397 | Bunions Aren't Just Genetic | New Research and Foot Health Tips with Gourgen Gevorgyan

[00:00:05] Welcome to the Optimal Body Podcast. I'm Dr. Jen. And I'm Dr. Dom. And we are doctors of physical therapy, bringing you the body tips and physical therapy pearls of wisdom to help you begin to understand your body, relieve your pains and restrictions, and answer your questions. Along with expert guests, our goal of the Optimal Body Podcast is really to help you discover what optimal means within your own body. Let's dive in. So we're so excited for this podcast because we've always heard, oh, bunions are just genetic. That's why you get them.

[00:00:34] But Gourgen really comes with a lot of great evidence on the environment that we put our feet in. And that's why Jen and I recommend barefoot shoes. We have worn Vivo barefoot shoes pretty much exclusively for the past five years. Jen has even put her mom in barefoot shoes and her mom swears that just by wearing the shoes, she's noticed a decrease in her bunions.

[00:00:55] So you tell me. That's why we think that the flat, thin bottom, the flexible soles and the wide toe box can really provide the environment that helps your foot naturally thrive, that helps your foot naturally build the strength and mobility that it's supposed to have to feel strong and confident in all of your movements. Probably my favorite thing about Vivo though is they have shoes for every single type of occasion. Yes, for working out or just going on walks or running errands, but they have shoes for hikes.

[00:01:23] They have boots for the winter. They have water shoes. They even have dress options. So they have something for every occasion that you'll be able to continue to get those barefoot benefits that are naturally built into the shoe. So you can head down to the link in the show notes or just go to the Vivo website and make sure you use code OPTIMAL20 at checkout to get 20% off your entire order.

[00:01:45] Jen and I are always excited to talk about foot health. And today we have Gorgon Gavorgian, who is the co-founder of My Foot Function, an innovative platform dedicated to helping people improve their foot health and overall movement patterns. With a passion for biomechanics and a deep understanding of foot anatomy, Gorgon has been instrumental in developing programs that promote natural movement, injury prevention, and rehabilitation.

[00:02:09] Through My Foot Function, he aims to empower individuals to regain control over their foot health and enhance their quality of life. His expertise in functional movement and his commitment to education have made him a respected figure in the wellness and fitness community. Gorgon's approach is holistic, combining knowledge from various disciplines to address the root causes of foot dysfunction and mobility issues.

[00:02:33] As a leader and educator, he continues to inspire and guide others on their journey towards better movement and long-term foot health. As you know, we truly believe unlocking the foot is the path to unlocking your whole body movement. So we really, really loved this conversation. Let's get into it. Gorgon, thank you so much for spending some time with us today. This is always a topic that Jen and I get excited to talk about because we are foot obsessed.

[00:03:00] We have a love affair with foot health and how that impacts our movement quality and health and our overall health and longevity throughout life. So we're excited to dive into your expertise today. Let's call this the triangle of foot love then because I'm there with you guys definitely. I'm excited to speak with you guys and thank you for having me on the show. So what first got you interested in understanding and wanting to bring education about foot health?

[00:03:30] So my background is in sports science and I specialize in biomechanics. That's really not where it started. But just to kind of give a context, I've always been interested in movement and health in my background. After my degree, I started teaching in many different schools that would educate personal trainers. I did this for about 10 years in the Scandic countries. And at one point we had somebody called Lee Saxby.

[00:03:57] I'm not sure if you're familiar with him, but he's known as one of the godfathers in terms of the kind of barefoot approach and foot health approach. And he came to educate us teachers in running technique and also foot health and function. So me and my colleague, Joseph Stone, who's the co-founder of My Foot Function, we were kind of taken aback when we started to kind of question everything that we've been teaching essentially.

[00:04:25] Because we realized we were just taken aback by the fact that obviously the foot is the foundation to human movement and that we've never actually considered it or thought deeper than, you know, okay, you should have these types of shoes. So we got incredibly inspired by this and we realized, okay, yeah, our feet are definitely not optimal. So we started on this personal journey on improving our foot health and function through changing our shoes, through starting to implement certain exercises.

[00:04:54] And we saw profound effects on not only our foot health and function, but the ability, our ability to move and exercise in different types of modalities of movement. So we started to hold his educations here in the Scandic regions for a number of years.

[00:05:10] And then slowly and surely we started to, we founded My Foot Function where our kind of core mission was to spread this knowledge and information with a passion we had for it to the general public, but also to other professionals. Because we just thought everybody has to know about this, right? Because it's so fundamental and it's so important, but at the same time, it's just so forgotten. Nobody talks about it in the type.

