Dr. Conley brilliantly reframes walking speed as a sophisticated diagnostic tool rather than just a fitness metric. It is a powerful reminder that the most profound indicators of longevity are often found in our most basic biological movements.
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Gait Speed: The #1 Predictor of All-Cause Mortality | Dr. Courtney ConleyAdded:
I think this should be on every single physician's prescription pad. This is the number one thing that we should be doing. It is the panacea of medicine.
>> You actually call in your book walking the most underprescribed medicine. Why is walking so crucial to our health and longevity?
>> As a human species, as a biped, it is literally what we were designed to do.
It's a core biological input that literally stimulates every single system in our body. And I want people to start thinking about walking like they do breathing and sleeping. That it's this physical necessity, not necessarily optional. When you think about breathing and sleeping, those things need to happen every single day. Well, you need to have quality respiration. You need to sleep well. And walking needs to be added into that trilogy if we want to thrive, if we want to live well into our later years. When we think about a step count, for example, when you look at dementia, if you wanted to reduce your risk of getting dementia by 25%. What do you think the step count would be for that? A daily step count.
>> Ooh, I don't know. A lot of people see different numbers that are out there.
They're probably thinking like, I need to hit like 12,000 15,000 steps, >> right? And that's what, you know, we'll get into the to those higher step counts, but it's 3,800 steps a day.
3,800.
That's not a lot. That's very digestible.
If that number goes up to 9800 steps per day, you can reduce the risks of dementia by 51%. So, this is science.
And I'm when I'm reading when I was researching all of this for the book, I'm going, we need to be telling everybody this. This should be at a minimum we should be getting telling people 3,800 steps if you want to facilitate your brain health. And there's really cool things that happen to your brain when you have regular aerobic activity.
And you know one of those is you have increased blood flow. So we have increased blood flow, increased heart rate, increased blood flow to our brains and in particular at the prefrontal cortex. M this is where we have decision-m in focus.
>> You know, we're going to go into it in a second, but you talk about in the book how walking has been engineered out of modern life and when we take something like dementia and also related to it, cognitive decline, Alzheimer's disease.
When we take those things, those are on the rise. And a lot of people listening today, I think like 75% of my audience is women.
>> Yeah. above the age of 40. Many of them don't know that actually women are at twice the risk of getting Alzheimer's disease than men. And that's a whole separate conversation. We've done podcasts on that. But this idea that you can reduce your risk of dementia by 51% by hitting 9,800 steps a day, that should be on the front page of every news that's out there. as a a single mom that's about to turn 50. When I was reading these numbers, I was like, "Okay, I'm busy." And I know that there's a way that we can start to fit these numbers in these numbers. A five minute walk is about 500 steps. A 10-minute walk is about a thousand. So, I think that makes it very digestible for people to understand, you know, and just thinking of your audience here, too. Like, when I go to pick up my daughter from basketball, if I'm 10 minutes early, I'm like, perfect, I'm going to park the car and I'm going to go for a walk for 10 minutes and I'm going to grab 1,000 steps. That was one of the things that I wanted to, you know, really encourage people that we can find little places within the day to squeeze this stuff in and the the effects that it has on your health are so profound.
>> Yeah. You know, there's couple ways of looking at it. Some people say that, hey, walking is a great added bonus to your life. And yes, you're not saying that sure, we should be walking more, but the mindset shift that's there is literally that if you don't walk, you're ignoring your survival and you're ignoring your opportunity to thrive in the modern day and age.
>> If you were to think of it as taking little, we talk about this in the book, like little movement snacks throughout the day. Uh, one of the questions I got asked this week was, you know, what's better, sitting or standing at your desk? And I said, "Well, neither really.
You're still you're still stagnant. The body still isn't moving. We as species were designed to move. We need movement variability in breaking up our day, even whether it's for 5 minutes or 10 minutes with this walking, this repetitive low to moderate intensity activity, it has so many effects on the other end of that in just these small doses. Do you think going back to cognitive decline, dementia, Alzheimer's disease, all these different diseases of the brain which are on the rise in modern society and it's not just cuz we are living quote unquote longer. There's so many factors that are there. When you look at our ancestors who are walking so much more than we are, do you think that walking and the lack of it could be the central driver, one of the central drivers behind these diseases?
>> I do. I do. I think that this lack we are moving literally in the wrong direction.
because so many of us are moving so much less. The average step count is about 4,700 steps, which means that there's many of us that are walking less than that. One of the beautiful things I loved reading about and studying was the concept of neuroplasticity, which is basically our brain's ability to reorganize and adapt. And I think that's such a conversation of hope because when I have my patients that are in chronic pain, I always talk to them about neuroplasticity. No matter what you've been through, addictions, traumas, pain, we can start to reorganize and change your brain with something as simple as walking because it stimulates this protein BDNF, which is brain derived neurotrophic crap factor. Think of it as like fertilizer to your brain cells, to your neurons, and it helps those neurons grow and it helps them um maintain basically their function. So when you look at it from that perspective, it's like, man, all I I just have to walk. And I'm like, yes, just start walking more and you reap these benefits from a neurological perspective that, you know, I don't think really can be beat. You know, one of the things you talk about in your book is that you regularly meet with people that you take care of, your patients that are out there, and you'll talk to them about the benefits of walking. And most people have actually no idea how little walking they're doing in their life. Which is why an episode like this and a book like yours is so needed because we think it's kind of like the fish and water. Like I don't know who discovered wa water, but it wasn't a fish. Like we all think, oh yeah, I walk a little bit. I'm going around the house. I'm doing this. I'm doing that. But most people are walking so little. Talk about your patients and that.
>> That's such a good point. So even my with my own like personal history with this, when I'm in my clinic, I feel like I'm always moving. I mean, I'm with patients for eight hours a day. I'm never sitting. And at the end of the day, I'll look at my watch and I'll see how many steps I took. And I'm convinced that I'm like, well, close to 10,000 and it'll be like 4,000 steps. And I'm like, wow. Because I have ambient walking, right? So, I'm walking around my office, I'm walking into the gym, I'm doing all these different things, but there wasn't any repetitive, intentional walk there.
So, it's a good reminder for me that when I get home that night, regardless of how tired I am, I know that if I just go out for 10 to 20 minutes, I can take that number, that 4,000, and get to 6 7,000 steps, and that's that's a minimal day for me, but that's right where I want to be. So, it's a good marker for people if you can figure out your baseline because I you're correct. I don't think people realize that even though they may be active moving what that step count looks like.
>> Going back to this idea that we shared earlier that this book is really putting people in the sense of like shifting their entire mindset number one by getting this incredible information about the power of walking as medicine and we're going to continue to drill into that. But then number two about how beautiful our feet are as a central process of allowing that medicine to take place. And then number three, from the way that I look at it, how to actually turn this into a plan >> that stays with you because consistency over time is key. Did I get that right?
>> You got all of it right. I always get excited when we start talking about feet, too.
>> I know. I know. People love to talk and hear about feet, especially when they understand how crucial it is to their longevity. So, just because we're on that, right? Just because we're on that, the last time you were on the podcast, I think we had a clip that went super viral that you had shared and it was this idea that your big toe is one of the predictors of longevity. Okay. You brought up feet. I save that for later, but since you brought it up, give our audience a reminder of big toe, feet, longevity, survival.
the importance of walking and protecting our feet over time.
>> I think when we think about walking, if you were to ask anyone, what do you want the last decade of your life to look like? That's going to vary across the board, but I can probably be pretty certain that everybody would say they want to be able to walk.
And when you think about the body part, the only body part that interfaces with the ground that is designed to keep us upright and balanced, I don't think most of us think about it. And that is our feet.
Our feet are sensory organs, if you will. And there's thousands of receptors in our feet that are designed to gather information.
