Episode 140: Is Pronation Bad

You go to a running shoe store to get into pair shoes. They're going to throw you on a treadmill or in some other way, identify how much you pronate and then give you something to correct that because pronation is a horrible thing that needs to be corrected. Or is it? Well, we're going to be talking about that and many other things on today's episode of the movement movement, the podcast or people who want to know the truth about what it takes to have a happy, healthy, strong body starting.

First, you know, those things are your foundation and we break down the propaganda, the mythology and sometimes the flat out lies. You've been told about what it takes to run or walk or hike or play or to cross with or yoga or whatever it is you like to do and to do that. Enjoyably, efficiently, effectively that I say enjoyably, don't answer a trick question. I know I did because look, if you're not having fun, you won't keep it up.

So do something different till you are. I'm Stephen Sashan from zero shoes.com, your host of the movement movement podcast. And we call it that because we're creating a movement. We include you.

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If you want to be part of the tribe, please subscribe because it's what you share that's making this whole thing grow and we've been excited to see that happen. All right, let us jump in. Rick, tell people who you are and what you're doing here. My name is Rick Meriam.

I'm a licensed massage therapist and I have a background in biomechanics and my office is in Dallas, Texas. So talking about your biomechanics background because most massage therapists, they get a massage therapy by going to massage therapy school and don't necessarily have the biomechanics part. So how did that happen and how does that inform what you do? Well, originally I started I had an injury to my back, like, you know, just from compensation is what I think just looking back on it.

So I had an injury to my back, like right after high school. I think it was due to compensation. I'd crack my tailbone earlier on just racing BMX bikes and yeah, racing BMX bikes, it was, it was not racing BMX bikes when I was at camp racing BMX bikes, cracked my tailbone and then ended up running in high school and had injury after injury. Eventually I had an injury to the disc.

This is now after high school. So I go from playing Ultimate Frisbee running anything pretty much I wanted to do to not doing anything. Now my parents were into alternative medicine. So I started working with a chiropractor.

That time I didn't really understand chiropractic like I do now. A friend of mine was going to massage school. He said, you know, I'd like to work on you to do my case study. And that was really, I was always interested in muscles and movement and really trying to figure out why I was injured, which I think is a lot of people's story.

So I remember just sitting in detention and in school suspension a lot and I'd be reading at that time, Runners World and Men's Fitness and looking at muscles and trying to figure out why I was injured. But I, you know, didn't really have anything that was looking back at it now. I didn't understand things like I do now. So I was just trying to different things.

I was always interested in that. So I go from massage school. Well, so I'm going to the gym. I get going into the gym, getting stronger.

The massage part really helped me. And then I knew when I was in massage school that I wanted to get into personal training. So I get out of school. I'm doing personal training and working as a massage therapist.

And I had been in a Tony Robbins many years earlier. And one of the things he teaches you is model the people that you most see yourself being like, so like, but it's her. And so I start going to these fitness conferences where the girl that I started dating at this gym that I was working at. So I'm doing massage at this gym.

I have an office there. I'm doing like real basic personal training at that point. We start going to fitness conferences and I knew right away, like, OK, I want to figure out who the biggest players are in this field of personal training at this time. So this is like 1995, 1996.

So the first time I listened to this one guy who ended up being my mentor, you know, unofficially, he sounded like I just wasn't ready to hear what he had to say. And I think if you were to talk to him, he was saying, he would say, you know, he was not the best presenter at that time. He was a little rough around the edges, a little prickly, you know. And ultimately, I hurt myself doing some stretching stuff that I learned at a fitness conference.

And then I start to question what I'm doing. And then he comes up on my itinerary maybe a year later, year and a half, like whatever it was, I'm in another fitness conference. So I'm like, I'll give him a shot again. Now I hear him a second time and I'm hearing it through or I was seeing it through a different lens because I've been injured via exercise via stretching specifically.

But anyway, it was like, wow, this guy makes so much sense. He was a physical therapist. His name is Tom Purvis. And to put a name to the face, he was the pitchman for Bowflex for many years.

He was the physical therapist on those infomercials. And, you know, he's really, I think, a genius. He teaches critical thinking and he just has a whole different way of looking at everything. And that was huge, especially in my 20s, because it really helped me to think differently, critically.

And that's how I ended up teaching actually was, you know, via critical thinking. And that ended up working out really well for me. Well, let me pause and ask a couple questions. So one, when you said you weren't ready to hear it the first time, what was it that you weren't ready to hear?

You know, it's so long ago now, but I think that he, you know, he was talking about, you know, the joints a lot. So if you're doing stuff in the gym, we think a lot about muscles, but we don't think about joints. And then more specifically, how are you applying force to those muscles? The impacts, the joint.

And that was in the early stages of his, you know, training. And then he, of course, evolved like everybody does. But I wasn't necessarily thinking about, you know, I always, I always understood, okay, you want to control the eccentric phase, you know, the negative for the, you know, gymsigns kind of thing would be the negative, but that's a, you know, the muscles eccentrically lengthening. And then you sure, but I always knew to control both ends of the movement.

But I wasn't thinking about the joint. I definitely wasn't thinking about how you apply force to muscles. And that, that makes the world a difference. And he had a background of, you know, having, you know, done bodybuilding for years and heard himself, you know, he had heard himself and started, you know, as a physical therapist, started to look at these things differently.

And I always look at it like, and this has happened many times in my career. But, you know, when the student is ready, the teacher will appear. And I feel like that's the opposite too. Having taught for many years, I talk in easyology, which I guess I didn't mention.

But having talked in easyology many times, I think it's the opposite too, where when the teacher is ready, the student will appear. Does that make sense? It does. Well, I just like how you've highlighted something in the fitness world, and think about that.

A lot of people get into certain things because of their own personal problems that they're trying to solve. And then they deal with that. It's similar to most therapists who get into therapy because they're trying to fix themselves. And then they go into being therapists.

Sometimes they really need to do more of the former before they can do the ladder. The thing about muscles and joints is very interesting because certainly when most people think about exercising, they just think about moving the weight. Or if you're doing body weight stuff, just moving the body and aren't paying attention to what you said, which is how these things actually interact in the right way. It's really easy to put strain on the joints.

