1 00:00:14,440 --> 00:00:18,320 Speaker 1: Hey, everybody, Emily a body here. You are listening to Hurdle, 2 00:00:18,600 --> 00:00:21,599 Speaker 1: a wellness focused podcast. Reconnect with everyone from your favorite 3 00:00:21,600 --> 00:00:25,800 Speaker 1: athletes to top experts and industry CEOs about their highest hies, 4 00:00:26,200 --> 00:00:30,320 Speaker 1: toughest moments, and everything in between. We all go through 5 00:00:30,400 --> 00:00:33,320 Speaker 1: hurdles in life, and my goal through these discussions is 6 00:00:33,320 --> 00:00:36,519 Speaker 1: to empower you to better navigate yours and move with 7 00:00:36,720 --> 00:00:39,720 Speaker 1: intention so that you can stride towards your own big 8 00:00:39,720 --> 00:00:45,640 Speaker 1: potential and of course have some fun along the way. Today, 9 00:00:46,080 --> 00:00:51,040 Speaker 1: I am so elated to bring you my conversation with 10 00:00:51,280 --> 00:00:55,400 Speaker 1: doctor Emily Splickel. She's a New York City paediatrist, a 11 00:00:55,520 --> 00:01:00,400 Speaker 1: human movement specialist, and CEO of Noboso, a come that 12 00:01:00,440 --> 00:01:06,320 Speaker 1: makes all good things for your feet, including insoles and toastspacers, socks, 13 00:01:06,600 --> 00:01:08,880 Speaker 1: foot where you name it. 14 00:01:09,480 --> 00:01:14,199 Speaker 2: We are talking today about all things feet. 15 00:01:14,400 --> 00:01:18,920 Speaker 1: I know, sexy topic, but honestly, the second I mentioned 16 00:01:18,959 --> 00:01:21,839 Speaker 1: on social media that I was navigating a little bit. 17 00:01:21,720 --> 00:01:22,800 Speaker 2: Of planter fasciitis. 18 00:01:22,800 --> 00:01:25,600 Speaker 1: I also talked about it in an episode here on Hurdle. 19 00:01:25,959 --> 00:01:31,080 Speaker 1: My messages, my emails, your questions went wild. So clearly 20 00:01:31,640 --> 00:01:34,959 Speaker 1: feet are a hot topic and that's why I have 21 00:01:35,360 --> 00:01:39,000 Speaker 1: doctor Emily Spleckelk here on the show. Today, we are 22 00:01:39,040 --> 00:01:43,760 Speaker 1: talking about all of your hot foot questions. I like 23 00:01:43,920 --> 00:01:47,080 Speaker 1: dying thinking about like this wording. It makes me laugh 24 00:01:47,440 --> 00:01:50,160 Speaker 1: from goodness. What to do about plant fasciitis and how 25 00:01:50,200 --> 00:01:53,000 Speaker 1: to treat it and maybe even prevent it. Plus we 26 00:01:53,040 --> 00:01:57,880 Speaker 1: wrap about achilles pain, stress, fractures, bruise toenails, and a 27 00:01:58,000 --> 00:01:58,800 Speaker 1: bunch of. 28 00:01:58,760 --> 00:02:00,440 Speaker 2: Other good stuff. 29 00:02:00,600 --> 00:02:03,680 Speaker 1: If you have more foot questions that aren't answered in 30 00:02:03,760 --> 00:02:06,520 Speaker 1: today's episode, hit me with a listener question by clicking 31 00:02:06,560 --> 00:02:09,040 Speaker 1: on over to the show notes and get an answered 32 00:02:09,080 --> 00:02:10,400 Speaker 1: in an upcoming. 33 00:02:10,040 --> 00:02:12,840 Speaker 2: Episode of Five Minute Friday. 34 00:02:13,440 --> 00:02:15,840 Speaker 1: Make sure you're following along with the show over on 35 00:02:15,880 --> 00:02:16,440 Speaker 1: the socials. 36 00:02:16,440 --> 00:02:17,720 Speaker 2: This is at Hurdle podcast. 37 00:02:17,840 --> 00:02:20,880 Speaker 1: I am over at Emily a body And if you 38 00:02:20,919 --> 00:02:24,880 Speaker 1: are not yet subscribed to the weekly Hurdle newsletter, I'd 39 00:02:24,880 --> 00:02:27,520 Speaker 1: love to be in your inbox every single Friday. The 40 00:02:27,600 --> 00:02:31,760 Speaker 1: link to subscribe, which is absolutely free, is in the 41 00:02:31,840 --> 00:02:36,560 Speaker 1: show notes as well. And with that, let's get to hurdling. 42 00:02:44,600 --> 00:02:45,000 Speaker 2: Today. 43 00:02:45,200 --> 00:02:48,440 Speaker 1: I am sitting down with doctor Emily Splickele. She is 44 00:02:48,480 --> 00:02:51,360 Speaker 1: a functional podiatrist. How are you doing today? 45 00:02:51,720 --> 00:02:53,400 Speaker 3: Doing awesome? Thanks for having me on. 46 00:02:54,200 --> 00:02:55,480 Speaker 2: So happy to have you here. 47 00:02:55,680 --> 00:02:58,120 Speaker 1: I feel like the fact that there's a word in 48 00:02:58,120 --> 00:03:00,760 Speaker 1: front of a podiatrists is probably something that we should 49 00:03:00,800 --> 00:03:02,040 Speaker 1: address right from the get go. 50 00:03:02,200 --> 00:03:05,960 Speaker 2: So what does it mean to be a functional podiatrist? 51 00:03:06,440 --> 00:03:11,000 Speaker 3: A functional pedietrist, almost like a functional medicine doctor, right, 52 00:03:11,120 --> 00:03:15,480 Speaker 3: is looking at the body from a very integrated, holistic perspective, 53 00:03:15,560 --> 00:03:18,919 Speaker 3: which is what I do. I'm looking at functional movement, 54 00:03:19,080 --> 00:03:21,240 Speaker 3: which is part of it. So the way that we walk, 55 00:03:21,280 --> 00:03:23,880 Speaker 3: the way that we move our repetitive patterns every day. 56 00:03:24,440 --> 00:03:27,000 Speaker 3: But then because of the type of patient that I treat, 57 00:03:27,200 --> 00:03:32,200 Speaker 3: I am factoring in stress levels, diet, sleep patterns, gut 58 00:03:32,240 --> 00:03:35,320 Speaker 3: biomes a lot of the stuff that a functional medicine 59 00:03:35,320 --> 00:03:36,160 Speaker 3: doctor would as well. 60 00:03:36,360 --> 00:03:38,520 Speaker 1: It's so interesting, right because when we think of the 61 00:03:38,600 --> 00:03:42,680 Speaker 1: feet clearly not directly next to the stomach, but you 62 00:03:42,720 --> 00:03:45,000 Speaker 1: say something like we think about the gut and there 63 00:03:45,200 --> 00:03:49,080 Speaker 1: is a correlation between even that, right, It's probably something 64 00:03:49,080 --> 00:03:50,840 Speaker 1: that a lot of your patients come in and they're like, 65 00:03:50,840 --> 00:03:52,640 Speaker 1: what do you mean my gut has something to do 66 00:03:52,720 --> 00:03:53,680 Speaker 1: with how my feet feel. 67 00:03:54,160 --> 00:03:57,320 Speaker 3: I feel like gut health really became a little bit 68 00:03:57,400 --> 00:04:01,480 Speaker 3: more in the known because of COVID. I don't know, 69 00:04:01,520 --> 00:04:04,400 Speaker 3: maybe in my world, it has because COVID really showed 70 00:04:04,480 --> 00:04:08,680 Speaker 3: like inflammation like this is what inflammation does. COVID can 71 00:04:08,760 --> 00:04:12,200 Speaker 3: destroy your gut and put a lot of inflammation in 72 00:04:12,320 --> 00:04:15,080 Speaker 3: the gut itself, and then that can cause a lot 73 00:04:15,120 --> 00:04:19,159 Speaker 3: of these obscure symptoms that people would start to connect to, 74 00:04:19,279 --> 00:04:22,840 Speaker 3: from brain fog to buzzing in the nerves. I've actually 75 00:04:22,880 --> 00:04:25,400 Speaker 3: seen quite a few patients with COVID who would get 76 00:04:25,440 --> 00:04:28,040 Speaker 3: buzzing and vibrating in the nerves in their feet, and 77 00:04:28,080 --> 00:04:29,760 Speaker 3: it's all inflammatory based. 78 00:04:30,080 --> 00:04:33,599 Speaker 1: This is some important information to know, only the beginning 79 00:04:33,960 --> 00:04:36,640 Speaker 1: of what we're going to dive into today. So before 80 00:04:36,760 --> 00:04:40,680 Speaker 1: I start asking you the hard hitting feet questions, why 81 00:04:40,680 --> 00:04:42,880 Speaker 1: don't you give us a little bit of background into 82 00:04:43,160 --> 00:04:44,680 Speaker 1: how you began practicing. 83 00:04:44,720 --> 00:04:46,280 Speaker 2: I know, not all that long ago. 84 00:04:46,640 --> 00:04:49,159 Speaker 1: You moved from New York to Arizona, So give us 85 00:04:49,200 --> 00:04:50,520 Speaker 1: a little bit of your backstory. 86 00:04:50,960 --> 00:04:53,760 Speaker 3: Yeah, lived in New York City for twenty years, absolutely, 87 00:04:53,839 --> 00:04:56,719 Speaker 3: love love love the city. Started there actually with the 88 00:04:56,720 --> 00:04:59,840 Speaker 3: background in forensics at John Jay College of Criminal just 89 00:05:00,400 --> 00:05:05,200 Speaker 3: so completely not related defeat, and then took a break 90 00:05:05,200 --> 00:05:07,840 Speaker 3: from that and actually became a personal trainer. So I've 91 00:05:07,880 --> 00:05:11,040 Speaker 3: been in the fitness industry for over twenty years, and 92 00:05:11,240 --> 00:05:14,560 Speaker 3: during my time in fitness, I reconnected to my love 93 00:05:14,600 --> 00:05:18,479 Speaker 3: for movement. I was a competitive gymnast for thirteen years, 94 00:05:18,520 --> 00:05:21,320 Speaker 3: so that is at my core of movement and barefoot 95 00:05:21,320 --> 00:05:24,800 Speaker 3: movement is being a gymnast. So then when I was 96 00:05:24,839 --> 00:05:28,560 Speaker 3: going through or being a personal trainer fitness, I wanted 97 00:05:28,600 --> 00:05:31,960 Speaker 3: a more advanced degree, so I started looking at graduate 98 00:05:31,960 --> 00:05:35,919 Speaker 3: school medical schools fell into pedietary kind of by chance. 