[00:05:37] It is becoming more known and more talked about today, but when we started about 13 years ago, nobody was talking about it essentially. Interrupting real quick. I absolutely love this episode because it is just getting to the root cause of things and what we actually need to be doing. And this is where strength in order to reduce pain and improve function becomes so incredibly important.

[00:06:02] It's what we are doing, not the support that we're using, not who we're seeing to quote unquote fix us, but what we're doing. And so this is why I created Strong Healthy Joints. This was a program where I'm taking you through how to increase your strength gains and feel confident in the gym status without injury and reducing the amount of pain that you have within your body.

[00:06:28] And we've had so many people go through this program and feel incredible within your body. You get lifetime access, lifetime access. So you can continue to learn and go through it. And not only are we doing strength workouts and there are only 30 minutes because as a busy mom myself, I do not have time to do a lot, right? So we need it to be structured. We need it to be functional. We need it to be effective. And that is everything that comes within Strong Healthy Joints.

[00:06:54] And I do the entire workout with you so that I'm really guiding and educating you. And I'm telling you the people who are like, oh my gosh, I can finally deadlift again with no back pain. And to hear these stories, it's just so incredible. And even my mom in her 70s is going through the program as well because it really helps to maintain Strong Healthy Joints as we age. So if you have not checked it out yet, we're going to have it linked up and we're going to have a discount for you as well.

[00:07:21] Of course, as our podcast listeners always use code optimal, you get an extra special discount. But this is the plan that we are going to be doing together as a community. And I hope that you join us. It is just gen.health backslash strong. And we'll have that linked up in the show notes as well. So that's the short story of how I got into it.

[00:07:44] And then from there, it's just kind of taken off because through just launching my foot function as a brand, as an education brand, we immediately saw the demand for people seeking help where they were let down by the traditional kind of approach that we're met with today, which is orthotics or certain types of shoes that are supposed to support the foot, which do have their time and place. Don't get me wrong. But there definitely needs to be another approach. And this is what we specialize in and pride ourselves in being specialists.

[00:08:15] I think you just touched on an important thing at the end there in saying and having the admission that like, yes, foot devices under foot technology like orthotics and things like that have a place. They shouldn't be the reliant crutch that we continue to use for life. And I think that we could both kind of agree generally on that statement. I'm glad that you said that because many people think, oh, if they're barefoot people, like they don't believe in orthotics.

[00:08:44] And I don't think that's exactly the reality. We just we believe in treating every foot where it's at to start and understanding that migrating towards that barefoot, you know, style can have a lot of general foot benefits. So can you just in general talk about why moving towards being barefoot more or a more barefoot style shoe? Like what benefits does that bring to your foot? Absolutely.

[00:09:11] So one of the core principles in biology is that form follows function, right? So there is there's a very important functional reason behind why Mother Nature has developed the human foot to look a specific way. And this applies to all biological beings in nature. You can observe this in the shape of leaves, in certain insects, how their claws look or mandibles look, etc. And the human foot is no exception.

[00:09:38] So the human foot should be the widest of the toes and they should have a certain direction of the toes relative to the other bones in the foot. And this is slightly individual from for most people, but the general trend is quite similar. And if you change that shape, then if you consider the fact that form follows function, that fundamental biological law,

[00:10:06] then you are definitely going to affect the function of that foot as well. So the main benefit of going to the more barefoot approach is having a shoe or if you're going to use a shoe or not to have or rather allow your toes the sufficient space that they need to split for the toes to be in the alignment they need to be so that they can actually be active and strong.

[00:10:35] And that is the main benefit for us. And then there is, you know, this is what we call the non-negotiable in terms of if we're talking about shoes specifically, the most important criteria is the toe box and the shape of the toe box and the width of the toe box so that the toes can be in their proper alignment. That's a number one non-negotiable. Why we say it's a non-negotiable is because there's zero risks really associated to that and only benefits.

[00:11:00] But when we get into, you know, a thin, flexible sole, a heel to toe draw, a toe or heel spring, etc., those we can negotiate with because we do know that there are risks associated for certain people in transitioning to those types of shoes. Can we talk about that a little bit more in terms of, I mean, we understand completely why having a wide toe box, you just kind of outlined it, you know, having that form of the foot in order for it to function.

[00:11:28] And hopefully people continue to hear that. I think it's hard when there's a certain fashion of things that people want to, you know, go by. But, you know, when it comes to now the base of the shoe, you know, we talk about zero heel drop shoes. When is that appropriate versus when is it appropriate to have more of that higher heel so that you have that heel toe drop?