Look, I talk about this with arch support. When people say, well, I need arch support, I go, well, what you're doing is when your foot is hitting the ground flat, your arch isn't engaged and you're trying to engage your arch when it's in a weak position to start with, then you put an arch support and you can't do it at all anyway, or you have a stiff shoe and you're trying to move your foot isometrically because it can't actually move all of these put strain on the ligaments, the tendons and the joints. And people are like, oh, they don't think about it in part because they've been sold bill of goods about orthotics, for example, and we can dive into that later if you like. But the, there's one other thing that you said that was really interesting to me.

Oh, man, it just flew right out of my brain. Well, it's like, I think that let's back up to the thing I tease this with. So you and I sort of chatting and we talked about this whole phenomenon about pronation and orthotics and support and the mythology around that and what people don't understand about that. Do you want to dive into that and we can see where that takes us?

Yeah, I think ultimately, you know, talking about the joints and joint forces. And in this case, with running, you know, we're talking about ground reaction forces. So no matter what you believe, you know, if you believe orthotics are good or whatever it is, you still have physics, right? So, you know, the physics are going to be there no matter what you believe.

Right. And that's really important to think about because ground reaction forces include a lot of things, you know, friction, for an example. So very often this is kind of like, let's call it possible for you to do that. Same more about what ground reaction forces are in this context for people who don't know that term.

Yeah. So basically when the foot comes into the ground, we can get into specific things about the foot. When the foot comes into the ground, the ground is pushing back at the foot. So if you land on your heel, and I know you know this, Stephen, you land on, you know, towards the outside of the caulkane, is for heel.

And then the ground is what drives the heel, right? So it drives it into what's called eversion. So do you want to give your pronation, supination example before I go on? You can do that too.

I'll do. I'll explain the pronation, supination thing. So we'll start with supination. So when your foot is approaching around, if you're relaxed, you're going to touch the ground on the outside of your foot first.

And this is that position where your foot is angled. So the outside is down is supination. And whether you land on your heel or your mid foot or the ball, your foot, same thing. If your foot is angled in that way, that supination, and then your foot's going to hit the ground fully, and it'll be flat.

And as you're coming off the ground, you tend to roll onto the inside slightly. And if you're thinking about the inside of your foot being down, that's pronation. And what most people have come to believe is that pronation is bad. And because frankly, shoot companies realize they could sell that story, because it's one of those things that everybody does, it's a natural part of the gait cycle.

But if you can pathologize a natural thing, then suddenly you have a unique selling proposition and you can convince people that they're wrong and broken. And then you can sell stuff to them because you're lying sack of crap. Yeah. Yeah, absolutely.

I think to add to that, you know, before the heel touches down, I think it's important piece that a lot of people don't talk about is that the foot is actually turned. So imagine you pull the top of your foot towards your shin. So that's called dorsiflexion. If you're sitting there right now, you pull the top of your foot towards your shin and all you have on the floor is your heel.

Now I'm at a turning your foot in and when you turn your foot in, your lower leg follows your foot, right? So that's like you're preparing the landing gear before the heel touches down. Right. And you'll see that in some of the running magazines, like, you know, they'll capture an image with the foot right before it strikes the ground.

So that's really important because it's how, how well are you preparing the landing gear for the landing, right? And so the heel touches down and we're going to touch more into the outside of the heel. The ground drives the heel and then ultimately you have to go to your big toe. Right.

Now, I remember many years ago, I was on the, I probably remember this, the run girl foot, the run barefoot girl podcast. And I remember hearing an interview with you, not on that podcast, but on another podcast from a long time ago. And this, I love this about you because you had just started a company at that time. And I remember hearing you say, and she was asking you about me, can't I?

This was not the run girl foot. This was not the run barefoot girl podcast. There was a different podcast around barefoot running at the time. I think the lady was on a candidate if I remember correctly.

And you were, it was the very beginning of the podcast and you talked about landing very lightly on the outside of the forefoot or front foot. And then you go to the big toe and she was challenging a little bit on that. And I was like, yeah, he's absolutely right about that. So I was so, I mean, I knew that, but I was super impressed that somebody who had started a running shoe company actually understood how the foot comes into the ground because I had never, I had never heard that before from anybody that started running shoe company.

So I was like, man, I like this guy. And I also recognize that I also recognize that you understood marketing. And I really appreciated that too. Or let me, not only did you understand, Mark, but you were good at marketing, but I love that.

I love that part of it. You're, whether you land on the front foot or the rear foot, meaning the heel, you're going to touch down on the outside of that front foot and then you're going to the big toe. But once the heel touches down, it's going to be the same thing, right? The same motion is going to occur, right?

But at a different time. And that's really the important thing. Because either way, like, so you're, I'm going to go back for a second, because I think this is really important. I don't know if you've thought about it.

But if you touch down on the outside of the front foot and you go to the big toe, what is the ground going to do to the front foot? Well, same thing as doing no matter where it hits. It's always pushing back and in place where you're right. Yeah.

That's right. So what would you call that? And hey, we're back to ground reaction forces. Yeah, because ultimately if you're touching down on the outside, your foot, your big toe, imagine the front foot, you're going in, right?

So like to use the running shoe store analogy, you're going in, right? So the big toe, right, comes into the ground, which is pronation. So it's pronation of the front foot, right? Or eversion of the front foot.

And then ultimately the ground's pushing back, right? Which is throwing the foot in the opposite direction. And then the heel goes in the same direction. What if you touched out on the heel?

You know, one of the things that I think is so interesting about when you're landing on your heel and pronation is that, and the, well, I'll say two things. One, it's almost inevitable because your heel is a ball. Balls are unstable. And so there's no way to avoid it, basically.

But more, you just don't have, if you think about landing on your, on the ball, your foot, your forefoot, when you land on the outside edge of your foot, you come in, you have this wide structure that's actually designed to address that, to handle that. In fact, if you're landing on your forefoot, it's really hard to pronate because you've already engaged the arch, you've already engaged the ankle. Like you said, you've already basically prepared the landing gear to handle that force, the way it's designed to handle that force. That's right.

Robert alignment of the bones and ligaments and muscles as well. And so it's this misunderstood idea. But of course, if you're landing on your heel, there's just no way around it. And I remember I was in the lab with Dr.