99 00:05:36,360 --> 00:05:38,840 Speaker 3: There's a pedietary school in New York City in Harlem, 100 00:05:39,240 --> 00:05:41,680 Speaker 3: and that is where I went to school. When I 101 00:05:41,720 --> 00:05:45,680 Speaker 3: was going through pedietary school, it was so isolated and 102 00:05:45,720 --> 00:05:47,880 Speaker 3: disconnected from the rest of the body, and I was 103 00:05:47,880 --> 00:05:50,240 Speaker 3: still being a personal trainer in teaching classes and I 104 00:05:50,279 --> 00:05:55,040 Speaker 3: was like, wait, there's something that's missing here. So before 105 00:05:55,080 --> 00:05:58,600 Speaker 3: I completed my residency, I actually went back to school 106 00:05:59,160 --> 00:06:02,400 Speaker 3: and got my master in Human Movement, and that helped 107 00:06:02,440 --> 00:06:07,560 Speaker 3: me to connect what I was appreciating and intuitively connecting 108 00:06:08,040 --> 00:06:12,919 Speaker 3: with fitness and movement to pedietry. Feet became this master's 109 00:06:12,920 --> 00:06:16,040 Speaker 3: in human movement, and then it just further evolved just 110 00:06:16,120 --> 00:06:22,720 Speaker 3: off of my own curiosity for breathwork, polyvagel theory, emotion, stress, 111 00:06:23,000 --> 00:06:26,880 Speaker 3: fascia nervous system, and it just kind of snowballed from 112 00:06:26,880 --> 00:06:28,080 Speaker 3: there into what I do now. 113 00:06:29,000 --> 00:06:33,160 Speaker 1: Well, you mentioned a buzzword, fascia, and that is the 114 00:06:33,200 --> 00:06:35,440 Speaker 1: first thing that I want to talk about with you 115 00:06:35,600 --> 00:06:40,560 Speaker 1: here today, specifically planter fasci itis. I am dealing with 116 00:06:40,600 --> 00:06:43,440 Speaker 1: it right now, although I'll knock on every piece of 117 00:06:43,480 --> 00:06:46,800 Speaker 1: wood that is near me as you and I speak, I. 118 00:06:46,480 --> 00:06:48,120 Speaker 2: Feel as though I'm coming out of it. 119 00:06:48,600 --> 00:06:51,280 Speaker 1: But it is I am sure you get it all 120 00:06:51,320 --> 00:06:55,560 Speaker 1: the time, the biggest pain point for so many So 121 00:06:55,640 --> 00:06:58,080 Speaker 1: why don't we start with what could be? And I 122 00:06:58,120 --> 00:07:00,919 Speaker 1: know they are endless, but some of the pauses of 123 00:07:01,040 --> 00:07:04,320 Speaker 1: experiencing plant fasci itis, and if you will kind of 124 00:07:04,360 --> 00:07:06,919 Speaker 1: break down exactly what that actually means is going on. 125 00:07:07,279 --> 00:07:13,680 Speaker 3: Yeah, So, plantifasciitis is irritation or microtearing to the planter 126 00:07:13,880 --> 00:07:16,040 Speaker 3: fascia on the bottom of the foot. And what the 127 00:07:16,080 --> 00:07:19,200 Speaker 3: plant of fascia is just quick anatomy lesson. It's the 128 00:07:19,240 --> 00:07:21,800 Speaker 3: thick band of connective tissue that runs from the heel 129 00:07:22,120 --> 00:07:25,160 Speaker 3: and it splits into five slips that goes into the 130 00:07:25,200 --> 00:07:28,200 Speaker 3: base of each toe. So your plant fashi extends the 131 00:07:28,360 --> 00:07:32,200 Speaker 3: entire foot and can be influenced by the digits, which 132 00:07:32,240 --> 00:07:35,480 Speaker 3: is important when I go into certain recommendations. Your plant 133 00:07:35,680 --> 00:07:39,200 Speaker 3: fascia is a rubber band and it is part of 134 00:07:39,320 --> 00:07:43,640 Speaker 3: how we transfer energy. So if you are running, jumping, walking, 135 00:07:43,760 --> 00:07:46,280 Speaker 3: whatever it is you're doing, you have to be able 136 00:07:46,320 --> 00:07:52,040 Speaker 3: to load and unload energy to obviously move and move efficiently. Now, 137 00:07:52,080 --> 00:07:57,080 Speaker 3: depending on your baseline elasticity or this rubber band effect, 138 00:07:57,760 --> 00:08:02,160 Speaker 3: you may overload or not have the stretch that is 139 00:08:02,200 --> 00:08:05,320 Speaker 3: required for the activity you're doing, so then you start 140 00:08:05,320 --> 00:08:08,840 Speaker 3: to micro tear it, and then that microtearing just creates 141 00:08:08,840 --> 00:08:11,120 Speaker 3: a pain cycle. We won't go into is it inflammation 142 00:08:11,240 --> 00:08:14,240 Speaker 3: or not. What's going to is this pain cycle that 143 00:08:14,520 --> 00:08:18,280 Speaker 3: is triggering and talking to the patient or the individual 144 00:08:18,760 --> 00:08:22,720 Speaker 3: as a sharp pain especially after a period of rest, 145 00:08:23,000 --> 00:08:24,720 Speaker 3: and I don't know if you experienced this, but it'll 146 00:08:24,760 --> 00:08:27,320 Speaker 3: be first step in the morning as very classic plant 147 00:08:27,360 --> 00:08:29,880 Speaker 3: refetcy ideas, or you've been sitting a while and then 148 00:08:29,920 --> 00:08:31,720 Speaker 3: you get up and you walk across the room and 149 00:08:31,720 --> 00:08:33,920 Speaker 3: you have that sharp stabbing pain in your heel. Again, 150 00:08:34,679 --> 00:08:40,240 Speaker 3: why that happens is because irritated tissue is sticky, so 151 00:08:40,280 --> 00:08:43,600 Speaker 3: it kind of gets stuck down and then you go 152 00:08:43,720 --> 00:08:45,920 Speaker 3: to stand up and you're like and you kind of 153 00:08:46,120 --> 00:08:52,720 Speaker 3: rapidly restretch it again, and then that causes this sharp pain. Now, 154 00:08:52,760 --> 00:08:54,800 Speaker 3: some of the most common causes that I see in 155 00:08:54,840 --> 00:09:01,200 Speaker 3: my office is a delayed stabilization of the foot is 156 00:09:01,240 --> 00:09:04,240 Speaker 3: one of the most common. Now that could be from 157 00:09:04,360 --> 00:09:07,839 Speaker 3: foot type, so flat feet, and there's many types of 158 00:09:07,840 --> 00:09:09,600 Speaker 3: flat feet, so we'll just keep it broad for now, 159 00:09:09,679 --> 00:09:14,080 Speaker 3: but flat feet cause a slower foot, so you are 160 00:09:14,120 --> 00:09:18,720 Speaker 3: not stabilizing as quickly foot wear can do it, meaning 161 00:09:18,840 --> 00:09:22,400 Speaker 3: that if you wear overly supportive shoes all the time 162 00:09:22,960 --> 00:09:27,040 Speaker 3: and you suddenly overload the foot, and you're so used 163 00:09:27,080 --> 00:09:29,840 Speaker 3: to the shoe doing the work versus your foot, you 164 00:09:29,840 --> 00:09:33,520 Speaker 3: can overload it. Or if you always wear cushion shoes 165 00:09:33,520 --> 00:09:36,640 Speaker 3: and you suddenly be into more of like a barefoot 166 00:09:36,679 --> 00:09:39,760 Speaker 3: or a minimal environment, you're going to overload the foot. 167 00:09:40,000 --> 00:09:43,599 Speaker 3: So sometimes people would associate this with their rapid transition 168 00:09:43,760 --> 00:09:46,839 Speaker 3: into bare foot shoes or minimal shoes, and they blame 169 00:09:46,880 --> 00:09:48,840 Speaker 3: the shoe. It's not the shoe, it was the transition 170 00:09:49,000 --> 00:09:52,320 Speaker 3: that they did. And then sometimes it can be from 171 00:09:52,960 --> 00:09:56,120 Speaker 3: very stiff, rigid feet, like really high archies or susceptible 172 00:09:56,120 --> 00:09:59,120 Speaker 3: to plantifaestiatis as well, and then some of it could 173 00:09:59,200 --> 00:10:02,719 Speaker 3: just be activity dependent. I used to see it a 174 00:10:02,760 --> 00:10:06,000 Speaker 3: lot and say like crossfitters doing box jumps and they 175 00:10:06,040 --> 00:10:10,840 Speaker 3: just didn't have the recovery or the balance between stress 176 00:10:10,920 --> 00:10:14,160 Speaker 3: and recovery to the tissue and eventually it broke down. 177 00:10:15,120 --> 00:10:15,440 Speaker 2: Yeah. 178 00:10:15,520 --> 00:10:19,560 Speaker 1: Yeah, so so many causes. Clearly here, it's not like 179 00:10:19,600 --> 00:10:22,280 Speaker 1: a one size all like, oh, you have planter fasciais 180 00:10:22,360 --> 00:10:24,280 Speaker 1: this is what you have to do to fix it. 181 00:10:24,400 --> 00:10:27,959 Speaker 1: I know in my case, I am realizing that I 182 00:10:28,040 --> 00:10:31,520 Speaker 1: haven't been actually using my toes much in my stride 183 00:10:31,720 --> 00:10:34,600 Speaker 1: and so because I am relying on the rest of 184 00:10:34,600 --> 00:10:37,280 Speaker 1: my feet to do the work, that is where the 185 00:10:37,320 --> 00:10:40,000 Speaker 1: pain kind of started from. And now a big part 186 00:10:40,000 --> 00:10:43,160 Speaker 1: of my physical therapy is literally just getting onto my 187 00:10:43,240 --> 00:10:46,840 Speaker 1: toes more like learning how to incorporate them into a 188 00:10:46,880 --> 00:10:50,520 Speaker 1: lot more of my movements and stuff like that. 189 00:10:50,640 --> 00:10:52,680 Speaker 3: So that's why it's important that I said that your 190 00:10:52,720 --> 00:10:55,240 Speaker 3: planet fascion goes all the way to your toes, So 191 00:10:55,280 --> 00:10:58,319 Speaker 3: you need to use your toes, strengthen your toes, engage them. 192 00:10:58,320 --> 00:11:00,880 Speaker 3: They're part of the party as well, right, and if 193 00:11:00,880 --> 00:11:04,680 Speaker 3: we don't use them, then things like this can happen totally. 