And this is what keeps us upright and balanced. You'll see with the the baby when you see children, the first thing they want to do, babies, is take their shoes and socks off because their little brains are going, I'm developing. I want to feel things. And so their foot wants to feel the ground.
Because that stimulation, that sensory stimulation is what's going to keep them upright and balanced.
When you look at strength of the foot, the big toe, if you were to measure strength at your big toe, in my office, we have this little like it's a little dyno dynamometer, and you can actually measure how strong the big toe is. And I think most people should figure out how strong their their big toe is.
It should be at a minimum about 10% of your body weight. The big toe, the muscles that surround the big toe are responsible for posture.
They're responsible for balance.
And it also again weakness at that structure at the big toe at our toes is a risk factor for falling as we age. So we know that sarcopenia is a thing. Okay, we lose muscle mass as we age. But do we think about that at our foot?
Because if we lose muscle mass, that doesn't mean you don't lose muscle mass at your foot. You lose muscle mass at your foot. Your foot gets starts to lose strength. You also start to lose sensitivity to the receptors in the feet that keep us upright and balanced.
So all of these things, if we want to stay walking as we age, the most important part of our body that we really need to pay attention to is how we're going to stay upright and balanced. And that is our feet.
>> So important because we often ignore our feet.
>> Yeah.
>> We cover our feet, we hide our feet, and then we spend our entire life not knowing it. But our feet are are are shaped in a way that goes anti in the complete opposite direction to what would support our longevity.
>> Until you've had foot pain, I don't think we think about it. One out of three people over the age of 45 experience foot pain. That's a very high number. Next to low back pain, foot pain is one of the highest diagnoses that people will suffer from.
And until you've had foot pain when you're walking, I saw someone the other day and she goes, "You know, Courtney, I have I'm starting to have pain in my big toe." And I never realized how much it alters my function. Because you can have low back pain and hip pain and shoulder pain and neck pain and still go for a walk, but if you have foot pain, you don't want to do anything. You don't want to walk to the mailbox.
And very quickly your not walking to the mailbox for one day turns into a week and then it turns into two weeks and then it turns into months and then you're in my office. And so a lot of the patients that I see are under 2,000 steps a day, under 2500 steps a day for years because their foot started with an injury. it was never appropriately taken care of and now they're afraid. So there's this this complicated factor that is happening that started with a muscularkeeletal diagnosis that is now complicated by emotional and mental um fear. It's a completely biocsychosocial um issue now and it stops people in their tracks and it's heartbreaking to me. It's why I'm doing all this. It's so heartbreaking and that is literally the driver of your of your work that's out there. You know, let's build a little bit on this thread that we were sharing earlier like what's actually happening in detail when we're walking.
>> Yeah.
>> Right. Because it's a unique thing. You talk about in the book how humans we were built to walk, right? We were born to walk and it's a central part of what has allowed us as a species to do all the things that we can do. It's it's made us even, you know, this is kind of surprising for people to hear. It's made us more resilient.
>> Yes.
>> Than a lot of the animals that are out there, animals that we look at and think like are so tough and strong and can do anything. Our ability to walk has actually helped us win as a species and allowed us to do many different things including having the big brain that we do. Yeah. Can you talk about that?
>> Humans were designed to walk. It's a bipeedal locomotion. When we went from quadriped to a biped, there are there's many reasons for that. It allowed us to become um more efficient. It allowed us to start using our hands. we had more energy to be used for our brains. Um, so there was a lot of reasons why we started walking on two feet because of the efficiency that that has enabled us to do.
You have to be able to maintain your system in order to walk long distances.
When you look at the foot, for example, it's always interesting. Like I'll have patients come in and for something that we were designed to do, it's always interesting for me to hear when they say, you know, I just feel like I'm walking weird or I feel something feels off or I don't feel like I can walk very long or I start having pain after about 5 minutes. Now, because we have evolved to be very efficient endurance walkers, the question we have to ask ourselves is why? Why is this happening?
And when you look at the foot, for example, when the foot hits the ground, there's these beautiful things that occur that allow us to absorb shock, not only at our foot, but at our knee, at our hip, and our low backs.
So that's where I think the the conversation between feet and walking go hand in hand because we have to be able to take care of our feet in order to walk long distances and also for the effect that it has above the kinetic chain.
>> You know, I love connecting everything that you're sharing about how powerful our feet are when taken care of, right?
When taken care of. They're so powerful for us along with these ideas of things that people know that they care about, right? They care about longevity. They care about aging well. They care about health span. And something that a lot of people would not be uh aware of is that walking speed predicts how long you live, which directly connects into our foot health and how strong our feet are.
Can you talk about that? When you go to a doctor's office, they take your vital signs. They take your temperature. They look at your oxygen saturation. They look at your blood pressure. They take if they if there's something wrong with any of these vital signs, it's like a red flag. They're like, "Hey, let's do something about this." It's an indicator that something could be going on.
And everyone stops and figures it out.
In the book, we talk about how walking speed is the sixth vital sign. And here's why. When you have a slower cadence, so when your walking speed is slow, this can be a predictor of things like dementia up to seven years in advance.
That's a big deal.
>> Huge. So, if we were able to identify with someone's walking speed, hey, why are you walking slowly?
Is this an indicator that there's some type of cognitive decline happening? Is it an indicator of muscularkeeletal weakness? Is it an indicator that there's something wrong with your balance or your coordination? It's a signal. It's a warning sign saying, "Hey, pay attention to me."
And that's where I think this conversation is so important because we want to be proactive with our health, not reactive. And if we have something like Gates that can predict something like dementia up to seven years in advance, then let's do something about it.
And when you look at the research of taking advantage of all these health benefits, a lot of the research will talk about walking speed. What should you be walking? How fast should you be walking?
And the research will say around 3.5 miles an hour, 4.0 miles hour, which is a little bit faster than that than I think most people realize. So the way you can kind of look at that at home is if you were to count how many steps you take per minute, you'd want to be around 135 to 140 steps per minute. And that's a fast clip.
>> Yeah, it's fast. Anybody who's been on a treadmill and put it up to like >> 3 and a half miles per hour, four miles per hour, it's like, okay, you're you're that's pretty quick. You're not, you know, >> it's >> it takes a it takes it takes some real focus.
>> Yes. Um I was I'm flying today. So I'm always before I fly, I'm in the gym on the treadmill. 4.0 miles per hour is about a 15inute mile for 30 minutes. So you want a brisk fastpaced walk for about 30 minutes.
And that's um you do your stride length changes. You have to shorten your stride a little bit. You know, you put that on an incline and you're getting your heart rate into zone two, sometimes zone three depending upon how high you climb. I live in Colorado, so I live at elevation, too. So walking around at that pace for 30 minutes up and down a mountain, you know, it's no joke.
>> Yeah. Going back to this idea that walking speed predicts dementia up to seven years early. A lot of people could look at that if they've heard about it for the first time and think, "Oh, wow.
Okay, so if you're on your way to getting dementia, something going on that prevents you from walking as much."
But it's kind of the other way around if I'm understanding that. or well they might be both connected in different ways is that if you can't walk that is actually a signal that all these things all these benefits that you're getting from walking regular like glucose control blood sugar all all these different aspects the BDNF for your brain those things not being around is actually correlated with the likelihood that your lifestyle is contributing to one where your body is creating the environment for dementia to exist or come a lot earlier than it should. Sorry to interrupt, but memory loss is on the rise. And that's why I've created a free guide that you can get right now featuring the top brainoosting foods that you can include into your diet starting today to help you combat this. I've worked with a few of my friends to feature five foods in this free guide. And guess what? A couple of them will probably surprise you. Make sure you're one of the people that focuses on keeping your brain sharp by downloading this guide today. Just click on the link below or scan the QR code and I'll send you the guide right away.
