Side Project Podcast 11: Foot Health with Dr. Emily Splichal

Ruthie Miller (00:24.824)

I’m excited to talk about foot health today, actually, because it’s random. I mean, it’s random and it’s not, right? Because our whole lives revolve around feet, but rarely do we ever think about them or take the time to really take care of them until something actually goes wrong.

 

Leyla Seka (00:43.534)

100%

 

Ruthie Miller (00:52.352)

A couple of years ago, my sister went to a session about feet with this fabulous woman that she couldn’t stop talking about. And many years later, she still talks about how much she learned from this woman, Dr. Emily. So we found Dr. Emily and we asked her if she would be willing to come and talk to us and give us the lowdown on foot health and how we can take care of our feet so we can, again, stay stronger for longer. So we’re sitting here today with Dr. Emily Splichal. She is a podiatrist, a human movement specialist, and a global leader in barefoot science and rehabilitation. She also just published her second book, Sensory Sapiens. But what I liked most about Dr. Emily’s bio is that she was trained as a surgeon, a podiatric surgeon. But while she still might do surgery, she considers herself more of a functional medicine doctor now. So, a lot of podiatrists, when you go to them, they kind of tend to just immediately go into orthotics and surgery. And she really tries to find ways to improve your foot health, ways to improve your problems and fix your foot challenges without doing those things first. So, super excited. Welcome Dr. Emily. Thanks for joining us.

 

Dr Emily (02:06.171)

Of course, thank you. And yes, I’m the black sheep of the pediatric profession. So yes, I challenged and tried to shake up the whole profession. Some people love it, some people hate it, but I’m here. 

 

Leyla Seka (02:12.367)

We like Black Sheep. We’re of that kind. All right, so break it down for us. Ruthie made a good point. We’re on our feet all the time and you never think about them until they hurt, right? So now we’re like, you know, in our 50s, nearing our 50s, whatever. We’re all calling that midlife because apparently we think we’re gonna live till we’re 100. But whatever, I’m rolling with it. But what should we be doing to… like I get a manicure and a pedicure, I’m that person, I like having pretty nails, whatever. But beyond that, like what are we supposed to be thinking about with foot health right now, and just generally how we should be taking care of our feet? Big question, but.

 

Dr Emily (03:00.531)

Yeah, so high level, our feet are our body’s foundation. Obviously, it’s the only contact point between the body and the ground. So when we stand, walk, run, move, squat, whatever activity it is that you like doing, almost all of them involve you standing on your feet or you’re in some sort of footwear experience. So our feet are used and abused all day, every day, and not many people focus on them. So there are very simple things that you can do to focus on recovery, to focus on strength, proper alignment. Of course, there’s things like nails and skin that I could go into as well. So there’s the aesthetic side of the feet, especially in sandal season and stuff like that. But yeah, it’s a very low priority in most people’s lives because they’re just hidden in shoes. And really a lot of people from the media onward focus on kind of the, not taboo, but it’s just this thing that is hidden, it’s very far away, it’s touching the ground. I love feet, not that I have a fetish, but I love feet. I’m fascinated by human movement and the feet are a critical part of human movement. I’m also fascinated by the nervous system in the brain, and the feet are a very powerful gateway into your brain. 

 

Leyla Seka (04:16.664)

Well, right, like when you go to the massage parlor and they’re always touching your feet, and they have those weird posters of all the… You know what I’m talking about? 

 

Dr Emily (04:26.369)

Yeah, reflexology. So that’s reflexology. Yeah, and there is a validity to that. I used to tell my patients when I practiced in New York City, I would say go to Chinatown, go to the $40 foot massage. And honestly, it was a huge part of their weekly foot recovery or foot health routine. And they would do an incredible job. So there’s something to reflexology.

 

Ruthie Miller (04:51.128)

What exactly is reflexology? It’s certain pain points or pressure points in your feet? Is that what it is?

 

Dr Emily (04:58.695)

Yeah, so I’m not trained, and I work with reflexologists, so I don’t want to say something incorrectly as far as what it is, but there are different points in the foot that connect to other parts in the body, organs and things like that, where they can pick up on, and release here, it’ll release tension in your liver or gallbladder, things like that. That’s an Eastern medicine reflexology approach. I take it a little bit differently and look a little bit more Western medicine, like these are the actual muscles and this is where they insert and then this is where the stress happens. So release it here. A little bit Western, or East meets West philosophy is how I look at the foot.