194 00:11:04,720 --> 00:11:07,520 Speaker 1: And I know that there are a lot of individuals 195 00:11:07,559 --> 00:11:10,240 Speaker 1: who ask a question like, well, how do I use 196 00:11:10,280 --> 00:11:12,439 Speaker 1: my toes? How do I warm up my toes? Do 197 00:11:12,480 --> 00:11:15,160 Speaker 1: you have any thoughts, feelings, opinions on that. 198 00:11:15,600 --> 00:11:16,400 Speaker 2: The action of. 199 00:11:16,360 --> 00:11:23,080 Speaker 3: The toes is that they are designed to be long, straight, flat, 200 00:11:23,120 --> 00:11:25,560 Speaker 3: and in contact with the ground, So that's that's the 201 00:11:25,760 --> 00:11:31,200 Speaker 3: ideal digit alignment is and spread right, so long, straight, flat, 202 00:11:31,280 --> 00:11:35,840 Speaker 3: spread and engaging. The engaging, which is called toe flex 203 00:11:35,920 --> 00:11:42,440 Speaker 3: or strength, is really a key foundational functional action of 204 00:11:42,480 --> 00:11:45,880 Speaker 3: the foot, and you can strengthen it by just pushing 205 00:11:45,880 --> 00:11:48,959 Speaker 3: your toes into the floor, which is called short foot. 206 00:11:49,480 --> 00:11:53,640 Speaker 3: And when you push your toes into the floor, what 207 00:11:53,720 --> 00:11:56,600 Speaker 3: you should see or feel is that your arch kind 208 00:11:56,600 --> 00:11:59,600 Speaker 3: of starts to lift or contract. There's a response that 209 00:11:59,679 --> 00:12:03,360 Speaker 3: happens from toe constractures, which is this lifting of the arch. 210 00:12:03,760 --> 00:12:06,560 Speaker 3: The way that I teach it to be more functional 211 00:12:07,240 --> 00:12:10,160 Speaker 3: is that when you push your toes down, I need 212 00:12:10,360 --> 00:12:13,960 Speaker 3: your pulvic floor to lift, because that's the way that 213 00:12:14,040 --> 00:12:17,880 Speaker 3: it actually works when we are moving in the real world. 214 00:12:18,440 --> 00:12:21,520 Speaker 3: And technically I would want to add in the diaphragm 215 00:12:21,600 --> 00:12:25,360 Speaker 3: as well, so you would want to be exhandling as 216 00:12:25,400 --> 00:12:28,160 Speaker 3: you push your toes down as your public floor lifts, 217 00:12:28,160 --> 00:12:30,439 Speaker 3: so you're stacking those three things. 218 00:12:31,040 --> 00:12:34,000 Speaker 1: I'm literally sitting here like doing it as you're talking 219 00:12:34,080 --> 00:12:35,760 Speaker 1: to me, practicing. 220 00:12:36,720 --> 00:12:39,360 Speaker 2: All of this movement simultaneously. Okay. 221 00:12:39,600 --> 00:12:44,000 Speaker 1: So for those that have chronic planter fasci itis, maybe 222 00:12:44,040 --> 00:12:47,280 Speaker 1: it's someone who feels as though they cannot remember the 223 00:12:47,400 --> 00:12:51,440 Speaker 1: last time they didn't have pain in their planter fascia 224 00:12:51,800 --> 00:12:52,920 Speaker 1: is their hope for them? 225 00:12:52,960 --> 00:12:54,200 Speaker 2: What do you tell them? 226 00:12:54,679 --> 00:12:57,080 Speaker 3: This is actually a lot of what I see in 227 00:12:57,080 --> 00:12:59,400 Speaker 3: my practice, and especially when I was in New York City, 228 00:12:59,400 --> 00:13:02,439 Speaker 3: it was almost every single one of my patients were chronic, 229 00:13:02,520 --> 00:13:05,760 Speaker 3: non responding plant or fasciosis let's call it. So it's chronic, 230 00:13:05,800 --> 00:13:10,360 Speaker 3: it's degenerated in nature, and they were doing what doctor 231 00:13:10,360 --> 00:13:12,560 Speaker 3: Google told them to do, or what their friend told 232 00:13:12,559 --> 00:13:16,280 Speaker 3: them to do, or maybe some other peddietist, whoever it was, 233 00:13:16,679 --> 00:13:19,240 Speaker 3: and they were really treating it actually more as an 234 00:13:19,280 --> 00:13:25,400 Speaker 3: acute condition, and an acute condition responds to plant or 235 00:13:25,440 --> 00:13:31,839 Speaker 3: fasciitis treatments differently than chronic. Chronic plant fascial stress is 236 00:13:31,880 --> 00:13:35,160 Speaker 3: when you've either had your symptoms for longer than six months, 237 00:13:35,400 --> 00:13:40,040 Speaker 3: so consistently for six months, or you get this waxing 238 00:13:40,120 --> 00:13:42,800 Speaker 3: and waning that it'll kind of spike and that'll be 239 00:13:42,840 --> 00:13:45,400 Speaker 3: there for a month and it'll go quiescent and that'll 240 00:13:45,400 --> 00:13:48,120 Speaker 3: come back a couple months later. And there's patients that 241 00:13:48,120 --> 00:13:50,640 Speaker 3: I could have that for years, like ten years, that 242 00:13:50,679 --> 00:13:54,360 Speaker 3: it's persisting like this waxing and waning. What I want 243 00:13:54,400 --> 00:13:57,040 Speaker 3: to do in those patients is rule out any sort 244 00:13:57,040 --> 00:14:02,040 Speaker 3: of thickening, degeneration, and even a partial tear of the 245 00:14:02,040 --> 00:14:06,280 Speaker 3: plant or fascion. And it's very common in chronic cases 246 00:14:06,360 --> 00:14:10,680 Speaker 3: to have tearing of the plant or fascia. And when 247 00:14:10,679 --> 00:14:14,000 Speaker 3: your plant or fascia tears, it actually phrase. So the 248 00:14:14,040 --> 00:14:17,120 Speaker 3: listeners could almost like visualize like a rope that's like 249 00:14:18,120 --> 00:14:20,080 Speaker 3: torn or frayed at the ends and it's kind of 250 00:14:20,160 --> 00:14:24,920 Speaker 3: chaotically sitting there and then the pieces sit next to 251 00:14:24,960 --> 00:14:28,120 Speaker 3: each other and then kind of get readheed to this phray. 252 00:14:28,200 --> 00:14:31,240 Speaker 3: It's like a messy, disorganized haystack, if you want to 253 00:14:31,240 --> 00:14:34,160 Speaker 3: think of it. So we need to bring organization to 254 00:14:34,240 --> 00:14:37,720 Speaker 3: that tissue. In my office, I do regenitive injections, so 255 00:14:37,880 --> 00:14:42,320 Speaker 3: either PRP, different growth factors. There's amniotic and placental injections. 256 00:14:42,360 --> 00:14:44,640 Speaker 3: The FDA is getting kind of weird with some of them, 257 00:14:44,920 --> 00:14:48,120 Speaker 3: so there's only certain ones on the markets now. But 258 00:14:48,200 --> 00:14:52,200 Speaker 3: that's what I specialize in in my practice. I did 259 00:14:52,240 --> 00:14:56,360 Speaker 3: surgery for five years out of residency, and that's where 260 00:14:56,360 --> 00:14:59,320 Speaker 3: people would do a fasciotomy and they would just cut 261 00:14:59,360 --> 00:15:02,680 Speaker 3: and release fascia and then just move the pieces far 262 00:15:02,760 --> 00:15:05,080 Speaker 3: apart from each other and say like, Okay, you're not 263 00:15:05,120 --> 00:15:07,080 Speaker 3: going to have any symptoms if it's just like not 264 00:15:07,120 --> 00:15:13,520 Speaker 3: even connected. Very successful these fasciotomies. However, there is a 265 00:15:13,520 --> 00:15:17,000 Speaker 3: research that shows if your plant or fascia is cut 266 00:15:17,200 --> 00:15:22,400 Speaker 3: the digit stabilization and your forefoot, you actually start to 267 00:15:22,440 --> 00:15:26,840 Speaker 3: get a delay and a disconnection in how that part 268 00:15:26,840 --> 00:15:30,960 Speaker 3: of the foot optimizes or stabilizes. So I opt more 269 00:15:31,000 --> 00:15:32,440 Speaker 3: for a regeneritive technique. 270 00:15:32,520 --> 00:15:35,160 Speaker 2: Okay, so there is hope, is basically what you're saying. 271 00:15:35,560 --> 00:15:38,440 Speaker 3: There is hope, but you need to make sure you 272 00:15:38,560 --> 00:15:40,840 Speaker 3: understand what you're dealing with. And I just wrote a 273 00:15:40,880 --> 00:15:43,400 Speaker 3: blog on this and did an IG post of that. 274 00:15:43,440 --> 00:15:46,120 Speaker 3: You really have to understand because if you're being treated 275 00:15:46,840 --> 00:15:50,360 Speaker 3: like you have acute plant or fasciitis, you're not going 276 00:15:50,440 --> 00:15:53,760 Speaker 3: to respond or you might respond for a week, and 277 00:15:53,800 --> 00:15:56,120 Speaker 3: then as soon as it you stress it again, it's 278 00:15:56,120 --> 00:15:59,440 Speaker 3: going to come back. So having an accurate diagnosis and 279 00:15:59,440 --> 00:16:03,600 Speaker 3: an understand is super important, and that's part of why 280 00:16:03,680 --> 00:16:07,240 Speaker 3: I do podcasts like this, is to advocate that patients 281 00:16:07,360 --> 00:16:10,080 Speaker 3: understand and take ownership of their body and question things 282 00:16:10,160 --> 00:16:12,200 Speaker 3: and say, no, I don't think this is right. I 283 00:16:12,240 --> 00:16:14,200 Speaker 3: think I might actually have maybe a tear. 284 00:16:14,760 --> 00:16:19,480 Speaker 1: Please investigate, right, investigate, So make sure you speak one 285 00:16:19,600 --> 00:16:23,240 Speaker 1: on one with an expert. The advocating is great, but 286 00:16:23,320 --> 00:16:26,760 Speaker 1: then it is in the power of the powerful hands 287 00:16:26,800 --> 00:16:30,120 Speaker 1: of the listener to take this information and do something 288 00:16:30,160 --> 00:16:32,080 Speaker 1: with it and advocate for themselves. 289 00:16:32,240 --> 00:16:33,880 Speaker 2: Exactly perfect. 290 00:16:33,920 --> 00:16:39,440 Speaker 1: Okay, let's switch gears a little bit and talk about toenails. Wow, 291 00:16:39,760 --> 00:16:42,760 Speaker 1: love all of these topics for us bruise toenails. 