That's such a great point. That's such a good point because I think when I'm talking to my patients, I'm always talking about stacking behaviors.
There's not one fix out there. You have to look at your health as a as a whole.
And so if we my foundation that I use with my patients is foot health and walking. So when we have the conversation of how important this is and I say to my patients, hey, we're going to start walking faster. You're going to walk more frequently. You're going to take care of your health. The squella of that is that they start sleeping better and they start eating better. And so it has this impact globally rather than just me saying,"I want you to increase your walking." And so that's my entry point, my scope with my patients. There could be someone else that says, "I'm a sleep expert." Well, this is where that trilogy comes in. If if I was a sleep expert and said, "I want you to start sleeping better."
Guess how you're going to feel better, which means you're going to start doing what? You're probably going to walk more.
So they all kind of feed one another.
And that's why I think this tool because it's so easily accessible can be an entryway or a neurological window to really opening up someone's health and improving their health.
>> What are the top reasons that your patients and people that you talk to say that they're not walking enough?
>> Pain.
>> Pain is number one.
>> Pain is number one for me. And for sure, you know, you are somebody that deals with that. So that's why people come to you. But people understand the statistics. What was it? One out of every four people, >> one out of three.
>> One out of three.
>> Mhm.
>> One out of three is going to be dealing with foot pain at some point in time or knee pain or some sort of pain that's there that prevents them.
>> So number one is pain, which is crazy because if you read your book, you see how we'll be diving into this more soon.
You see how at the first signs of pain people pull back and that's the worst thing they can do. We'll come back to that. Okay. So number one is pain.
>> Yes.
>> What's the next one?
>> We've engineered our way out of walking.
You know when you look at some statistics for example after COVID when people started working from home more we saw saw a drastic decrease in step count because we didn't have to really go anywhere. You can now work from home. We can stay in our houses. We have, you know, very easy ways to get around. And I'm not saying that technology is bad there. It's wonderful. But you also, it with technology comes great responsibility. And so we have to be very well aware that we have engineered our way out of, you know, moving as much as we should. So we have to be very diligent and very aware of when we can take these little movement breaks so that we can make sure that we're stimulating our system. So just the fact that um ease in the modern society has decreased our activity levels pain. And then the third one that I think is very important and probably most people don't think about is their footwear.
>> Amazing. Okay, we're going to talk about that. Going to the second one that we've just engineered it. A lot of times people don't even realize how much their daily life has been set up even if they're not trying to walk less.
>> They just >> they just inherently do it because it's this millu that we were all kind of born into, >> right? Give us some examples of simple things that people are doing on a daily basis whether they realize it or not. It just becomes habitual and it ends up creating a situation where they end up not getting as many steps as as they could.
>> Well, I mean, I'm just thinking about my past 3 days being here and I was in my hotel room and I I did not have to leave that room.
I had to actively decide to leave, but I could get all my work done. I could hold all of my meetings on Zoom from my computer. I could order everything that I needed from Door Dash and the conveniences that we have. I could have been in that room with probably under a thousand steps. We have so many ways that we can just have things brought to us where you start to take away those steps. You don't think about it, but if you're like, "Oh, I'm going to go to the grocery store." You probably grab a lot of steps, a couple thousand walking around, parking your car. But when we don't have to do those things, when things get or brought to us, it's just a little way that we're slowly engineering our way out of movement.
And that's not what we want to do.
>> It's crazy because we can do more, right? I'm putting this in air quotes.
We can do more. We can fill more. I even look at my schedule sometimes and I'm like, >> "Oh, wow. You can get an extra meeting."
>> Yeah. You can add so much more because we're able to do things through the computer which is beautiful. We can do all this stuff.
>> But then what gets crowded out if you don't actively fight to include something like walking >> which also is really great when you're doing it outside. You're getting sunlight.
>> Yeah.
>> You're supporting your vision health and you're not, you know, so tunnel vision on the computer. You're supporting your mental health. You're getting fresh air sometimes depending, you know, on the day in LA.
that's out there.
>> So, there's so many benefits that are there, but you have to like fight for it. You really have to fight to prioritize it. Otherwise, >> our modern world will suck all of that >> out of you, and you'll wake up one day and think, I don't feel good.
>> It happens um slowly. And I don't think a lot of people realize how poorly they start feeling because it's this gradual decline.
And I have my patients that come in all the time and it's been this slow trickle of decline until the point where they just feel miserable and then that's we have to start at baseline. You know, I was thinking this as you thinking about this as you were talking too. An interesting statistic that I always think about is did you know that in national parks there's more paved roads?
And so a lot of people you think you're going to a national park where you're going to be walking around, but you can pretty much drive up to most of the monuments or things that you want to see in all these national parks. And a friend of mine was saying if people would just get out of their cars and actually walk around the area, you'd have a better view or you'd be able to actually move more. And I always just found that to be interesting that even in a national park, we have engineered our way out of walking around and moving.
>> This really goes back to this idea of a mindset shift. Once you see it, >> yeah, >> just how much modern life by default has engineered walking out of it, you start to now think of the opportunities that are there. You know, >> you've mentioned you're a business owner, you're busy, you you're an author, you're doing a lot. There's a lot on your plate. You mentioned you're a single mom. Yeah. Right.
What are the ways, you know, let's just give people a couple little things that you're doing as we continue in the conversation to make sure that even you are having those cues, time slots, those opportunities to get um, you know, even 500, a thousand more steps in the day, which which is not just good for your long-term health, but actually just makes you feel better on the course of the day.
>> This was a fun part of the book to write. Um, we talk about taking a time inventory.
So, you can do this for one day, two days, do it for a couple days during your weekday and just take go through your day on an hourly basis and see what's happening.
And then if you look at your time, think of a couple categories.
Are there any places where you can either substitute stack or squeeze a walk-in. So, what I mean by that, let's say in the morning you find yourself scrolling on social media for 30 minutes. That would be an opportunity where you could substitute a behavior, even if it was for five minutes.
The second example would be to stack a walk. So, the example that I like to give for this is I um my mother lives in Pittsburgh and I'm in Colorado and she's Italian and I talk to my mother three times a day. And so when I get home from work, if I don't have my steps in and I haven't talked to my mother, one of those is going to give me a bigger problem than the other. So, what I started doing was stacking. So, I have my headphones. I will go for my 10-minute walk, but I call my mom. So, I'm starting to stack behaviors. And that has turned in Drew to one of like my favorite times because I'm outside.
I'm telling her about my day. I'm walking and it's just it's a really it's really special to me. Um, and the other is to squeeze it in. So, I talked about that earlier. If you're picking up your kids, you can go a little bit earlier.
If you are in between meetings, keep in mind that you this these little micro walks of 5 minutes or 10 minutes can have a profound effect on your health for every system in your body. So we have these opportunities if you can take this time inventory to look at is there a place where I can substitute am I that where I would be not wasting time but I could be doing something more productive like walking. Can I stack a walk or can I squeeze it in? And I think when you look at your day, you'll be able to find these little windows of opportunity.
>> Yeah, it seems so small and it is in the way of incorporating it as a habit, right? These are all very doable things, >> tiny things that you could be doing on a regular basis. But when you zoom out and you stack these things together, you understand now how something, you know, I didn't even know this research and I feel like I'm always looking in this space, how something like walking more, especially faster walking can lower the risk of cancer.
>> Yeah.
>> Like that's crazy.
>> Crazy, >> right? Can you talk about that?
>> When we looked at that research, it was brisk pace walking for 30 minutes. And if you look to five to 7,000 steps, you can decrease your chance of getting cancers by 11%. Five different types of cancers. That number jumps to 16%.
When you get to 8 to 9,000 steps with this 30 minute fast-paced walk. I mean that is so profound to me when you look at cancers, diabetes, dementia, like these pretty significant diseases that a lot of us have been touched by.
