351 | The 4 Pillars to Improve Foot Health and Preventing Pain with Functional Podiatrist, Dr. Emily Splichal

[00:00:00] Welcome to the Optimal Body Podcast. I'm Dr. Jen. And I'm Dr. Dom, and we are Doctors of

[00:00:10] Physical Therapy bringing you the body tips and physical therapy pearls of wisdom to help

[00:00:14] you begin to understand your body, relieve your pains and restrictions, and answer your questions.

[00:00:19] Along with expert guests, our goal of the Optimal Body Podcast is really to help you discover

[00:00:24] what optimal means within your own body. Let's dive in!

[00:00:28] Dr. Emily We're so excited to bring Dr. Emily back on the podcast because she really is a guru in

[00:00:33] everything foot health and you might be listening and thinking, hey, I've got foot issues. I have pain

[00:00:38] or plantar fasciitis or I've got bunions and sometimes I don't even really feel the ground

[00:00:43] underneath my feet or I can't sense what the ground is doing underneath my foot. Niboso

[00:00:47] technology has you covered. We'll be talking about some of their products and how the neuro ball

[00:00:52] or the textured toe socks can really help wake up those feet so you can better feel the ground

[00:00:57] underneath you. Another one of Jen and my personal favorites is their textured toe splay. It helps

[00:01:03] open up those feet so those toes can move more properly how they're meant to. We have a special

[00:01:09] discount code if you go to the link down in the show notes and use code Optimal, you can get

[00:01:13] 15% off your entire Niboso order. And when I tell you their products are specifically designed

[00:01:20] to help your foot work more naturally, feel the ground better underneath you and help your feet

[00:01:25] and toes move better and get stronger. And when you improve your foot health, you improve your

[00:01:31] overall movement and whole body health. So go to that link down in the show notes and make

[00:01:36] sure you use code Optimal at checkout to get 15% off. We are so excited to have this guest

[00:01:41] back on the podcast. Our favorite functional podiatrist Dr. Emily Splickle aka the movement

[00:01:47] longevity doctor who is a functional podiatrist human movement specialist author of Barefoot

[00:01:54] strong and CEO and founder of Niboso technology with over 23 years in the health and fitness

[00:02:00] industry. Dr. Splickle has positioned herself as a global leader on the topics of postural

[00:02:05] alignment and human movement as it refers to barefoot science, foot to core integration

[00:02:12] and sensory integration. Again, we're so excited to have her back on because in episode 183 we talk

[00:02:18] a lot about the biomechanical aspects anatomical things when it relates to foot health and different

[00:02:24] diagnoses like plantar fasciitis and bunions today we're taking a little bit of a different

[00:02:29] approach some things you may not initially think of when you think of foot health, but

[00:02:33] they are massive topics that can impact your foot health and overall movement health

[00:02:38] and longevity. Let's get into it. Dr. Emily, thanks so much for coming back on another

[00:02:45] repeat guest which we don't have often so but our favorite functional podiatrist out there

[00:02:52] we love talking foot stuff ourselves and so glad we can have you back on. Thank you so much and

[00:02:59] I am honored to be one of the repeat guests. I mean truly your information and the way that

[00:03:07] you educate is really so beneficial because I think you're able to educate on things that not

[00:03:14] everyone is hearing about or understanding and in a way that people can actually take it in and

[00:03:21] start to identify what they need within their body and in their foot health. So that is something

[00:03:26] that I want to dive into specifically because I know we've already done a podcast with you

[00:03:30] which people can go back and listen to episode 183 we talked a little bit more about like

[00:03:34] the mechanical aspects of the foot and a lot of the common diagnoses or issues that people are

[00:03:40] having but what I want to dive into or what we want to dive into a little bit more is specifically

[00:03:46] first just covering like the four pillars of your healthy feet. Like what are those four

[00:03:52] pillars that really make up because I think this is just it alone going to be something that

[00:03:57] people hear and kind of wake up to that they don't really think about. Taking a quick

[00:04:03] pause from your foot health to remind you that if you are having trouble hydrating your body because

[00:04:09] this is full body health. If we are not getting proper and adequate hydration especially if you're

[00:04:15] trying to be mindful of not getting a lot of processed foods we need to replenish our body

[00:04:21] with electrolytes especially as we start to go from spring into summer and the warmer weather is

[00:04:25] happening and we're going to be working out and sweating we need to replenish our body. I'm

[00:04:30] telling you you're going to feel so much better not only physically but mentally your energy every

[00:04:37] day. This is something I do not go without when we travel we stuff packets of element whether it's

[00:04:43] in Dante's diaper bag or we're putting it in our suitcase a whole box of it so we can help

[00:04:49] replenish everyone else around us as well. Element goes with us wherever we go and I'm

[00:04:53] telling you just at least start with half a pack in like 16 ounces of water if you're not used to that

[00:05:01] much you know flavor and electrolytes and salt it is quite salty if you're not used to it but this

[00:05:07] is going to be a game changer even my mother-in-law told me what a big impact it made when she noticed

[00:05:13] that she didn't have it in her life and how her energy would drop throughout the day. So rather than

[00:05:18] reaching for that extra cup of coffee that you know your body doesn't want because it's

[00:05:23] going to just make you feel a little weird get in some hydration with some element in your water

[00:05:29] it's going to help you to drink more water to feel better throughout the day so if you haven't yet

[00:05:33] please go to the link in our show notes the link is drink element that's lmnt.com

[00:05:40] backslash optimal with every purchase you get a free sample pack so you get to explore their