 

Leyla Seka (05:41.07)

So for us, for a lot of people, so a lot of people shove their, I mean, I don’t know if women shove their feet in tennis shoes and don’t look at them. Of course some do, but like at some point, you know, I don’t know. There are a lot of people at the nail salon, I’m just gonna say. But, like I hurt my foot, right? I had like something happen to my Achilles and my foot started hurting and it sucked. Like when your feet, but not just like I’ve been on my feet all day and I’m tired. Like really it’s hurt and it messed up the way I walked. It hurt a lot. And that starts to become, you know, I don’t know, more prevalent as we age. So what is a foot routine that we should do? You know, they tell you stretch routines, yoga, this, that, and the other, but like, is there a foot protocol or a foot health routine for women our age?

 

Dr Emily (06:24.865)

For all humans with feet, yes. We are going to focus on women, around 50. So the first thing that I think about is changes in hormones. And this is important because changing in hormones, especially estrogen, affects your collagen, your connective tissue, and there are over a hundred ligaments in our feet. Plus there’s obviously a lot of tendons and there’s very unique forces.

 

So there is just as a side comment, there is what’s called an adult acquired flat foot, which is where one foot arch just suddenly drops. Typically there’s a predisposition that I would be able to screen for, but the way that the patient sees it is that just one arch suddenly drops. And now one of their feet is flat and the other foot has an arch that’s called an adult acquired flat foot. That has a tendency to be more in women who are peri- or post-menopausal, kind of somewhere in their menopausal journey. And it’s just classically this over 40 change in hormones that is changing your connective tissue. So it’s something that I do mention with women in their 50s is that you have to understand that your connective tissue is changing. The connective tissue is what creates the structure and the support to your foot. So yes, your arches can fall with age. Yes, your foot size, can become bigger because when your arch drops, your foot becomes wider and longer. So people may say, I don’t fit my shoes the same anymore. That’s also why, during pregnancy, especially women who have had multiple pregnancies, their feet grow during the pregnancy, they didn’t actually grow. It was that the ligaments lengthened through hormone changes and the foot became wider slash longer. 

 

Ruthie Miller (08:17.752)

That makes so much sense.

 

Dr Emily (08:19.913)

Yes, which no one talks about. So I actually recommend to women, again, this is more towards the pregnancy side, but women who are pregnant as they’re going through the third and the fourth trimester, that’s where I actually want them using arch supports to try to minimize the dropping of the arch and the stress to the ligaments with the hormone changes. No one really talks about that around that third, fourth trimester.

 

Ruthie Miller (08:44.408)

That would have been really valuable information.

 

Dr Emily (08:47.037)

Mm-hmm. Yes, totally. I gave myself a stress fracture after I gave birth, so I totally didn’t follow my own advice. But I had a summer baby and it was hot and I had to walk around New York City in the concrete jungle with my baby. But I totally, totally did the same thing because your foot just starts to drop with that laxity of the relaxant hormone. Estrogen is another really important hormone for your connective tissue. So that’s something to note. Having said all of that, what you were asking was what are these simple habits of what we could do? And I teach women and everyone how to do an easy daily foot release that’s using the narrow ball. So can you just release your feet every morning, every evening when you brush your teeth, release your feet, super, super easy. Can you incorporate some sort of foot activation? I teach people what’s called a forward lean where you stand nice and tall, stiff as a board and you slightly lean your body forward. Every time you lean your body forward, you activate your feet. Super easy. Stand on one leg 10 seconds. Do that a couple of times each side. boom, boom. And then the third one is just recovery at the end of the day. So activate, strengthen, and recover your feet in a very easy way every single day.

 

Ruthie Miller (10:05.272)

So let’s talk about that little ball thing. And so for anybody who’s not watching on video, Dr. Emily is holding up a little ball. looks like a tennis ball, but it actually splits in half. So you’ve got two semispheres, right? Is that the right word? I don’t math. Domes! That’s a better word. So what I do with them is I kind of just stand on them and I shift my weight around and I do one foot at a time. Is that… am I doing this right? Is it kind of like releasing pressure points on your feet?