Walking faster for 30 minutes a day can help reduce the risk of these things.
I mean again on every prescription pad on every single prescription pad.
>> Yeah. It's not just that walking is medicine in the way that I'm looking at it. actually not walking and being sedentary is poison for the body. You know, it's scary. But the beautiful thing about it is that when people really get it and I hope that the audience is like, you know, feeling that enthusiasm and excitement and sort of, you know, getting that bug for walking >> is it's so within your control no matter how busy you are.
>> Yeah.
>> Because you don't need any equipment.
You don't need anything special that's there. Everybody has that opportunity.
Sure, it can take a little bit of work to re-engineer your life to go against the momentum that's trying to get you sedentary.
>> But it's all available for you. It's just really actually feeling motivated enough, excited enough, and now saying, "I'm going to make it consistent as part of my lifestyle."
>> It's an immediate mood enhancer.
like and when you have something just like you said that's so easily accessible that if you do not feel well mentally, emotionally, physically and you have the opportunity to walk out your front door for 5 minutes, I guarantee you, I 100% guarantee you that in those five minutes you will feel better. There's not much else I think you can say that we do that can produce that type of result.
>> It's crazy because so many people have this feeling and I've had this feeling where you have such a busy day or a busy day turns into a few weeks or a few months for people and then you finally get a chance to go out and really say like, "Ah, I need to like go and take a walk." And you're outside, you know, in the sunshine, even if it's cloudy, it's so much brighter outside than it is indoor. You're walking, you're getting fresh air, and you're like, "Why the f do I not do this more regularly? I feel amazing."
kicking yourself for forgetting how good you feel with something as simple as a walk.
>> You know, one of the um >> other things that I'm so grateful for >> when I was working on this project was the research that I found for relationship walks.
And you made me think of that when you're like, man, why don't we do this more? I have I mentioned I have a 14-year-old and there is research that we found that should be of no surprise that when mothers and daughters walk together, their communication improves and their relationship can change. And when she walks in the front door after school, this is the other beautiful thing about watching someone walk. You can I can tell if she had a good day, if she had a bad day, what happened with her friends just by her gate, you know? I that's what's beautiful about walking gate.
It's like a window. It's a neurological window to your soul really. And so I'll ask her, "How was your day?" "Fine."
"How are your friends?" "Fine." "How were your classes?" "Fine." "Can you take me to Starbucks?" Like that's that's what happens, you know? And so as I was doing this, I'm like, "Gosh, Courtney, just have her walk with you after dinner," which is almost like pulling teeth, by the way. But I said, "Listen, just come with me five minutes, five, 10 minutes, and I'm not going to ask you any questions. We're not gonna we're just going to go outside." Drew, within 5 minutes, we're outside. This happened the very first time we did this. And it was like the floodgates opened and she just starts going. It was so and so is doing this and this is what happened. And I was like, man, I don't know what it is. Like, are we outside?
Is it that she's neurologically distracted? Is it not that I'm sitting across the table from her drilling her like how how are things? But once we got moving and she could just kind of relax a little bit, it was so awesome. And I can't get that kid to shut up when we're on a walk, which is really a really great thing, you know. So she is even starting to like when she's studying for she'll be like mom I need to go for like a five minute walk clear her head you know and break up the pace the monotony of sitting in front of her computer and that that message to her is what gets me excited too.
>> Oh that's you know amazing. It reminds me of a few things. Number one you know listeners of this podcast know that we just had a baby. my wife gave birth last year >> and you know there's so many different things that you're doing as first- time parents and stuff that you're worrying about >> and often it'll be a thing where either my wife will tell me or I'll tell her like hey >> this is a walking conversation right where you might be overthinking right >> it doesn't mean don't talk about it it's just that hey this is one of those things let's let's talk about it while walking it could be a layered conversation where we're trying to figure out >> you know what's the best type of nanny that we need and the schedule and that sort of thing. It could be something that somebody's overthinking, right?
Your emotions are heightened after you gave birth and you're in sort of protection mode. You're, you know, worried about your child.
>> Uh, >> and and so, but when you walk and you get that perspective and you get that bilateral movement of your eyes sort of scanning the horizon >> and you feel like all of a sudden things are a lot easier to talk about. They're a lot easier to make sense. I don't know if on the last time you were on the podcast I mentioned to you, but for the last 10 plus years, I have a group of guys that meet every Thursday morning, right? If there's 52 weeks in a year, we meet probably like 30 weeks out of the year at least.
>> Love it.
>> And we call it man morning.
>> Yeah.
>> And it's beautiful because we're in LA.
There's generally great weather. And we have about four or five spots around LA.
>> Yeah.
>> Where we will meet up. It's always on time, 8 am, and there's a captain. And the captain does two things. They pick the location and they pick the question of the day. But we don't sit down and drink coffee and talk, >> right? We go on a walk.
>> Yeah.
>> And the things that end up happening that people are sharing, these are all busy entrepreneurs, some of running like massive hundreds of millions of dollars companies.
And people always have the same sort of feeling of like, man, I haven't even said this out loud to myself. The reflections that come from guys who tend to be not as great as women in terms of talking about their emotions or what's on their mind, like, dude, I really needed that. I needed that opportunity.
>> I love hearing that. It makes all of this work just so worth it because that is exactly what happens. It's a calming to your nervous system. It kind of lets lets the nervous system dial down. We get more creative. We get more open. And some of my best ideas have come from me staring at my computer and I'm being like, I I don't know what I want to say right now. I don't know what I want to write. And then I go out for just 10 minutes and then you come back and it's like a reset. It's literally a body reset for pretty much everything. But that community that is built around walking that you have is such a gift.
Like I really hope that people hear that and you know are encouraged to even start their own walking group like that.
You know that's what I would love to see happen with this book too is that these these little walking clubs and people getting together and having this social community because there's so much power in that.
>> Yeah. Not only do you get the benefits of walking, sunlight, fresh air, but now also you're getting the social aspect of connecting with another human being.
>> Yes. and getting a chance to hear that, you know, even if their problems or what they're navigating or what they're celebrating. That's actually one of our default questions is tell us one thing you're celebrating.
>> Tell us one thing you're navigating.
Right? We all have something in our life that we're happy about, but maybe we haven't shared it out loud or even pat oursel on the back. Type a personalities are great at not remembering, you know, something difficult >> that they've done. And we all have something that we're navigating. Yeah.
Right. I stole that question from a group uh that I was part of called Summit Series, but we've continued to use that and um it's really really powerful. So, walking is not just good for you, for your immediate health, for your long-term health to avoid all these big killers or at least reduce your risk of getting them. It's not just great for your relationships, whether it's your daughter, your son, your husband, your wife, whatever. You know, I love walking with my parents. Consistent walking is one of those things that a lot of people in our age range, you were talking about your mom, right? I was going to ask you like you're walking, have you been able to convince her to walk while she's talking to you at the same time, too?
>> My mom's a big walker.
>> Okay, great.
>> Yes. Yes, she is.
>> Because you know many of us who are in that 40 50 age range, we have focused on our health, but now we're thinking about like how do we keep our parents healthy?
And getting them to walk more is such an important aspect. I think a lot of people listen to podcasts like this and the other ones that are out there and are like, "Man, I got to get my parents on resistance training. I got to get them on this and that." And yes, those are important things and you know, there's ways to go about that process, >> but they forget about the power of just simple things that you can do like calling your parent.
>> You know, a lot of people get that sort of uh guilt trip text like, "Why don't you call me more?" Right? I'm on the same board as you. I'm super close to my parents. I've been calling them all the time for as long as I can remember of living out of the house.
>> Um, but having that component of like, "Hey, mom, >> why don't we, you know, talk on the phone, but we'll go for a 30-minute walk, right? You can go for a walk, I'll go for a walk, and we'll both be on the phone." Like, that's so powerful and easy to do for so many people.