[00:05:44] incredible favors which I absolutely love zero sugar added I highly recommend so go check out

[00:05:50] that link and we'll get back into the podcast. Absolutely so these are going to be my four pillars

[00:05:57] for not just healthy feet but the reason that I look at healthy feet is for movement longevity

[00:06:03] so all of the listeners want to move well we want to move well for a really long time

[00:06:08] so your feet being really your basis support is you have to be doing something for them or

[00:06:14] about them proactively and preventively to support again this movement longevity

[00:06:19] so the four pillars are going to be first awareness so do you even feel your feet

[00:06:26] this is thinking about surfaces you stand on being barefoot wearing certain shoes that support a very

[00:06:33] sensorily rich environment the second one is going to be strength so you have to have strong feet

[00:06:40] but the foot strength that I look at is integrated strength so to me strong feet

[00:06:46] must be connected to a strong core and that is through fascial lines that they connect to each other

[00:06:52] you could also think of it as our base being our foot has to connect to our center of gravity or

[00:06:59] our center of mass so to move well you have to have control of your center of gravity or your

[00:07:04] center of mass so those talk to each other so it's your second pillar third one is going to

[00:07:11] balance so we need to have sufficient single leg stability to move well and when I say move well

[00:07:19] I mean walk well and the most foundational functional movement that we do every day is walk

[00:07:25] and I'm kind of obsessed with bipedalism and gait and that our nervous system is really

[00:07:32] shaped around being able to walk so as longevity so that would be balance single leg stability

[00:07:38] and then fourth would be recovery and when I think about recovery it's not just oh do I massage my

[00:07:44] feet am I doing the nirl ball release right it's more what am I doing to support the circulation

[00:07:50] of the feet which is an important part of recovery in the whole body but foot circulation is unique

[00:07:56] because it's really micro circulation it's itty bitty because the foot is so far away from the

[00:08:01] heart so everything just gets really small down there so those are my four pillars and I

[00:08:05] want people to address every aspect every single day and that's amazing because I I mean if I were

[00:08:11] to think about four pillars of foot health I think a lot of the aspects of what you talked about

[00:08:16] would be in my four pillars or would be there but just the way you frame them is so unique

[00:08:21] and I think again it's done in a way that is function forward preventative and proactive

[00:08:28] and I don't think many people look at foot health in that way and even some of the things that

[00:08:34] you said are the things that you talked about being sensory rich environments micro circulation

[00:08:40] these are not terms you tend to hear talked about when we're talking foot health when we're talking

[00:08:46] plantar fasciitis or when we're talking you know bunions or some of the mechanical things

[00:08:52] but those things being a sensory rich environment being you know working on our micro

[00:08:56] circulation and the recovery of that foot day to day can really help with the mechanical

[00:09:03] aspects and can really help anatomically as well at least in my mind you can correct me if I'm wrong

[00:09:09] but why don't we jump in and talk about why it's so important for our feet to be in a sensory

[00:09:16] rich environment and be able to feel to develop that awareness you were talking about yeah so

[00:09:23] if I can just kind of re-emphasize and like underline what you had said is that a lot

[00:09:27] of people do think about feet very biomechanically which is what our first podcast was around thinking

[00:09:34] bunions flat feet plantar fasciitis high arches lower just range of motion those are very mechanical

[00:09:40] which is important that's actually what my entire podiatry training was around and then it was

[00:09:47] this other aspect that I'm very much into which is the sensory side of the feet that was not

[00:09:52] emphasized in school but it's very important for human movement is that our foot is controlled by

[00:09:59] thousands of nerves these nerves are found in the skin in the bottom of the foot but the nerves are

[00:10:04] also found wrapped around all of the fascial spider web that is everywhere in the bottom

[00:10:10] of the foot actually it's everywhere in the body of every muscle group and then muscle fiber

[00:10:15] and then every fibral and it just gets deeper and deeper interwoven those nerves help to build

[00:10:23] an awareness to just that you can even feel your foot in the first place right do you

[00:10:28] do feel all 10 toes do you feel the tripod and then when you walk do you feel the ground do

[00:10:35] you feel the vibration of impact forces so that you can read and auto adjust to every

[00:10:42] step that you're taking and that ties into balance which is one of the pillars that ties

[00:10:47] into strength which was another pillar so each kind of builds off of each other to this overarching

[00:10:53] need to be able to walk well so how do we start to like what does addressing your sensation

[00:11:03] and starting to bring awareness to that really start to like what on a day to day

[00:11:08] does that start to look like yeah and to add to that I think that people don't realize the

[00:11:13] importance of sensation until we start seeing some of those end of the road or downstream

[00:11:19] diagnoses that come up that are very common like neuropathy like different peripheral vascular

[00:11:24] diseases and disorders that tend to be more degenerative but start building up when we're

[00:11:31] in our 30s when we're in our 40s you know based on how we treat our feet long term so

[00:11:36] framing it with that in mind and some of those terms or diagnoses may have triggered for some

[00:11:41] listeners like oh neuropathy yes or that runs in my family yeah that runs in my family I have a

[00:11:46] grandparent or a parent that is dealing with that yeah so that that would be the latter stage

[00:11:51] of it so totally if you can't fill your feet from neuropathy and the neuropathy doesn't

[00:11:56] have to be diabetic it could be chemo induced could be small nerve could be idiopathic

[00:12:01] there's a lot of autoimmune related neuropathies there's some that relate to

[00:12:06] different vaccines I just won't even go there but they're over there and they kind of