 

Dr Emily (10:33.643)

Yes, so we teach that there’s five points on the bottom of the foot. For those that are watching the video, there’s just five points at the heel, middle of arch, ball of foot, outside arch, inside arch, five points. And then you would stand on the domes, hemispheres, on the domes for 20 seconds per point. Go to the next point, 20 seconds, dot, dot, dot. If you do both feet at the same time, check, check. You get it done in less than two minutes. And you do that while you’re brushing your teeth, putting on your makeup, all of that morning, evening. I’m very much, as far as it relates to the feet into habit stacking or somehow minimizing resistance or friction to increase compliance. I’ve been doing this a long time. It takes a lot for people to prioritize their feet. So I need to be as streamlined as possible.

 

Leyla Seka (11:28.366)

That makes sense. And so really just doing that in and of itself would be a lot towards keeping your feet super healthy and in better shape. They just need to be sort of moved around on those pressure points and released. Is that sort of the thing?

 

Dr Emily (11:42.215)

Yes, now the one thing that I do want to mention, so on the ball for those that can see it, there’s a little tiny pyramid. So all of the Noboso products have a texture on them and that is a very specific texture to stimulate a certain nerve in the bottom of the feet. And that nerve happens to be the same nerve that your hand uses to read braille. So it is the braille nerve. So we call Noboso braille for your feet. When you bring a specific stimulus to the nervous system, to the body, to the brain, it recognizes it and that’s where you get the effect.

 

Leyla Seka (12:17.038)

Interesting. So doing this, what does it do? It just makes your feet more flexible, more capable, like walking around and you’re in better shape. They’re stronger, like muscles. 

 

Dr Emily (12:29.525)

Yes, so it wakes them up, right? So this is it. Most people don’t feel their feet, right? Like I know we’re talking about feet, but even if I just said like, hey, how many of the listeners right now as we’re sitting here are thinking about their feet? How many of the people as we’re sitting here are actually aware of their posture? I don’t know, are either of you aware of your posture as you’re sitting in your shirt, right? Most people are like, huh? Right? They just don’t think about it.

 

Ruthie Miller (12:52.118)

Never.

 

Dr Emily (12:57.469)

My goal through sensory stimulation and understanding the sensory system is to make body awareness, posture awareness more conscious, more at the forefront and a priority of your brain and what you focus on because that’s how you minimize stress. Stress meaning the pounding and the gravity and the impact forces and all of that stuff to then minimize joint wear and tear, muscle wear and tear, to then support what’s called movement longevity. And it’s a, this is a lifestyle thing, right? So your posture, how you move, how you carry yourself, how you relate to the ground and gravity and all of this, this is a long game. This literally has to be a lens at which you look at the world or how you relate to the world.

 

Leyla Seka (13:50.092)

And if you do it right, you will just stay upright longer.

 

Dr Emily (13:54.618)

Like alive? I guess. 

 

Ruthie Miller (13:58.168)

No, no, like you will be able to, you will have movement, will not be the old person with osteoporosis and who knows if we’re gonna get that, but our goal is kind of longevity, stronger for longer.

 

Dr Emily (14:04.447)

Yes. So I actually talk a lot about movement longevity. I talk a lot within the active aging market. I talk a lot within the fitness and the wellness markets, and this whole longevity space is one of the fastest growing markets around the world. People just want to live better longer, right? Have a high quality of life all around. The one thing that is the hardest to deal with is arthritis. So what you had said is degenerative joint disease, wear and tear, like, your joints, right? To me, the thing that even in my early 40s gets me is joint stiffness and joint pain. So that is based on how you carry your body. What is your posture? What is your alignment? What is your foot posture? How do you relate to gravity and the ground? That is the key part to minimizing joint wear and tear, which is arthritis.

 

Ruthie Miller (15:09.09)

So I’ve noticed that you have a product, they’re socks that are kind of textured socks. And I’ve been noticing this in other areas too, like they now sell yoga pants that kind of have textures and shirts that have textures on the inside, you know? So is that really what it’s designed to do is sort of make you more aware of your body so you are sort of focusing on that? The textured socks help you focus on your feet while you’re exercising or while you’re walking.