[00:11:54] Like, would that be beneficial for people in certain times or is it something that we're always trying to move away from and go to zero zero drop shoes? That's a very good question. I think the very simple general rule of thumb that I like to use is if we have someone that's, you know, under the age of 35, relatively healthy,

[00:12:19] no previous injuries of specifically and particularly Achilles tendinopathy. So strain at the Achilles tendon or major, you know, ankle range of motion issues or other kind of injuries at the ankle. Then I think there is less of a risk and more benefit for someone to transition into a shoe that's zero drop. That's not to say there's no benefits for people that do have a history of those issues to transition,

[00:12:49] but that transition should be done more carefully with exercises implemented into it and more progressively. However, for people that are generally over the age of 35, have obviously spent a considerable more amount of years in these types of shoes. And as we know, as we age biologically, we're not as adaptable. And particularly if you do have a history of these types of injuries,

[00:13:12] particularly with Achilles issues, then there are certain risks associated to it where I would be more cautious with it. I would still approach it and still go for that as a goal, but it needs to be done a bit more cautiously. So with exercises implemented is what I mean. I think that's a great kind of guideline. And we get those questions all the time because, again, we're recommending people get into barefoot shoes.

[00:13:37] And when you throw out the blanket recommendation and then have somebody who might be in their late 50s, 60s or something saying, if I try walking around my house barefoot, I have pain within 15 minutes. And again, that's when we have a much longer answer for those people about transition and what that might look like in their case. Because, again, there can still be significant benefits regardless of where you're at in life.

[00:14:02] I know Jen's mom is 70 now and has transitioned to the barefoot style shoes and focusing more on her feet. And she is convinced that her bunions have reduced in symptoms and in angle just by wearing the shoes more so. Because I can't say she's been super consistent on doing other exercises. She's pretty good at her toes. She is pretty good at putting splays in.

[00:14:28] And even in my own case, I am a very rigid foot. I have a very high arch. I have very little flexibility in my midfoot and ankles and excessive, excessive mobility in my toes, specifically into extension. I mean, that just gives you a little bit of understanding of where my foot's at. And I was under that 35 range when I'd made my transition, which for me was basically putting on the barefoot shoes and just trying to do everything I normally did.

[00:14:57] And I had some pretty, I wouldn't say rough, but some eye-opening moments when I tried going on my first jog. And I could hardly walk downstairs because my calves and Achilles were so tight for about a week afterwards. But that being said, with my primary, I don't do any ankle mobility, anything like that. Just wearing those barefoot shoes for about four or five years, I can now get into deep squats with a normal stance.

[00:15:26] Where in the past, I would have to have a wide, wide sumo stance with my feet turned out to just get into a below parallel squat. And so, I mean, just some of, a couple of testimonials from myself and mother-in-law that show this small bit of focus can make profound, profound change. Absolutely. And we see that, you know, we've worked with thousands of people globally with this in all age groups.

[00:15:55] Even, I've had clients in their, you know, 75, 80 years of age. And a lot of people will feel at that point, maybe it's hopeless, particularly if they have had a lot of injuries, if they have arthritis in the joints, you know. Obviously, improvements are slightly more limited. They take more time, but there is a tremendous amount of improvement they can still make. In case an example of your mom, Jen. But it's, there's definitely a lot of improvements that can be made in terms of applying exercises.

[00:16:23] But just even making those simple changes of going barefoot slightly longer or having more appropriate shoes, particularly with a wide foot-shaped toe box, can have a profound impact on one's foot health and movement ability. And I want to, you know, now that we brought up bunions a little bit, I want to dive into this, particularly because you guys have been doing studies in bunion health, which is so incredibly needed.

[00:16:51] And I think we are starting to have some exciting studies that have been coming out showing, you know, how exercise and certain tools can be beneficial in reversing mild to moderate bunions, which is really incredible. But the debate still stands on whether it is purely genetic. Well, my mom had it, my dad had it, I'm going to have it. Or does the environment of what we put our foot in have a major effect?

[00:17:19] And can that combat what is happening genetically? So can you go into that? Absolutely. So, you know, first of all, the reason why we chose to do this study, which I'll get into in a bit more detail, is number one, bunions is the world's most common foot deformity, right? It flicks the majority of a lot, a lot of people, particularly in Western societies.

[00:17:43] And it's one of the more debilitating ones because it does have a cascading effect of leading to other types of foot pathologies or problems down the line. When it comes to bunions and their formation and whether it is genetic or it's the environment, I think it has been a discussion for a very long time just for people to understand why the argument of the genetic argument is so heavily pushed.