[00:12:10] tie into it as well just because of inflammation so inflammation can be quite toxic to the

[00:12:15] peripheral nerves which is where a lot of these neuropathies actually present

[00:12:21] but way over here on this side which is what I'm going to address is that you don't have to

[00:12:24] have lack of sensation in your feet to need to do what I'm talking about which is thinking about

[00:12:32] photo awareness movement awareness posture awareness what am I doing every day to support

[00:12:38] the nerves and the micro circulation and the muscles in the feet so that can start with

[00:12:43] what you do in the morning when you brush your teeth which is my favorite time to do foot

[00:12:47] stuff is you could stand barefoot you could be on a hardwood surface harder surfaces are more

[00:12:55] stimulating to the nerves in the feet than softer surfaces so instead of the carpet you're on a

[00:13:00] hardwood floor obviously naboso ties into this this is why I started naboso was I wanted to

[00:13:07] have products and surfaces and ways to help everyone wake up their feet and connect to

[00:13:13] the sensory side of the feet and the micro circulation and everything that we're talking

[00:13:16] about so do you want to do that do you want to release your feet on a neural ball great check

[00:13:24] the box with the texture do you want to just release your feet with a golf ball or a tennis

[00:13:28] ball just the act of releasing your feet is stimulating circulation and waking up the

[00:13:34] nerves to get a little bit more released with the naboso sure but I'm trying to keep like a

[00:13:41] an unbiased approach to what people could do so I'm giving options here

[00:13:46] I believe that people should get at least 30 minutes of barefoot stimulation every day

[00:13:50] that could be walking around your home that could be doing a barefoot workout like Pilates

[00:13:54] yoga something like that I'm a huge fan of earthing and grounding which is going outside on

[00:14:01] the grass on the dirt and you are essentially connecting to the planet barefoot for those

[00:14:08] that are not familiar with earthening grounding is that the earth has a negative charge to it

[00:14:12] we have a positive charge or acidity inflammation aging as a positive charge and you're essentially

[00:14:19] canceling out the acidity in the body through the basic or the negative of the earth so I'm

[00:14:25] a big fan of it there's also really good research around earthening and circulation

[00:14:30] 15 minutes a day outside earthing you get really good

[00:14:34] vasodilation or opening of blood vessels in the foot whole body vibration platforms I'm obsessed

[00:14:41] with these as well I have one in my office and 10 to 15 minutes of standing on a vibration platform

[00:14:47] increases microcirculation to the feet and to the muscles into the fascia so really supportive

[00:14:53] to what we essentially were talking about as well so there's different modalities or different

[00:14:58] ways to do it you know I like to incorporate as many as I can at the same time because that's just

[00:15:04] great makes a little bit more efficient but you can easily do these things in 15 to 20 minutes a day

[00:15:12] while doing something else read your text messages and go outside on earth if you want to

[00:15:17] and I think that's where it helps make it a little more accessible for people is like

[00:15:22] do a few things while you brush your teeth make your morning coffee and go enjoy it

[00:15:26] standing in the grass or sitting where you can have your feet in some dirt or grass rather than

[00:15:31] you know on the couch you know where you're not getting that sensory stimulation well and I was

[00:15:36] going to ask to you know so often what I hear is well what shoes are best for home and what can

[00:15:42] I wear around my home and so it's like people are going from outside wearing shoes to inside

[00:15:48] their home still wearing shoes and even if we're wearing barefoot more slippers or anything

[00:15:54] or socks on our feet like are we impeding that connection of truly being barefoot and getting

[00:16:01] that stimulation and I've heard some people say that I don't feel comfortable walking barefoot

[00:16:05] or I have pain when I walk barefoot around my house so what do I do in that situation walking

[00:16:10] 30 minutes barefoot that sounds like that sounds awful you know yeah and I know many people

[00:16:16] actually literally just saw a patient who wears sneakers every waking moment so it's that's

[00:16:22] a reality of certain individuals yeah now what that does it is creating a sensory disconnect

[00:16:29] to the earth to the ground to the surface and the nerves in your feet so if that is the case

[00:16:35] can we create a safe way to get at least 30 minutes of barefoot stimulation every day

[00:16:44] if it's the act of walking in your home on marble floors I understand that but could you stand

[00:16:53] when you're doing dishes have or try to weave it in right so it's just taking a little dose

[00:16:58] could it be 15 minutes in the morning 15 minutes in the evening so you're segmenting it so that

[00:17:03] the total dosage still hits that 30 minutes but you're not thinking wow I don't know if I can

[00:17:08] make 30 minutes house shoes are on the rise you can think certain footwear companies for

[00:17:14] reading and awareness to house shoes and things like that I do try to get people to still think

[00:17:22] about okay if I'm in a smooth recovery sandal could I have the naboso sock on to stimulate my

[00:17:30] feet could I have them but still make sure I put my feet on the vibration platform could I

[00:17:37] still do right so it's about like this is good this is your reality can we sneak in and weave in

[00:17:43] just a little bit more sensorial stimulation into your day knowing that you might have to be in those

[00:17:51] because of the floors or a history of foot pain and things like that yeah and I think that's just

[00:17:56] the reality that as providers we know we need to approach like we can very easily say oh yeah 30

[00:18:01] minutes a day but we know that's not the case for everybody or they're not going to be able

[00:18:05] to jump right into that so I appreciate how you're saying many different ways we can get that 30 minutes

[00:18:11] many different ways we can just add that influence in a little bit more even if it's not walking 30

