they care not only about the success of the athlete, but also the success of the person. And that, to me is, you know, extremely important. But at those high levels, I've had certain schools and coaches that I would say, Can you please not wear that footwear? And they're like, I have to wear this footwear if I'm on campus. So I write, I write a lot of letters, and yeah, the airlines. I write a lot of letters to airlines, because it wasn't until recently that the flight attendants had to wear a certain heeled shoe in the airport, yeah, on the airplanes. And these women were, you know, they're coming to me with neuromas in four foot pain. And I'm like, This is bizarre. This is antiquated. You should not have to wear a high heel, especially if a, you don't want to, or B, your foot hurts right, right?

Dr. Spencer Baron:

I I think of how the stiletto was. I mean, first of all, how do you balance on a little heel that's like, this big and yes, that was such a high fashion statement. You know, it takes practice. How do you know this practice? Okay, moving right along. I don't want you to be wearing your red bottoms, or whatever those things are. How long

Dr. Terry Weyman:

I save for those?

Dr. Courtney Conley:

I think one way around the stiletto conversation, and this is what I the conversation I have with my 13 year old. Listen closely. Dr, Terry is strong as the new sexy, you know, and that, that is the the verbiage that I'm using as she's starting to, you know, talk to me about all this. Is that, especially from a female perspective, strong is the new sexy, and that is where I'm hoping we can switch the script with some of this, especially for our women. Yeah,

Dr. Spencer Baron:

all right. So back to athletics. So we know that for you know, professional athletes, like some of those that you work with, Phoenix Suns or the New York Yankees, how does footwear? How do you find that footwear affects their performance or injury prevention?

Dr. Courtney Conley:

It's really interesting to me with some of these teams that they don't have a foot person, because the majority that I work with, there is not a foot person on staff. And especially with if you look around the professional sports world, we are building jet engines. So very big, strong athletes on paper airplanes, we're not paying attention to their foot. And if you look at a walking and a running gait when you're walking, you have four to six times your body weight going through your foot when you start running, that those numbers can jump up to 11 times your body weight. The good news is, our foot was designed to handle those types of loads. The bad news is, is we're not training them to do so. So with these athletes, you're not going to, you know, some of them like the snug cleat, some of them like, you have to have tools for the trade, and I understand that. But when you're not in the cleat, or maybe you have a different practice cleat, you better be looking at your foot strength. You better be looking at your calf strength, or your plantar flexion strength. That's push off, right? So, you know, training your everters, by the way. So. Coronavirus brevis, for example, is increases speed. We know that. So when we get specific about how we train the foot and ankle, you're going to see increases in performance. And I think of it as stacking. Let's go back to the super shoe, for example. If I have a shoe that gives me two to 4% running economy, and I have a strong foot and ankle, there's research that will also show you that plyometric training, so jumping, sprinting, things like that, will also give you two to 4% running economy. I take a strong body, a strong foot, a strong ankle, and then I put it on top of the super shoe on race day, you're gonna feel like you're, you know, running on an engine. You're, you know, I'm always cautious about saying injury prevention. I think sometimes you just have a bad day, right? But the better prepared you are, then when you stack these therapies, then you can get the results that you're looking for, and that's where I think we need to put the focus on. And then when you're not on game day, you're in a wholly, a completely different scenario, you're building Foot and Ankle strength, and that's when you're going to see the results you're looking

Dr. Spencer Baron:

for. You know, I think a great metaphor, as you're describing this, is when a batter goes up to bat, he puts the weight on the on the end of the bat and swings it around to get a feel for how hard it is. And then when he gets up there, that bat, when he gets up there to actually bat, it feels like, like a like a toothpick, yes. So that makes a whole lot of sense, and I think that would it's a great way to deliver to our patients some of what, what you're describing is viewed perfect now you comment on injury prevention and Dr Terry, I don't remember who I think was. Dr Tim Hewitt, our guests, are they taught, or was it Gary Gray? Anyway, they refer to risk reduction instead of injury prevention. I love it. Yeah. What a beautiful way to to put it. Risk Reduction, you can't prevent, you can't always prevent something, but you can reduce the risk. So I, I love that. Start adopting that nomenclature as well, moving into the idea of, you know, Achilles tendon injuries, one of the one of the or, or just simply, ankle sprains. One of two of the things that that still continues to this day, is when you're dealing with a sponsor for a big team, like, Oh, I almost said the name, nevermind. But when you're dealing with a big sponsor, like for the NFL, I remember several years ago, guys were coming in to our athletic trainers with ankle sprains, and it was pre season, and our head athletic trainer had the the wherewithal to to realize that there was a trend going on with the cleats, and he made a call to the to our big sponsor, or the contact person, and says, We are returning all The cleats that you have provided us as standard issue. They're causing an increased frequency at ankle sprains, and we haven't even started the season yet, and they had to send in a completely different pair, a better pair of cleats as standard issue is, you know, aside from you know, the obvious thing that you know, you know ballet slippers are horrible to the feet. Because I know you know firsthand. Can you make some comments about cleats? And I think that they're the cleat is probably one of the most neglected footwears ever.

Dr. Courtney Conley:

Well, I'm curious, do you know what they changed in the structure of that cleat that changed the mechanics of it.

Dr. Spencer Baron:

Now, that was several years ago. I was even surprised that they noticed that. But I

Dr. Courtney Conley:

think with any type of footwear, when we keep trying to make the footwear do more, you're going to run into issues. Rather than focusing on what we're putting into the cleat. For example, when we start changing, you know, when you think about, I don't know what they did to change the structure of the cleat, but if you look at the base of support of the cleat, if things are tapered right, and it provides a platform where the foot can't feel balanced. If there's more a lot of footwear, they will put changes to the medial aspect of the shoe, because everybody's trying to do what pronation we've deemed. Pronation in this world, it's like you have a flat foot, you better put something under it. And if you look at current research that came out in 2023 it's basically challenging our biases to everything we have been taught about. If I have a flat foot, we better put it's bad. If you have a flat foot, you better put something under it. So the foot has to recoil. The Arch has to change shape. So when we start designing footwear, cleats that start to prevent some of this from happening, you're changing what the foot was supposed to do. And I really think you start altering foot mechanics there, and I think that needs to be taken into consideration.

Dr. Terry Weyman:

That's so important. I got one thing on that, because, you know, at the school, I work at the d1 school, and now we have n i l money coming in. You also have these pros. They're getting huge footwear sponsorships. What happens if you get a sponsorship that's giving you a lot of money, and the these kids are wearing, putting these shoes on and their feet are killing them? Have you had experience with dialog of how to navigate out of this, where they can talk to their foot sponsors or whatever, and how to find this fine tune between being forced to wear something for money, but it kills their feet,

Dr. Courtney Conley:

yes, and typically what we have to do is custom, so we can have discussions with depending upon status, because some of these guys, they really want in their shoes. So we will have discussions with can you make the toe box wider? Can you alter the shoe to customize it to better fit what's happening? And those are you know that can be very important if you don't have that luxury. It's unfortunate, and it's the conversation, if you have to wear this, then you have to be doing these things when you're outside of that cleat. Have a different training cleat, if this is the performance cleat. But it is, it certainly is a problem. And this is what I don't understand, is pain affects performance totally. So

Dr. Terry Weyman:

and then you get these teams that the team is sponsored by a shoe company, and you may have your superstars that the shoe fits fine, but then the other guys, it doesn't fit them at all, but they have to wear it because they're part of the team. Yeah,

Dr. Courtney Conley:

I really, I'm in very encouraged, though, because one of the biggest, the biggest shoe mark or shoe company out there came out with a toddler shoe recently, and in their marketing for this toddler shoe, they said, we've done our research in this shoe will help the development of your child's foot. And in their marketing, it said it has a wide toe box. It has a flexible soul. Everything that we talk about, this is the biggest shoe company out there, and I'm sitting, I wanted to, like, get on the phone with the CEO and be like, yes, thank you. Why then? Why do you think that would change as we age? So I've seen this footwear world over the past five years grow at a tremendous, tremendous rate. You're seeing professional athletes. If you watch the NFL, they're a pregame there's a lot of these guys taking their shoes off in doing their warm ups barefoot. There's a lot of these guys wearing toe spacers. People are becoming aware, and I think that is why this is growing at such a rapid rate, and these high level athletes are starting to pay attention. This doesn't make sense. I had a football player that I was working with, and he was having pain at push off. He was a defensive lineman, so instead of addressing the problem, they switched him the other side so he could push off the other way. I'm like, please don't do that. It's bizarre, and this was NFL, so I mean, it's just, I am encouraged, though, because I think that the research and the education is is coming at a faster rate. And if the you know, if the guys with the money, unfortunately, that's how things happen, if they start to pay attention, we'll see this move in a direction that I think it needs to

Dr. Spencer Baron:

wow. Many years ago, our American Chiropractic Association Sports Council had a program or a symposium at the Nike Research Institute, and it was absolutely fascinating. The thing that was very I was. So curious about they have so much technology that gets into the shoe that that they, you know, we saw a demonstration of how a basketball shoe was being tested, and they did it under high speed photography on a court. And, I mean, we're talking high speed photography, and you can just determine the increments of change that go on with with with natural basketball related movements, and yet they still come out shoots that were compromising to the feet again, this was, like 20 years ago, or something like that. But, you know, I give them credit, but at the same time, they're sometimes clueless. You know, you

Dr. Courtney Conley:

know, I like to have the conversation of trade offs, that there's always a trade off when you look at footwear. And I think that's where these companies are getting a little, kind of a little skewed. A perfect example would be cushion, for example, there's, you'll see a lot of people walking around in very cushioned footwear. Why? It feels good? You put a you put on a shoe that has a lot of stack height, you're walking around the store, you're like, oh my gosh, this feels wonderful, right? It's giving you protection. It's squishy. But here's the trade off with that. The more cushion you have on the between your foot in the ground, the less sensory acuity you have, the less sensory perception that you have, you cannot feel. So the trade off for protection and comfort is sensory perception and balance. That is a problem. As we age, we lose sensation to our feet, and we also lose strength. So it's you're when you're having these conversations with, you know our elderly population, you're like, Well, we know that falls are a very big risk for you, but here's a big old cushion shoe like, that's backwards to me. So, you know, I love Michael Easter's book The comfort crisis, because I think we're, you know, we run around in society today. It's like, how can we get to be the most comfortable? And it's like, we need to realize that there is a cost for some of this, and that's when you dance. You dance along the shoe spectrum, wear your protection or your stability shoes when you're going on a long walk on man made surfaces, but then take them off or wear a shoe where your foot can actually feel the ground and start to gain strength, so that you can gain some of that you know, the benefits of Foot strength and sensory perception.

Dr. Spencer Baron:

Let's talk pasta, oats, grains and more. I'm gluten free, and this one item I can have without any consequences, since we always talk about fueling our bodies the right way, that's where Guardian grains comes in. No kidding, their products are a massive shift towards healthy eating. Guardian grains is all about healthy, sustainable grains that not only taste great, but are great for you and the planet, whether it's breakfast, lunch, dinner, Guardian grains has you covered with all kinds of nutrition that keep you going strong, perfect for long days of just living life plus knowing it's sustainably grown. That's a win. Win. Sincere appreciation goes to The Guardian grains for sponsorship of this episode and for making it easy to stay healthy while supporting sustainable farming. Click the link below the description to buy some of your own. You'll taste the difference. I love this. This is really this is juicy stuff, because the foot juicy so many sensory fibers in it. Sensory nerves are so rich in the foot that and think about it when, when your foot hits the ground, that information and how I described the patient, that information has to go all the way up to your brain. You have to make an emotional decision on which way to pivot move, or decide on what you're doing, even with your upper extremity, and at the same time, send the messages to the motor units of the feet to to do what it needs to do. It's such a complex reaction that we just take it for granted, and you're absolutely right. You got to feed those sensory fibers what the ground feels like. And I think that is that that probably one of the greatest messages that we can give to our our patients. I have, I have two things. I. Want you to comment on one is the thing that blows my mind that only very few athletes, especially in the NFL, get, and that is taping the ankle. That is a routine process before, before practice, before a game, they spat, they spat the ankle. So love for you to make a comment about that, and also about the opposite end of the spectrum, that barefoot running, and how that really feeds the foot sensation.