[00:18:10] To understand that, we have to delve into kind of the scientific literature, which I won't bore the audience too much about. But there has been a lot of studies looking at the epidemiology, so the root cause of bunions and whether it is genetic. So they have taken, you know, families and they've looked at the incidence of hallux valgus between family groups and they found a high correlation, which is, you know, not weird. But the weird thing is that in none of these studies did they ever actually look at the shoes that they were wearing, right?

[00:18:40] Which is weird. That would be an obvious kind of thing to look at, I would think. But none of these look at it and they just look at the genetic factor. And there is a genetic factor that plays a role here. And that is that you may be born with hypermobility, say, for example, or you may be born with very wide feet as opposed to other people in your culture, which makes you more predisposed to developing bunions if you wear the incorrect shoes.

[00:19:09] And the genetic factor does play a role, but it is only impacted when shoes come in and affect the position of the big toe. And then there's other biomechanical factors that do play a role. But we do believe that shoes are the root cause because we've never been able to document anyone that's been born with bunions. We don't observe this in habitually barefoot populations. We didn't observe this in the habitually barefoot population in our study.

[00:19:39] We saw a few foot deformities in the few in some habitually barefoot people, but we could always link that to certain injuries that they've had in the past. Right. So none of them were born with it. And I think that's so important. And we chatted a little bit before we pressed record. And one of my frustrations is that it never seems to be all one or the other thing.

[00:20:03] And I've never felt like it's a controversial statement to say that the environment we put our feet in habitually impacts the development of bunions. Like, I don't give two shits what the research says. Like, my science mind is very confident saying that and being able to back it up with the environment we put our body or our feet in is going to have an impact on how they develop. Is there a genetic component at play?

[00:20:30] I will usually never say genetics never has any impact because, as we know, it's not often just one or the other. And so I appreciate you saying that. And I want to talk a little bit more about this study that you did. I believe you went to Sri Lanka, which I love because I went to Sri Lanka when I was young on kind of a service trip and got to spend some time there.

[00:20:55] So and one thing that I noticed in the village that we were in is everyone was barefoot. Everyone was running around climbing. I mean, it was after a tsunami. So climbing through piles of garbage or the rubble of what used to be their home barefoot. And we have all these like tough kind of trail type shoes on to protect our feet because of, you know, where we were coming from. So why Sri Lanka?

[00:21:21] Why did this give you a good population that was kind of, you know, great for your research that you were looking to do? So it started with my colleague and co-founder, Joseph Stone, who was on vacation in Sri Lanka. And he made the same observations you did that many people there were habitually barefoot, walking around barefoot.

[00:21:43] And it wasn't very far into the cities or from like the rural areas into the more suburban or the cities where you could quickly observe the change in foot shape and the use of shoes. So logistically speaking, we thought, wow, this is a perfect place to actually go and do a study.

[00:22:04] So we discussed this, me and Joe, and then we brought this forth to two guys that we know here as well, Melker and Rasmus, who founded a barefoot shoe company or rather a functional shoe company. I should say they don't identify as barefoot. They focus on the foot shape. But in any case, they got really excited about this study as well. And we started to talk about this more in depth and started to get serious about it and plan it.

[00:22:33] And it was about a year of planning. And then we actually went out and did it. And we had a partner with us that supplied the 3D scanner, Volumental, they're called. They have 3D scanners globally around shoe stores. And they've done massive research on foot morphology as well. So they supplied the 3D scanner for us. And then we went out there. We were out there for about a month. And we went all over the country. We had a fantastic guide with us.

[00:23:03] And we were all five of us in this minivan just traveling around the whole of Sri Lanka to different villages. So we saw everything from, you know, we were at a fishing village. We were at tea plantations. We were at schools. We were at police stations. We were in hotels. We were literally everywhere you could find. And we managed to scan about 1,040 or 70 something.

[00:23:31] 71 people out of those, I think 960 something was usable data. So at this point in time, the data has been processed. And we do have the results. But the study is still in process of being published and will hopefully be published now by the end of this year. And the study results do show very black and white that habitually barefoot people have essentially no hallux valgus. Right.

[00:23:58] And the people that were shoe wearing either with closed toe box shoes or sandals that do also restrict the toes had statistically significant higher degrees of big toe misalignment or what we call HVA or hallux valgus angle. And this is a very black and white. And the interesting thing was as well that we found differences in different occupations.