[00:18:17] minutes straight on hard ground which might be difficult for some people and I know one of the

[00:18:23] pillars that you mentioned was balance and I think that this development of awareness this

[00:18:28] increase in our connection with the nerves also the improvement of the micro circulation

[00:18:33] can play a lot into balance and I know a lot of people throw around this term proprioception

[00:18:39] which you kind of alluded to when you talked about nerves you know our our body's ability to

[00:18:44] understand there's a foot there and that I have 10 toes and that I'm wiggling certain

[00:18:49] pose so to what degree is this work on the sensory environment and micro circulation going

[00:18:57] to help improve proprioception and therefore balance yeah so on the balance of just so the

[00:19:04] the listeners have a gauge of do I have good balance or not good balance you really want

[00:19:11] to think about 10 seconds so can you stand on one leg for 10 seconds that is where research has

[00:19:17] shown if you can good you've essentially checked the box that you are mitigating falls and this

[00:19:24] is for everyone this could be mitigating an ankle sprain if you're 25 years old and you're thinking of

[00:19:29] your role in this right so when I assess a patient and when I teach other practitioners to assess the

[00:19:35] feet I build in a single leg or a balance test on every single patient as we flow through

[00:19:40] the foot assessment which is really easy to do when I train someone's balance through

[00:19:48] different single leg exercises that I have out there I actually created a barefoot workout

[00:19:53] a barefoot balance training workout that I did in New York City for years before I moved to Arizona

[00:19:59] and then obviously at Nibosa we have like the kinesis board in different products for balance

[00:20:04] everything is built around 10 second balances so can you stand on your right leg 10 seconds

[00:20:10] and go left right left right left and you just keep switching and then I will incorporate

[00:20:15] different perturbations a perturbation is I'm trying to throw you off right that could be

[00:20:20] moving your eyes it could be shaking your head no or nodding yes and there are things that are

[00:20:25] trying to look at how we balance through a sensory stacked strategy which is your eyes

[00:20:32] your vestibular proprioceptive would be joint so you mentioned that Dr. Dom the proprioception in

[00:20:37] the joints and then mechanoception or touch which is the hands and the feet the palms of them

[00:20:43] so thinking about balance is you have to feel your feet to balance well but you have to

[00:20:49] feel your center of mass to balance well you actually have to feel your whole body

[00:20:55] which is called a body schema or a mind's how connected are you to your mental picture of

[00:21:01] your body in space and that's a really important part of movement as well why I focus on single

[00:21:08] leg stability is that it is a segment of how we walk so in order to walk well there's a

[00:21:18] point during the gait cycle where you're standing on one leg it's called mid stance but also to take

[00:21:22] along steps you have to have single leg stability to go upstairs you have to have single leg

[00:21:29] stability so there's a lot of functional movements around that and all of that is really based around

[00:21:35] your perception of your body as well which I call movement accuracy so can we move accurately

[00:21:42] through the perception of our body and our foot in space and then how does that translate to each

[00:21:48] segment of movement for some people you know you've been diagnosed or told you have flattening of

[00:21:54] your arches as you're watching as you're walking you have overpronation so you need an insert

[00:22:00] every time you walk how impactful is this mechanical aspect of pronating in the foot and

[00:22:07] and being should we be afraid of this is this something to fear is this something we can work

[00:22:12] on do we have to wear inserts for the rest of our life or orthotics so can you kind of give some insight

[00:22:18] on on this single leg stance and does it improve if we are doing stuff like stimulation and balance

[00:22:25] yeah so the foot type is actually really really important to single leg stability

[00:22:29] and what you were asking of is the overpronation which is where the foot

[00:22:33] collapses in and then the leg kind of rolls inward and follows it every foot type or

[00:22:39] imbalance of a foot type has a spectrum so you could be like a little bit pronated or you could

[00:22:45] be like really really pronated so the answer is wherever you are on that spectrum as far as your

[00:22:51] orthotics so a mild collapse of the foot pronation I want the listeners to think unlocked

[00:22:59] so you just unlocked the foot right when your knee is straight your leg is straight and you're

[00:23:04] standing it's locked you're not like locking your knee but it's locked it's stacked right

[00:23:10] so if I were to have the listeners slightly bend their knee they'd be essentially unlocked the

[00:23:16] knee so that term locked and unlocked it's a big I'm sure you guys use it all the time it's a

[00:23:20] big podiatry term and it's a foot term that I like people to understand so the more that we

[00:23:26] collapse in or pronate the more unlocked your foot is and if it's very unlocked it becomes

[00:23:33] very unstable and then obviously you're shifting the skeleton which means your jenga blocks stacked

[00:23:40] higher up become malaligned because of your base so a over pronated foot mechanically

[00:23:49] is like the jenga blocks but it also an unlocked foot is a slower foot so it has a harder time

[00:23:59] feeling the ground and reacting to the ground and contracting to the ground and communicating with

[00:24:04] the core insufficient time to absorb impact forces to transfer energy so they may actually need an

[00:24:13] orthotic that you'd referenced and the orthotic may be an important part of their story because

[00:24:20] of where they sit on that scale or spectrum you want to say of over pronation the further

[00:24:28] you go into the over pronation side the harder it is to control without an orthotic and those are a

[00:24:36] lot of the patients I see because they you can't try to fix those on the internet yeah you might

[00:24:42] need some some eyeballs on it on the other side where it's mild that's where a lot of the work

[00:24:48] that you guys demonstrate through exercises and things like that to strengthen that you don't have