Bill Sands when he was out here in Colorado. He used to be the head of biomechanics for the US Olympic Committee. And he would say pronation is not an issue, hyperpronation. How can it happen so fast?

You can't control anything is an issue. And not only does that happen when you land on your heel, but it happens even more. I've been holding up a shoe. If you have a shoe with a flared soul, yes, it hits the ground first is not where you're healed with hit the ground, but a half an inch to an inch further out, which if you think about using a wrench, you can basically move more with a wrench than you can with your hand because for physics people, because you've increased the moment arm gives you more leverage.

But the flip side is true as well. In this case, that allows having that flared soul creates that hyper that fast movement into pronation, which you can't control. So the shoe itself is a problem in multiple ways, especially if you're landing your heel. But same thing on the forefoot, if you have a flared soul on the forefoot, same thing creates hyperpronation, which is again, you just don't have the time to correct for what does and no amount of foam is going to do it because you're hitting the ground with so much force.

There's no foam that can stand up to that force. Yeah. And I think what I was trying to get to too is, you know, like looking at a minimal shoe, when I talk to patients, I'll show them what a shoe should look like when they go out. So I have a lot of clients patients that have zero shoes.

There are other shoes that I recommend. A lot of clients do have zero shoes. So, but long as for short is I could pick up a shoe, let's say they walk in with their zero shoes and I will twist the front of the shoe in the back of the shoe in opposite directions, because that's what the foot's doing when it's on the ground. Right.

So we can show it like from a marketing standpoint that we can roll it up in a ball, but really we want any shoe where I can hold the front in the back and twist it in opposite directions. Now a lot of shoes won't do that. Right. But can we, if we're, if we're walking around in our casual wear, say it's a female, walking around in their casual wear and they're wearing zero shoes or some of whatever minimal barefoot shoe it is, they're often looking for other shoes that they can wear.

So like you have sandals, right? We would want something that would be on the back of the foot, right? A strap or whatever it is. That's why I think Anya's doing a great job actually.

I don't know if I said her name, right? But Anya Anya, you know, she's doing a great job because she's called a mean tremendous because I have females all the time asked me, you know, what are some other options because once you start going barefoot or barefoot shoes, minimal shoes, it's hard to go back. Right. And I've been doing it for 12 years and I can't wear anything else nor what I want to, you know, but that's really the big thing.

And then of course, podiatrists say the opposite. They'll show you the stiff issue you could ever possibly imagine, which makes no sense based on going back to function. Right. So you always have to go back to the mechanics and we're wearing these shoes for a tremendous amount of reasons.

Don't allow the foot to function the way the folk was designed to function. Right. Here's a weird one for you. If you think about runners who are running, especially like the 200 meters or the 400 meters where they're taking a turn as fast as they can, yeah, the foot has to do something there that most humans never have to experience where it's actually, you know, this impossible describe where basically it gets a little banana shaped.

So the forefoot's on the ground and when the heels coming down, it's basically getting sort of banana shaped and there's no running shoe currently that accommodates that. And so it creates a whole bunch of craziness for people. And we're and when I was started training as a sprinter again, about running the 200, what they have you do instead is try to teach you to put your foot in a really weird angle because the shoe can't accommodate what your foot is trying to do naturally. Yeah.

Yeah. That's an interesting. I think I heard you mentioned that I want to one of your episodes. Oh, man.

That is an interesting surprise because I don't think I did, but I don't remember what I have for breakfast. So it's entirely possible. So it might not be that exact thing. There was pieces of that, but I definitely remember you talking about there's terms.

You have to turn. Well, what I normally talk about is how I'm a hundred meter guy. So I don't take turns because I don't know. Yeah.

I get lost if I try to take a turn, but you know, if something comes to you and says, Hey, I pronate because they got quote diagnosed at a shoe store. How do you respond to them? You know, it's really at this point, having done this for as long as I have, it's really difficult not to smile or maybe even laugh a little bit. You know, I mean, that might just be my nature too, but, but, but, you know, you get so tired of saying the opposite of pretty much every practitioner that's out there.

You know, I mean, I just kind of keep it like a little light. And if they haven't met me initially, they don't necessarily know my personality, but you know, it ends up working out like nobody's offended or anything. But I just kind of laugh because it's like that makes no sense. So recently a woman came in and she had orthotics and she had been to the podiatristic and she mentioned her podiatristic three times.

And I said, well, you know, I listened to her, you know, listen to her, the whole thing. And then as she's talking, I'm trying to figure out, okay, how am I going to take this woman from the way she's thinking to the way I want her to think, which makes her more anti fragile because really she was here because a friend had referred her. So that's always a good thing. And she was tired of going to massage therapists every week and, you know, spending the money there.

I think she had gone on a chiropractor for a little while. And then she did the orthotics route. So I said, you know, I just came right out and said, well, just so you know, and I can back this up some confidence saying it, but just so you know, anything that a podiatrist is talking about as far as the foot goes is pseudoscience. Because here's how, I mean, that's true.

I mean, and I don't know, I'm probably not legally supposed to, but if you give me, if you, if you look at my background, I mean, I can back it up. So I'm going to say it because it's the truth. And so I literally, that's what I said to her. I said, you know, she's on a shoot.

It's actually just like, you know, just so you know, everything her podiatrist is telling you is pseudoscience and I can, you know, I can show you that. And she was so then right away, she's like, you know what, I'm totally open to whatever you have to say. My father was a science. So I'm totally, I'm in it, man.

I'm in and I'm in and I'm, whatever you have to tell me because she had gone so far into the fragile side of the spectrum, right? That she was willing to take in anything that would bring her to the other side. And of course, it's worked out very well for that. That's an interesting point.

We do hear from people who by the time they come to minimalist footwear or natural movement is because they've tried all these things. They spent all this money and it hasn't worked, but, and they're just looking for something they've heard from other people that has been beneficial. But I'm curious when you refer to podiatrist pseudoscience, can you give me an example? Well, everything.

I mean, seriously, I mean, I'll give you specifics, but it's just crazy that, you know, someone goes to school and what is it? Two, four years? I don't even know. And everything is wrong.