[00:24:21] So if you were a police officer on your feet 12 or 8 to 12 hours a day, oftentimes seven days a week where they would be wearing these kind of, you know, restrictive shoes. Their feet were definitely amongst the worst that we saw. And we saw this very clearly. And it's one thing, you know, reading this in research, it's a completely different thing seeing it as well in real life.

[00:24:45] And we saw that stark difference between, you know, just visually looking at these people with their, that habitually wore shoes and the ones that were habitually barefoot. We were also at a barefoot tribe or rather a tribe that still lives like hunter and gatherers. Essentially, they do survive quite a lot of tourism naturally nowadays, but they still live essentially the way they do. And they had amazing feet.

[00:25:13] This did the tea plantation workers that were just out in the fields working barefoot. They had certain other issues, but all their feet were perfectly healthy and functional. So it's amazing just to see that visually. So what we wanted to do with this study and what we want to show with this study on why we chose Sri Lanka, apart from the logistical aspect, is that we wanted to look at the same ethnic group. Because there's no study to date that has done that. There's two studies that have done something similar to what we've done.

[00:25:43] The first one was in 1905 by Dr. Phil Hoffman. I'm sure you guys have seen those black and gray or gray and white images of those feet. And then there's one in 2009. I'm going to butcher the researcher's name, D Out, I think it is, who looked at habitually barefoot Indian population versus a Western, I think, in a Dutch population. And these are the only kind of studies really looking at it the similar way we did.

[00:26:12] And apart from that, we obviously also had more advanced technology with us to look at this and a much larger sample group. So what we wanted to do is kind of put the nail in the coffin or try and put the nail in the coffin of the argument, the genetic argument, right? To show that this is primarily a factor of shoe wear. Genetics do play a role, but the main factor is shoe wear. Because we did observe this in families as well.

[00:26:37] And you can find some of these images on our website, but we had the opportunity to also interview some of these families and take pictures of their feet. And we saw one fantastic example was this family, a mom and dad with their three daughters. And only one of them had started to go to school. And she was the only one. She was about 14, 15 years old. She was the only one that had bunions and quite severe. Because a lot of them economically, they're not so well off.

[00:27:06] So they kind of get passed down shoes or just find the size that they can kind of wear. So a lot of the shoe fitting is not appropriate for a lot of them. So she had quite pronounced bunions. None of the other family members had that. And we saw that through other family members throughout the research study as well. Wow. I think that's so fascinating and such a good reminder to like, okay, we have to take responsibility into our own hands.

[00:27:33] Because it's so easy to just say, well, you know, my whoever has it. And so, of course, I'm going to have bunions. And like, this is just what it is. And I'm going to do what feels comfortable for me. That's fine. But like at some point, we have to take responsibility for the fact of what we have within our power. Now, with that said, do you or have you worked with people that you've been able to see changes in bunions from now getting information like this and changing the environment that you're putting the foot in?

[00:28:03] Like, have you been able to see significant changes? Definitely. I mean, hands down, we've worked with hundreds or thousands of people globally with this everywhere from mild degrees of bunions to even very severe degrees of bunions where we see improvements in all cases.

[00:28:24] I mean, in very severe degrees, there is limited improvements you can make, but there are still improvements that you can make to the point where many of them can still lead a normal kind of functional life and be relatively pain free. But there's definitely improvements to be made there. I mean, it's not so far fetched to think that as well.

[00:28:44] So, I find it weird that we get stuck in this mentality of that there is nothing we can do about it because we see the foot for some reason as a completely different part of the body or that it is not a part of the body because it is composed of soft tissues, ligaments, tendons, muscles. It has a blood flow, as mobile joints, just like the rest of the body. And if you subject the rest of the body to specific demands or loads, it's going to adapt itself.

[00:29:11] You know, you go to the gym, you lift weights, your body's going to grow, etc. The same thing is going to happen to the foot. And you can work through injuries as well, like we work through the rest of the body. And the same thing applies for the foot. It's just a bit more complex and tricky and a bit daunting, I guess, for a lot of people because the foot is a bit a lot more complex and there's a lot of contradicting information out there. There is. And you're on your feet all day long. Yeah, you're constantly using it.

[00:29:37] So, you know, it could be hard to wrap your mind around maybe trying something different and being afraid of getting, you know, the pain that you used to get or whatever it may be. One question I did want to ask, too. I remember, so when you're talking about and you guys, obviously, such a wide variety of people that you got in this study, which is incredible.