Dr. Courtney Conley:

I think it's interesting. If you look at the taping of the ankle over the years, it's like it's getting bigger and bigger, and you know, it's like you're using a whole roll of tape on these ankles now. And it's like, hold on a second. And it goes back to that conversation of building gigantic, strong bodies on feet that just cannot handle that load. And so instead of taking a step back and saying, we need to work on especially with ankle sprains, you can tape that thing as much as you want, but if you're not really focusing on proprioception and strength, then you know these extrinsic modifications are only going to carry them so far. So, you know, when you look at these increasing taping and all of those things, it can be beneficial, I think, in an acute situation, but we have to look at, you know, weaning off of these types of things and really restoring function. And I think that's really important, rather than just saying we're going to tape more and we're going to build you a bigger orthotic, and we're going to keep doing all of these things to mask an underlying issue that, from a functional perspective, can be can be fixed. So, you know, it's very similar when you look at a hiking boot, for example, because patients will always say, I really need a hiking boot, and they really do not need a hiking boot. There's really, there's going to be great research coming out and looking at the increase of ankle sprains in a boot and versus and not wearing a boot. And it's, you put it this way, by the time you're done, you'll be like, Why would I even wear that hiking boot? And it's interesting, because the more you restrict mobility at the ankle, so whether I'm taping it or I have a real stiff boot, that load in those ranges have to be transferred somewhere. So if I'm walking down a mountain and I don't have good ankle dorsiflexion, I'm going to shift the load up to my knee, for example. So it's, you know, it's not, it's just about restoring function. And when you talk about the whole barefoot running thing, it springs up like such a so many conversations. When we barefoot run, it completely changes, I think, how our foot interacts with the ground. Because, for example, you're not going, you know, to put it very simply, over striding when we run, if we wanted to just do one big kind of blanket statement over stride is the enemy. So how far in front of my body is my foot striking? We want the foot to strike as close to our center of mass as possible. Wow. So people will always, you know, it's that, it's the conversation of heel strike, midfoot strike or four foot strike, you know? And people are like, I feel striking. Is like, I don't heel strike. Most recreational runners heel strike. If you are running barefoot, and I'm over striding in my heel, my beautiful calcaneal fat pad that has all these, you know, receptors in it that are designed to give us information. If I put a big piece of cushion on there and I heel strike, what I'm not taking advantage of any of that. I can't feel any of it. So you're not going to barefoot run in heavy heel strike because it would hurt. So it changes the position of how you strike. So even when I have runners that you know, especially if they have knee pain or hip pain, I'll say, Take your shoes off. I want you to run back. Barefoot for a minute, you can put your shoes back on, because they're going to be like, Oh my gosh, I can't believe you just told me to do that, you know. And I'm like, it's going to be okay. You'll be all right. Your foot's very resilient. Okay, just run barefoot for a minute. Their gait will immediately change because things are not things will hurt if you land hot and heavy, so you run softer, you change how you land, then we can have the conversation of, you know, what type of footwear? There's a really cool study that looked at patients with chronic heel pain, plantar fasciopathy. And there was, it was it was a small study. There were like 20 of them, and their treatment was to run barefoot in the grass twice a week for 15 minutes for six weeks, which, if anybody has had chronic heel pain, you're like that sounds opposite of everything we were ever told to do because we need an aggressive orthotic. I need a really cushion shoe, and I need to keep offloading the fascia. 19 of the 20 people in that study reported with less symptoms, both at the six week and 12 week marker, and it was a COVID. You know, it was a small study, but I think this really needs to challenge our biases. How are we treating these conditions? Are we just going to continue to offload? You can't offload an Achilles tendon. Rest will make it feel better, but return to sport, you're not doing anything unless you load that thing. And I think that's the way we have to look at these foot diagnoses. Is you cannot continue to de load and offload. Things will get weak. Oh, my goodness, I am I get a little animated there. Sorry, jump through the computer. No, no,