I mean, they don't even know how the foot functions, but then I think another side of an easier way to say it is they only focus on the foot, right? That's all they're licensed to focus on. But you can't change what the foot does, right? You can't change what the foot does mechanically in an abnormal way without changing what the knee does.

And that's huge. Cause we went, you know, going back to joints and I know this has come up with the D joint with the Harvard Gate Lab woman, her name is Casey Carrey and I think Dr. Casey Carrey. Oh, Casey, yeah.

Yeah, I listened to that episode and she's talking about osteoarthritis, the knee specifically. I think she was saying the medial side of the knee. We can like get into that a little bit. But you can't change what the foot does without changing what the knee does.

That's a mechanical thing. And so I'm going to, I'm going to have laid out like this. Because there's another part where not only can't change what's happening at the knee, but also at the hip and the flip side is you can change what's happening at the hip and that will affect what the foot is doing. That's right.

So if you're only paying attention to the foot, you might miss that and make some sort of intervention that's missing the point. Now I do want to say I have met many podiatrists who actually understand this shit because they have like you questioned it and started to look and found things that they weren't taught. I asked, I asked the podiatrist recently on the podcast what they learned about shoes and his answer was essentially nothing. Like they had one session, which was, here's the right shoe to fit the orthotic you're going to prescribe to people.

Yeah. So let me rephrase that because when I say these things, I'm talking about most and when I consider most, I'm considering 51%, but I do know, you know, I mean, when you draw that line, right? Yeah. But I mean, it's a lot more than I'm being extremely generous.

I mean, that's really the truth. I think there's 12,000 podiatry members in the podiatry, whatever it is, deal where they probably pay something and they share information and go to conferences. So I think it's 12,000 because it recently came up in an article. And I would imagine most of those 12,000 or so on orthotics on every day basis and how couldn't they sell orthotics on every day basis?

Because that's their bread and butter, right? Like a chiropractor is bread and butter is adjustments in most cases. Again, most cases being 51%. And I think I'm being generous when I say 51% because I think it's a lot more, a lot more chiropractors than 51% are doing adjustments every day, which I also think is pseudoscience and a placebo.

And we can talk about that if you want, but then going back to the dietary, okay, going back to the podiatry, I do know that there are podiatrists. There's a few out there, right? And I only know of maybe a handful, you might know more, but that actually do understand these things. I'm going to, I will maybe we'll see be generous since they tend, but I think I maybe heard of five.

Okay. And so that's like 90. You know, that's a lot of it. Wait, I can introduce you to five, like immediately.

They're maybe a little venn diagram thing going on, but suffice it to say, without even blinking, I could do 10. Now that doesn't mean that that's the only 10 by any stretch. We're hearing, I mean, I'm hearing from more and more people who are what's often happening if somebody's walking into the office of a podiatrist, sometimes in a pair of zero shoes and then that starts a conversation. Usually the podiatrist is antithetical to the points that that person is making or non-disposed to it.

But then at a certain point, they kind of sits in their brain and eventually they start looking at things and they call me and ask me questions. And then my favorite part is they say, well, you know, you don't have a medical background and you don't know anything about footwear design, to which I say, well, no, I was only a pre-med from the time I was 10 and decided not to go to medical school. And I've been, you know, and I've got my other biomechanical, autobiactical cred. And yes, I didn't come in knowing footwear, but in 13 years, you know, you'll learn shit.

So, and in fact, just to say a bragging kind of the thing I'm most proud of, one of the two things I'm most proud of are related. One is that professional footwear designers take my idea seriously and know that I have valid input, which I was surprised by, but I just understand how this works. And the same thing with people who are researching and who are kinesiologists, biomechanists, et cetera, is they treat me the same way. And I feel proud is not my thing.

I do really enjoy that because I like the conversation with smart people who are willing to question things and investigate things and use and use critical thinking, which is tricky. When I say that, it's funny. I got accused on YouTube the other day by a European footwear designer of being American and using science to try to make a point, which I thought was one of the funniest things I ever heard. It's like, yeah, as the science backs up real reality and you're just using what people had told you and mythology to back up what you're saying.

I'm giving you actual data. And one of their sponsors was, well, you know, then how come all these big shoe companies, they spend millions of dollars every year in R&D. I go, right, well, that's great. But then how come running injury rates haven't changed since the end of the modern athletic shoe?

It's still 50% of runners, 80% of marathoners getting injured every year. If their R&D was so good, don't you think they would have fixed that by now? And that's when the conversation ended. And of course, there's no research to show that or if there is or isn't a lot of it.

And but that is the bottom line is just thinking, again, critical thinking. If all these things you say are working or working, then why are we spending over $100 billion on back pain and things like that? Right? Because even though you might not be talking about back pain, your shoe makes an impact on back pain.

You know, I mean, you know, well, and the other one that I say about when doctors are saying something about this not being real, I said, you know, the people who try minerals, footwear, natural movement, who have a good experience, don't make an appointment to come see you, right? You're only hearing from people who have problems. And then I say, and when they say they have foot hip ankle, knee, whatever problems they claim to have as a result wearing minimal shoes, do you ask them or do you get video of them running or walking whatever it is they're doing? And do you know how to analyze that video?

And have you asked them what their training protocol was and how they made the transition? And I've literally never had one doctor say yes to any of those three questions. I go, that's the important part. They go, oh, you're saying that anyone has a problem with their running barefoot.

It's because of a form problem. And I go, yeah. Yeah, I mean, yeah, I think the other way I would say that is they have no idea what muscles are doing, they don't know which muscles are tight. They don't know which muscles are weak.

And when I say weak, I mean, neurologically, weak first, and then we look at the physiological part, but you know that. I mean, they'll still give somebody a cash stretch for plantar fasciitis. And, you know, they've been doing that for how many years. And there's a lot, there's more than one muscle there and more than two muscles back there that cross that posterior axis or go posterior to that mean a lot of axis at the ankle, not to mention the subtail joint.

And they don't know which muscles are tight in which muscles are weak. And a lot of times it's interesting. The gastrochemia, which if nobody's familiar with that is a muscle, you see, you know, it stands out more when somebody has heels on. Sorry for humans, for humans, AKA your calf.

