Come on, there we go.
The best conversations happen at happy
hour.
Welcome to ours.
Welcome aboard.
This is the PT podcast.
Here's your host, physical therapist,
Jimmy McKay.
Thanks, voice person.
I appreciate that.
Yeah,
we're live at APT's CSM for two days.
If it sounds like my voice is slowly
degrading,
it's because my voice is slowly degrading.
Melissa's here.
How's your conference?
Is the nicety we say to each other
while we're in the middle of chaos and
noise?
But how's it going?
It's going great.
I work at U.S.
Physical Therapy,
so we are here meeting tons of students
who we provide clinical rotations to.
What's your superhero backstory?
How did you get to here in the
profession?
What's your superhero origin story in the
profession?
I'm a sports and orthopedic PT.
I'm a Rock Tape alumni.
I spent almost ten years with that brand.
Good.
University faculty,
and so I run education at USPH.
Do you think that's what you were going
to be doing when you started?
No.
Isn't that fun though?
It is.
I thought I was going to own an
orthopedic clinic and, you know,
grind and which I did,
but then I turned into a faculty and
then I turned into an education
professional.
It's not one lane.
It is not one lane.
It's a lot of paths.
Yeah.
All right, so before we started, I said,
hey, what are we talking about?
You said the word spicy, like spicy takes,
and I like spicy takes.
So what's a spicy take or two that
you've got,
things that shouldn't be and they should
be this way?
Yeah, so I'm launching a book in May,
and one of the primary things we're
talking about is footwear and what shoes
we should be wearing and what shoes we
perhaps should be avoiding and how our
foot health completely impacts our overall
health.
I feel like if you're going to own
a term, foot health would be pretty good.
Yeah.
So how do you look at it?
How should people be looking at it from
your point of view?
So one in three adults in America has
foot pain.
Over sixty percent of adults are wearing
the wrong sized shoe.
Wrong size.
Is that our fault?
Because you know what?
I was in a store the other day
and I'm looking for the little shoe sizey
thing and it wasn't there.
It wasn't even there anymore.
You know what those things are called?
No.
That's a Brannock device.
It's its hundredth anniversary.
It has not been changed since it was
innovated.
It's American made.
And I remember kids,
somebody at the shoe store used to do
it for you,
whether they knew how to do it right
or not.
And then I remember as I aged,
they were just, oh, yeah,
it's over there in the corner.
And now it's not even really there
anymore.
Why are we wearing the wrong shoe size?
I mean,
I just named like nine possible points of
failure in the proper size,
but why aren't we?
And what does that do?
Yeah.
So if you're not wearing the right size
of shoe, generally speaking,
it's creating orthopedic problems and
biomechanical propulsion problems.
So if you've got corns, calluses, bunions,
heel pain, Achilles pain, I could go on.
A lot of times it's related to wearing
the wrong size, length of shoe.
Beyond size,
I'm going to take a wild guess and
say type probably is also a thing.
Yes.
How are we doing it?
Back in the day before PT,
I would choose my shoes very
scientifically, color, texture,
if it was in my brand,
if I had running shirts or shorts that
matched that.
Probably not the best way to do it.
What is a simple approach?
You've got a book coming out.
We'll have to get deeper into that.
But the fifteen second rapid fire view,
why are we doing it wrong and how
do we do it better?
The reason we're doing it wrong is the
marketing budgets of shoes that are not
shaped like feet are much greater than the
marketing budgets of shoes that are shaped
like feet.
So there's your spicy hot take number one.
Yeah, buy based on the foot,
not the fashion.
Yeah,
so my non-negotiable foot-shaped shoe.
Meaning what?
Meaning it should not be tapered.
Yeah.
That's a big place to start.
I forget who it was,
but had some great photos on Instagram of
like the toe box cut out.
Oh, there's a van.
There it is.
But yeah,
there's that's a great X-ray picture right
there.
Right.
Is from ultra running.
You're looking at one on the left.
Sorry.
Yeah.
My my left.
You're left there saying that looks like
it's a little.
Like my shoe,
my feet are kind of cramped in there
versus the one on the right,
which there's a little more space for
those little toesies in there to spread
out.
Yep, space for toes.
So space for toes allows us to splay
the toes, which improves our biomechanics.
It reduces pressure on things like the
nerves that run in between those
metatarsals.
allows your muscles in between the bones
to have better function.
They can hypertrophy over time,
get bigger.
Your interossei is a big player there.
And babies aren't born with bunions.
And so another unpopular opinion,
hot take that I'll be sharing with
everyone today,
where do you think bunions come from?
Shoes?
Yeah.
One of the contributors.
Yeah.
I mean...
We look at, somebody had taught this,
mentioned this in PT school,
but we look at like foot binding
practices.
Like those are ridiculous.
I can't believe people did that while
we're sitting there in shoes that are
maybe not as extreme as binding,
but kind of doing the same thing over
time and over a longer period of time.
And we voluntarily do that.