[00:24:54] to be in orthotics and art supports on the earlier side of the scale so it's really important for the

[00:25:02] listeners to understand where they may sit on that so that they approach it appropriately

[00:25:09] and are not feeling misled or frustrated because they're trying to do something and

[00:25:16] really their foot type didn't mirror where they thought that they were and I appreciate that you

[00:25:22] bring up there is a time and place for orthotics and I know the way that Jen and I educate in feet

[00:25:31] people will often think like oh we're demonizing the use of any external device

[00:25:38] in our optimal state like people should be able to and hopefully can get on a path to train

[00:25:44] their feet to where one day they won't need to rely on that where someone is at we definitely need to

[00:25:51] meet them there and so there there always is a place for that orthotic and you brought up briefly

[00:25:57] previously one of the sensory devices that I know that you've created through niboso being the

[00:26:03] the stimulation toe socks and you have a whole host of these other products being the insert

[00:26:10] sensory mat remind me because you created a orthotic does that also have sensory component on it so

[00:26:17] these products these products itself are a great option for the individual who may not feel comfortable

[00:26:24] outside of the shoe to get 10 minutes to get 15 minutes of that sensory stimulation to get a

[00:26:31] little bit better feedback regardless of what type of footwear they feel like or they feel most

[00:26:36] supported in yeah and I think that's where that's why you get a lot of people seeking what you guys

[00:26:43] are delivering with foot health and ownership of your feet and strengthen your feet is because

[00:26:48] there is at the same time from the medical side an over prescription of orthotics so you have kind

[00:26:57] of these two sides that then the patient or the people in the middle become confused right

[00:27:02] they know that they're often over prescribed so they don't know the appropriateness right of them

[00:27:08] right now what is important to emphasize is that if someone truly does need a custom orthotic because

[00:27:15] they have ligament laxity and they have a little bit more aggressive over pronation they're over

[00:27:20] here on the more severe side they still need to do the exercises that you guys are demonstrating

[00:27:27] right so just because you use a custom orthotic does not mean that exercising your feet is irrelevant

[00:27:35] the orthotic does not take the place of still strengthening the feet still feeling the feet

[00:27:41] and there is research that shows chronic use of custom orthotics and arch supports and cushioned

[00:27:46] shoes causes atrophy of the intrinsic muscles of the feet in denervation of the foot there is

[00:27:52] research that is demonstrating that so that that is actually one of the reasons why at Nebosa we did

[00:27:58] develop our arch support with the texture on it which is called the nebosa form because of that

[00:28:05] research saying if you need an arch support at least let's keep the texture and like hello

[00:28:10] little guys like stay awake and strong because I know you need that arch support so let's

[00:28:17] let's elevate the experience to the people that do need arch support so they can still stay strong

[00:28:23] and aware of their feet despite that I personally feel like that it should be required

[00:28:28] to disclose that to people upon the prescription of you know cushioned shoes arch supports is

[00:28:35] like hey there is this research that shows this which is why it's also important to have this

[00:28:41] you know the strengthening and then these other aspects as a part of your foot

[00:28:45] health journey I personally just think that we underwhelmingly follow the Hippocratic oath

[00:28:51] the do no harm and make sure we get tell people all risks benefits and you know consequences of

[00:28:59] prescriptions that we give them that being a perfect one when we give someone an insert

[00:29:03] we should say hey there's research that says if we do nothing else these might be some of

[00:29:07] the consequences and someone who is in an orthotic and wants to make the journey say

[00:29:13] they're not you know they're still pretty early on could they make the journey of getting off of

[00:29:20] an orthotic and working into a stronger more balanced foot and wearing more minimal type

[00:29:26] shoes and how long will it take tell us exactly no to the timeline okay so is it possible for

[00:29:37] someone who had our supports and orthotics and let's say they're on this earlier side of the

[00:29:44] scale right so they're mild mild to moderate let's scope it to that yeah yes you can 100%

[00:29:51] get out of an orthotic now that is a little bit based off of injury history as well

[00:30:00] and the activity at which you are going to be placing the foot under

[00:30:06] and then third to me is also the patients in the commitment of the patient or the individual right

[00:30:12] so if someone has had recurring for five years on and off plantar fasciitis which means now we

[00:30:19] know it's an osis there's got to be some degeneration in there so the collagen fibers

[00:30:24] are changing maybe they even have a little more micro tearing this partial tear I don't

[00:30:28] have some complex history with their plantar fascia that may be one of the exceptions that

[00:30:33] it is difficult to get them out because they have progressed injury history we just got to

[00:30:40] understand that right if someone does not have that injury history and they're just like I don't

[00:30:45] know I've just been in them since I was a kid because that's what I was told I've never had

[00:30:49] foot pain and now I'm just starting to you know I follow doc Jen vitt and I'm like I want to

[00:30:54] know these things right I want to understand my feet let's say that's them because that's going to be

[00:30:59] the majority of the listeners is yes you can 100% get out of them you do it slowly Dr. Dom

[00:31:07] slowly and you do it based off of the demand at which they're placing their foot under

[00:31:15] so let's say they get into a healthy foot release routine they get into

[00:31:22] the barefoot stimulation every day so they're starting to do some of the pillars but they

[00:31:26] still stay in the orthotics we got to kind of do these at the same time right I'm starting to

[00:31:31] strengthen my feet all I do I'm going to do all my kettle bells barefoot but when I work on my feet

[00:31:40] as a bank teller it's the only thing I can think of is a nurse or I actually work with a lot