Yeah, yeah, your calf, right. But ultimately that muscle a lot of times is it can present as tight, which tightness is a sensation, but it's actually not functioning as well as it could or it's not functioning to the best of its ability. And that's not the only muscle that will present that way, but it is one muscle. And it's a very unique muscle because even though we we say gastrochemia because it has two heads and those two heads are responsible for very different things.

You know, I pointed out and I've shown this with people who say that their doctors told them they have plantar fasciitis and I can kind of spot it from the while away and go, yeah, can I stick my thumb on your calf in this one spot? And they go, all right. And of course, it's very tender. And after I worked that out a little bit, I got a plantar fasciitis when you walk around now, they go, wow, it's like 90% better.

I go, yeah. So you have tight calves that are pulling and giving those same symptoms, but it's not what they told you. Yeah. And I originally was on the podiatry arena.

What do they call it? The dietary podiatry arena, I think they call it, which is their online forum. They need attention to it a little bit because it would come up for alerts. Like I get alerts of different topics every day, like orthotics or early to be mentioned or whatever it is.

Anyway, I was familiar with the podiatry arena. So I would, you know, listen, I would read what they were saying, but then all of a sudden I was gone there and they were talking about an article I wrote about plantar fasciitis. And the title of the article, I don't know the exact, I was something about plantar fasciitis has little to do with your foot and it ended up being like 10 shared like 21,000 times. And so that ended up in the podiatry arena and they were, they were really not happy about it.

And then I wrote the article on orthotics, which also took off. Um, and they also weren't happy about that, as you might imagine. Well, what, what do you write about orthotics? Oh, geez, it's, it's long.

I mean, I recently updated because I had originally written that 2016 and I wanted to go back for the longest time and update it. And I, so I finally did a couple of months ago and, you know, I don't think there's anything good that comes out of putting orthotics in your shoes. And I recently going back to something you say, because I have my online presence too. And I have people that will challenge me here and there too.

Right. So I was answering a question the other day on fora and it only partly had to do with orthotics. But the question was something like, if you have really good orthotics, does it matter if you put them in a cheap shoe or something to that effect? Right.

And so then I'm like, okay, what a really good or thought it. Exactly. And then, you know what I mean? I know what a cheap shoe is.

So I kind of went, you know, I went, I went into, I mean, that could be a lot, that could be wide ranging, right? But I, but I then went into, you know, if you do put orthotics in a cheap shoe, what's going to happen? The question is going to break that really fast. You're going to end up on the outside of your foot, blah, blah, blah.

So I go through all this stuff and then I even gave the opposite. And then I might even go on into, eventually went into, if you put orthotics in a barefoot, you're going to end up with the majority of the weight or you're basically forced to supinate, right? Which means now you can't pronate. And so now you're just supinating away forward, which is not a good way to go forward.

It's not an official way to go forward, right? But but long story short, it's a, then a physio from the UK, you know, chimes in and says, you know, I found orthotics to be helpful for me and helpful for many patients throughout the years. That's something to that effect. So then I give more science, you know, and then he comes in again with something and I get more science.

And then at the end, he says, you know, you really should get more higher education, maybe study kinesiology. So I said, well, so I just said, I talk in physiology for 15 years and I actually wrote the forward to a kinesiology textbook. And then it was like crickets from there. You know, but I mean, seriously, like a lot of this stuff and I'm sure you can relate.

I can bring the science, but I could also bring the common sense. Right. And then you get into some cost fallacy and the self serving bias, confirmation bias. We definitely see that where they'll cherry pick little things that, you know, others, it don't even stand up to research actually.

But I mean, it's undeniable that for, well, I got an article on our site. This was, it was one of my, it's one of my favorite science writers for two reasons. One, she's a brilliant science writer and two, I love her name, which is Gina Colotta. Oh, yes.

Right. So the times has written a number of awesome books and she did some research on orthotics and basically came to the conclusion. They don't really do anything. No one knows what, if anything, they do, they're unreliable and there's no difference.

We've been getting $1,000 custom made orthotic and $25 Dr. Schull's in soul. But if you have, you know, in the same way, if you've injured some muscle, ligament, tender joint and you immobilize it so that it can not be under strain, that can be beneficial, but then you want to get out of that as quickly as you can and start using your body again, building up strength, building up flexibility as necessary. Because if you just keep it immobilized, it's just, it's a vicious cycle that gets progressively worse and worse and worse.

And you know, not using something feels good because it's relaxing, but watch what happens when astronauts come back from space where they were totally relaxed and it takes them while till they can walk again. Yeah. And if you think about plantar fudgetitis, I mean, most people would say that their calf is tight, right? So now if the diet just gives them the stretches, which don't do much, and then they put in their orthotics, right?

And so now they're in orthotics, but the subtailors won't can't move properly. And so the more your subtailors, when it can move, going back again, just eversion, imagine that the heel is supposed to go out, right? And the foot ultimately rolls in, but the heel can't go out and the foot can't roll in. And that determines what your ankle does, right?

That determines how much flexion you have at your ankle, right? So the opposite side of that, say you have no orthotics, stretching the cap doesn't make a big difference in the bigger picture, because like, basically, you're going to have to keep stretching your calf because you're not getting to the root cause. It's like a band-aid. But basically, if you don't have stability of your subtailor joint, your ankle is never going to flex more.

Can you decide? Yes, it makes sense to me. Can you describe the subtailor joint for people who don't have that physiology background? Yeah, absolutely.

So if you imagine the heel going out, so imagine like it rolling, we'll say it's going to roll in. And then on top of that, you have a bone. It's called the tailus. And so that forms the subtailor joint and that tail is when the heel, the calcaneus goes out or rolls in.

That sets up a situation where the tail is sitting on top can actually slide down and in. It just basically there's a little shelf there and it can then slide down and in. Now that tail is that sits on top of the heel and I have a foot here. Okay.

You have the same one. It's a big two. I have the same one. Okay.

Yeah. So ultimately that heel goes, let's do, let's do eversion. Okay. So let's show it from the back though, see my thing.

So then the heel goes, so it's going from in to out. So I go out. There's the out and then we're rolling in. Yeah, you're rolling in and then that tail is going to go down and in and the tibia, right, is going to follow the tailus.