Dr. Spencer Baron:

great, great. No. I don't even want to go back, but I got to go back and ask you a question that about some of my patients that have ankle sprains, we're seeing a rise in women's sports that is absolutely fascinating, volleyball, basketball, soccer and lacrosse, and they're spraining ankles. There's they're coming in, and there's a couple of them that will not get out of that, like sweeto Break that, that lace up race, that because they're afraid, they're and they're using that as a handicap. And I tell them, I go, that's becoming a crutch. It's weakening your the mechanic. So please, please talk about this for just a moment, and then we'll go back to the other stuff. I think with my athletes,

Dr. Courtney Conley:

I like to use objective markers, because pain is a poor objective marker. You know, you break up with your boyfriend, you're gonna have more pain. So, you know, that's where I think pain is tough, but with objective markers, especially with the athletes. So we'll test toe strength, for example. So we use a dynamometer in our offices. We'll test big toe strength, and I'll test the two through five, yes. FHL flexor hallucis, longus is correlated the weakness of that muscle with ankle sprains, if you can. I talk a little biomechanics here. Oh, sure, yes. So flexor house, longus is on the fibula. Starts on the fibula, so when you press that big toe down, and you have good big toe strength, it takes the fibula and it descends it. So now we have what, something there to help, what prevent another ankle sprain, or reduce the risk, as I should say, of an ankle sprain. So you will often see these athletes that have chronic ankle sprains, they cannot press their big toe down. I'll pull that card out. We look for about 10% body weight.

Dr. Spencer Baron:

Explain the card. Explain the card thing. So

Dr. Courtney Conley:

if I'm their foot's on the ground, and I will put in my office, will use the dynamometer, but you could simply put a, you know, credit card just underneath the big toe. And I'll tell them, these are the rules. You can't do what I don't want you picking up a marble, because they all want to do that. The toe has to press flat and don't let me pull the card out. You can't lift up the heel either. And your athletes, it's so funny, because they'll be like, you know, they're like, holding their knee down and, like, this is just your foot. Okay? Some of them, it's shocking to me. They cannot press down to get any I mean, you do, there's nothing even there. They should feel tension in the arch of the foot. And if we're testing the big toe, they should feel it up in the calf. And for these athletes, when they have that, they're like, wait a second, I can't do this. It's a very good objective measure and a conversation starter for. Me to have saying your big toe is how you push off. You want to be a good athlete, you better learn how to use your foot appropriately. And if you don't, where are you going to go? So those are good objective measures. The other one I love doing are calf raises, because it is shocking. So there's a study that we have that looks at per decade. So in your 20s, you should be able to do X amount of single leg, calf raises. 30s, right? Very rarely do we have people hit those numbers, they'll cheat, they'll toe grip. There's your calf strain. They'll lean into the wall, but they're not powering through their foot and ankle. So when an athlete comes in and they don't have any toe strength and they can't do a single leg calf raise, and I tell them, what do you think running is running is a single leg hop over and over again. So when you can't do these things, it should not surprise us. Then when we keep seeing injuries like this because things aren't matching. You know, in the capacity conversation, there's a Peter maliaris. He's very big in the tendinopathy research world, and there's a study that looks at baseline return to sport for runners. So if I was going to do a single leg calf raise, the healthy individuals were holding half of their body weight for six reps. So think about that. I'd have to hold a 70 pound kettlebell and do six single leg calf raises. Most people can't do body weight, let alone hold half of their body weight. If you were to go seated and do a seated single leg, calf raise one and a half times your body weight, six times. So these are the conversations I'm having with these NFL players. I'm like, Listen, guys, this is what this is the capacity that your calf has. This is the the load that's going through your foot and ankle. And I always use the word opportunity, right? You got to be real wise. You got to watch your words, yeah. There's nothing weak here, if we just have opportunity to improve, but there's always room for it,