 

Dr Emily (15:36.981)

Yes, 100%. So the way that you notice your feet during movement, working out, things like that is either be completely barefoot. That’s a great one. I’m definitely an advocate of barefoot training. Could be wearing minimal shoes like a Vivo Barefoot, a Zero Shoe, Lamb, something that is very low profile, no cushion. It could be using something like the Noboso socks. And I’ll just show the socks for the people that are watching the video that have the texture on the inside. So you’re feeling the tiny little pyramids on the inside. Same pyramid as the ball that I showed. But that is helping you to feel your feet. You could use whole body vibration platforms. You could use kinesiology tape. So that’s the tape that like the Olympians would wear that was colored. I am familiar with the brand that you’re talking about with the texture on the inside, right? I assume that it’s Elastique, which is a brand. I don’t know if this is the one that you’re thinking of. Theirs is a little bit different. So they have these little silicone dots that are on the inside of the fabric, which is stimulating more lymphatic. But there’s a very strong interplay between circulation and awareness, texture, perception, proprioception, they all kind of, they’re all playing in the same sandbox. So anything that heightens an awareness, I actually love compression apparel as well. Like anything compressive is building your connection and your awareness to your body. Wrist weights, those are awesome as well. Weighted vest, weighted apparel. There’s many different ways that you can kind of tie it in. Dry brushing. That’s another great one since you’re just stimulating the thousands of nerves that are in your skin.

 

Ruthie Miller (17:28.44)

Do you have any plans to make those socks in a white? I’m asking selfishly. I like white socks. I like the idea of those socks, but I don’t do black socks. I know.

 

Leyla Seka (17:39.532)

How very American of you.

 

Leyla Seka (17:45.228)

Okay, so I mean, this is fascinating and not like not at all what I do. Like I thought I was doing a great job because I wear Hokas and you know, I sort of keep my feet relatively clean and all that stuff. But obviously there’s a lot more to foot health as far as getting things sort of moving and getting to know your feet, right? I feel like I’m getting to know my body at 50 because I feel like I spent most of my childhood and preteen and the young adult years trying to ignore it or hide it or act like it wasn’t there or ashamed of it or not into it or whatever. So it’s this weird part of the podcast. This is a revelation of like, oh, I feel this, this hurts that, whatever these different types of things. But so I get that, practically feet, like feet get messed up. Like a lot of my friends have weird ass feet, like bunions and like toes that go and like, you know, really.

 

So if you’re in a situation where you have sort of feet like that, like what do you, I don’t have that. said, whatever, so ridiculous and vain that I said that, but I don’t, but like whatever. What do you do? Like what do you do when your feet are sort of like kind of a hot mess, right?

 

Ruthie Miller (18:50.232)

Like how do you know when you need to go see a specialist versus when you can do a roller or something?

 

Dr Emily (18:55.659)

Yeah. So I would say a couple of different ways. what Leyla’s describing is bunions and hammer toes, right? So there becomes a potentially cosmetic alignment of the toes, right? Where there’s always an interplay between cosmetics and function. That’s how I think, right? There’s both that are really important. When you have a bunion, which is a bump on the side of the toe and the big toe is deviated over some trying to make a bunion, right? This angulation of the toe and makes this bump on the side. That is showing that there is a loss of stability in the feet and in the hip. And many, many times those people that have big old bunions have sleepy glutes on the same side, like their butt won’t activate, the muscle won’t activate, which means that their hip muscle is asleep at the wheel, which puts stress on the hip joint, the lower back, the knee, the ankle, the foot. So could you have someone who has a bunion which destabilized the glute now get plantar fasciitis or heel pain on that side because the foot isn’t stable when you walk and when you strike the ground? Absolutely, you could totally see that, right? So it’s not just the cosmetic, it’s a functional stability issue of what we’re dealing with. We got that.