Yeah, right. It's going to, it's going to follow the tailus down and in. And so it's important to recognize that that calf, some of those catmals that are attaching to the tibia or the fibula, but ultimately, if that rear foot, so the subtailor joint and the ankle joint can't move properly, that's going to impact what the calf can do. Meaning that if you block it with arch support, so we'll say you're not going to move your body or your body.

Now that subtailor joint can't move, which means, yeah, which means now you have an ankle, which is a pure hand. Just like if you go over to the door and you open and close the door, it's only going to move in that plane, right? So your ankle joint is a pure hand. It only moves in that one plane, which is the satchel plane.

So if you change motion of the joint that's closest to the heel, which is the subtailor joint or the joint that's, we'll say the joint that's closest to the ground, which is a subtailor joint, that's going to change what happens with the joint above, which is the ankle joint. And so that's where it's stretching the calf. It's really not doing what people think it's doing, whether it's plantar and fasciitis or anything, because you're never going to get more motion of that ankle until you have stability at the joint below, which is a subtailor joint. Now that's going much further into it than most people do, but that's really the truth.

Yeah. I mean, that's the truth of stretching. I mean, we can, we can say that stretching helps. We can say that stretching works two words that I hear a lot in the office.

So when I hear stretching helped or I hear stretching worked or I hear a chiropractic adjustment helped and chiropractic suggested worked, what did I reverse it? You get a helper work. I pay attention to those words, help or work right away. I'm thinking, okay, how is that possible?

You know what I mean? Cause I don't see that happening. And so then we might have that conversation down the road that let's stop stretching because it's going to undo what I do. Does that make sense?

Yeah. You know, it's funny having a foot skeleton to play with. It's really interesting because we just don't really appreciate how many bones and joints there are and what they do. And if you just even look at it for just a few minutes, it seems something's just become kind of obvious about what should or shouldn't move and what it should do.

I mean, I have to tell you one of my favorite ones is I didn't was not aware that your big toe, your first ray that there's this joint right here that cramps just like your finger, can crack your knuckles in your hand. And first time someone cracked that joint because it was a little over stiff. I thought they broke my foot. And but then it was like, oh my God, it's just way more flexible.

It was just all tight and I didn't know it. And I didn't know that was possible. And then you look at, you know, this foot skeleton and you see all these places where there are little things that could go right or wrong. And like you're saying, if you don't understand some of this and it's not like everybody has to understand the anatomy of the foot.

But if you don't have some familiarity, it's really easy to be misled by someone who's going to say you need an orthotic, you hope you pronate and that's a problem. Even though there's no evidence that there's any relationship between pronation and any injury whatsoever. And you know, saying about the heel, it's like, yeah, when you see that it's a ball and you're landing on your heel, that doesn't take any rocket science to know. Balls are unstable and it's just fascinating.

And I wish people, I wish people knew more physics. I wish people knew more anatomy because it would just save them so much time, effort and money. Absolutely. And I see that all the time.

Most of the people that come to see me have done all sorts of things. Orthotics, chiropractic, physical therapy, they, you know, they spent thousands of dollars a lot of times and now they're going to start paying out of pocket, you know, coming to see me. That basically is my, you know, my niche market. But but the foot is a fascinating thing.

It's a big part of my practice. I love the foot. I'm sure you've heard people say that the foot is not designed well. And that is not true.

The foot is designed perfectly. It's a it's a beautiful. I mean, it's the foot is just so amazing when you think about how it moves and how it interacts with the ground and all the things that it's supposed to do. But shoes have taken away the foot's ability to do what it's supposed to do.

And then shoes have taken away the foot's ability to do what the knee is supposed to do. And so a lot of people with it, even though they don't realize it because they don't have pain are walking around with weak feet. Yeah. So that's where you have to start.

I mean, that's really where you have to start. Now that's probably not realistic at this point. But hopefully with what you're doing and what other people are doing, we're going in a direction where maybe people will start to look at that in the bigger picture. Well, I'll tell you something.

I'm going to preview something that you'll get a kick out of. So there's two really interesting studies. Study number one is from Dr. Isabelle Sacco in Brazil, where she took runners in regular shoes and had one half of that group was, I think, over 200 people and had half of them do an eight-week foot strengthening program and then track them over the course of the year.

And over the course of the year, the people who did the foot strengthening program had 250% fewer injuries than the ones who didn't do the foot strengthening program. Eight-week intervention, one year's worth of value. Now, obviously, if you'd kept doing more strengthening, might have been even better. But it was literally eight-week intervention.

Well, here's the second study from Dr. Sarah Ridge showing that walking in minimal shoes builds foot strength as much as doing that foot exercise program. So the foot exercise program is in the middle of this equation. Now, there's not a study that shows that if you just walk in minimalist footwear, then you will get the foot strength that will allow you to have that 250% risk reduction of injury, but do the math.

It's the same exercise program in the middle of the equation. So what I'm starting to do, and I've just compiled that into an e-book that we're going to start promoting to runners to say, you don't have to run any shoes. Don't run any shoes. Wear minimalist footwear when you're not running to build that strength that seems to be collected, connected to, reducing your risk of being injured.

Now, I will also confess that it's a bit of a bait and switch because, of course, once they start wearing minimalist footwear, just like you said, once you get used to it, you can't go back. One day, everyone's going to put on their running shoes and feel like they're going to fall on their face and bemoaned that they can't feel the ground and get that feedback that they need. So that's my evil plan. But it's an evil plan based on, I mean, I call it the dumbest science I've ever done because we have to prove use it or lose it.

We have to prove strength is better than weak or strong is better than weak, which seems absurd. But that's where we are right now. Well, I think he knows as far as to say, like a dietary, just might say, this is going to go to splinter fetishitis, your heel is dropping, your particular, excuse me, your ridiculous dropping, your foot is weak, whatever the, whatever it is they're using that day, right? Depending on the digest.

And then they'll say, oh, and we have these orthotics for $500 that we can put on your shoes. And it's like, if you're a thinking person, it's like, okay, he just told me my feet were weak. Right. But now he wants to sell me $500, you know, what you're basically pebbles, you know, they're driving my foot and then my feet aren't going to get weak and my feet aren't going to get stronger.

You know what I mean? That's like, it just doesn't make any sense. It doesn't add up. And it's definitely throwing you more towards the fragility side of the spectrum.