[00:31:47] of police and MTA workers and TSA and right so we're say let's say your job requires you on your feet

[00:31:55] this is a little different because your demands are here right but you could do your workouts barefoot

[00:32:02] you could make sure that you start doing some foot to core strengthening you do your balancing

[00:32:07] you're wearing the naboso socks at home for recovery I don't want to care what you're

[00:32:09] doing right when we're kind of doing these things but the one the one exception to your

[00:32:14] orthotic experience is when you're on your feet eight hours a day as a nurse or nurses work more

[00:32:20] like 12 hours so long time right that's where we have to take a nugget and then filter in the

[00:32:29] reality of the individual right and those are a lot of the conversations that I have with my patients

[00:32:36] is I say we're going to keep the orthotics for just when you run or just when you're at work

[00:32:44] and now I want you to start to break the rules a little bit on the weekend you're hanging out with

[00:32:50] friends like you don't have to be in prison with these orthotics right let's kind of defy and break

[00:32:55] the barriers and then just understand our foot type understand the demands of various stress

[00:33:02] on the feet and be intelligent about which ones do I need to use your thought for and that's the

[00:33:08] ownership that I want people to have with their feet and their foot health is to be able to make

[00:33:13] those decisions very well informed and educated so that they can prevent foot pain I think I

[00:33:20] like that answer because in a way it reminds me of how I talk to people about training when it

[00:33:25] comes to sport you know that's where my mind goes because I was an athlete and we train in the

[00:33:31] gym in a controlled environment like you said you can do maybe some of your exercises barefoot

[00:33:36] when your focus is on movement when you're not in a completely fatigued state which for people who

[00:33:42] work on their feet that is your part your your sport and when you're on your feet eight to 10

[00:33:48] hours a day fatigue is setting in it's a more unpredictable environment because you're not

[00:33:54] paying attention to what your foot's doing so we train in the gym in the controlled environment

[00:33:58] so that we can start to become more automatic with that in the uncontrolled and fatigued environment

[00:34:03] and I think that's you know how my brain processes it a little bit we've been talking more about the

[00:34:10] flat foot and slightly because I'm selfish I have very high arched rigid feet I struggled with

[00:34:17] that growing up I was always getting foot pains and arch pains but I feel like we should just

[00:34:22] give love to the other people out there who have high arches myself included um I started kind of on

[00:34:29] this more natural foot health progression four years ago now we'll say I don't feel like when

[00:34:37] I look at my feet or when I try to even not force myself into pronation but go into controlled

[00:34:43] pronation and stuff I honestly don't feel like that has improved significantly but the way my foot

[00:34:48] feels has definitely improved and the way that it absorbs the shock that my rigid feet used to not

[00:34:55] be able to absorb well is definitely different um I don't know if you can speak to that where

[00:35:03] I've been doing some of these things the sensory the awareness bits all the pillars to some degree

[00:35:08] probably not every day so I need to get on it a little bit more um but can you speak to why

[00:35:15] I can now go run two to three miles in barefoot shoes where four years ago that would have laid me

[00:35:22] up in a hospital yeah so for all the high arches out there that were like don't forget about me

[00:35:29] so I'm with you is so the most important thing I think with foot type but this is really particular

[00:35:37] to higher arches is that foot shape the visual looking at the foot shape is not going to have

[00:35:48] an equal predictor of function meaning that um you're not going to see this huge change to be like

[00:35:55] now I'm going to achieve peak function of my foot and movement and awareness and

[00:36:00] fascial connections and foots of core and all of that because small small changes in the foot

[00:36:06] actually make huge impact in the body and this is just the uniqueness of the human foot

[00:36:11] is I will tell people if you get a one degree change one degree mind you the naked eye cannot

[00:36:18] see anything less than five degrees so one degree will make a big impact on your function so you

[00:36:26] don't need to see it to know that it's happening and that's really the the Dr. Dom example will be

[00:36:32] like he feels it he's feel it but he doesn't see it okay so my arch might never lay flat on the floor

[00:36:39] you're saying that's totally fine but walking in the sand feels so good because my arch actually

[00:36:46] feels something no right so we're getting unlocking of the foot and to unlock the foot isn't

[00:36:56] isn't a arch that is then touching the floor yeah right that doesn't mean that your foot has unlocked

[00:37:04] the foot the midfoot actually moves it's called a mitered hinge which is going to be confusing or

[00:37:09] hard to show without having any sort of video but it's like twisting like twisting a rag

[00:37:14] right your forefoot and your rear foot twist in opposite directions in a sense which allows

[00:37:21] the foot to absorb energy that you're not going to see through how high is your arch and how much

[00:37:28] is it now dropping okay so that's an important function of a high arch that I think people might

[00:37:34] not understand the blackboard which is a product that is out there is a board that essentially

[00:37:42] creates that torquing mechanism in the foot and it works really well for higher arches so for

[00:37:49] anyone that is feeling very rigid very tripod it's kind of what I think you're like just stuck

[00:37:59] very stiff on your tripod don't really take impact well the foot is a little bit tighter in the

[00:38:06] ankles you will jam your the bones the midfoot together and can get quote-unquote top of foot pain

[00:38:12] a lot of these things that you have probably experienced and then just bringing a increased

[00:38:20] awareness allows you to just move softer in your movement as well so you're waking up the nerves

[00:38:26] you don't strike your heel as hard there's you're moving more fashionably versus stiff

[00:38:33] so continue doing what you're doing and for the listeners is you don't have to see an actual

[00:38:37] change or visible change in your foot to know that you are unlocking it that you are waking