 

Okay, could they have pain literally in the bunion and in the joint because of arthritis, which is what we spoke about earlier? Yes, you could have that. What I will say is your big toe, if you get arthritis in your big toe and you cannot move it, you cannot take long steps when you walk. And part of longevity is walking speed. And if you cannot walk fast enough because you can’t take these long steps because you have no range of motion in your big toe, then you slow down the way that you walk. You stop rotating your torso and your pelvis and you start to kind of march and shuffle and it completely changes the way that you walk and the way that you move. That in itself is a predictor of morbidity and mortality, not to be a Debbie Downer. But there’s a research that predicts that, that as you slow your walking speed, morbidity and mortality goes up. So I assess that on all of my patients. And what is not often thought of in the larger medical space is the big toe. They just look at the movement pattern and no one went all the way down to the feet to look at the toe. it be. So it’s actually relative to your height and to your own unique state and anatomy.

 

Ruthie Miller (21:29.944)

That is so fascinating.

 

Leyla Seka (21:31.854)

How fast are we supposed to walk?

 

Dr Emily (21:40.129)

What I will often tell people, because no one’s going to know, I mean, unless you’re on a treadmill, no one knows like what pace they’re walking, really, right? Is you will know your speed when you fall into momentum. Like mall walking – I love mall walking, right? Go to the mall, leave your stuff at home, like don’t carry your purse and like all of this. Or I used to give this kind of story when I lived in New York City. And it’s the one of the things that I absolutely love and miss about New York City is that you walk everywhere, and you walk fast, right? So go to the mall, go to New York City, whatever. And you want to walk fast enough that you’ll actually feel that you’re in this state of momentum. And the listeners will know exactly when that is because if someone is about to come in front of you, you are, have so much momentum behind them that you are going to like barrel into them, right? And you will feel where you switch into that. Now walking speed and energy with walking and like all of this is if I walk, my boyfriend is six four, and if I walk at his pace to keep up with him, I’m taking like twice as many steps as I need. My energy efficiency gets thrown off. If he slows down to walk at my pace, he becomes very inefficient. So this is a very individualized of what your walking speed is. And the more efficient you walk, the less stress you have on your system, which prevents arthritis, and then you move longer. So it’s a very interesting interplay.

 

Ruthie Miller (23:18.424)

I’m gonna tell my husband that because he always complains about how fast I walk. He walks slow, he ambles, and I’m like, no, when I am walking somewhere, I have got a place to be and I am out there moving.

 

Leyla Seka (23:30.988)

My husband tells me I walk too slow and he’s 6’4″. So we got it, we got it. Both of us got it right there. That’s perfect.

 

Ruthie Miller (23:38.072)

So recently we had a dermatologist on here who kind of walked us through a lot of the new treatments that people are doing on their faces. But it sounds like a lot of people are doing very similar treatments on their feet, like red light therapy, like acupuncture and stem cell therapy. I put stem cells on my face, but it sounds like now people are using stem cells on their feet. What are all these doing and is this something that we need to get involved in for foot health?

 

Dr Emily (24:05.793)

So yes, absolutely. I love red light therapy or photobiomodulation. I recommend that to all of my patients, everyone. It is a chronic game. So whether you’re doing on your face, your body, I don’t care what you use it for, it becomes also like a lifestyle. 

 

Ruthie Miller (24:23.446)

Is it cosmetic or is there some kind of lifestyle thing that’s going to change?

 

Dr Emily (24:26.922)

Lifestyle. So red light therapy increases vasodilation or circulation to the area. It can increase mitochondria. So this is the activity, the youthfulness energy source. It can decrease substance P. So that’s kind of a pain modulator. So again, some of the foot stuff is going to be related to pain, not your face. But I would focus on it from a mitochondria, vasodilation, circulation, you’re keeping all the little cells happy and active. That’s the way that I would think about it. In the feet, it’s very much about the nerves. So you need the peripheral nerves, the itty bitty nerves that are in your feet to be happy. Red light therapy is a great way to do that. So you think about that. Stem cells, I use stem cells when someone has a tear in their plantar fascia or a tear in a ligament or a tendon. That is where I do different stem cell injections and all these stem cells are really growth factors. So they are stimulating what’s called a fibroblast, which is the cell that makes collagen. That’s really where stem cells come in. So it’s stimulating collagen production through the cell that makes the collagen. That makes sense.

 

Ruthie Miller (25:46.033)

And that’s an injectable? It’s not, I can’t just take whatever I’m putting on my face and put it on my feet?