Yeah. I'm sure you've seen this. It's very sad. People get to the point I hear this all the time for people because of that orthotics article that they can no longer walk around their house without orthotics.

It was the most amazing conversation I ever had. This was maybe eight years ago and a meeting with a guy in Boulder who's like one of the richest guys in town, big deal investor. And he says, you know, even if I wanted to, and if I invest in your company, I could wear your shoes because I've had plantar fasciitis for 20 years. And I said, well, first of all, you can't have any inflammation for 20 years.

So something else is going on. And he says, well, you know, wait for about a year and a half out of nowhere. As it proves it wasn't plantar fasciitis because things like that just don't magically go away and then magically come back. So I can tell you what you actually have is tight habitually, tight calves, chronically tight calves, for whatever reason, it went, you know, they loosened up for a year.

It doesn't matter. But I said, well, let me ask you a question. How are you walking barefoot? And he goes, I can't walk barefoot in my house.

I have hardwood floors. And I said, do you think that's normal? Do you think that, you know, you're somehow some horrible fragile little snowflake where it's impossible for you to walk across your floor? I mean, does that seem right to you?

And he was a little dumbstruck. And I said, dude, first of all, just because I look like this doesn't mean I don't know more than your doctor because all my friends who became doctors didn't go as high on those tests as I did, just FYI. But more importantly, I can give you some foot exercises that if you just did them while you're watching TV, you could build up enough strength to walk around barefoot in your house and I can give you some extra exercises after that, where if you wanted to, you could probably be running a 5k barefoot and I'm not suggesting you do it. I'm just saying you could.

Sure. A 5k barefoot if you wanted to in about six months. And he just looked at me like I was insane because he'd spent all this money with doctors who told him that he was a fragile little snowflake that, you know, needed to have an ask them how much of your thought it goes 1500 bucks a year. Oh, geez.

Yeah, that's a lot. I haven't heard 1500. That's for one pair. You forgot this guy's super rich.

Yeah, that's true. That's true. Yeah, that's true. I forgot that part.

Yeah. No, it is sad. I mean, I, I often one of the things I tell people regularly and they just think this is the biggest thing and in some ways it is is, okay, I want you to walk around in your house barefoot. But if you have wood floors, don't walk around in your house with socks on.

And you know, it's very different. It's like walking on ice. Yeah. Brain recognizes, okay, I have to shorten stride.

I'm not getting friction, which is part of ground reaction forces is having that friction. And so then the brain's not recognizing that things can move at the right time, even though they don't have any robotics or any overly sport or shoes on. It's not great to walk around wood floors with socks on. It's very interesting to say that there was some research with elderly people.

I wish I remember where I read it about injury rates if they got out of shoes. And the highest injury rate was people in socks. And it didn't matter if they had hard with floors or carpeting. It just makes it so that it is, it is changing the feedback that you're getting.

It is changing the way you move around. It is changing the coefficient of friction and you might be slipping more as a result. And, but no one considered that and which struck me as utterly mind blowing. But again, we just see people who, look, I can't, I can't fault people for not thinking about this stuff clearly.

If for no reason, then as humans, we're wired to look for authority figures and believe what they say, just like chips and other primates. So, you know, and we want simple answers. Unfortunately, you know, the simple answer isn't as sexy. The simple answer is harder to sell because it doesn't involve buying something usually.

And we've just been trained for so long. I mean, my favorite, you walk into a shoe store and you listen to some 23 year old kid who got was told what to say by the guys trying to sell a particular shoe. And he doesn't know any better. You don't know any better.

And you assume how could you get a job in a running shoe store? If you don't know any about running shoes, happens all the time. So it's, you know, again, I'm, I'm, I'm mad at the industry, frankly, just for the sake of venting for a second, because the people in the industry, the guys who run these shoe companies, they know this. They know what they're doing.

They know they're misusing physics to sell a story that isn't true. They know that when someone has tested, here's the shoe that we recommend from having you on a treadmill and analyzing and running versus here's a random shoe off the wall, they know it doesn't make a difference, but they keep doing it anyway. And I understand that too. They've got to make a living.

This is what they do that you can't just change course like that in theory, but you can, you know, gear up so that you can change course at what looks like a drop of a hat after years of preparation. So, you know, I understand it all, but it's infuriating because it's not good for people. Well, you figure if you're a podiatrist, you went to school for podiatry and you hadn't run board, read, or run or you haven't listed your podcast, now you've already spent that money and invested that time going to podiatry school. So where do you go from there?

There's always a sunk cost fallacy. Yeah. I think that applies to chiropractors a lot. They get into it and they realize, Oh, wow, this isn't exactly what I thought it was going to be.

And then there's all sorts of things that happen, but there's a sunk cost fallacy there and saying, I spent all this money and all this time to be this professional. So I have to do what this professional does. I mean, that's kind of the things that go through people's heads. You know, so they're looking for everything to sell or any way they can build insurance, including selling or products.

Because, you know, chiropractors will talk about alignment and that is not, that is not what you want. I mean, you don't want to be aligning your foot. And there is, you know, I mean, that going back to what we're talking about before the ground doesn't care how you feel about aligning the foot. You know what I mean?

Like the physics are still going to be there. Yeah. Right. Yeah.

Well, I hope this has given people some things to think about, slash argue about, slash complain about and then we can, we can dive into it. But you know, you opened, I don't, did you open by saying that you did massage therapy, which of course is such a small fraction of what you're clearly doing as we've had this conversation that should be obvious to people. So let me just do this simple thing. If people want to engage with you, hopefully to come see you or get some help or read what you've written that would be helpful as well or anything else that be useful.

Or if they want to argue with you because, you know, put it out that by the way, really quick, the guy who I was arguing with on YouTube, I invited him to be on my podcast and he said, I have no, of course, you were your podcast. It's really hard for me not to reply scared. So it would have been fun. But anyway, if people do want to get in touch with you, which I highly recommend, how do they do that, Rick?

They can contact me. Well, they can go to engagingmuscles.com, first of all, and then they'll hold on and slow engaging muscles.com. Yeah. So they can, they can reach out to me or go to my site, engagingmuscles.com.

And there they'll find all of my information, like YouTube and Twitter and everything. So I'm on Twitter at Rickmarium. So at Rickmarium. Yes.