292 00:16:42,840 --> 00:16:44,760 Speaker 2: I'm a runner. I'm sure you meet with a lot 293 00:16:44,800 --> 00:16:45,320 Speaker 2: of runners. 294 00:16:45,320 --> 00:16:48,880 Speaker 1: Obviously, tonail bruising not exclusive to the running community, but 295 00:16:48,960 --> 00:16:52,720 Speaker 1: seen very frequently. For someone who has a bruised toenail 296 00:16:52,840 --> 00:16:56,280 Speaker 1: or toenail pain, how do they go about doing something 297 00:16:56,320 --> 00:17:00,160 Speaker 1: about that or should they just be leaving it completely alone. 298 00:17:01,040 --> 00:17:05,480 Speaker 3: I do not advocate bathroom surgery, so whatever I recommend 299 00:17:06,520 --> 00:17:10,520 Speaker 3: I didn't tell you to do it. So any of 300 00:17:10,560 --> 00:17:14,679 Speaker 3: these the blood under the nail. So you're running, and 301 00:17:14,720 --> 00:17:17,639 Speaker 3: what happens this is primarily to the second. You can 302 00:17:17,680 --> 00:17:20,280 Speaker 3: see it in the first, especially with like the marathons. 303 00:17:20,280 --> 00:17:22,520 Speaker 3: I would see a ton of patients getting it into 304 00:17:22,600 --> 00:17:25,600 Speaker 3: the great toe as well, but primarily the second, because 305 00:17:25,600 --> 00:17:29,320 Speaker 3: the second is longer on many people. So you're jamming 306 00:17:29,359 --> 00:17:31,680 Speaker 3: into the shoe when you run, and then you're essentially 307 00:17:32,840 --> 00:17:36,240 Speaker 3: not bruising it. You're creating a micro injury that bleeds 308 00:17:36,400 --> 00:17:40,160 Speaker 3: underneath the mail, underneath the nail, So the blood stuck 309 00:17:40,200 --> 00:17:43,959 Speaker 3: under the nail. It's called a subungle hematoma. It's your 310 00:17:44,000 --> 00:17:47,000 Speaker 3: medical term for it. And it can be very painful 311 00:17:47,240 --> 00:17:50,960 Speaker 3: because it is pressure. So this pressure of the blood 312 00:17:51,040 --> 00:17:56,960 Speaker 3: under the nail is just extremely kind of pressure increasing. 313 00:17:57,400 --> 00:17:59,920 Speaker 3: It's in a fixed space. So what you want to 314 00:18:00,080 --> 00:18:03,840 Speaker 3: do is you have to relieve the pressure. Is ultimately 315 00:18:03,840 --> 00:18:06,120 Speaker 3: what you're trying to do in an acute setting. Right, 316 00:18:06,480 --> 00:18:08,439 Speaker 3: So what I would do again, this is not your 317 00:18:08,480 --> 00:18:12,119 Speaker 3: bathroom surgery, but I would use a sterile instrument and 318 00:18:12,160 --> 00:18:15,399 Speaker 3: I would poke poles in the nail to allow it 319 00:18:15,440 --> 00:18:19,800 Speaker 3: to bleed through. Now, when you do that, Almost all 320 00:18:19,880 --> 00:18:22,400 Speaker 3: patients notice in an immediate decrease in the pain because 321 00:18:22,400 --> 00:18:25,840 Speaker 3: I relieve the pressure, the blood comes out. And then 322 00:18:26,119 --> 00:18:28,679 Speaker 3: this is the important part because if this is happening 323 00:18:28,760 --> 00:18:33,320 Speaker 3: a lot to your listeners, trauma is the number one 324 00:18:34,200 --> 00:18:39,080 Speaker 3: trigger to fungal nails because now you have this opening 325 00:18:39,280 --> 00:18:42,880 Speaker 3: and fungal infections in the nail are in and under 326 00:18:42,920 --> 00:18:45,880 Speaker 3: the nail bed. So trauma, you want to be really 327 00:18:45,880 --> 00:18:48,200 Speaker 3: careful and watch the nail and how it grows out. 328 00:18:48,760 --> 00:18:53,200 Speaker 3: If there's too much blood under the nail, you disconnect 329 00:18:53,920 --> 00:18:55,720 Speaker 3: all the fibers that are connecting the nail to the 330 00:18:55,800 --> 00:18:58,600 Speaker 3: nail bed, and you could actually lose the nail. If 331 00:18:58,600 --> 00:19:02,240 Speaker 3: you do lose the nail, then I do advise seeing 332 00:19:02,240 --> 00:19:05,080 Speaker 3: a pediatrist. I know it might seem really small or 333 00:19:05,119 --> 00:19:07,760 Speaker 3: like a small issue, but to make sure the nail 334 00:19:07,840 --> 00:19:12,360 Speaker 3: grows out appropriately and in a way that you're not 335 00:19:12,400 --> 00:19:15,240 Speaker 3: going to get fungus. So I would actually give patients 336 00:19:15,320 --> 00:19:19,560 Speaker 3: a topical anti fungal laquer as the nail is growing out, 337 00:19:19,560 --> 00:19:21,680 Speaker 3: because I do not want fungus at any point to 338 00:19:21,720 --> 00:19:22,840 Speaker 3: get under that nail bed. 339 00:19:24,080 --> 00:19:28,480 Speaker 1: So hypothetically speaking, if someone you were speaking to right 340 00:19:28,520 --> 00:19:32,280 Speaker 1: now had lost their pinky toenail somehow and had no 341 00:19:32,359 --> 00:19:35,280 Speaker 1: idea how it happened. Is it bad to get a 342 00:19:35,280 --> 00:19:38,440 Speaker 1: pedicure and have them paint the pinky as though there 343 00:19:38,320 --> 00:19:39,520 Speaker 1: was a nail there? 344 00:19:40,480 --> 00:19:44,680 Speaker 3: No, that's totally fine. You know, the pinky nail of 345 00:19:44,760 --> 00:19:47,160 Speaker 3: all of the nails is the one that you will 346 00:19:47,240 --> 00:19:51,560 Speaker 3: probably get some hypercha fy to it, so some thickening, 347 00:19:51,600 --> 00:19:54,280 Speaker 3: and the thicking doesn't necessarily mean that there's fungus in it, 348 00:19:54,680 --> 00:19:58,880 Speaker 3: But a lot of people's pinky toenails just look random. 349 00:19:59,040 --> 00:20:02,199 Speaker 3: They're super small. You cut them off, there's like no 350 00:20:02,320 --> 00:20:05,400 Speaker 3: nail there then, so it's just kind of this interesting 351 00:20:05,640 --> 00:20:09,520 Speaker 3: vestigial nail. So yeah, I don't know. If this is you, 352 00:20:11,119 --> 00:20:11,640 Speaker 3: you can. 353 00:20:11,480 --> 00:20:13,080 Speaker 2: Paint spoiler alert, it's me. 354 00:20:14,160 --> 00:20:15,840 Speaker 3: You can totally paint it. 355 00:20:16,440 --> 00:20:19,360 Speaker 1: Okay, good, I feel more confident knowing that I literally 356 00:20:19,359 --> 00:20:21,119 Speaker 1: did this about an hour and a half ago. So 357 00:20:21,600 --> 00:20:24,480 Speaker 1: for those that are wondering, But what about the bigger tonails, Like, 358 00:20:24,600 --> 00:20:26,880 Speaker 1: is that something that you shouldn't be doing if you've 359 00:20:26,920 --> 00:20:29,280 Speaker 1: lost maybe did you refer to it as the great 360 00:20:29,400 --> 00:20:30,199 Speaker 1: toe before? 361 00:20:30,400 --> 00:20:31,280 Speaker 3: This is the great toe? 362 00:20:31,359 --> 00:20:34,119 Speaker 1: Yes? Okay, if you lose the great toe, the biggest 363 00:20:34,240 --> 00:20:36,880 Speaker 1: toe you got is it bad to paint that? 364 00:20:37,200 --> 00:20:41,280 Speaker 3: Honestly, I wouldn't. One is just going to look like crazy, 365 00:20:43,040 --> 00:20:46,320 Speaker 3: it's not going to look the same. But there are 366 00:20:46,480 --> 00:20:52,480 Speaker 3: these medical products that you can It's essentially acrylic, but 367 00:20:52,760 --> 00:20:55,800 Speaker 3: a medical acrylic and it goes on like a nail 368 00:20:56,359 --> 00:20:58,960 Speaker 3: and it is intended to guide the way that the 369 00:20:59,040 --> 00:21:01,639 Speaker 3: nail is growing out that you can paint. And I 370 00:21:01,640 --> 00:21:06,040 Speaker 3: would not do this from a nail spa on the corner. 371 00:21:06,119 --> 00:21:08,720 Speaker 3: I would go to a pediatrist to do it more medically, 372 00:21:09,400 --> 00:21:11,560 Speaker 3: and then yes, you could paint that and you would 373 00:21:11,640 --> 00:21:15,159 Speaker 3: essentially follow that as the nail grows out and it 374 00:21:15,200 --> 00:21:17,359 Speaker 3: takes year. Here's a fun fact. It takes a year 375 00:21:17,880 --> 00:21:20,720 Speaker 3: for a nail to grow out. Your toenails to grow out. 376 00:21:20,920 --> 00:21:22,600 Speaker 3: But the pinky guy is a little less. 377 00:21:22,760 --> 00:21:25,879 Speaker 1: Another question that came in does the drop of a 378 00:21:26,000 --> 00:21:29,440 Speaker 1: shoe matter? I know this is a yes, but let's 379 00:21:29,440 --> 00:21:31,639 Speaker 1: talk a little bit about what someone may need to 380 00:21:31,720 --> 00:21:35,200 Speaker 1: know about shoe when it comes to either stack height 381 00:21:35,480 --> 00:21:36,200 Speaker 1: or drop. 382 00:21:36,840 --> 00:21:39,360 Speaker 3: Yeah, so, keel toe drop is really what this this 383 00:21:39,400 --> 00:21:42,439 Speaker 3: listener is referencing. The heel toe drop is the angle 384 00:21:42,560 --> 00:21:45,760 Speaker 3: between the heels of the toe. Right, So how much 385 00:21:45,840 --> 00:21:51,240 Speaker 3: there is this declination, how much of a you know, 386 00:21:51,280 --> 00:21:53,000 Speaker 3: think like high heels, right, so how much are you 387 00:21:53,040 --> 00:21:57,320 Speaker 3: pushing the foot into what's mimicking like a heeled position 388 00:21:57,640 --> 00:22:02,760 Speaker 3: or a plant or flexion of the ankle. Now, the drop, 389 00:22:03,000 --> 00:22:07,280 Speaker 3: why that was initially put into shoes running shoes, was 390 00:22:07,359 --> 00:22:11,840 Speaker 3: to offload the achilles tendon. It's just putting it on 391 00:22:11,920 --> 00:22:16,080 Speaker 3: a little less tension and to pull the foot into 392 00:22:16,200 --> 00:22:19,520 Speaker 3: more of a neutral position. So it also offloads the planter, 393 00:22:19,720 --> 00:22:23,800 Speaker 3: fascia and other structures of the foot. Now that is 394 00:22:23,960 --> 00:22:29,480 Speaker 3: in certain foot types. Not all foot types will respond 395 00:22:29,520 --> 00:22:33,960 Speaker 3: the same to a heel toe drop because they start 396 00:22:34,560 --> 00:22:39,480 Speaker 3: on a flat ground, beautifully neutral or maybe even higher 397 00:22:39,600 --> 00:22:42,360 Speaker 3: arch and rigid. So you don't want to be pushing 398 00:22:42,480 --> 00:22:48,640 Speaker 3: those feet into a more rigid, plan reflex supinated position. 