[00:38:42] up these nerves one question that I do get a lot as it relates to higher arches is they say well

[00:38:49] flat feet are unstable unlocked and need strength and stability short foot foot to core all the

[00:38:56] exercises right like strength and strength and strength then so then they're like over here

[00:39:00] this higher arch foot that is up rigid stiff they don't need to strengthen their feet right

[00:39:08] because they're like too stiff too strong and I'm like it's actually very different when I talk about

[00:39:13] strengthening the foot it's really around like toe flexor strength the timing at which your toes

[00:39:19] engage it's your deep muscles connecting to your pelvic floor just because you have a high arch

[00:39:26] that is quote-unquote stiff does not mean that those muscles are talking to the pelvic floor

[00:39:32] or that the toes are engaging so yes yes yes yes big takeaway high arches still need to strengthen

[00:39:39] their feet but it's not for the purpose of building in arch because that's not how I actually look at

[00:39:45] foot exercises is not around I am trying to build an arch and that's why I do foot exercises

[00:39:51] it's I'm trying to get your toes strong so you can balance I'm trying to get your feet

[00:39:56] and your pelvic floor to stabilize so that your hip can transfer into a single leg stance so you

[00:40:01] can jump high you can accelerate so it's in a different way than I think this literal association

[00:40:10] of foot strength is for arch yeah this does not equal strong yeah yeah and I totally agree with that

[00:40:19] I I completely used my bony structure to you know create that artificial stability I actually tore

[00:40:26] the Liz Frank ligament in one of my feet playing basketball because of the that that mitre joint

[00:40:32] twisted one degree too far and so yeah I mean I think this is huge and crucial for people to

[00:40:39] understand because that is what most people want you know they want the structure of what it's

[00:40:45] supposed to look like so I'm going to do exercises to improve my arch because my arch is

[00:40:50] supposed to look a certain way and so I'm only doing you know pulling in a towel because that is

[00:40:56] going to pull in my arch you know instead of really understanding the function of how it all works

[00:41:01] together in the coordination like you were saying and how that relates to the to the entire body

[00:41:07] in the inner core so how can someone you know listening to this start to say okay wow what

[00:41:14] are some exercises then that I can just start with that might start waking up the the fascial

[00:41:22] lining from my foot up into my core or are there specific things that you recommend is it just

[00:41:28] using more like your kinesio board and starting to bring awareness to balance um obviously the

[00:41:33] stimulation from all of the tools that you guys have because you have the stimulation on everything

[00:41:39] you know obviously that's going to help to build that awareness but where do I where do I go and

[00:41:44] what exercises can someone start with just in that strengthening and connection process

[00:41:50] yeah great question so the exercises that I recommend are really based around short foot

[00:41:56] short foot is kind of like a domain and we just said don't talk about the arch well

[00:42:02] I'm not talking about it but the action is not just in the arch so this is really important

[00:42:06] it's not just an arch building exercise for quote unquote short foot right um but that's

[00:42:11] really everything is based around I am not a not that I'm not a fan of doing like toe yoga or

[00:42:21] there's one where you can tap your big toe out to the inside it's a toe induction tap

[00:42:29] but it's really based around compliance see I want people to actually do something

[00:42:35] and then looking at research and there's a lot of newer research articles that are out there

[00:42:40] within the last couple years that are comparing a lot of these exercises and saying which one

[00:42:46] has the highest EMG like muscle activation which means which of these exercises has the

[00:42:52] highest ROI to what we're trying to achieve which is intrinsic strengthening or small

[00:42:57] muscle strengthening so I really everything is built around that so my exercises are

[00:43:03] not overly exciting sometimes we think that the variation of exercises creates the greatest

[00:43:11] excitement I'm just a realist and I look at the research and I know people are not going to be

[00:43:15] doing that many anyway so let's just hit it on the head okay so what we want to do is first

[00:43:21] one is a forward lane forward lane is one of my favorite exercises this is kind of pretending

[00:43:28] like a ski jumper but it's not that extreme or like Michael Jackson not that extreme either

[00:43:33] but we're more like a tree blowing in the wind so you would stand with your feet shoulder with

[00:43:37] the part you would want to set your base and this is very important if you have a falling

[00:43:43] arch over pronated flat feet higher on the other side but pronation are the one that

[00:43:48] are going to have to correct their feet a little bit more you want to make sure that you

[00:43:52] are rotating your hips finding your tripod spreading your toes and you're setting your

[00:43:57] base so I have videos and just like this is literally how you set your base before any foot

[00:44:01] exercise or any balance exercise boom okay feet or shoulder with the part arms are by your side

[00:44:08] you're imagining that you were stiff as a board stay stiff as a board you're going to slightly

[00:44:11] lean your body forward like the ski jumper kind of analogy and as you lean forward your toes

[00:44:18] are going to reflexively push into the ground what's happening is every time you

[00:44:24] lean forward you activate a postural reflex in your nervous system we do not want to fall over

[00:44:30] that is a a postural reflex so your toes will engage and essentially you go back to a vertical

[00:44:36] position so you lean forward go vertical lean forward go vertical every time you lean forward

[00:44:40] your toes are going to push into the ground the toes pushing into the ground is short foot

[00:44:48] short foot is pushing your toes into the ground so it's a way that you could play with it a little

[00:44:54] bit more to create variety or it could be a good way to teach foot activation to someone who has low

[00:45:02] foot awareness because I'm not even talking about the foot I'm actually giving you a different cue