>> Now, I was talking to my father. He's turning um 80 this year and he's a big golfer. So he'll golf three times a week and but the other four days a week he's not as active.
So that's what we talk about with this regular aerobic activity where you can you have to be consistent day after day.
So, I've been telling him, "Dad, I know it's I love that you're golfing three times a week, but on these other days, you got to start small, 5 to 10 minutes." And that um at least him in that generation, they the idea of strength training for him u was a little it's a little more difficult for him to get comfortable with. The walking was a much easier conversation, but I was struggling to get him out there. And then this is a funny story. He calls me a couple weeks ago and he's like, "I went to see my doctor." Uh, and my dad doesn't take any medications. He's he's pretty healthy guy. Um, but he said, "You know, Courtney," he said, "dr. Campbell told me I need to walk more."
And I was like, "Dad, I'm going to kill you." I was like, "I've been writing a book on this for three years. I've been telling you about this for three years, and now you're going to start doing it because Dr. Campbell told you to do it."
So, we laugh about it all the time.
>> You know what that's called? You know what that's called? It's called powdered butt syndrome. Okay, I stole this from Dave Ramsey, the financial adviser. He talks about this. He says once somebody's powdered your butt, which you know, people used to do back in the day.
Once they've put talcum powder on your butt, they think that there's no advice that I could take for, hey, I've seen your butt and I used to put powder on it. What could you possibly tell me about life? Yeah. But I love that you didn't stop because I feel like it's sometimes still again going to this conversation of like helping our aging parents, you know, just double down on the basics and walking is one of those central basics. Even if they ultimately end up taking action because they heard it from somebody else or somebody else's podcast or some sort of WhatsApp group meme that's there, they they it's always in their subconscious, right? It's always in their subconscious because they've seen you do it or they've heard you talk about it and then finally somebody says something and they're like, "Oh my gosh, have you heard about this?"
>> Right.
>> That's exactly what happened.
>> Yeah. That's amazing. Um, we can't have this conversation without talking about the problem with footwear.
>> Yeah.
>> And why it's so central to this idea.
You know, you said pain is one of the top reasons that people stop walking.
The number one reason, especially I'm sure, you know, as people get older and pain and footwear are directly connected. Talk to us about that.
>> When you look at the foot, if you were to take your shoe off and look down at your foot, the widest part of your foot should be your toes. Not the ball of the foot, not any other part of the foot.
And there's a reason for that. Because when we walk or when we stand, when we balance, we want to be have a foot that can feel the ground. We want to have a lot of real estate. So the toes should be able to spllay. They should be strong and they should be wide.
When you look at most modern-day footwear, footwear does not respect the anatomy of the foot. If you were to take out your factory insert of your sneaker and stand on it, most shoes, your foot will expand over the factory insert. So the big toes hanging off one side, the little toes hanging off another side, and then the toe box is tapered, so it comes into a point.
And this is um a problem for many reasons. But from a societal perspective, we have put fashion over function when it comes to footwear.
And as a result of that, we see a lot of problems at the foot. So when you take your toes and you squeeze them into a toe box, that is going to change the function and structure of your foot. We shouldn't be asking ourselves why one out of three people have foot pain. It would be like me walking around with a sling on my bicep for 20 years. My bicep would get weak or it would get sore or it would not function like it should.
And that's what we've done to our feet.
So all a lot of these diagnoses, bunyions and hammer toes, a lot of them I believe can be alleviated and obviously when caught earlier by just putting on a shoe that respects the anatomy of your foot and that is how it plays into walking because like I mentioned there's really no other diagnosis where that will stop you in your tracks when your foot hurts.
Yeah, it's so crazy to think about, you know, this is a man and woman problem, but I look at like my wife's history with her foot health. She was in investment banking for years. You know, she's with clients, other stuff, living in Manhattan, doing all the things that are there. And essentially, there was no room to not wear anything besides heels.
>> Yep.
>> Right. You would have been an outcast.
Your boss would have said something to you. I feel for so many women who then later on in life, luckily my wife didn't have to go through this, but then they end up with bunion surgery.
>> Yeah.
>> Right. And they end up with these other issues and then you know dress shoes for men.
>> Yeah.
>> Right. I heard you on my buddy uh Dr. Rungan Chatter's podcast. He was talking about how he mostly wears these barefoot shoes. Yeah. The same I do the same. I mostly wear Vivo barefoot shoes.
>> Um I had actually heard about them from him. But then a couple times over the years, I've had to wear like these dress shoes, right, that like my wife picked out that are these beautiful Italian dress shoes and everything. I'm at like a wedding. I'm like, my feet hurt so bad. In fact, before I started wearing >> barefoot shoes, and you have recommendations of of of that. We'll we'll uh touch on that in a second. I was wearing like a standard sort of I had a friend that was at Nike. Yeah. And like as a gift, they got me all these, you know, shoes uh to say thank you cuz they would always stay with me when they would come to Los Angeles.
>> And I was like, "Oh, amazing. I have like all these different shoes that I can wear, you know, from Nike or New Balance or whatever, you know, was there."
>> And over a period of time, right around the age of like 30, I would have this like knee pain. And I just thought, "This is weird. Oh, maybe it's because I used to run, but I'm not running as much." And, you know, you come up with all these different mental gymnastics to try to justify. And then Dr. Chady was in town. He was visiting me here in Los Angeles with his family. This was like many, many years ago. Probably now almost 8 years ago, 10 years ago. He's like, "You know what, man? Like sometimes that knee pain is just your shoes. Try wearing something like Vivo or another brand that's out there and see what happens." And I switched over to them and pretty much within two weeks that knee pain went away. How could something like wearing appropriate shoes that are not crowding your feet and are giving them room to spllay as you mentioned, how could that, you know, get rid of knee pain?
>> I love hearing that story. I hear it all the time in my clinic, >> all the time. My knee pain got better, my hip pain got better, my low back pain got better. When you start altering the function of your foot, you best believe that it's going to affect every single joint above your above your foot. above your foot and ankle. So when my foot is in a position where it can be strong and it can be mobile, that affects all of the joints sitting above it. So for example, when I'm walking, my big toe needs to extend a certain amount of degrees.
And that big toe extension, so that would be this motion. my big toe lifts when I'm pushing off that big toe extension sets up extension at my knee and at my hip.
So when we start compromising joint function at the foot, we start moving differently above the foot. So someone might start lifting their leg instead of rolling through their foot. There's a lot of different compensations that you will see when someone isn't using their foot correctly.
The other thing with knee pain that I think is really interesting is when you're walking, it should be a grazing of the heel.
So the heel should touch the ground and soft because when you can feel the heel strike the ground, it gives you information.
So the fat pad at the bottom of the heel is filled with receptors and it's again this sensory organ. And so when you hit the ground, if you were to hit the ground hot and heavy, you're overstriding. So, you're reaching your leg out in front of you and you're hitting the ground heavily. That puts a lot of load through your knee, for example.
>> And a lot of people walk that way.
>> Yes. And here's why. They can't feel their heel >> because when you look at all the footwear out there, it's like the alien invasion of footwear. It's like this this thing doesn't look like a foot. And not only that, but there's enough cushion on there that you could probably, you know, bounce your way through your through gate. That's not how we were designed to walk. So when you have a lot of cushion or stack height or too much stuff between the sole of your foot and the ground, your heel can no longer feel what it's supposed to feel. It the sensory acuity, the sensory perception is now decreased.