399 00:22:48,840 --> 00:22:51,960 Speaker 3: Let's say, So this is where I try to put 400 00:22:51,960 --> 00:22:56,920 Speaker 3: as many people into a transitional drop, which is between 401 00:22:56,960 --> 00:23:00,800 Speaker 3: eight and ten millimeters. A traditional drop for the listeners 402 00:23:00,840 --> 00:23:04,320 Speaker 3: is between fourteen and sixteen millimeters, So it's it's not 403 00:23:04,440 --> 00:23:07,240 Speaker 3: that much. It's not like five inches, right, but it's 404 00:23:07,359 --> 00:23:12,480 Speaker 3: enough to overload the tissue in certain ways. Transitional eight 405 00:23:12,520 --> 00:23:15,359 Speaker 3: to ten millimeters zero drop, which is kind of like 406 00:23:15,400 --> 00:23:19,239 Speaker 3: these quote unquote barefoot shoes that are out there is 407 00:23:19,440 --> 00:23:22,680 Speaker 3: zero to three millimeters. I'll give a couple brands of 408 00:23:23,040 --> 00:23:27,320 Speaker 3: different ones. Vivo Barefoot is probably the most well known 409 00:23:27,720 --> 00:23:31,560 Speaker 3: zero drop zero shoes, kind of like the name, but 410 00:23:31,600 --> 00:23:34,520 Speaker 3: it's spelled different with an X. Is another zero drop 411 00:23:34,520 --> 00:23:38,240 Speaker 3: shoe that's on the market. More that transitional is going 412 00:23:38,320 --> 00:23:43,760 Speaker 3: to be like on running ultra falls under transitional, and 413 00:23:43,800 --> 00:23:48,000 Speaker 3: then like your new balanced sockeny all of those are traditional. 414 00:23:48,600 --> 00:23:52,439 Speaker 3: Now stack is different. Stack is not the same as 415 00:23:52,480 --> 00:23:55,359 Speaker 3: a heel toe drop, even though heel toe drop shoes 416 00:23:55,920 --> 00:23:58,320 Speaker 3: have a stack under them. But the stack is how 417 00:23:58,680 --> 00:24:03,000 Speaker 3: much cushion and elevation is the entire shoe lifted off 418 00:24:03,040 --> 00:24:09,080 Speaker 3: of the ground. The higher the stack, the more removed 419 00:24:09,200 --> 00:24:12,760 Speaker 3: you are from all of the sensory information from the 420 00:24:12,800 --> 00:24:16,080 Speaker 3: ground that you need to move. So I am for 421 00:24:16,119 --> 00:24:20,240 Speaker 3: the most part anti stack, because I want people to 422 00:24:20,320 --> 00:24:24,960 Speaker 3: connect to the ground from a sensory perspective. The shoe 423 00:24:25,000 --> 00:24:28,159 Speaker 3: that all the listeners know that push stack to be 424 00:24:28,320 --> 00:24:33,280 Speaker 3: super trendy is Poka, and they started as a ultra 425 00:24:33,400 --> 00:24:36,840 Speaker 3: marathon shoe. So there was a reason for all that 426 00:24:36,920 --> 00:24:41,680 Speaker 3: stack and that cushion because you were defined physiology by 427 00:24:41,760 --> 00:24:45,520 Speaker 3: running ultra marathons, right, So it was like, hey, let 428 00:24:45,520 --> 00:24:48,280 Speaker 3: me just take some of that impact from you by 429 00:24:48,320 --> 00:24:52,080 Speaker 3: giving you this stack or this cushion. Now it's super trendy. 430 00:24:52,480 --> 00:24:55,639 Speaker 3: All the shoes are stacked. It's a trend now, but 431 00:24:56,480 --> 00:24:59,639 Speaker 3: I would ideally want someone with as little stack as 432 00:24:59,680 --> 00:25:02,840 Speaker 3: possible to optimize natural foot function. 433 00:25:08,000 --> 00:25:11,240 Speaker 1: Popping in to today's episode to give some love to 434 00:25:11,320 --> 00:25:17,520 Speaker 1: my sponsors. 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It's hard enough as it is. 475 00:27:57,000 --> 00:27:59,040 Speaker 1: I want to be able to get a leg up 476 00:27:59,080 --> 00:28:01,720 Speaker 1: and do the best that I can with what I have, 477 00:28:01,960 --> 00:28:07,040 Speaker 1: and that begins with inside Tracker. You can get a 478 00:28:07,200 --> 00:28:11,000 Speaker 1: twenty percent off discount on the entire inside Tracker store 479 00:28:11,240 --> 00:28:14,639 Speaker 1: by heading to inside Tracker. That's I N S I 480 00:28:14,880 --> 00:28:18,480 Speaker 1: D E t R A c k e R dot 481 00:28:18,520 --> 00:28:22,439 Speaker 1: com slash kurdle today. Again, that's twenty percent off the 482 00:28:22,600 --> 00:28:26,359 Speaker 1: entire inside Tracker store today by heading to inside tracker 483 00:28:26,440 --> 00:28:27,600 Speaker 1: dot com slash kurdle. 484 00:28:28,000 --> 00:28:30,280 Speaker 2: Knowe what's going on with your body? Trust me, it 485 00:28:30,440 --> 00:28:33,720 Speaker 2: is the kind of knowledge that we all need. 486 00:28:38,920 --> 00:28:42,280 Speaker 1: So aside from the hookahs, a lot of individuals listening 487 00:28:42,280 --> 00:28:45,120 Speaker 1: to this may lean into a high stack Heit shoe 488 00:28:45,480 --> 00:28:49,480 Speaker 1: for something like racing. Those shoes as well, many of 489 00:28:49,520 --> 00:28:53,560 Speaker 1: them including a carbon plate. What should someone know about 490 00:28:53,560 --> 00:28:57,080 Speaker 1: integrating carbon plated shoes into the routine if they want 491 00:28:57,120 --> 00:29:00,760 Speaker 1: to keep the betterment of their foot health in mind. 492 00:29:01,160 --> 00:29:07,719 Speaker 3: Yeah. So carbon plates are a well known orthopedic cadorthic 493 00:29:07,920 --> 00:29:12,840 Speaker 3: kind of within this medical foot space material that was 494 00:29:13,040 --> 00:29:18,160 Speaker 3: used to transfer energy. When you take something that is 495 00:29:18,800 --> 00:29:24,000 Speaker 3: medical and get twist it to be consumer based, you 496 00:29:24,160 --> 00:29:28,240 Speaker 3: now don't know the quality of the carbon that you're getting. 497 00:29:28,920 --> 00:29:33,360 Speaker 3: So the you know, miracle responses of what we think 498 00:29:33,760 --> 00:29:36,360 Speaker 3: of any sort of ad just take it with the 499 00:29:36,360 --> 00:29:39,120 Speaker 3: grain of salt. Because it has to do with the 500 00:29:39,160 --> 00:29:43,680 Speaker 3: stiffness and the thickness of the carbon fiber that's being used. 501 00:29:44,440 --> 00:29:46,040 Speaker 3: So it's not going to make you win the race 502 00:29:46,080 --> 00:29:49,040 Speaker 3: guarantee because of the shoe, is what I'm trying to say. Now, 503 00:29:49,160 --> 00:29:52,800 Speaker 3: carbon fiber is stiff, So this is one thing that 504 00:29:53,080 --> 00:29:57,000 Speaker 3: is an advantage of carbon fiber is that it is 505 00:29:57,040 --> 00:30:01,560 Speaker 3: going to be harder and stiffer, harder. Different interfaces with 506 00:30:01,640 --> 00:30:07,040 Speaker 3: the foot are more neurologically stimulating. So if you have 507 00:30:07,080 --> 00:30:09,479 Speaker 3: a shoe with the stack with the cushion that is 508 00:30:09,560 --> 00:30:12,959 Speaker 3: not really sensory friendly, but you put a carbon fiber 509 00:30:13,120 --> 00:30:18,560 Speaker 3: interface on it, now you've put stiffness back into the interface, 510 00:30:18,840 --> 00:30:21,440 Speaker 3: which just upped some of the sensation to the foot. 511 00:30:21,720 --> 00:30:26,280 Speaker 3: So I actually would favor that environment more. I would 512 00:30:26,360 --> 00:30:29,720 Speaker 3: just again say like, is this shoe gonna make me 513 00:30:29,960 --> 00:30:31,640 Speaker 3: you know, super Emily? 514 00:30:32,080 --> 00:30:32,560 Speaker 2: I don't know. 515 00:30:32,720 --> 00:30:33,320 Speaker 3: I doubt it. 516 00:30:33,800 --> 00:30:35,440 Speaker 2: But it's just. 517 00:30:35,360 --> 00:30:38,880 Speaker 3: Another trend that everyone is using carbon fiber right now 518 00:30:38,880 --> 00:30:39,920 Speaker 3: within the footwork space. 519 00:30:41,120 --> 00:30:45,760 Speaker 1: For someone that is navigating clanter fasciitis, and they may 520 00:30:46,040 --> 00:30:49,760 Speaker 1: be thinking about alternative treatments aside from talking with a 521 00:30:49,800 --> 00:30:53,640 Speaker 1: physical therapist or a diadris and getting an actionable like 522 00:30:53,760 --> 00:30:59,800 Speaker 1: exercise plan. Can that person be considering something like ibuprofen 523 00:31:00,200 --> 00:31:02,800 Speaker 1: or ice rolling or what else would you recommend to 524 00:31:02,920 --> 00:31:05,040 Speaker 1: them when it comes to managing that pain. 525 00:31:06,240 --> 00:31:10,479 Speaker 3: So pain associated with an acute itis here we'll talk 526 00:31:10,520 --> 00:31:15,160 Speaker 3: about plantifreesci itis. Yes, you could do icine. There is 527 00:31:15,480 --> 00:31:18,840 Speaker 3: some controversy around icing. Does it work, does it not 528 00:31:18,960 --> 00:31:23,160 Speaker 3: work in the acute setting? And just across the board. 