[00:45:07] now real quick on that one is I will give that to older patients meaning that they

[00:45:14] they're a fall risk they might have that mass or Parkinson's or something so they're they're older

[00:45:19] and what I tell them is all I want you to do is pretend that you are a tree in the wind

[00:45:24] and you're just swaying forward don't sway back but just way back to vertical right and you're

[00:45:30] just swaying all we're doing is these subtle sways and I want them to feel what happens when

[00:45:36] there's just a subtle shift in your center of mass and how that activates the system then

[00:45:43] can you do the foot the toe activation without doing the lean so that's me taking the reaction

[00:45:51] and consciously contracting my toes okay now every time I do that as my toes push down can I exhale

[00:45:59] as I exhale I'm going to lift the base of my pelvis my pillow floor so I'm lifting there

[00:46:05] okay great now can I do that on one foot and can I stand on one foot and hold that with the toe

[00:46:11] engagement and I'm exhaling for eight to ten seconds on one foot so now I'm doing a balance exercise

[00:46:18] okay and then we do it on the other side okay now can we do it on the kinesis board which is a

[00:46:24] microwabble board can I stand on there toes down exhale the whole to see how I'm just yeah

[00:46:30] what I'm doing is adding little layers to the exact same cue that occurred from the forward

[00:46:38] lean and I build that off so that it's very transferable or progressive for someone to see okay I understand

[00:46:49] now that the most important action that we can pull into our foot is toe flexion and that toe

[00:46:56] flexion builds the arch so people want the arch builds the arch but it also is how we balance

[00:47:03] it's how you push off and take a step so when I am about to take a step and I go into a lever

[00:47:11] so if the listeners did a calf raise and you look at your foot that's a lever position

[00:47:16] when you're in a lever about to take a step you have to have strong toes pushing down

[00:47:23] and this is newtons third law I believe where there's an opposite action to every right so you have to

[00:47:31] have a downward force as you go forward right so this opposite action and if we didn't have our toes

[00:47:38] pushing down into the ground we would have no strength we would have no energy release

[00:47:45] so that's it's really important so I'm totally obsessed with the toes right now

[00:47:48] I love the arch too but it's all about the toes and building off of those few

[00:47:55] exercises that I just demonstrated that was huge that so impactful and just such a great way to wrap

[00:48:02] it all into a couple exercises one exercise even that somebody can just start start to do to

[00:48:09] build that tripod build some foot awareness get into those toes a little bit like you said

[00:48:14] stack the arch of the foot the pelvic floor the respiratory diaphragm helps start and tie that

[00:48:21] all in and I love bringing in the breath because anytime we consciously do that automatic thing that

[00:48:27] our bodily body normally does called breathing it helps connect us into those other cues and helps it

[00:48:34] become more automatic the more and more we do it and then the more we add the variation of

[00:48:38] the one foot and the kinesis board and everything that you just brought up and I I think toe flexion

[00:48:45] strength is getting is getting the shout out that it has so desperately needed for so long

[00:48:51] especially in the high end performance realm I had a buddy who was playing in the NFL and he

[00:48:56] he was talking to me he's like it's so funny how obsessed they are with toe flexion strength

[00:49:00] right now because it is that last few percent that a top-end athlete if you have weak toe

[00:49:07] flexors that's going to lower your speed that's going to lower your vertical that's going to lower

[00:49:11] everything because it's the last thing that is you know propelling you off the floor so

[00:49:17] I personally think that's an amazing place to kind of wrap up and leave people with

[00:49:21] an exercise or two that they can just take out and start to introduce start giving a little

[00:49:28] attention to these four pillars that are going to help into the future build that optimal

[00:49:35] foot health so that longevity that's key Dr. Emily thanks so much for taking the time to come back

[00:49:42] on and you tell us a little bit about where people can go to learn more from you and to maybe get

[00:49:47] their hands on some of these amazing neboso products that we have been mentioning yeah

[00:49:51] 100% so on instagram my instagram handle is the functional foot doc I have a lot of content

[00:49:58] on there neboso's instagram is neboso underscore technology I will spell neboso for the listeners

[00:50:06] and a b o s o so neboso underscore technology that's the instagram my website if anyone is curious

[00:50:13] as far as how I practice and see patients is just my name so dremily splical com

[00:50:19] and that will take you to my practice I see a majority of my patients virtually

[00:50:23] so that's great for people all around the world and then for neboso is n a b o s o dot com so neboso

[00:50:31] dot com and then you guys have a fun discount so people listeners can take advantage of that yes

[00:50:38] and of course we'll have that all linked up below so that you guys can easily access any of the

[00:50:42] links that she talked about thank you again so so much for educating the way that you do making

[00:50:48] practical making it understandable and giving the tools that people need to really help longevity

[00:50:54] of their entire health not just their fat health so thank you dr. Emily you are so welcome I hope

[00:50:59] everyone got at least one takeaway yeah another great episode with dr. Emily if you missed the

[00:51:06] first one that was episode 183 that talked more about the biomechanics meaning plantar fasciitis

[00:51:12] and bunions so if you want to listen to that one another great one but this is why we love

[00:51:16] the neboso products because it goes beyond just the biomechanical aspects of the foot and into

[00:51:21] the sensory aspects the aspects that are going to really help our foot and our whole body health

[00:51:27] long term so if you want to check out any of that we're going to have it linked up below

[00:51:31] to check out any of the neboso but don't forget to use code optimal because that gets you that

[00:51:36] 15 discount on any of their products right so check that out in our show notes below