Dr. Terry Weyman:

yeah, Doc, I got a question for you, yeah, and I want to see if you and I are on the same page on this, because I'll tell athletes, you don't wear mittens on your hands and do stuff where I wear mittens on your feet. And expect them to be individuals, right? So, but they're always going well, what can I do? Don't give them exercises. But I came up with something. I go if you're driving your car more than half an hour, take your shoes and socks off and operate, operate your gas pedal, your brake with just your big toe and and by doing that, it's, it's and go, and you have to leave the other four toes relaxed. And by just doing that, it's you're, you're doing what you're you're doing that. And I said, If you drive and you don't, you're not allowed to use cruise control. You're not allowed to use even you can just operate with the big toe. It's just something else. What are some other exercises that people could do in their daily life, while they're sitting at the office, or stuff like that, that can strengthen their feet and their lower extremity?

Dr. Courtney Conley:

That's such a good question, because it brings up such a good point. And this is the challenge I have with you know, in the NFL, they're like, we have all this other stuff we have to do. And now you're telling me, I have to strengthen my toes. I'm like, so you have to find ways to trickle it in. I like things like that from a balanced perspective. You know, I always say, you know, we're brushing our teeth for two minutes. One balance on one side for a minute, balance on the other side for a minute. I think it's McCue protocol. I could be wrong on this. Or they looked at collegiate athletes with ankle sprains, and they were balancing on like an air x pad. You know, incorporating those types of things with daily activity can be extremely helpful in the gym when you're strength training, take your shoes off, wear toe spacers. Just doing that can be very beneficial. You're getting sensory perception. You're allowing for toe alignment, you know. So that's a very good opportunity. Sarah Ridge did a did great research, where they just wore minimalist footwear, and they looked at hypertrophy of the intrinsic muscles of the foot, and just wearing the footwear showed increases in strength. So there's little things you can do that can. Have a great impact. And it doesn't have to be a thing, you know, we have little toe strengtheners. So when someone's sitting at their desk, or they're, you know, they're just lifting, spreading, reaching their toes, you know, I think all of those little things will go a very long way, because people don't pay attention at all. So a little bit is going to take them, is really going to carry them.

Dr. Terry Weyman:

You mentioned you mentioned them. I want to elaborate on that every patient of mine, whether they have a headache, a shoulder pain, a wrist injury, everyone walks out with foot exercises and toe spacers, every one of them, yes. And can you elaborate more on toe spacers and why they're so? Because I'll put some in there, and they're like, oh my, my podiatrist told me they have to wear cushy shoes and this and protect my feet. And you're telling me, go barefoot, wear toe spacers, and I have a shoulder injury. Can you elaborate more on toe spacers?

Dr. Courtney Conley:

I mean, I wear them every day. Just show you mine. I Yes, I It's like, one of the it's one of those conversations where, after you have the conversation, people would be like, Wow, that really makes sense. Why would I not do that when, let's just talk about push off when I push off when I'm walking, you want to be able to roll through the foot. If I have a toe that looks toes that look like this, think about it from balance. Wrap a rubber band around your patient's toes and have them balance and then put a pair of toe spacers on and have them balance. It's It's not a trick question. It's very clear what will happen. So right from the beginning, you're going to have a change in how they're feeling the ground. That changes into how they propel forward, they're going to roll through their foot better. These are imperative with patients with bunions, for example, because the bunion is not a problem here. It's a problem here. So yeah, especially if it's flexible. You throw those toe spacers in and you get them in the right type of footwear. It's like the lowest hanging fruit, and I think from a perception as well as the implications that has above the kinetic chain, it is a no brainer.

Dr. Spencer Baron:

You know, just to emphasize that whole toe strength thing, like I was mentioning earlier, Dr Karen slota, had you watch your program on with Peter Attia and I immediately had to go try the seated calf raise with one. What is it? 1.5 times my body weight, Terry, you have no freaking idea how hard that is. And I train so I and I go heavy. I thought, I thought my calf was going to snap, but that's, that's a lot. Yeah, it was pretty impressive, though it was. It's a cool way to elicit that, that that need to strengthen, because it gives you some inspiration you have to do. It's when

Dr. Courtney Conley:

you start training, especially, like, I'm a big fan of the seated calf raise, when you start acquiring strength there, gait is just, it's just easy, you know, in that's what it should be, walking, I think, is such an underrated activity. And it's the lowest hanging fruit everybody can do it. And when you start to have power at your foot and ankle, it that's we. That's what carries us. And it allows things like walking, which we should be able to do for very, very long periods of time to be enjoyable and easy.