529 00:31:23,200 --> 00:31:26,720 Speaker 3: What ice does is it vasoconstricts, which means it's just 530 00:31:26,840 --> 00:31:30,200 Speaker 3: narrowing your blood vessels. If you do that in acute 531 00:31:30,240 --> 00:31:33,960 Speaker 3: setting you sprain your ankle boom, put ice on it 532 00:31:34,040 --> 00:31:37,160 Speaker 3: right away. It's going to limit the swelling because it 533 00:31:37,280 --> 00:31:40,840 Speaker 3: just constricted the blood vessels that dilated as a response 534 00:31:40,920 --> 00:31:45,520 Speaker 3: to the injury, right, So that's the strategy behind it. Similarly, 535 00:31:46,000 --> 00:31:49,080 Speaker 3: or in addition to this vaso constriction with the itises 536 00:31:49,320 --> 00:31:52,320 Speaker 3: is that it has a numbing effect, so it is 537 00:31:52,480 --> 00:31:56,000 Speaker 3: actually just numbing the area so you do not perceive 538 00:31:56,160 --> 00:31:59,000 Speaker 3: the pain. Does that give you a little like time 539 00:31:59,080 --> 00:32:02,920 Speaker 3: out from the sensation? Sure, and that's great. Now does 540 00:32:03,080 --> 00:32:05,800 Speaker 3: it accelerate the healing process? That's where some of the 541 00:32:05,800 --> 00:32:07,880 Speaker 3: research is like a little back and forth on it. 542 00:32:08,280 --> 00:32:12,720 Speaker 3: But I think from a roll in the healing process, 543 00:32:13,120 --> 00:32:16,760 Speaker 3: it is something that you could do, I like rolling 544 00:32:16,800 --> 00:32:19,719 Speaker 3: the foot on a frozen water bottle, because you're getting 545 00:32:19,800 --> 00:32:22,160 Speaker 3: then the foot massage that I want you to do anyway, 546 00:32:23,080 --> 00:32:25,000 Speaker 3: and if you're going to do it on ice, then okay, 547 00:32:25,120 --> 00:32:28,320 Speaker 3: we're numbing the area, we're getting some bvaso constriction. There's 548 00:32:28,560 --> 00:32:31,160 Speaker 3: we're killing two birds with one stone or checking more boxes. 549 00:32:31,880 --> 00:32:35,560 Speaker 3: In addition to that, you can do oral anti inflammatories. Again, 550 00:32:35,960 --> 00:32:37,760 Speaker 3: this is where knowing do you have a cute or 551 00:32:37,840 --> 00:32:42,600 Speaker 3: chronic so chronic plant or fasciosis, right, not going to 552 00:32:42,680 --> 00:32:46,600 Speaker 3: respond to this stuff the same that acute setting. You 553 00:32:46,720 --> 00:32:50,520 Speaker 3: will respond like a majority of textbook patients to what 554 00:32:50,560 --> 00:32:54,560 Speaker 3: we're talking about right now, could you take oral anti inflammatories? Yes, 555 00:32:55,000 --> 00:32:59,000 Speaker 3: this is my advice on it. Successful oral anti inflammatories 556 00:32:59,000 --> 00:33:01,440 Speaker 3: for let's say a cute nifaestiitis is that it has 557 00:33:01,480 --> 00:33:04,520 Speaker 3: to be taken every single day exactly is prescribed. You 558 00:33:04,560 --> 00:33:07,320 Speaker 3: can't take it when you feel pain and then tomorrow 559 00:33:07,360 --> 00:33:09,000 Speaker 3: you feel like, wow, it's actually not that bad, So 560 00:33:09,040 --> 00:33:10,760 Speaker 3: I'm not going to take it. It's not the point 561 00:33:10,920 --> 00:33:14,640 Speaker 3: of the medication. It's not a pain killer. It is 562 00:33:14,720 --> 00:33:19,400 Speaker 3: trying to modulate the inflammatory process that is happening. So 563 00:33:19,520 --> 00:33:22,600 Speaker 3: I would always put my patients on mobik, which is 564 00:33:22,640 --> 00:33:26,440 Speaker 3: a one pill, once a day medication. So it's just like, hey, 565 00:33:26,440 --> 00:33:29,320 Speaker 3: you wake up, take it. Just do this for two weeks, 566 00:33:29,640 --> 00:33:34,400 Speaker 3: not something high compliancy, easy to take. I do speak 567 00:33:34,440 --> 00:33:37,640 Speaker 3: about systemic enzymes a lot in my practice as well, 568 00:33:38,080 --> 00:33:43,200 Speaker 3: and they are a supplement that naturally modifies the body's 569 00:33:43,240 --> 00:33:46,240 Speaker 3: inflammatory process. So that could be if any of the 570 00:33:46,280 --> 00:33:49,280 Speaker 3: listeners are saying, I don't like medication, what are some 571 00:33:49,520 --> 00:33:53,160 Speaker 3: supplements that I could take more in a natural way, 572 00:33:53,920 --> 00:33:57,800 Speaker 3: then I say systemic enzymes. Bromlin is in some of 573 00:33:57,840 --> 00:34:03,800 Speaker 3: the systemic enzymes. Megas are naturally anti inflammatory. Rezveritol so 574 00:34:03,840 --> 00:34:08,560 Speaker 3: there's a lot of naturally anti inflammatory supplements that are 575 00:34:08,600 --> 00:34:09,239 Speaker 3: out there as well. 576 00:34:10,200 --> 00:34:13,560 Speaker 1: Great and something else that we haven't touched on just yet. 577 00:34:14,239 --> 00:34:17,840 Speaker 1: We did talk about the carbon fiber plates, but we 578 00:34:17,960 --> 00:34:21,319 Speaker 1: haven't chatted about insuls. How do you know if you're 579 00:34:21,360 --> 00:34:24,200 Speaker 1: someone that could benefit from an insult. 580 00:34:24,880 --> 00:34:29,000 Speaker 3: Yeah, insul to the listeners is probably having them think 581 00:34:29,560 --> 00:34:32,640 Speaker 3: art support. Right, If I need an insul, that means 582 00:34:32,640 --> 00:34:35,680 Speaker 3: you're essentially saying I need an art support. Now, that's 583 00:34:35,760 --> 00:34:38,280 Speaker 3: what ninety nine percent of the insuls on the market 584 00:34:38,400 --> 00:34:43,800 Speaker 3: are are art support based. Now, at Naboso, we develop 585 00:34:43,880 --> 00:34:48,360 Speaker 3: a sensory insult, so it's totally flat, has texture across it, 586 00:34:48,640 --> 00:34:52,799 Speaker 3: and it is functioning different. So I want to first 587 00:34:52,880 --> 00:34:57,120 Speaker 3: reference the art support insults. Now, part of my acute 588 00:34:57,120 --> 00:35:01,840 Speaker 3: plant or fascial treatment or foot stress treatment is to 589 00:35:02,000 --> 00:35:05,320 Speaker 3: offload the foot and the tissue. So that's going to say, Okay, 590 00:35:05,400 --> 00:35:07,839 Speaker 3: I need to just support you. 591 00:35:07,760 --> 00:35:08,359 Speaker 2: A little bit. 592 00:35:08,400 --> 00:35:09,920 Speaker 3: I'm going to put you in like a little bubble 593 00:35:10,200 --> 00:35:12,560 Speaker 3: for a period of time to make sure that the 594 00:35:12,600 --> 00:35:15,200 Speaker 3: tissue can heal itself and that we don't overload the 595 00:35:15,239 --> 00:35:18,680 Speaker 3: system more than we already have. That's where I would 596 00:35:18,680 --> 00:35:22,160 Speaker 3: actually look at art supports, and that is where I 597 00:35:22,200 --> 00:35:25,360 Speaker 3: would also look at foot type. So if you have 598 00:35:25,560 --> 00:35:28,279 Speaker 3: a flatter foot and you have a cute plant of 599 00:35:28,360 --> 00:35:31,480 Speaker 3: fesci itis, I need to give you a timeout, and 600 00:35:31,520 --> 00:35:34,360 Speaker 3: that timeout is going to be with an art support. 601 00:35:34,800 --> 00:35:37,640 Speaker 3: Doesn't need to be a five hundred dollars orthotic because 602 00:35:37,640 --> 00:35:40,680 Speaker 3: this is temporary. I'm just trying to put the fire out. 603 00:35:41,160 --> 00:35:44,799 Speaker 3: So for that I often recommend power Step. There are 604 00:35:45,320 --> 00:35:48,479 Speaker 3: many over the counter art supports or insuls out there, 605 00:35:49,719 --> 00:35:53,480 Speaker 3: not all of them are created equal, so just know 606 00:35:53,600 --> 00:35:56,920 Speaker 3: you get what you pay for. So I recommend power Step. 607 00:35:56,920 --> 00:35:59,120 Speaker 3: It's the one that I get the best response with 608 00:35:59,239 --> 00:36:04,000 Speaker 3: patients and the best positive feedback from the patients from 609 00:36:04,080 --> 00:36:06,239 Speaker 3: the sensory insult side, which is what we have at 610 00:36:06,320 --> 00:36:10,120 Speaker 3: Niboso is an insul that is designed to actually strengthen 611 00:36:10,160 --> 00:36:14,200 Speaker 3: your feet. So that's where I would incorporate that. Once 612 00:36:14,239 --> 00:36:17,160 Speaker 3: we put the fire out and we now want to 613 00:36:17,200 --> 00:36:21,200 Speaker 3: strengthen your foot so that plantifaesciitis or foot stress doesn't 614 00:36:21,239 --> 00:36:24,200 Speaker 3: come back, we need to strengthen your foot, and could 615 00:36:24,280 --> 00:36:28,040 Speaker 3: we do that with a sensory insult such as Noboso. 616 00:36:28,480 --> 00:36:29,880 Speaker 2: This is also helpful. 617 00:36:29,920 --> 00:36:33,040 Speaker 1: So one other topic that we should touch on something 618 00:36:33,040 --> 00:36:36,239 Speaker 1: that I know is frequent with people, whether they are 619 00:36:36,360 --> 00:36:40,640 Speaker 1: active or not super active, is fractures. Foot fractures happen 620 00:36:40,920 --> 00:36:44,160 Speaker 1: all the time, whether it happens during movement, whether it 621 00:36:44,239 --> 00:36:45,839 Speaker 1: happens or when you're literally. 