[00:29:59] Did you also see, and I know the focus with bunions, but I want to just ask if there was any correlation that you might have seen to other elements of the foot, like plantar fasciitis that people might get or other type of plantar pain. Yeah, flat feet versus high arches. Like, was there any other correlations made? Yeah.

[00:30:22] We, in the questionnaire that we handed out to the participants, we did have a kind of a regional foot pain map, if you will. So they had to answer where they had foot pain, how long they've had foot pain, etc. And that data hasn't been completely summarized yet. So I'm not going to, I want to avoid answering that for now. And that will be, that will be published and we will come out with that.

[00:30:48] But with the study, we want to also show that these, the people that do wear shoes have a higher incidence of foot pain. And we would have loved to have delved a lot deeper into this, but it is, we were constrained in terms of time, but also language was a factor there.

[00:31:11] We had to have a translation, a lot of people didn't, weren't literate either, or didn't know their diagnoses, or, you know, it was very hard to kind of communicate. So we had to make it as simple as possible to get reliable data. So that data wouldn't be kind of biased or it wouldn't be misconstrued in any way. So, but from experience with working with so many people that have misaligned big toes, right?

[00:31:39] Not even classified as bunions, but just misaligned big toes. It has such a massive impact on how you can move and steer your foot and has a cascading effect, obviously, on how you can stabilize your knee, your hip and the rest of your body when you're moving.

[00:31:55] And I see so often the correlation with misaligned weak toes to many other types of foot pathologies or problems such as plantar fasciitis or Achilles tendinopathy or meditersalgia or Morton's neuroma. And the list goes on because what we have to understand is that the toes have direct and several direct and several indirect links to the rest of the joints in the foot.

[00:32:22] And also all the way up to the lower body and through the fascial line through to the rest of the body. So the toes are literally there to steer and stabilize the rest of your foot. If you incapacitate them, forget about, you know, being able to steer and stabilize the rest of your foot. And this is what leads to, you know, flat footedness or what we call overpronation or the other kind of issues that I mentioned.

[00:32:49] Because a lot of the more passive tissues will get overloaded, such as the plantar fascia and the joints will get into misalignment. So, you know, particularly when it comes to, say, for example, flat feet, the big toe has more than half the foot muscle mass associated to it.

[00:33:10] And we know that through activating and strengthening and realigning that big toe, we see a significant difference just in the arch height in healthy individuals, but in individuals that have problems as well. And we know through just observing the anatomy and the architecture of the foot anatomy and the muscles, the way they attach their origin insertion, we can see that the big toe literally has a very important role in stabilizing the arch.

[00:33:38] And there's many other muscles in the foot that are made to control pronation, right? Pronation is a good thing, but we need the muscles to control it. So, I do think that a lot of these problems that many people are facing with modern kind of foot issues that we're faced with, a lot of them do have their primary root cause in the misalignment and the weakening of the toes.

[00:34:01] And I think that's a great point you bring up that if a bunion has started to develop or you're starting to have that hallux valgus angle, like it's likely because one, yes, footwear, but it's also probably resulting in lack of strength and or mobility somewhere else in the foot. And then it becomes some sort of cascade. And I think that, like you mentioned, a lot of people have started to realize that.

[00:34:29] I'm glad you kind of brought up flat-footedness or, like I said, in my case, high arches. I feel like that's also something that a lot of people will start to point to and say, like you said, there's this kind of helplessness where people just say, oh, I have flat feet. That's why I have foot pain. Conversation over. You know, or I have high arches. That's why I need to wear this type of shoe. And that's it. That's my fate.

[00:34:57] You know, when you actually look in the research and see that the morphology of the foot, whether flat-footedness or high arches, you know, really doesn't have a high association with pain itself. You know, many people who do have flat feet or high arches are symptom-free. So, can you just speak to that?

[00:35:16] Why this style of living, whether it be, you know, the barefoot or the functional type shoe or, you know, living a more barefoot lifestyle can benefit in both high arched or flat-footed individuals? Yeah. So, this thing with the height of the arch is misconstrued quite often. I can see in kind of this space.

[00:35:43] The height of the arch does play a role, but the more important question is whether that foot is rigid or flexible and whether the toes are able to control the motions of the arch. So, the height of the arch is also a genetic factor. I mean, if you're born with flat feet, that's not necessarily a bad thing. And if you're born with high arched feet, that's not necessarily a bad thing. It only becomes a bad thing if you incapacitate the toes where they're no longer able to steer and stabilize the foot.