Dr. Spencer Baron:

A little, a little trick that that we learned during I took a program in mild traumatic brain injury, and we had to analyze people's gates and to do so, you know, being that walking is the most primitive aspect of mechanic biomechanics. You would have people walk up and back, but they would be so conscientious that you're, you're watching them walk. So what we would do is have them access more executive level functioning. So we would have them walk, and we'd say, the months of the year or and then to step it up even more, you would say, All right, I want you out loud to say every other month of the year, yeah. And that you would see, you would see faulty mechanics come out. We would say, did you injure your shoulder? You because you're. Your arm, does it? Your left arm moves, beautiful, the right round. How did you know? And I go, Well, give me your phone. I'm going to videotape you, and you can see right? So that was really, that was, I go ahead. Go ahead,

Dr. Courtney Conley:

please. I love that, that neurological distraction. I have a very quick funny story to tell you. We were working with a patient of mine, probably one of the smartest. He was, like, building rocket ships. Very smart, socially awkward. He knew that. And we were working on his gate, and he was, we were assessing his gate, and he was walking really stiff. And so I was like, okay, and we did the same thing. I said, I want you to out loud, name states. So he starts walking down my gym, and he goes depression, anxiety, fear, and this guy starts naming states and minds, and we just died. And he was laughing. I was like, I was looking for New York. But you know, that'll work. And it was, it was, it was one of my favorites. But we had, we all had a good chuckle there. But it does change everything when you can, you know, neurologically distract what's happening. That's

Dr. Spencer Baron:

Wow. So let me ask you one other thing in reference to something you said, you know, I noticed that the just the idea of running biomechanics, has evolved over the years. It used to be, you know, people would land flat on their foot, or then it became heel toe. And then i i noticed as I got older. I mean, I I'm not, I'm not a runner by any stretch of the I run. I've been running since I was 10 years old. I love running. It's a thing for my head. But I noticed my gait has changed as I age and and because I do a lot of you know, I've always weight lifted. I thought that my, my gosh, my quads and my my hamstrings have shortened, but my gait, stride is shortened. And you made a comment about that being an important approach to natural running. Could you just, could you just elaborate a little bit more about a shorter stride and and more of a minimalist shoe? Maybe?

Dr. Courtney Conley:

I think, yeah, so there's kind of some layers to that. I think the important thing to understand is that the ground reaction force doesn't disappear when we change different strike positions. So when we are heel striking, you have more ground reaction force going through the knee and the hip, for example, when you switch to a mid foot or forefoot strike that ground reaction force doesn't disappear. There was more load going through the foot and through the ankle. So we can work with our runners in modifying strike pattern to change load. So if you were running, for example, and you're running and said, you know, my hips really bothering me, I would look at something possibly like increasing your cadence. There's thing, there's research that will say of increasing cadence by 5% will decrease knee pain in increasing cadence by 10% can decrease hip and low back pain, and the reason for that is the faster feet. So I can't really go faster feet if I'm hitting all the way out in front of me. So you have to bring the foot under you a little bit more, and that will, in turn, change the stride length and the strike patterns. So I think those are all, you know, fun, and you know, they're not so easy. Changing cadence is not easy, but, you know, I'll have my patients listen to a metronome, like just download a metronome app if your cadence is 150 increase it by 5% listen to it for five minutes, turn it off and try to match it. So then you can kind of work with people on, hey, I still want to run, but I have knee pain, and that's one of my biggest kind of pet peeves, when people are like, my doctor told me I can't run anymore because I have knee pain. I'm like, No, you just need to work on how you're running, because it's actually very good for your knees.

Dr. Spencer Baron:

That is fantastic. Okay, we are very attentive to the time here, and we have to go through my one of our favorite parts is rapid fire questions. They sometimes have absolutely nothing to do with what we've been talking about. Okay, but you're quick on your feet, and I believe that you'll be able to handle this quite well. So we got five questions. Tell me, Okay,

Dr. Courtney Conley:

I'm ready. All right.