622 00:36:45,600 --> 00:36:46,960 Speaker 2: Kicking something in your home. 623 00:36:47,480 --> 00:36:51,160 Speaker 1: When it comes to getting back to quote unquote normal activity, 624 00:36:51,360 --> 00:36:54,880 Speaker 1: is there a quote unquote typical amount of time that 625 00:36:54,920 --> 00:36:57,319 Speaker 1: you should be resting if you happen to get a 626 00:36:57,400 --> 00:37:00,279 Speaker 1: stress fracture in your foot. 627 00:37:00,840 --> 00:37:06,640 Speaker 3: Yeah, So a stress fracture is the healing process, and 628 00:37:06,680 --> 00:37:10,799 Speaker 3: then the return to activity after a stress fracture is 629 00:37:10,840 --> 00:37:13,880 Speaker 3: dependent on the severity is the stress fracture in the 630 00:37:13,880 --> 00:37:18,560 Speaker 3: first place. So the most sub acute stress fracture out 631 00:37:18,600 --> 00:37:20,799 Speaker 3: there can take as quick as two weeks to heal, 632 00:37:21,400 --> 00:37:25,000 Speaker 3: and I would have them immobilized for two weeks and 633 00:37:25,040 --> 00:37:28,600 Speaker 3: then I would do a gradual return to stress to 634 00:37:28,680 --> 00:37:32,440 Speaker 3: the foot, probably over four weeks. So we wouldn't want 635 00:37:32,440 --> 00:37:34,440 Speaker 3: to go from okay, two weeks clear to now I'm 636 00:37:34,480 --> 00:37:36,200 Speaker 3: running ten miles again. We don't want to do that 637 00:37:37,160 --> 00:37:41,640 Speaker 3: if someone does not treat the stress fracture right away 638 00:37:41,800 --> 00:37:44,080 Speaker 3: and they keep stressing it right, no pain, no gain. 639 00:37:44,160 --> 00:37:46,360 Speaker 3: When they're running, or they're just like, I feel something, 640 00:37:46,400 --> 00:37:48,319 Speaker 3: but then I ce it and they don't know. This 641 00:37:48,440 --> 00:37:51,720 Speaker 3: is very common that let's say runners will experience something 642 00:37:51,840 --> 00:37:54,680 Speaker 3: and they think maybe it's just like a little more 643 00:37:54,719 --> 00:37:57,239 Speaker 3: of an itis, not a stress fracture itis, Right, walk 644 00:37:57,280 --> 00:38:00,520 Speaker 3: it off, it's good, okay, And then they actually are 645 00:38:00,600 --> 00:38:03,560 Speaker 3: running on it for like a good six weeks. That 646 00:38:03,640 --> 00:38:06,960 Speaker 3: can take closer to a average fracture healing, which is 647 00:38:07,000 --> 00:38:09,040 Speaker 3: six to eight weeks, So they would be in a 648 00:38:09,120 --> 00:38:12,279 Speaker 3: walking boot for the six to eight weeks. I then 649 00:38:12,400 --> 00:38:17,240 Speaker 3: would have to retransition them back over probably a similar 650 00:38:17,280 --> 00:38:20,839 Speaker 3: six to eight week period. But what I'm doing is 651 00:38:20,920 --> 00:38:27,799 Speaker 3: not saying okay, walk or lightly run like shorter distances 652 00:38:27,880 --> 00:38:30,839 Speaker 3: as the technique to strengthen the foot. We need now 653 00:38:31,239 --> 00:38:33,359 Speaker 3: to take a step back and say, Okay, why did 654 00:38:33,360 --> 00:38:35,440 Speaker 3: you get the stress fracture in the first place. Was 655 00:38:35,480 --> 00:38:37,960 Speaker 3: it the shoes that you're wearing. Is it a disconnect 656 00:38:37,960 --> 00:38:40,160 Speaker 3: from the foot? Is your foot is not strong, your 657 00:38:40,200 --> 00:38:42,799 Speaker 3: foot's not connected to your core. And then go back 658 00:38:42,800 --> 00:38:46,520 Speaker 3: to that and say, let's do intrinsic muscle strengthening. Let's 659 00:38:46,520 --> 00:38:50,680 Speaker 3: do foot to core activation. Let's slowly build this over 660 00:38:50,719 --> 00:38:53,680 Speaker 3: the six to eight weeks. So after the eight weeks 661 00:38:53,760 --> 00:38:57,040 Speaker 3: you are fully back to running and actually stronger than 662 00:38:57,320 --> 00:38:59,160 Speaker 3: before you first got your stress fracture. 663 00:39:00,160 --> 00:39:01,040 Speaker 2: Got it okay? 664 00:39:01,120 --> 00:39:04,920 Speaker 1: So varies from first person to person, but really important 665 00:39:04,960 --> 00:39:08,200 Speaker 1: to make sure you're prioritizing the strengthening of the foot 666 00:39:08,480 --> 00:39:10,920 Speaker 1: before you get back to the activities that you were 667 00:39:10,920 --> 00:39:13,960 Speaker 1: doing before this injury occurred. 668 00:39:14,600 --> 00:39:16,040 Speaker 2: Two more things I want to touch on. 669 00:39:16,320 --> 00:39:21,160 Speaker 1: First thing, Achilles tendons thankfully knocks on everything around me. 670 00:39:21,400 --> 00:39:25,160 Speaker 1: I personally haven't dealt with anything rof when it comes 671 00:39:25,160 --> 00:39:28,080 Speaker 1: to my achilles, but obviously a huge pain point for 672 00:39:28,200 --> 00:39:30,320 Speaker 1: so many people. 673 00:39:30,719 --> 00:39:31,960 Speaker 2: What is it that we should know? 674 00:39:32,160 --> 00:39:35,520 Speaker 1: I know, we talked about everything from anti inflammatories to 675 00:39:35,920 --> 00:39:38,799 Speaker 1: icing for a Planter fasciitis. I'm sure that some of 676 00:39:38,800 --> 00:39:41,279 Speaker 1: those takeaways may be the same here, but talk to 677 00:39:41,360 --> 00:39:43,280 Speaker 1: us about the Achilles tendon. 678 00:39:44,080 --> 00:39:49,160 Speaker 3: Yeah, Achilles tendonitis is the biggest beep to treat because 679 00:39:49,640 --> 00:39:53,000 Speaker 3: when someone comes in, I'm just like, no like Achilles 680 00:39:53,000 --> 00:39:55,799 Speaker 3: tendon It is so hard to get under control, and 681 00:39:56,000 --> 00:39:58,959 Speaker 3: it's because we use it literally every step that we take, 682 00:39:59,040 --> 00:40:03,200 Speaker 3: so it is so hard to offload it or give 683 00:40:03,239 --> 00:40:06,960 Speaker 3: it the rest that it needs without literally being in 684 00:40:07,080 --> 00:40:10,480 Speaker 3: like a boot. Now Achilles tendonite is similar to the 685 00:40:10,520 --> 00:40:14,400 Speaker 3: planet of fascis and the elasticity injury that you've overloaded, 686 00:40:14,400 --> 00:40:16,879 Speaker 3: the demands of the tissue, micro tearing, all of that. 687 00:40:17,560 --> 00:40:19,759 Speaker 3: But here's the thing about the plant, the Achilles tendon 688 00:40:19,800 --> 00:40:22,279 Speaker 3: that's different from other tissue in the body is the 689 00:40:22,320 --> 00:40:26,120 Speaker 3: blood supply is probably some of the worst of any 690 00:40:26,160 --> 00:40:28,160 Speaker 3: of the tissue in the body, and it just has 691 00:40:28,200 --> 00:40:32,560 Speaker 3: to do with its anatomy. So part of this healing 692 00:40:32,600 --> 00:40:36,520 Speaker 3: process is first be patients got to be patient. It's 693 00:40:36,520 --> 00:40:38,680 Speaker 3: going to take probably five times as long as you 694 00:40:38,719 --> 00:40:42,239 Speaker 3: think it actually is to heal it. Second one is 695 00:40:42,440 --> 00:40:45,240 Speaker 3: certain things that you could do is like a heel lift, 696 00:40:45,600 --> 00:40:48,520 Speaker 3: heel toe drop, like the shoes that we mentioned, actually 697 00:40:48,560 --> 00:40:51,520 Speaker 3: go into those for this and stay in those. Avoid 698 00:40:52,080 --> 00:40:56,879 Speaker 3: totally barefoot, minimal shoes, avoid doing barefoot activities because you're 699 00:40:56,920 --> 00:41:00,960 Speaker 3: trying to give the tissue time out so that it 700 00:41:01,040 --> 00:41:04,200 Speaker 3: can heal itself, knowing it's going to take longer to 701 00:41:04,280 --> 00:41:07,680 Speaker 3: heal than normal. Third thing, and this is where a 702 00:41:07,719 --> 00:41:10,879 Speaker 3: lot of the research sits is eccentrics. And I'm sure 703 00:41:10,880 --> 00:41:13,520 Speaker 3: that you have heard of that to some degree of Okay, 704 00:41:13,560 --> 00:41:16,200 Speaker 3: you have to do eccentrics four it could these tendon issues, 705 00:41:16,600 --> 00:41:20,000 Speaker 3: and that is doing the negative. So instead of doing 706 00:41:20,080 --> 00:41:23,120 Speaker 3: a cafraise, you get up on your toes and you 707 00:41:23,160 --> 00:41:29,080 Speaker 3: slowly lower your heel down. The proper eccentric load is 708 00:41:29,120 --> 00:41:31,839 Speaker 3: actually much higher than people think, so you have to 709 00:41:31,880 --> 00:41:34,920 Speaker 3: do many more repetitions than you think. You actually have 710 00:41:34,960 --> 00:41:37,680 Speaker 3: to load it. So I want people to either put 711 00:41:37,680 --> 00:41:40,600 Speaker 3: a backpack on and put a lot of stuff in there. 712 00:41:40,640 --> 00:41:42,080 Speaker 3: I don't know what it would be. I was going 713 00:41:42,120 --> 00:41:47,080 Speaker 3: to say your school books, but that and to load 714 00:41:47,160 --> 00:41:50,080 Speaker 3: yourself so that you can actually load it. You want 715 00:41:50,120 --> 00:41:52,920 Speaker 3: to do it in different times or tempos, so it's 716 00:41:53,000 --> 00:41:55,960 Speaker 3: really important to do the eccentric side of it. And 717 00:41:56,000 --> 00:42:02,480 Speaker 3: then anything from a topical. Yes, do the Orleans inflammatories, 718 00:42:02,520 --> 00:42:04,360 Speaker 3: but what I work with a lot of patients is 719 00:42:04,400 --> 00:42:07,520 Speaker 3: doing red light. Actually really like red light therapy with 720 00:42:07,600 --> 00:42:10,200 Speaker 3: a lot of these soft tissue injuries. So you can 721 00:42:10,239 --> 00:42:12,040 Speaker 3: get a red light box if you want to go 722 00:42:12,120 --> 00:42:16,760 Speaker 3: to a red light sauna facility that's in your town, awesome, 723 00:42:16,960 --> 00:42:20,040 Speaker 3: do that laser so some physical therapists will do laser. 