So I can overstride and I can land hot and heavy and that's going to change the forces going up my knee, up my hip, and into my back, for example. So that's why when you allow the foot to feel the ground and you start wearing footwear that is allowing your mechanics, the way we were designed to move as humans to function appropriately and not interfere with it, then people are like, "Man, this feels good." And here's the conversation I have to have. If you've been wearing footwear that either doesn't look like the shape of your foot, it's very aggressive, there's a lot of stuff going on, this conversation is going to make a lot of sense to you, and you're going to say, "Well, this makes sense. I'm going to go get rid of all my shoes and start walking around in a minimal shoe." And I will caution you, you have to earn your right.
Because yes, we are designed to walk with our foot on the ground, but if you haven't been doing it for long periods of time, you have to transition slowly.
And that's a very important conversation.
So, it's like start with 5 minutes, start with 10 minutes. Some of us are able to transition in two weeks and it's you don't even think twice about it.
Others, it takes longer, but it's well worth it on the other end.
>> Yeah. I think I spent so much time barefoot growing up.
>> Yeah. that the transition was so easy for me. But then I got some of these barefoot shoes for my wife and initially it was like I actually feel worse wearing this.
>> Oh yeah.
>> And you hear that from a lot of people and starting slow and building up is definitely one of the keys. And you know you shared another big key the last time you're on this podcast with people that I'd love to mention here again because it's in your book is that even separate from that just being barefoot more often, right? And just how powerful that is because the human foot, there are all these intricacies in there that if we don't use it, we'll lose it.
>> That's right.
>> And it's directly related to the eventual pain that stops people from walking at the degree that we know is connected to healthy aging.
>> I can't stress how important this is.
I don't think people realize that when you start losing the capacity and strength at your foot, you it will affect every system in your body because you aren't walking. So, even being able to put your foot on the ground. I have patients who have had foot pain for years and when they get up in the middle of the night to go to the bathroom, they have their slippers or their sandals right by the bed so that as soon as they get up, their foot doesn't have to hit the ground. We need to create resilient bodies. We need to be resilient. We can't baby this guy.
He wants to feel things. So, that is so important to be able to regardless of where you are, just start with little bits of just little duration, even if it's a couple minutes.
You know, I think from for the aging population too, you know, it seems counterintuitive because it's like, well, you know, I was talking to my mom about this. She's like, well, my knee hurts and my my hip would hurt. And you'd think she thinks that, well, I might I must need more cushion. That must mean I need more stuff.
and we have dropped her down into a shoe, an ultra running shoe that has about 22 millimeters of stack height. So basically what that means it's it's a little more than a Vivo barefoot, but it's not this big cushion shoe. She loves it. No back pain, no hip pain, no knee pain. And it also I feel better about that because she's closer to the ground now. She's also going to be close to 80 years old. Do you know what I don't want her doing? Falling. Yeah.
>> And so the closer I can get her to the ground and she can feel more stable, her risk of falling is going to go down.
If when I see people walking around on these shoes that are very high off the ground.
All I look all I see is like if they step off a curb and their foot does this, they're spraining their ankle and they're going down. And you see so many people that are above the age of 60, 70, 80, they're wearing these shoes.
>> You're taking away their proprioception.
You're making it harder, you know. And the challenge is as we age, you know, the fat pads of the feet start to decrease and the foot starts to get a little bony, things like that because of muscle atrophy. So you they have to have a little something under there, right?
>> But it doesn't have to be a lot. It really really doesn't. And if we can work on that transition, I think that um you're you'd see a lot of positive changes there. A lot >> because people like you have been talking about this for so many years now. The exciting thing is there's a ton of different brands that are out there that are trying to solve this and also make it fashionable, which is important.
You know, when I first started wearing barefoot shoes, people would look down and say, "Dude, those look like clown shoes." Right? And I'm like, I don't give an F because they feel great. And kind of like if you're really committed to it, that's kind of your answer in the early days. But now there's brands that are out there that look really great.
>> Yeah.
>> And you know, there's a lot of options.
We'll link to your website. You have a bunch of things there. And also in the book, you have a bunch of recommendations as well, too.
>> That's important. When I first started this, there was one brand out there, and now there's hundreds. And in the book, we talk about the difference between functional footwear and minimal footwear. So, I think that's an important delineation. If this is a new conversation to you, the functional footwear category is where you want to transition because it's going to give you the wide toe box, the lower heel to toe drop. So, it's going to bring your heel down so that your heel and toe sit on the same plane, but it's going to give you more stack heighter cushion, which is again a transition for people.
And then the minimal category is what takes you down into like a Vivo barefoot where the sole is very thin and flexible. So you can dance between both.
You can have, you know, two different types, but I think that's important. But there are so many companies out there.
Um I was very excited. My daughter um I get sho I have a bunch of shoes at my house and she said to me the other day, she because she's usually like, "You make me wear these platypus shoes and all the other kids, you know, get to wear Nikes." I'm like, "Well, um you'll thank me one day." But there there's been a couple companies lately where she's like, "All right, I'd wear those.
>> I can get on board.
>> I can get on board with those." So, that's exciting. So, you know, the the fashion conversation is is improving, we'll say.
>> Yeah. Yeah. I bet I bet if you look at who follows you on Instagram, there's probably some celebrity or influencer that she cares about. And just like your dad, she needs to hear from somebody else.
>> That's a really good idea. You're going to look into that.
>> You look into that. See who follows you, right? I bet there's somebody Dulip, somebody is following you, right? Uh, and then she'll be like, "Mom, oh my god, >> did you know X is so and so is wearing it?" And you'll be like, "Uh-huh."
>> That's a great idea.
>> Let's talk about what people can do to start significantly improving their health today, their brain health, their cancer risk, their sleep, all the things that you've mentioned, minimum dosage that people are looking at, right? You talk to your patients, many of them don't even know how much they're walking. Is one of the steps to audit that and take a look. You took the words out of my mouth. That's number one is find your baseline. Figure out where you are because anything is better than nothing. So, no matter where you sit along the spectrum, if we were looking at step counts, if you're less than 2,000 steps, if you're less than 3,000 steps, improving your step count by 500 steps per day decreases all cause mortality by 7%.
>> Huge.
>> It's huge.
So even if those step counts are low, the power that you can get from just improving that by 500 a thousand steps is a very very good place to start. So we have to find what our baseline is so we know where we need to improve. Um in the book we have three different programs that are built. So there's a base, there's a build and there's a boost. So based on your assessment of yourself, you can plug yourself into one of these three categories.
Some of them are more focused on just building your step count. Some there's added strength in there. Some we talk about speed. So there's a way to really um improve no matter where you sit there. And I think that's a that's a very good place. We all we all should know that. I feel like in every doctor's appointment, it should be, you know, these vital signs and then also what is your step count? Every single patient that comes into my office now, it is what is your step count? You'd be surprised. you know, when it comes to step count, you know, you talk about in the book how everybody knows the term 10,000 steps, and it's been talked about on this podcast before, so we won't go into all the detail, but it came from a Japanese company that was looking to market this these uh step counters that they have >> and they came up with this number that was there. And when people hear an episode like this and they think like, I need to walk more, often one of the things that they'll do is they'll say, okay, great. I need a dedicated hour to try to get as many of those steps as I can. And there's nothing wrong with having >> Yeah.
>> time to be able to do that. But for most people, your argument is finding those opportunities throughout the day, these snacks, these exercise snacks.
>> Is that one of the next things that people can start doing today to increase their walking and improve their health?
>> And that's where you have these little small wins. I think sometimes when we say, "Okay, we're going to walk every day for an hour.
That is a big goal. You know, that takes a lot of time and you don't want to make it difficult right out of the gates on yourself. You know, there was really cool research looking at glucose levels and what happens when we walk, right?
So, and how that's good for your glucose tolerance and your insulin sensitivity.
And what they found was that three 15minute walks after we ate was equivalent to one 45minute walk. And so I was like this is great for people because if you don't have the time to say I'm going to go out for 45 minutes you can get that if that works for you better these little 15minute windows by all means do that especially after you eat. I mean, I think that's pretty powerful. But that's where I think a huge opportunity for people is, especially if time is a factor.