 

Dr Emily (25:50.517)

No, no, no. Yeah. So it’s an injection. That’s where like the vampire facial, right? So they’re doing the micro needling to open the skin to then allow the growth factor of the PRP to get into the skin. So that’s where it comes into play or like hair loss. My boyfriend probably doesn’t want me sharing that he’s doing it, but whatever. 

 

Ruthie Miller (26:12.969)

Haha!

 

Dr Emily (26:13.857)

They do microneedling and then they do exosomes or PRP or some sort of, again, stem cells are loosely used in this. But in my practice, I focus on functional podiatry but also regenerative podiatry. So a large part of my practice is actually these regenerative injections and I always stack them with red light. So it is always a stack that I use with patients. Very, very good. Some other ones that people do for the feet, you can do fillers. So you could do dermal fillers in the feet. If you have fat pad atrophy, that is very expensive.

 

Leyla Seka (26:52.558)

What does that mean? What does that mean? Stop, I don’t understand. Nothing atrophies in my fat, unfortunately.

 

Ruthie Miller (26:55.416)

What is fat pad atrophy? 

 

Dr Emily (27:04.417)

Yes, the foot is one area where you lose fat. Where you lose fat in your face and fat in your feet. So those are two areas you don’t want to lose fat in your body, right? Or your hands also. So you would essentially be injecting fat, fillers, et cetera, into the ball of the foot, which can be very painful. Oftentimes this is women who are wearing heels that will notice a little bit more because they’re on the ball of the foot. You could do that. You can do Botox for people who sweat a lot. So that’s called hyperhidrosis. So you can do Botox. This is extremely painful because you have to inject the entire bottom of the foot with the Botox to try to then shrink the sweat gland.

 

Leyla Seka (27:47.197)

So your feet don’t sweat? Your feet don’t smell, basically?

 

Dr Emily (27:50.497)

Well, so really the only time that I would do this is if you actually have clinical hyperhidrosis. They do this on the hands. They’ll do it in the armpits. So a dermatologist will do this everywhere. A podiatrist would do it in the feet, but they would do that. But that’s usually, I don’t know if you’ve ever shaken someone’s hands where you’re like, woo, like, are you nervous to see me? Or like what? You know, that’s actually hyperhidrosis. That’s a clinical condition. People will get that in their feet. And I remember when I was a resident, we were doing something with these young athletes and this athlete, he was like a soccer player and he had such bad hyperhidrosis that like a layer of the skin would just like slough off. Yeah, it was, that is the worst case that I’ve ever seen of hyperhidrosis and this poor kid had to be in soccer cleats. 

 

Ruthie Miller (28:40.183)

Brutal. What about acupuncture? How can that help with foot health?

 

Dr Emily (28:47.153)

Acupuncture is great. Dry needling, acupuncture, both of those. So I will recommend that to people who have nerve pain. We had mentioned a little bit on kind of the menopause symptoms. You can get a menopause related neuropathy. And this is important for women to know because not a lot of people will talk about it. That is a really good example that I will then recommend. Okay, let’s look at some of these alternative methods such as photo, biomodulation or red light, acupuncture, et cetera. You can focus on that for the nerve, for the circulation, certain conditions, plantar fasciitis. 

 

Leyla Seka (29:23.49)

That’s terrible, that plantar fasciitis, the people that get that, it’s really bad and it’s hard to get rid of, right? I mean, it’s not, and a lot of people have it. A lot more people have it than I think even know they have it, is my feeling.

 

Dr Emily (29:36.511)

Yes, that is one that I see. My practice is primarily based around chronic conditions, meaning it would be a chronic plantar fasciitis, which is really fasciosis. And then I have a very specific protocol that I put patients through and it’s so that I can determine, we need to actually do something regenerative? So that’s where if any of the listeners are like, my God, I’ve been dealing with heel pain for two years, three years, five years, 10 years, whatever it is. And it’s just on and off and on and off. You definitely will want to reach out to me, I’ll help you. But you have to think outside of the box and it is most likely they have a partial tear of their plantar fascia or they have thickening and degeneration and the tissue is just in a state of chaos, I guess you could say. And then you have to bring reorganization to the tissue before you can finally get rid of this plantar fasciosis.