[00:36:13] So, obviously, having a flatter foot or a higher arch will maybe mean that, okay, you're maybe not going to be, you know, the world-class sprinter, for example. Just like, you know, someone having a really large ribcage and short arms is more predisposed to be the world champion in bench press. These anatomical differences will make us more able to perform better in certain activities.

[00:36:38] So, that kind of, we can apply that to the foot as well, but that's not necessarily a bad thing having a high or low arch. So, it's whether the arch is, if you can actually move your arch, if it's flexible, and also whether you have the toes to control that movement at the arch.

[00:36:54] Such good information here, and I hope people are really starting to see how exercises, along with what we put our foot in, right, plays such a huge role in the impact on what we are feeling and how we function. And it's not just go buy this shoe and it's going to be the magic fix, which is hard. This is what people want, right? Give me the insert. Give me the shoe. Give me the thing that's going to fix all my issues.

[00:37:22] But it does take work on our part as well in terms of exercises that we can do to help make the arch more functional and more mobile and not have such rigidity or improve the strength of the big toe, the movement of the toes altogether.

[00:37:38] And I think it's really cool of what you guys are doing because beyond just social media and trying to help people or beyond just educational programs and trying to help clinicians, you're now taking it a step further and getting into the research and saying this is evidence, right?

[00:37:57] And how do podiatrists or anyone look away from evidence that is truly coming into the space to make a real big change and hopefully difference in what we all start to prescribe and how we really start to move the needle for people. So I think it's really, really incredible.

[00:38:18] If you were to say, you know, for people who feel, well, this is the shoe I have to wear for work or this is what I have to do, you know, in my every day and I just don't have time to commit or I don't have whatever it may be. What are some of the key takeaways that you can say for people to start to help their feet today? Like what are the main factors that you recommend people just start paying attention to now?

[00:38:46] I think that's a good point, especially the person who has like a uniform, like the police officer. Right, right. Like they kind of have to wear the shoe that is part of the uniform. Like what can they do? Yeah, that's a great question. And there's quite a lot that can be done. Obviously, if you have a certain profession that restricts you in terms of your footwear, it's a bit harder, but you can actually size up half a size or even a full size. That does make a big difference.

[00:39:12] But, you know, looking apart from that, what you can do outside of your work is one, be more barefoot is a good approach, right? It's just simple because I know here in Scandinavia where I'm from originally, people naturally are always barefoot or in socks when they get home. But I think, correct me if I'm wrong, it's maybe just my bias, but in the States, a lot of people wear shoes indoors. Is that right? They do. You hear about it all the time. Yeah.

[00:39:42] So that's one good thing that you can do today to improve your foot health and function. And there's studies to prove that as well. That goes a long way. But if you will start, if you start experiencing pain, when you do start going barefoot, then you do need to make some investment into, you know, doing some foot exercises. But also having shoes outside of your work that accommodate your toes fully.

[00:40:09] One very quick, simple thing that people can do is just remove the foot liner or the insole or the foot bed out of their shoe. If it's removable, just put that on the floor. Put your foot on top of that foot bed with your full body weight on that foot and splay your toes. And splay them so that they, if you just, you know, extend your toes up, you'll see these tendons that run along the top of the foot. They run parallel to the metatarsal bones.

[00:40:36] The toes should ideally continue in a straight line from those bones. So try and align your toes in that position. Put your full body weight on top of that foot bed and see whether your foot or your forefoot fits within the parameters of that insole. If they don't, then you know it's definitely too narrow for you. You definitely need to make that change. That's one change you can make.

[00:40:57] And unfortunately, for a lot of people, just going barefoot or wearing kind of functional foot-shaped shoes is not going to necessarily mean that their toes are going to splay out into correct position. So the kind of least time investment thing that you can do there is start to wear toe spacers to passively align the toes. And just doing that in combination with being more barefoot or in foot-shaped shoes goes a very long way with very little time investment.

[00:41:27] And if you do start experiencing problems or you have a history of injuries or you're having pain, then it is very important to start applying exercises. I think that's fantastic. I'm tempted to just put one more little question out there because I was looking at the MyFoot Function Instagram page before we got on this interview and I saw a homunculus. And not everyone will know exactly what that is.

[00:41:52] But I want to bring up and ask your opinion on the importance of how much of our sensory nervous system is devoted to our feet and why that is so important and why being barefoot more often nurtures that sensory side as well. That's a very good question. That's a whole kind of other fascinating subject.

[00:42:17] So the foot, naturally, if we think about the foot, it's the part of the body that's usually in contact, direct contact with our environment. So through evolutionary history, and this applies for a lot of mammals that spend time on their feet, there is a lot of sensory nerves in the foot. The foot has about 200,000 sensory nerves.