It don't be overwhelmed by this. It's there's so many things to overwhelm us now. You know, I have to I mean, I'm going I'm going through menopause. It's like I got to eat enough protein. I got to strength train. I got to do this, you know, and and now this woman's telling me to strengthen my big toe. You know, it's it's a lot of information. So just getting your foot on the ground and doing something that you can kill a bunch of birds with one stone I think is very impactful and and easily easily accessible for most of us. One of the studies you talk about in the book is that if you're sitting more than 50% of the day, you have a major risk increase of 16% of all cause mortality, 34% of cardiovascular disease, which again a lot of people don't know is the number one killer of not just men but women as well too, right? More than breast cancer, more than Alzheimer's disease, cardiovascular disease. So I love this idea of these exercise snacks because it also helps you counteract. Yes, >> you could end up walking for an hour but still sit for more than 50% of the day.
So, just breaking it up on a regular basis is going to help you beat the inertia of modern life that just wants us to be on our ass the entire day.
>> It's such a I love that because I'll have a lot of uh patients that'll be like, I get my workout in in the morning. They're like, "I'll go for my run for an hour before my workday, or I'll go to my spin class, or I'll go to the gym for that window in the morning."
But then for the rest of the day, they're sitting in front of their computers. Just because you get your hour in doesn't excuse you from not getting your steps in throughout the day. It's that repetitive. Remember, walking is breathing is sleeping. It's something that has to be ha has to happen every single day. You have to find a way to trickle this in. So that's a very good point that just because you clear it up in the morning, if you're sitting for the majority of your day, that's not what our bodies want and or need.
>> It's crazy because, you know, there's some data that's out there on these modern um hunter day hunter gather societies or nomadic societies that are out there. Uh there's a there's a few around the world, but in particular, there's a couple in Kenya like the Messiah. People know the Messiah. Um, and you know, you look at their diets and they have primarily a diet that is has a lot of saturated fat because they mostly live off of milk all day. Now, dairy has a protective benefit, you know, in general, even if you have a lot of saturated fat content. But one of the theories is why do they have such little cardiovascular disease? Well, when you're walking all day long in these modern nomadics, you know, groups that are out there like the Messiah, and I went to go stay with one group called the Sambururu, which are cousins of the Messiah.
>> Yeah.
>> You have this benefit of when you're walking throughout the day, you have lipid clearance inside of the body. So any of that lipid that's floating around, your body becomes better at clearing it, metabolizing it, getting rid of it. So even if you have a super high saturated fat inside of the diet, it's not necessarily going to correspond with cardiovascular disease because you're just moving and getting rid of it through all this movement throughout.
>> Yeah. It's this lowgrade stimulus that you can get throughout the day. That's what I think is is so important about it. It's this lowgrade kind of constant stimulus and that's going to keep everything moving. It's going to keep at literally every system, you know, churning along. We don't have to overt tax, you know. I think that's a a really important conversation. It's not like more more. It's like, hey, it, you know, let's just just be consistent.
>> Yeah. Absolutely. You know, I mentioned that we were going to come back to this, but there's some people that are out there that are listening that have been told because they're pain or they feel like they've been told to not move as much or to slow down the amount of walking that's there. What do you want to say to that person who's been given that advice?
>> Don't do that.
Plain and simple. Um, our bodies are designed to move. Movement is what decreases inflammation.
Um this concept of pain I think is very complex, very very complex and it there's a lot of factors.
Um I talk about this one story in the book. Um, I had a patient of mine who was down to 2,000 steps a day because he had had heel pain and then over the next three years he had seen a lot of people in the last position that he had went to said, "You need to drop down to 2500 steps a day." This kid was 27 years old.
He moved into his father's basement because he was pretty much at home. Now, three years into a diagnosis and you're telling someone that they can't walk more than 2500 steps a day. Now, this is a much bigger conversation because it's no longer a muscularkeeletal diagnosis.
Now, we have a me a mental issue here, emotional issues. So, when someone is in pain, I think the mistake is saying our goal is to get you painfree.
We got to get you pain free before you can start moving. That is not the conversation we want to have. You'll be waiting a very long time for that. And to tell people or patients that the goal is pain-free or to be zero out of 10 is also a disservice. Pain is a normal human experience.
So if it's normal and it's a signal to us, why are we all trying to get rid of it all the time? I think the conversation is we reframe it. We say, "Okay, you have this heel pain. you're taking 2500 steps a day.
What if we walked for 5 minutes?
Let me know how you feel. He comes back um the same. Perfect. So, not any worse, not any better. He's not down to a zero, but we're we're plateauing. We can build off of that. So, it's teaching him and teaching people how to live well with pain and so that they can stay active.
they can reach, they can experience something different when they do have pain. And I think that's how we can dig oursel out of the hole of you can't move when you're in pain >> because it's so multifaceted because if you're not walking as much, you may not start sleeping as well as sleep could be a big part of helping with mitigating the level of pain that you feel on a regular basis, >> right? And then there's this other component which we've talked about throughout this podcast that is a central idea in the book is that if you don't use it, you will lose it. Yeah.
You know, our body is so resilient. You have the, you know, you have a a foot in front of you. Not a real foot, although that'd be pretty cool.
>> I will. This will be probably the last one of these uh podcasts that I do with the foot because TSA does not like him.
So, I get stopped every time.
>> And what do they say?
>> And they say, "Do you have a foot in your bag?" And I say, "Yes, I do." And then everybody starts laughing and then but it's you know now I got to get through the airport so you don't want anything that's going to slow you down.
>> You have a foot in front of you and a crazy stat that I heard you share is that people have to realize like how specifically the foot was designed like the heel of a woman's foot if I understood this correctly is bigger than the heel of a gorilla.
>> That's correct. That's a fun fact is >> that's a crazy fact. And what does that fact mean? Because when we walk, our heel was designed to hit the ground.
This is this is human gate. So when our heel hits the ground, the the beautiful um thing that starts to happen is it initiates pronation. So pronation is an unlocking of the foot. It's when the foot starts to lengthen. And this is our first opportunity for shock absorption when we move. So that heel because it hits the ground and handles this load, that's what causes all this cascade of events when we walk. So our heel was designed to hit the ground.
>> And now just imagine because of modern footwear or just not walking that much.
>> Yeah.
>> What happens to that heel when it goes through that process?
>> A very good example to think about here is a recovery sandal. So you everybody has seen the recovery sandals. It's like a it's a slip-on and it kind of looks like a boat and when you put it on it kind of rockers you forward. Okay? It has what we call a toe spring on it. So if you were to put the shoe on the table and you were to press the tip of the shoe it kind of >> it would rocker for you.
>> Okay? And there's other shoes that do this. They have to springs built within their shoe. There's a rockered sole to the shoe.
So, there's always a trade-off. So, when someone puts this type of footwear on and they start walking around in the store, the first thing they're going to say is, "Wow, this feels great.
>> It's like walking on a cloud.
>> I got all this protection. I got all this cushion. It's basically walking for me."
And you can think about that and you can be like, "Yeah, that sounds great." And this is the conversation. If you don't use it, you will lose it. So when you do not have to produce power at your ankle and you do not do not have to be able to control your foot because you have this shoe that is rockering you, the intrinsic muscles of your foot will get weak. Your ankle power will get weak.
And I can promise you as you age, that is the last thing you want if you want to continue to walk.
So it's a it's a conversation of tradeoff.
What are you looking for here?
Are there times when wearing a recovery sandal or the shoe can be beneficial?
Absolutely. There is a time and a place for everything. What I am saying is you cannot spend your life in a shoe that rockers for you.