I wore tuxedo shoes yesterday because I
thought it'd be funny to wear a tuxedo.
And those shoes,
Did not do a whole lot for my
feet and my calves and my back,
and I'm feeling that today.
Yes, the dogs are barking.
The dogs are barking.
I will say these are sneaker bottoms,
so they do look like dress shoes from
the top,
but on the bottom and on the inside,
they are pretty small.
Nice.
We could maybe do a shoe reveal while
we're chatting today.
What is a shoe reveal?
If you're so inclined.
Well,
I would have you pop that shoe off
and we could decide if it's shaped like
a foot.
Let's do it.
So what am I looking at?
Where do you begin your foot?
The journey?
Well,
let's take the shoe off to start with.
Got it.
There it is.
Okay.
All right.
Yep.
And so when we look at this...
That's a tapered toe box.
Whether or not it has the heart of
a running shoe,
as these are typically billed to be.
Right.
If we look at that toe box,
that is a narrow toe box.
That's based out of fashion.
Right.
It's very fashionable.
What is normal.
Right.
Hang on to that thing.
Go ahead.
So I'm going to take my shoe off.
See how my single leg balances.
Thanks, Jimmy.
All right.
So this shoe is shaped like a foot.
Right.
So see how my toe box is a
little bit wider.
Yours is more tapered.
And those Mickey Mouse for a second there
on the bottom.
Keep going.
Yeah, this is a Vivo barefoot shoe.
It's one of their sneakers.
So when we look at it from the
top as well,
you can see that that would allow my
toes to splay.
It's not drastic, though.
It's not like someone's going to look at
you and be like, oh,
those are clown shoes.
Like, I wouldn't have noticed.
Even when you said that,
I didn't notice that yours were that much
wider.
Yeah.
So the innovations have gotten a lot
better as wide toe box shoes have gotten
more common.
They don't have to look as extreme.
Yes, exactly.
Yeah.
Because, I mean,
getting people to completely abandon...
their footwear, probably not gonna happen,
but asking them or giving them better
options to choose between is probably a
better option.
Yeah,
and there's a concept we talk about which
is called the twenty-four hour shoe clock.
So you have twenty-four hours in a day,
and we think of that as a pie
chart.
So you're spending some time barefoot,
you're spending some time sleeping,
perhaps you're spending some time in a
dress shoe.
Maybe you work in a profession where
you're a flight attendant,
or you're in the military and you have
to wear a narrow uniform shoe.
And so you can counteract that, right?
So all is not lost.
Those of you who are in fashion shoes,
choosing fashion shoes,
going to a wedding,
going to a hot date, you know,
I'm probably not going to be...
It's not all or nothing.
It's not a light switch.
It's a volume dial.
Okay.
So talk more about the book.
First of all,
I pat myself on the back when I
read a book.
I'm like, I don't want to brag.
You wrote a book?
I wrote a book.
Yeah.
Walk us through it.
So Jimmy, the book is called Walk.
I have an advanced copy of it right
here.
Nice.
She's a pretty gal.
I wrote it with Dr. Courtney Conley,
who's a chiropractor,
foot and gait expert.
Her brand is called Gait Happens.
Gait Happens.
She's also a Rock Tape alumni.
So shout out to all those Rock Tape
alumni who hopefully will
Catch up with this.
Shantae, Mike Stella, Joe LaVaca,
Megan Helwig, all of our homies.
Mike Stella was rocked.
I didn't know that.
Follow him like crazy.
Steve Capo, Alison Evans, like the core.
I love those people.
They're my family.
So start with this.
Why?
Writing a book, I've never done it,
but again, can't be easy.
You're gonna put blood, sweat,
and tears into it.
What was the big, this,
we're gonna plant our flag here,
and then what does someone become when
they're done reading?
Yeah,
so we planted our flag at Mike Stella's
wedding.
Nice.
Courtney came up to me and said, hey,
I need your help with a project this
year.
I said, great,
what do you need from me?
Because I, at the time,
was doing consulting work for her brand.
And I was assuming what she needed for
me was to help operationalize it, sell it,
biz dev, that sort of thing.
And she was like,
I'm going to write a book about feet.
And I said,
ten people are going to read that.
How about if we write a book about
walking?
So there was my helpful point number one.
That is good.
And so it was really a passion project
of her wanting to get her messaging out,
talk about foot health,
how that impacts total health,
teach people about self-assessment,
footwear, pain, selecting time,
how many steps should you take per day,
and then it really just became this
immersive experience.
Yeah.
Simple, not easy.
Correct.
Right.
I feel like if you had written this
ten years ago,
okay but right now there is such a
great light shine on wellness taking care
of myself i need to be an active
participant or you know the most active
participant in my in my care so i've
said pts or people in health hey this
is our moment like they're paying
attention yes as we know with moments they
come and go they do while we've got
this can we how many behaviors can we
change again ten years ago even if it
was the same book great i feel like
this is a this is a great
It's a moment.