[00:42:43] So it's the highest density of sensory nerves in the foot, including five different type of what we call mechanoreceptors that are incredibly sensitive to stretch, direction of force,

[00:42:57] so that that information gets immediately fed up to your central nervous system, so that your brain, your motor brain can deduce what is the most appropriate movement strategy to apply for this given movement task. So if you don't have that appropriate amount of information or don't get that fast enough, then your movement usually starts to suffer.

[00:43:23] And the flip side of it is if you do start going barefoot, usually what tends to happen is that your movement starts to improve when you start going barefoot. And it's a very good way to coach yourself in terms of standing, walking, because your feet with their sensory nerves will give you immediate feedback if you're doing something wrong.

[00:43:46] So one thing that many people do wrong, which they'll often realize when starting to walk barefoot more, particularly outdoors and like asphalt or very hard surfaces, is that they'll start to get pain in their heels. And this is because most people overstride, they'll take too long strides, which is an adaptation of wearing shoes that have too much cushioning, but also that have an elevated heel.

[00:44:13] So this gets kind of wired into our motor system and it becomes habitual. So we keep doing that even when we're barefoot. So by just being barefoot, you'll get that immediate feedback of usually pain or discomfort, and you'll adjust your movement habits and slowly and surely you'll adopt a more efficient stride due to this. That is so great to know.

[00:44:34] I mean, and a quick fix for people to realize, oh, it doesn't mean the barefoot shoe is bad or doesn't mean, you know, going barefoot is bad, but I might have other things that are now built into my system that I can start to work through immediately. I mean, so fascinating. And I can't wait for this research paper to come out. Do you have an estimated publish date? By the end of the year. I don't dare give an exact date. That's okay.

[00:45:02] But it should be by the end of this year. Yeah, this podcast should be coming out sometime mid-February. So we will likely have the final paper. And if so, that'll be linked up in the show notes for anyone listening. 100%. Great. Where else can people go to learn all of the information or education and courses that you guys have available? So they can visit us on our Instagram, which is myfootfunction or our website, myfootfunction.com.

[00:45:31] There we have more information about the study, all the products and foot training tools that we provide, which usually comes with free education as well. And also there we have a lot of other resources. We do also have an app called Foot Function, which is downloadable on iOS Play Store or Google Play, where we have a lot of free resources that people can go inspire themselves with. And other educational resources with training programs for all the types of different foot pathologies that you can see out there.

[00:46:00] Whether you're looking to rehabilitate yourself from pain or just improve performance, all your kind of foot health needs will be there. Perfect. Amazing. Well, Gorgon, unfortunately, this is where the foot love triangle ends today. But I know that you'll continue to go on and make differences in tons of people's lives through their feet. And we appreciate the work that you do. Yeah. Thank you. Thank you very much. It's been an absolute pleasure talking to you both.

[00:46:25] I did want to also mention quickly, maybe this will be put in the show notes, but we'd like to offer all your listeners a discount, which is Gen15 on our website. And that applies to everything on our website. So, thank you once again, Gen and Dominic for having me on. And I look forward to sending you the published research by the end of the year and hopefully discussing more foot love in the future. Yes. Appreciate the discount. Yeah.

[00:46:54] Anyone who's interested, go check that out. I was on their site. They've got some awesome foot tools. So, hopefully people get their hands on those and we'll chat soon. Thank you. Such a great interview and I hope you feel inspired to create change. Maybe pass this along to other people within your family who might have a bunion or other friends that you might know. And what we can really start to do to create health and change of our feet. I think it was just so great.

[00:47:22] Of course, we're going to have everything linked down in the show notes. But also, don't forget that we just launched our Strong Healthy Joints course. Now, this course is made to really push you, empower you to take it up a notch maybe than you haven't before. And I'm telling you the feedback we've received from people no longer having pain in their back when they're doing deadlifts or other lifts, being able to squat lower, feel better within their bodies.

[00:47:48] And I'm talking people who, quote unquote, have bad backs, have bad knees. The changes that people have been able to make within 30 days and beyond is really incredible. So this is your chance to get in. This is our pre-sale price that is only going to be for a limited time. This is a lifetime access course. So for lifetime access, something that you can repeat over and over again, it is such a reduced price. So that's going to be down in our show notes as well.

[00:48:16] Or just go to Jen.Health backslash strong and get in with a community. Get in with me to all be able to move together, feel strong and feel empowered within our bodies. I hope you take action and I hope we see you in the community.