 

Ruthie Miller (30:34.476)

What about shoe brands? Now we talk a lot about heels and how bad they are for you and stuff like that. And I honestly, I get pain in my toe box, like around my pinky toes when I wear heels. And now I have to wear kind of a block heel or a flat or a fancy sneaker. I love fancy sneakers. Are there brands that you really recommend or brands you say, you know, maybe maybe that we should avoid that one?

 

Dr Emily (31:08.833)

I have the stilettos that I like, but that’s just a fashion thing. I was on on a other podcast and they’re like, we want like a confession from you. And I was like, I love stilettos. That’s my confession.

 

Ruthie Miller (31:26.857)

Dark secrets from Dr. Emily.

 

Dr Emily (31:28.033)

I know, I know. I also do ballroom and they’re just like I can’t believe you wear those shoes and I was like I have to! Like, it is required. So I would say when it comes to I’ll talk about sneakers first because that’ll be a little easier. I try to get people into minimal shoes as much as possible if their feet can tolerate it.

 

Ruthie Miller (31:52.024)

What do mean minimal? Like minimal, like minimal heel? 

 

Dr Emily (31:55.999)

Fully flat, no cushion, no drop, no structure, like you could twist the shoe, all of that stuff, especially when you’re working out or you are trying to optimize your foot strength as much as possible, then more minimal. That’s like a Vivo Barefoot, zero shoes, I’d mentioned some of those. They have a wide toe box, so they allow your foot to spread, splay and open up your toes. If someone wants a little bit more of a transitional shoe, that would be like an Ultra.

 

and Ultra is a little bit wider, has a little bit of cushion. On Running is another brand that you can look at for that. Then you of course become more structured along that lines. And I’ve worked with many of the brands. I can give pluses and minuses of every single last shape. Like Nike is just by design more narrow.

 

Vivobarefoot, which I mentioned, is just a little bit more, it cuts around the fifth and the fourth digit a little bit sharper than say, Zero Shoes. They all have their own last, which is the shape of the shoe, right? That is unique to every brand. And I think sometimes people don’t understand that, that they’re just like, how come the on running didn’t work for me in my, but it works for my mom and my best friend, right? It’s just the unique last of it, the shape, right? So we just have to be understanding about that. As far as other ones, if people are looking at like sandals and flip flops and kind of sandals, slides, generally you want the shoe connected to your foot. If the shoe is just like slid on, which is, show you my bad shoe. This is not Emily approved. But you know, the reality is I love Tory Burch and like the, what are you going to do? 

 

Leyla Seka (33:48.366)

What about Birkenstocks? Birkenstocks are okay, right?

 

Dr Emily (33:51.487)

Well, Birkenstocks don’t always connect to your foot, right? So when a shoe is not connected to your foot, you change the way that you walk. 

 

Ruthie Miller (34:03.48)

What do you mean by connected? Like a heel, you’ve got to have some kind of something holding your heel in is what you mean? Okay. Yeah.

 

Dr Emily (34:07.803)

Yes, like it’s wrapped around your ankle. It’s connected. It’s something with the heel and the ankle where my shoe is not. So take that for what it is. You will either slide your foot. You will contract your toes and pick the shoe up when you swing through or people will do what I call flip-flop foot, and they swing their leg around like this and they kind of do this egg beater at the knee joint and they’re kind of walking like that. I used to love seeing that one in New York. So they’ll do something or a lot of these kids are wearing Crocs, right? Just, I’m in Arizona now, so like every kid wears Crocs and they just like slide around in their Crocs. I’m sure it’s everywhere also. It’s just crazy. It’s bad for gait mechanics to slide your feet around, but it’s just kind of the thing, right?

 

Leyla Seka (35:03.468)

My kids wear those Crocs like crazy and then they’ll put the strap up and say they’re in sport mode.

 

Dr Emily (35:10.387)

Yes. Yes. don’t know who started that, but yeah, let’s just kind of, I don’t even know. Yes. So those are times.

 

Ruthie Miller (35:17.058)

Okay, what do you think about Golden Goose shoes? Are they podiatrist approved?

 

Leyla Seka (35:20.718)

That’s what’s on Ruthie’s agenda. She wants to know about her favorite tennis shoes very quickly before we finish.

 

Ruthie Miller (35:23.624)

Yeah. Okay, okay. Says the one that he asked about Birkenstocks. Ya hippie.