Yeah, it's a moment.
We're in our taking care of ourselves era.
We are.
And we're talking about longevity.
We're talking with experts like Dr.
Vonda Wright,
who is so big into muscle tone and
bone health for women.
We're talking about zone two loading.
We're talking about power training.
And all of those can be achieved.
with walking as a platform.
And so for us,
it really just became this collision of
the timing of the passion project and then
us taking a very operational mindset and
saying, all right, well,
how do we commercialize this sucker?
What do you do to get a book
published?
There's self-published,
there's big traditional publishing.
You have to get an agent,
just like a real estate agent,
and then that agent goes and shops you
out.
Wow.
Who is it for?
Who do you hope is holding this?
And then what does that person hopefully
become or feel empowered to do or be
able to do when they're done?
Yes.
The book is for people who walk.
A lot of people.
We did, you know,
really try to as clinicians.
Right.
I'm a physio.
She's a chiropractor.
We were really trying to struggle.
We struggled with, you know,
individuals who don't walk.
So if someone's a wheelchair user or those
sorts of things.
And unfortunately,
this book can only be so long.
Right.
So there are all sorts of wonderful,
continuous mobility that individuals who
don't walk are able to engage in.
Unfortunately,
we weren't really able to address that in
this project.
But so this is anybody who you could
have a prosthetic.
You could be walking with an assistive
device.
You could be returning from an injury.
You could have an amputation,
whatever the ideal.
Reader is someone who is interested in
today's wellness and tomorrow's longevity
and wants a incredibly low cost,
immediately accessible thing they can play
with.
And the great part of the book is
it really just has like it has all
these little snacks in it.
the five-minute micro walk,
how to swap an activity and do a
walk,
maybe how to do a walk and talk
meeting, strategies you can use,
all sorts of assessments.
How's your big toe mobility?
How's your ankle mobility?
How's your foot awareness?
It feels like a salad bar.
To me,
it feels like there's a little something
for everyone.
And you can pick and choose the elements
that really need to be improved for you
to become someone who has walking as a
part of your day.
Yeah.
Where are you with the ten thousand steps?
I think I saw something online that you
had said where, hey, what?
So what is your what is your spicy
take?
Agree.
Disagree.
Somewhere in the middle.
Ten thousand steps is a marketing hangover
from the nineteen sixties.
It was never science backed.
And so it is a myth we're trying
to bust with our platform.
Because what?
We don't need that much.
That's correct.
Right.
So, hey, don't feel shamed if you're not.
Because, you know,
two thousand is better than one thousand
and six thousand is better.
Yeah,
so there's a rate of diminishing returns.
The top end is around eighty-five hundred
if you're under sixty years old.
There's some really big randomized
controlled systematic reviews with
hundreds of thousands of patients in them.
So eighty-five hundred if you're under
sixty,
seventy-five hundred if you're over sixty.
If you're someone who's looking for
benefits related to depression symptoms,
fifty-five hundred.
Lifetime risk of developing depression,
seventy-five hundred.
And there's really great data on dementia,
where if you're at thirty nine,
thirty eight hundred,
you reduce your risk of dementia by about
twenty percent.
If you hit ninety eight hundred,
which is high and close to ten K,
that has almost a fifty percent reduction
in lifetime dementia risk.
There's also some really great data on
cancer.
There's great data on sleep and a ton
related to mental and cognitive clarity
and cognitive performance.
Love it.
All right.
So the date on the book and where
they can get it.
Yes.
We close the loop.
Yes, absolutely.
Let's close the loop.
So this is available for pre-sale right
now on Amazon and anywhere else you buy
your books.
Target, Walmart, Barnes & Noble,
Book Civilian.
It publishes on Cinco de Mayo this year,
five, five, twenty, twenty six.
Read the book,
then have the margaritas because I don't
know how much walking you want to do
after.
Yes, that could be unsafe.
Might be a little bit.
Big advocates of sober walking.
Sober, sober walking.
All right.
Last thing we do on the show is
call the party.
This is The Parting Shot.
One last mic drop moment.
No pressure.
Just your legacy on the line.
Parting shot is your chance to like burn
something into someone's brain.
What's the last thing you'd want to leave
with the audience?
Because we know the last thing we're
usually taught is the thing that sort of
sticks.
So what's the last thing?
Everybody knows ten thousand steps is a
myth.
So I'm not going to spend my parting
shot on that.
I just kind of snuck it in there.
Pick the right shoes.
That's all I'm asking you for.
If you have a foot shaped shoe,
if you're recommending a foot shaped shoe
to your patients,
if you're staying away from a tapered toe
box,
you improve that foot health,
the ability for the muscles to do their
job, and your propulsion dramatically.
So my advice to everyone listening,
please stay away from the tapered toe box,
no matter how pretty you think they are.
They are not good for your overall health.
Well, when you say get a foot-shaped shoe,
it sounds so obvious when you say it.
Of course we would.
I appreciate the time.
Thanks so much, Melissa.