Dr. Spencer Baron:

Dr Conley, question number one, what is your favorite outdoor activity to enjoy in Colorado's Great Outdoors

Dr. Courtney Conley:

right now, snowshoeing and cross country skiing.

Dr. Spencer Baron:

Snowshoeing is that biomechanically sound?

Dr. Courtney Conley:

That's why I love living out here, because every season you can, like, switch it up. I, I, I've converted from downhill skiing to cross country. My I can't ski with my daughter anymore. She's too

Dr. Spencer Baron:

good. There we go. Okay, Bucha. All right, when you question number two, when you need a little pick me up, what is your go to song? Oh,

Dr. Courtney Conley:

Pearl Jam. Yeah, Pearl Jam. I'm a big Pearl Jam person, so yes, always Pearl Jam.

Dr. Spencer Baron:

Oh, any song there, right? Yeah. Love it. Question number three, if we went into your room, what book would we find in your nightstand? Keep it clean.

Dr. Courtney Conley:

No. Currently, think again. Adam Grant, really, it's a it's wonderful on how to challenge our biases and rethink what we're what we've been really trained to believe and think

Dr. Spencer Baron:

say the name of the book again, think again.

Dr. Courtney Conley:

Adam Grant, yes. Great

Dr. Spencer Baron:

question number four, if you could travel anywhere in the world for a vacation, where would you go and why?

Dr. Courtney Conley:

That's such a good question. I love to travel. My I have a love, a love affair with Australia. I went to school there, and I've taught some courses there. I got engaged there. So that's always kind of my go to spot. If I had to go back

Dr. Terry Weyman:

where in Australia, I

Dr. Courtney Conley:

went to University of Newcastle. But, you know, so Sydney, Newcastle, Perth, I've kind of floated around, and they're just wonderful people, and I've always enjoyed being there. So

Dr. Terry Weyman:

if you So, as you go east coast to west coast, if you could go back for a vacation,

Dr. Courtney Conley:

really, probably east coast. There you go, Byron Bay, all that stuff. I love that. Yeah, Bondi Beach, yeah, yeah.

Dr. Spencer Baron:

Question number five and the last one, what's a hobby or interest you have that might surprise people?

Dr. Courtney Conley:

Well, it's funny that you ask that, as I have my first piano Christmas recital next week. I used to play as a kid, and I've been talking about feet so extensively for 20 years. I'm like, I need to, like, tap into other parts of my my existence here. So I started taking online piano lessons about a couple months ago, and I had my first piano recital. Awesome.

Dr. Spencer Baron:

I'll bet you're good at using the foot pedals underneath the paper.

Dr. Courtney Conley:

That's when I use that FHL. I'm getting some good action there with that. FHL, always barefoot. Always barefoot. Great.

Dr. Spencer Baron:

Okay, one, we got one last Bonus Question here. Question five A is, what is one trick to keep your feet healthy that you do or suggest if

Dr. Courtney Conley:

you have the opportunity, and it sounds counterintuitive, even if you've had pain, just take your shoes off and just walk around, let your foot feel the ground, even if it's for a couple minutes inside grass sand, and just start to allow your foot to feel things.

Dr. Spencer Baron:

Oh, that is fantastic. Well, that was absolutely, you know what? Dr Terry, I know we have, like, we had so many more questions that we want to ask. These were absolutely beautiful. This hour went by so fast it did. We really thank you so much. It was fun. It was funny and extremely informative. And some of the things I can't wait to tell I can't wait to have patience listen to some of the things that you have been backing us up on and adding to that would help with their their rehab or recovery or or, you know, just anything. I appreciate

Dr. Courtney Conley:

this so much. It was so fun. Thank you both. Thank you.

Dr. Spencer Baron:

Thank you for listening to today's episode of The cracking backs podcast. We hope you enjoyed it. Make sure you follow us on Instagram, at crack and backs podcast. Catch new episodes every Monday. See you next time you.