 

Dr Emily (35:25.249)

Well, she said fancy sneakers. That is exactly where my mind went. So yes, you can keep wearing your Golden Goose shoes.

 

Ruthie Miller (35:35.596)

Okay, good. They’re the best travel shoes. I mean, listen, I can do the girl math, like cost per wear.  I’ve gotten my money’s worth out of those dang shoes.

 

Dr Emily (35:43.765)

That is how I justify my Louboutins as well. But yeah.

 

Ruthie Miller (35:46.676)

Exactly!

 

Leyla Seka (35:46.702)

Okay, I have one more, I have another question really quickly. Inserts, like you know, you go to the CVS and you stand on the Dr. Scholls thing and they tell you to buy size D, I buy that every now and then, should we do that? Is that stupid? Why am I doing that?

 

Dr Emily (36:04.351)

So the over the counter arch support that I like, and I’m not paid by this brand in any way. Well, one, my company is one. Naboso. So we have arch supports, but you don’t have to use those one if you don’t want, is PowerStep. So PowerStep is one, and this again, I’m not paid by the company in any way. It is just based off of me recommending various ones to patients. And this is patient feedback to me of the one that has the highest satisfaction rate is PowerStep. Of course, there’s super feet, there’s Keerax, there’s Dr. Scholl’s if you want. The materials are always going to be cheaper because it’s over the counter, right? So it’s designed to be replaced at a certain point. It is not specific to your foot. So where the arch hits, this is the Noboso form, so it has the texture on it and the arch, but where the arch hits on your foot is going to be just a little bit different. This is just a template, right? So hopefully it hits as many feet as possible in the right place to give the proper support. But again, it’s not personalized. Custom orthotics. So I do do those in my office. I do recommend them in certain situations. I do think they’re highly over prescribed.

 

Leyla Seka (37:23.458)

That was what I was getting at. Like, do we all need them? 

 

Dr Emily (37:25.899)

No, no, no, no, no. It could be activity specific. So one example would be, let’s say one of the listeners has a little bit of flatter feet or their feet get tired at the end of the day and they’re a nurse and they work 10 hours straight on tile and concrete floors in the hospital. You need to be using something, right? Put this in your HOCA and that’s what’s going to help you survive going through that. Or if you have a little bit flatter feet and you’re a runner. So now you have fast acceleration going through your feet. Okay. That makes sense. But I try to not make blanket statements and you know, X does not always equal Y and how do we make this individualized? And if you use our thought it’s at work, maybe you don’t need it on the weekend or when you work out, like how do we make it a little bit more personalized? That’s what I try to go out.

 

Leyla Seka (38:16.664)

Yep, gotcha.

 

Ruthie Miller (42:12.256)

Okay, tell us quickly about Sensory Sapiens.

 

Dr Emily (42:18.049)

Yes, so Sensory Sapiens, for those that are on the video, just share the cover of it. So this I published a couple of weeks ago and it is a book. is Sensory-based approach to movement and longevity. And the focus of it is that we are, we by design are sensory beings. That’s the sapiens, right? We are sensory sapiens. And what that means is that the more that you can tap into the quality and the quantity of sensory stimulation you experience every day, that will then support mood, memory, and movement. So you want to optimize the emotional regulation, you have to have a connection to your body and how you relate to it. This is both internally and externally. Cognition, very, very important. If you want to protect your memory and your brain, you have to think about sensory stimulation because that ultimately affects movement. And then these three feed into each other, but sensory is at the core of everything. I actually believe that that is kind of the purpose of being alive is to be sensorily stimulated.

 

Ruthie Miller (43:21.496)

Amazing. Very cool. Well, we will link to that and everything else we talked about on our website and in our social channels. And thank you so much, Dr. Emily, for joining us on Side Project today. You guys can look up Dr. Emily at DrEmilySpichal.com or on social media at the Functional Foot Doc. And of course, we will link to all those things as well. But thank you so much, Dr. Emily, for joining us. I’m so excited to put all this stuff into practice.

 

Leyla Seka (43:49.102)

Me too. You’re amazing. That was so fun. Thank you so much. I keep moving my feet. I’m trying to make them wake up. So you already got me hooked on foot health. Thank you.