You have to have a spectrum where if you just ran a race, for example, and you want to wear your recovery sandal, by all means.
But if there's no reason for you to be in that type of shoe, wear a shoe where you can actually you got to work a little bit. It's okay.
That's the environment where we get stronger.
You know, it's okay to be a little uncomfortable. It's the healthy stress >> that keeps us active and living well into our later years, which is what everybody would want.
>> Yes. You don't ever want to be afraid to be in your house and be like, man, I can't I got to wear my shoes all the time. Like, I don't think people want to live like that where it's like, I have to constantly have a shoe on. What type of shoe am I going to wear? We want to have a foot that we can put on the ground when we want to and be resilient and not be shackled by being afraid of what's going to happen if I have to walk around barefoot for 10 minutes >> which surprisingly is one of those things that catches up with people and you end up finding yourself in that position cascading of different things.
Is there one of the separate from pain?
Is there one of the earliest warning signs especially for people above the age of 40? Is there one of the earliest warning signs that you are are not walking as much as you should or you're not taking care of your feet as well as you should? Is there something >> happens can happen even before 40? If you look at your foot, notice things.
Are there bunyions? Are your toes starting to curl? Are there things that you can see at your foot? That's the beautiful thing about the foot. It's the only place in the body where you can actually look at it and be like, hm, something doesn't look right here. You need an X-ray at the knee. You need an X-ray at the hip, but you can look down at the foot and see aarent load. And people will say, well, I have a bunion because my grandma has a bunion.
And my response to them is, you didn't come out of the womb with a bunion. Now you might inherit connective tissue laxity or hypermobility.
But my response to this is also when you go to the doctor and they ask you um do you have a family history of heart disease? Do you have a family history of diabetes or cancers? The reason they ask you those things is so that you can actively do something about it. Right?
Okay. My mom had heart disease. Well, you better make sure you're walking. You better make sure you have a good diet.
you better make sure you exercise. So, if we know if you live in the camp that your mother has a bunion and your grandma has a bunion, then my response to you is going to be, well, do something about it. Start wearing the right footwear now. Start strengthening your feet now because that doesn't mean that you're going to suffer like your parents suffered because of what you see. That's what's awesome that you can just look down and be like, "Okay, maybe I should start wearing different footwear." You know, if you can't do things like lift just your big toe, lift your four toes, spread your toes, balance for 30 seconds, do single-legged calf raises, if you cannot do these things, you have to take a little time out and say, "I need to start paying attention." There's a whole foot assessment chapter that we've put in there because I think when you start to fail these basic tests, it's one of those predictors. Your gate speed's going to go down eventually and you're going to have an issue producing power at your foot and ankle as you age and that is a problem.
>> And our life literally depends on these things.
>> Yes, it does. This has been a powerful conversation and I think that the last item that I want to touch on which is a psychological component and I'm sure you deal with this all the time with your patients is with this modern world that we live in and so many different messages of what we can or quote unquote should do. There's a lot of people that are out there that feel like if I'm going to do it, I have to do it perfectly and then they set the bar too high >> and naturally we all fall off the wagon with every aspect of our life a little bit here and there and it's not about how many times you fall off, it's about getting back on. What have you seen have been the top things for people who struggle with consistency to make this idea of walking a central part of their life to the degree that they don't even think about anymore?
>> It's literally why we designed the microwock and and coined this term because it's so it's this five minute window. That's all it is. If you think of James Clear, the atomic habits and all, if you really want to change something, you cannot set the bar up here, you have to have little cons little consistencies. And so that little microwock has been so powerful for so many of my patients because it has been something digestible that they can do.
It's a it's hard for me to be able to have a conversation with one of my patients if they can tell me that they cannot fit in a five-minute walk. like you have to prioritize your health to a certain degree and I think that's a very easy window and then you can start to build off of that and that's what's so powerful about it because when you get outside and it's even for five minutes there's very few people that will come back from that five minutes and say well that sucked you know very few even those in pain because whether it's back pain or knee pain or foot pain even that little five minute window is just submaximal loading. Walking is very safe. It doesn't take your joints to their end range. So, it's a perfect little opportunity to build someone's confidence in their movement and to start to build a type of consistency that you know that they can do day after day.
>> And for somebody listening who's like, you know what, I'm in that camp. I haven't been giving my walking as much attention for whatever reason. I love this idea of a micro walk. start off with just even shooting for one or two a day.
>> Yep.
>> And then what could be a goal that they're working towards?
>> That's when you figure out your baseline.
>> Take a take a look at your baseline.
Audited. You had 2,000 steps. Even adding in 500 to a,000 more in a way that's sustainable for you that you can keep up. That's winning. the even if your step count is low, all the really cool research where people get the benefit of this is when the step count is low is when you're basically sedentary. If you just made small micro changes, that's when all the research is like, hey, you can decrease all cause mortality. You can decrease your risk of diabetes with very small little chunks of time. That's why every prescription pad, it's got to be on there. And then if you're one where you're like, okay, like I'm living in this 5,000 step range, that kind of window for maximizing the longevity benefits is about 7 to 8,000 steps a day. Also digestible because the research doesn't say 10 plus. The research actually says that 10 plus the health benefits plateau, which is also an interesting conversation because I'll have patients that'll say, "Courtney, I'm walking 15,000 steps a day." I said, "That's wonderful. Are you strength training?"
And they'll say, "Well, no, I don't have any time because I'm walking 15,000 steps a day." So, that's a perfect opportunity for me to say, "Hey, let's dial it down. Let's dial you down to 10,000 steps."
and now I've given you some time back that you can start doing these other things. So that's where I think no matter where you find yourself with your baseline, you can tweak it a little bit with small changes to make a huge impact.
>> That's key is not sleep is amazing, but we're not telling people to sleep for 14 hours a day. Right? If you're sleeping 14 hours a day, there's something wrong with you.
>> That's right.
>> Right. So, we want to do the dose that's appropriate that lets us give love and attention to the rest of the things that we care about in life.
>> That's fantastic. Uh Courtney, this has been an amazing >> Thank you so much >> conversation. I so loved our round two and you were talking about and giving a little bit of a preview about your book the last time you were on and I just remember feeling like dude this is going to be amazing. I I feel like this health, even though walking is not a trend, it's literally the thing that's been part of our survival. From a health perspective, as things kind of become more popular, less popular in these cyclical movements, I feel like walking being so exciting right now and viral because of your work.
This is the time.
>> This is the time where people are ready to hear it. I have my theories about why which is that, you know, health has turned into this such a long list of everything that you need to do right and these four-hour morning routines and etc etc >> and people have been a little bit fatigued about that and now they're like hey look I just want to double down on the basics and live a good life.
>> Yes, >> right. I don't want my health routine to take away so much from me that it prevents me from spending time with my family or giving attention to my work or doing these other things. and walking is so central to it and yet nobody broke it down in the way that it could have been broken down until you wrote this book that got people excited to say like how did I not know this information?
>> It's not a fad.
>> It's not a fad.
>> It's not going anywhere.
>> It's not going anywhere.
>> Like when people in my um clinic all runners are like I'm a runner. I'm a runner. I want people to say I'm a walker. Like I am a walker. It's so important and it's not going anywhere.
It's what we were biologically designed to do. So, it's not it's not a fad. And I think when people really understand the power that it can that it can hold, it should be an easy conversation.
>> The book is called Walk: Rediscover the Most Natural Way to Boost Your Health and Longevity, One Step at a Time.
Courtney, thank you for joining us back here.
>> Thank you so much. Thank you. Hey YouTube, if you enjoyed what you just saw, keep watching for more great content on how to improve your brain and your life.
>> You got to pick the one exercise that everyone needs to do for the rest of their life. I would 100% say walking with weight. You're getting multiple benefits, stacking a ton of benefits that these other types of exercise, they're missing
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