Yeah. So Twitter is at Rickmarium, I C K M E R R I A M. And then I also have a Facebook page, which is engagingmuscles massage, but engagingmuscles.com, they can find a lot of, a lot of information on me. Brilliant.

Well, this has been super fun. And it's not just because we're both preaching to the choir, but it's nice to take a dive in a little deeper than we often get to. And for people who are overwhelmed by the physiology, my apologies ish and the ish is taking it. This is not rocket science.

It's not hard to learn enough to be able to help yourself and even possibly, you know, help others just because you have information that they may not be getting from a medical professional that they're seeing. Because, you know, the joke is what do you call the guy who graduated last in med school, doctor. And, you know, there's a lot of people who admittedly are doing the best they can, but with limited information and possibly a limited skill set and maybe not the same ability to think as well as you might be able to, I started to have a flashback. When I got back at a sprinting and I was having a bunch of deep problems, I went to a doctor and after like four sessions of him doing things that had no impact on me, he suggested that maybe I should do some exploratory surgery so he could figure out if there was something else going on, which I knew was a dumb idea.

And he said, well, you know, you just have a serious case of patellar tendonitis. I said, dude, that's what I walked in here saying to begin with. I just didn't say it in Latin. Yeah.

I got very upset with me because he thought he could snow me by just naming it instead of giving me some information. So, you know, you want to be, you want to obviously find medical practitioners that you can rely on, but you also want to know just enough at the very least to be able to do not just take what they say as gospel. Anyway, that's number two for this podcast. Yeah.

And the problem is people just don't know what they don't know. And that's just such a big thing, right? I mean, I get what you're saying, but you have to, you know, you do the saying is you can have enough, you can have enough knowledge to be dangerous, which is true. But man, I mean, you have a lot of knowledge that you can see it from the other side.

If you don't know what you don't know and you're in pain, people get desperate, you know, well, absolutely. And but that's a good place to be. I mean, it's a good place to, I'm not suggesting that I know everything by any stress and imagination, but you don't want to. Well, thanks, but you can, but you can learn enough to know how to ask a good question.

Yeah. If you don't know, you can ask a good question. Like what causes that? What else could be a cause?

Is there something where I'll tell you something funny, I did something weird the other day and I tweaked what feels like it's my lower back above my hip on the right hand side. And if I twist like to wipe my butt to be a little graphic, it was painful. It took me a week of noticing that that was where I was feeling pain. But then I felt a little lower and there's something really tight happening lower down kind of in my hip, like, you know, in my top of my glute.

I hadn't even noticed that before. If I just gone to a doctor saying I pain right here, there's a high problem above my hip. There's a high probability they would have never noticed the thing happening with my glue. And I don't know what I did.

Yeah. Whisted, like walking because, you know, I understand. No, I understand. I understand.

But you know, but just people to ask questions like, could this be coming from somewhere else? And if so, where to get them to start having to think with you is all it takes is some really basic questions, I would think. And you can just start finding those happily from listening to people like you talk about these things. And, you know, if you got to realize that doctors are their, their job is taking care of the 8% of the people they're going to see who have 8% of the problems are simple to deal with.

But if you go into something that's in that 20% and they're not hip to that 20%, then you got to know how to ask good questions or even ask what other questions might I ask that might be helpful? That's crazy. I asked that I met a question to ask that'll get them thinking about something different than what they are just there. How can I get in and out of here?

Yeah. I think it's also been shown that people make bad decisions under stress. You know, so when I mean, that's, I think that's a real research has shown that. So if you're, you know, if you're coming to a podiatrist as an example, with plantar fasciitis and you've been dealing with it and it's really, you know, it's impacting your life.

You know, maybe you have a trip to Spain in three weeks. I see these kinds of things, you know, there's, there's all sorts of things, right? And it's like, I got to have an answer. I don't care.

I'll pay $500, you know, and then they don't realize that, man, you impacted your life in so many, you know, you impacted your health in so many ways that you don't know. Because, you know, there's a pod just that will say, hopefully it's not to five to five minutes. But they'll say, I think there are a couple that will say this, you know, orthotics are good for a short time and then you kind of work your way out of them. Yeah.

And I don't agree with that. I think you wear them for a day and you're starting to fuck yourself up. I don't know if you're recording anymore, but you know, you really are because your brain is taking all the, but basically you're adding compensation upon compensation, right? My only argument for that would be if you do have something, I mean, if you're in the article that I have, I'll find a way to link to it in the show notes.

The article that I have, there are a couple of researchers who mentioned the whole point of an orthotic is to immobilize your foot because you've injured it and need to rest the tissue. That's it. And so there are those circumstances where you've done something where you need to let things rest, but you can let things rest and simultaneously build strength, build, keep that flexibility, et cetera. But so, you know, Irene Davis says it best if you're in a car accident and someone puts you in a neck race, you know, it's only temporary and that you don't wear that all day.

You need to do things to get your mobility back and make sure you have strength. But if a doctor said to you, you're going to have to wear that for the rest of your life, you'd sue them from malpractice. But not only do people, do doctors do that with orthotics for your feet. They do it with orthotics for your ankles, your knees, your hip, your back, your neck, which doesn't make any sense if you give it the barest amount of thought.

But we're not wired to do that, especially because we've been hearing it for 50 years. Theater fragile. They're not made well. You need orthotics and you choose a lot of cushioning and support.

And after you hear it for long enough, you know, you tell a lot of long enough that it becomes the truth. Yeah. I say the same thing. I heard you say that the other day on the podcast, you know, a lot of these things that we talk are talking about and a lot of things we haven't talked about are based on people saying the same thing over and over again.

And it eventually becomes the truth, which is scary. But I know that especially happens in healthcare. I'm assuming it helped it happens in other fields, probably financial, you know, let's not even talk about politics. So anyway, well, this has been a total talk about that.

Oh, no, no, fine with me. As you may have gathered, I'll go anywhere in these conversations. So thank you again. And thank you everybody else for jumping in and going on the ride with us.

Just another reminder other than going to Rick's website and engaging, engaging, engaging, like getting engaged, engaging muscles.com and Rick Mariam at Twitter as well and engaging muscles massage on Facebook. Right? Yeah. Yeah.