724 00:42:20,600 --> 00:42:23,200 Speaker 3: You can do that as well. I like topicals like 725 00:42:23,239 --> 00:42:26,920 Speaker 3: topical CBD and things like that work really well on 726 00:42:26,960 --> 00:42:31,120 Speaker 3: the tissue as well. That is really like the big 727 00:42:31,200 --> 00:42:32,960 Speaker 3: things and it's again. 728 00:42:33,040 --> 00:42:38,920 Speaker 1: Time time time, all right, last topic here, just regular 729 00:42:39,120 --> 00:42:42,040 Speaker 1: foot maintenance. It's probably not something that a lot of 730 00:42:42,040 --> 00:42:44,280 Speaker 1: people think about, like what should I be doing regularly 731 00:42:44,360 --> 00:42:47,319 Speaker 1: for my feet, but it's an important question, especially if 732 00:42:47,320 --> 00:42:50,719 Speaker 1: we do want to remain injury free, and like we 733 00:42:50,760 --> 00:42:53,640 Speaker 1: talked about before, keep all those toenails, so anything that 734 00:42:53,640 --> 00:42:55,720 Speaker 1: we should keep in mind when it comes to regular 735 00:42:55,760 --> 00:42:57,560 Speaker 1: practices of taken care of our feet. 736 00:42:58,520 --> 00:43:02,759 Speaker 3: I have three pillar for movement longevity and those three 737 00:43:02,800 --> 00:43:08,600 Speaker 3: pillars are foot strength, foot recovery, or mobility kind of 738 00:43:08,600 --> 00:43:12,200 Speaker 3: call them the same. And then sufficient sensory stimulation of 739 00:43:12,200 --> 00:43:15,239 Speaker 3: the feet so with the foot, strengthen knee and would 740 00:43:15,280 --> 00:43:17,520 Speaker 3: be some of the stuff that we spoke about. But 741 00:43:17,560 --> 00:43:21,480 Speaker 3: it's not just doing like towel crunches and picking up marbles. 742 00:43:21,880 --> 00:43:26,080 Speaker 3: We want your feet to be connected to your core. 743 00:43:26,600 --> 00:43:30,680 Speaker 3: So any foot contraction I need incorporated with the pelt, 744 00:43:30,719 --> 00:43:32,600 Speaker 3: floor and the diaphragm because that's the way your feet 745 00:43:32,600 --> 00:43:38,320 Speaker 3: actually work. So it's very intentional or intent full foot exercises. 746 00:43:38,960 --> 00:43:41,400 Speaker 3: I actually am not a fan of doing towel crunches, 747 00:43:41,440 --> 00:43:43,880 Speaker 3: because it's kind of like doing bicep curls and then 748 00:43:43,960 --> 00:43:46,959 Speaker 3: saying like, there, my bicep is functional, but that's really 749 00:43:47,000 --> 00:43:50,600 Speaker 3: not the way your bicep works. Second, with the recovery, 750 00:43:50,680 --> 00:43:53,680 Speaker 3: would be five minutes of releasing the feet and the 751 00:43:53,760 --> 00:43:57,600 Speaker 3: lower leg, specifically the soliest which is the bottom calf muscle, 752 00:43:58,239 --> 00:44:01,600 Speaker 3: every single day, five to eight minutes if you can. 753 00:44:02,280 --> 00:44:04,920 Speaker 3: I'll tell people to release their feet while brushing their teeth. 754 00:44:05,200 --> 00:44:07,480 Speaker 3: So it's just something to give it a little bit 755 00:44:07,520 --> 00:44:11,080 Speaker 3: of a reset every single day. And then the third 756 00:44:11,239 --> 00:44:15,840 Speaker 3: is that sensory stimulation that is going barefoot, even around 757 00:44:15,840 --> 00:44:17,920 Speaker 3: your home for at least thirty minutes, get out of 758 00:44:18,000 --> 00:44:22,440 Speaker 3: your shoes, that the toes spread, splay, breathe. Even better 759 00:44:22,480 --> 00:44:24,759 Speaker 3: is be barefoot out on the grass, so you get 760 00:44:24,840 --> 00:44:27,080 Speaker 3: kind of this earthing component to it as well, which 761 00:44:27,120 --> 00:44:30,200 Speaker 3: is super awesome for inflammation and recovery. But you want 762 00:44:30,239 --> 00:44:34,800 Speaker 3: to do something sensory for the foot. So those three 763 00:44:35,120 --> 00:44:39,040 Speaker 3: are my pillars of supporting the foot. And then, honestly, 764 00:44:39,080 --> 00:44:41,200 Speaker 3: when you do these things, the fourth that kind of 765 00:44:41,200 --> 00:44:44,040 Speaker 3: ties in their circulation. We need really really good circulation 766 00:44:44,120 --> 00:44:47,280 Speaker 3: of your feet, but you will get that through sensory 767 00:44:47,280 --> 00:44:50,320 Speaker 3: stimulation being barefoot spreading and then releasing the bottom of 768 00:44:50,360 --> 00:44:51,120 Speaker 3: the foot. 769 00:44:51,880 --> 00:44:55,160 Speaker 1: You mentioned that there could be more pain for someone 770 00:44:55,360 --> 00:44:59,399 Speaker 1: navigating planter fasci itis after longer periods of inactivity, whether 771 00:44:59,480 --> 00:45:01,680 Speaker 1: that be for a night's sleep or perhaps sitting at 772 00:45:01,719 --> 00:45:04,200 Speaker 1: a desk all day and then getting up for someone 773 00:45:04,440 --> 00:45:08,680 Speaker 1: to maybe attempt to keep that initial pain at bay. 774 00:45:09,280 --> 00:45:13,800 Speaker 1: Could doing something like drawing the alphabet help in that situation, 775 00:45:13,880 --> 00:45:15,760 Speaker 1: getting that foot moving again before you get. 776 00:45:15,680 --> 00:45:17,880 Speaker 2: Up or is that an old wives tale? 777 00:45:18,400 --> 00:45:20,960 Speaker 3: I would say that is an old wives tale. But 778 00:45:21,120 --> 00:45:24,600 Speaker 3: what I will give you to do is do something 779 00:45:24,640 --> 00:45:27,279 Speaker 3: to the bottom of the foot. Whether it is just 780 00:45:27,400 --> 00:45:31,719 Speaker 3: like a hand massage to the fascia right, you could 781 00:45:31,760 --> 00:45:34,440 Speaker 3: do that, or if you have a percussive gun something 782 00:45:34,480 --> 00:45:36,239 Speaker 3: like they're a gun for the listeners, that's probably the 783 00:45:36,280 --> 00:45:38,759 Speaker 3: most well known on the market. And then you're just 784 00:45:38,840 --> 00:45:41,600 Speaker 3: kind of lightly engaging and waking up and starting to 785 00:45:41,640 --> 00:45:45,000 Speaker 3: warm it up, because remember what causes that acute sharp 786 00:45:45,000 --> 00:45:47,000 Speaker 3: pain when you step down first step in the morning 787 00:45:47,600 --> 00:45:51,120 Speaker 3: is that the tissue is sticky. So we're just trying 788 00:45:51,160 --> 00:45:54,040 Speaker 3: to warm it up and bring the circulation so that 789 00:45:54,080 --> 00:45:56,760 Speaker 3: you're not stepping down with that rapid pull. 790 00:45:57,800 --> 00:46:01,120 Speaker 1: All right, gotta keep my little hyperval next to my 791 00:46:01,200 --> 00:46:07,879 Speaker 1: bed now perfect well, Doctor Emily, this has been so 792 00:46:07,880 --> 00:46:11,040 Speaker 1: so helpful, so many good tips, tricks and takeaways here. 793 00:46:11,320 --> 00:46:13,600 Speaker 1: How do the hurdlers follow along with you? How do 794 00:46:13,640 --> 00:46:15,400 Speaker 1: they keep up with you so that they can get 795 00:46:15,440 --> 00:46:16,560 Speaker 1: more in the future. 796 00:46:16,920 --> 00:46:21,000 Speaker 3: Absolutely so. My Instagram is d r Emily DPM. I 797 00:46:21,080 --> 00:46:23,040 Speaker 3: put a lot of content on there so people are 798 00:46:23,120 --> 00:46:26,400 Speaker 3: hungry to continue to learn more about their feet. Follow 799 00:46:26,440 --> 00:46:30,160 Speaker 3: me on Instagram. My pedietry practice is my name, so 800 00:46:30,280 --> 00:46:34,200 Speaker 3: Dr Emilysplicckle dot com. I do see patients virtually so 801 00:46:34,320 --> 00:46:37,520 Speaker 3: not just in person, so that is fun. And then 802 00:46:37,560 --> 00:46:40,800 Speaker 3: for any of the Niboso products, which is a company 803 00:46:40,840 --> 00:46:45,280 Speaker 3: that I founded, that website is Niboso Naboso dot com. 804 00:46:45,719 --> 00:46:49,040 Speaker 3: And then to learn more about feet, I wrote a 805 00:46:49,040 --> 00:46:52,120 Speaker 3: book called Barefoot Strong. And actually if you go to 806 00:46:52,160 --> 00:46:54,240 Speaker 3: the website for the book, I also have a foot 807 00:46:54,360 --> 00:46:57,440 Speaker 3: type quiz so people can go on there and actually 808 00:46:57,440 --> 00:47:00,239 Speaker 3: determine their foot type and what it means. And that 809 00:47:00,320 --> 00:47:03,480 Speaker 3: website is barefootstrong dot com. 810 00:47:03,520 --> 00:47:06,719 Speaker 1: So many great resources here. Again, doctor Emily, thank you 811 00:47:06,760 --> 00:47:09,279 Speaker 1: so much for your time. I have a feeling that 812 00:47:09,320 --> 00:47:12,520 Speaker 1: you'll be back and there will be more questions to 813 00:47:12,600 --> 00:47:15,759 Speaker 1: be asked. I'm over at Hurdle Podcast and at Emily 814 00:47:15,840 --> 00:47:17,920 Speaker 1: Abadi another hurdle conquered. 815 00:47:18,239 --> 00:47:19,279 Speaker 2: Catch you guys next time.