Episode 244: A Podiatrist That Actually Endorses High Heels? episode artwork

EPISODE · Sep 25, 2024 · 55 MIN

Episode 244: A Podiatrist That Actually Endorses High Heels?

from The MOVEMENT Movement · host Steven Sashen

As a Podiatrist, Human Movement Specialist, and Global Leader in Barefoot Science and Rehabilitation, Dr. Emily Splichal has developed a keen eye for movement dysfunction and neuromuscular control during gait.  Originally trained as a surgeon through Beth Israel Medical Center in New York City and Mt Vernon Hospital in Mt Vernon, NY, in 2017 Dr. Splichal put down her scalpel and shifted her practice to one that is built around functional and regenerative medicine.    Listen to this episode of The MOVEMENT Movement with Emily Splichal about the truth about orthotics.   Here are some of the beneficial topics covered on this week's show: - How functional podiatry emphasizes the connection between movement and foot function while using a holistic approach to foot health. - Why orthotics should be used for healing purposes instead of indefinitely. - How expensive orthotics aren't necessarily superior to off-the-shelf options, especially when treating plantar fasciitis. - Why podiatrists face challenges in integrating natural movement into patient treatment protocols. - How foot foundation awareness is crucial for balanced posture and gait. Connect with Dr. Splichal: Guest Contact Info Instagram@thefunctionalfootdoc Facebook Facebook.com/dremilysplichaldpm Links Mentioned:dremilysplichal.com Connect with Steven: Website Xeroshoes.com Jointhemovementmovement.com Twitter@XeroShoes Instagram@xeroshoes Facebookfacebook.com/xeroshoes

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Episode 244: A Podiatrist That Actually Endorses High Heels?

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A podiatrist that actually enforces wearing high heels. Oh yeah, we're gonna have some fun with this. On today's episode of the Movement Movement Podcast, the podcast for people who wanna know the truth about how to have a happy, healthy, strong body starting with a beat first, because that is your foundation. And on this podcast, we break through the mythology to prop again and often the lies that people tell you about what it takes to run, to walk, to dance, to play, to do yoga, crossfit, lift weights, whatever you do, enjoyably and more effortlessly.

I'm Stephen Sashin, but you already know that. And on this episode, we're talking with my dear friend, Dr. Emily Splickle, but don't say anything, Emily, because I gotta say some other things first. And that is, if you are new to the podcast, welcome.

And if you're new or old, you know what you need to do is go to www.jointhemovementmovement.com to find out all the different places where you can interact with us. And of course, share, like, review, hit the bell button on YouTube to get alerted for future podcasts. Basically, if you wanna be part of the tribe, please subscribe. And being part of the tribe means we are trying to create a movement, movement making natural movement, the obvious, better, healthy choice, the way natural food currently is.

I like to say that zero shoes, we're trying to become the gluten free of footwear. And we want your help. So back to you, Emily, for the win. I hate doing introductions other than saying, hey, it's wonderful to have you here.

And I'm gonna let you tell people who you are, and then we'll talk about this, but I trust endorsing high heels. I know, right? That's the way to introduce me. But thank you so much.

We will definitely address that soon. I'm Dr. Slickill. I'm a functional podiatrist, and a human movement specialist out of New York City.

I am in private practice. I was trained as a surgeon, and then I moved very far away from surgical practice, and I promote much more functional movement, functional medicine. I do regenerative medicine as well. And in addition, I travel the world, speaking about barefoot science.

We only have 55 minutes, you know. Oh my gosh, barefoot movement. And I'm the founder of DevOps Technology. Namaste.

So let's back up that first part, which you trained as a surgeon and you moved into functional podiatry. Tell people more about, tell people more, or say more about what that means for you. And more importantly, how did you, what was your kind of awakening moment that moved you from one into the spectrum to seemingly the other? Yeah, actually my entire training to podiatry school, I was fighting with what was being taught to me.

It was very isolated. None of the patients were getting out of the chairs. Really, it was every patient was being told the exact same thing. You have plantar fasciitis, stretch your cap this way, do X, Y, Z.

And I was like, I know that just doesn't fully jive with what I think of with movement. I actually started in fitness. I was competitive gymnast for 13 years. Wait, wait, wait, wait, wait, wait.

And we never had this conversation? I don't know. I was not American gymnast. Really?

Oh, really? Like I'm lying about that. I don't know. Yeah, we've never had that conversation.

We're gonna have to do that. That's awesome. Yeah, no, gymnastics is. We'll put together a partner.

Yeah, okay. Yeah, so when I was going through my training and seeing how it was so isolated and then how it got even more surgical focused, that a patient would come in and he would just start to see pathology through the lens of a scapble, right? Like, okay, this is exactly how I could fix it surgically. Or I was like, why do we have to jump to that right away?

Like, there's always these risks to surgery. Even a minor surgery, there's a risk. Right. So then actually I was in my first year of residency, surgical residency, and I left.

And cause it was just so contrasting what was in my DNA. And then I was like, I don't even know if I want to practice medicine. So I left and I went back to school, got my master's in human movement. And then that connected the fitness movement, gymnastics with the medicine.

And then the reality of like, okay, I have a quarter million in debt. I need to get my license one day. So I went back to residency. And I did the surgical training.

I had to. Oh yeah, yeah, of course. Yeah. So I had to go through the motions of doing surgery.

I did surgery for five years out of residency. And then I stopped doing it partly because I was just traveling the world so much teaching. But it was also just not my passion. And if you're going to literally be putting your body in the hands of a surgeon, you want that surgeon to be crazy passionate about it.

And I was in fashion. And even that, I mean, like you said before, when you only have a camera, I'll say my idea with the scalpel, of course. And it's funny, the number of people that I've met who have said, I've said, how you doing? How you doing?

I'm okay, but I'm getting surgery for planet fasciitis. Like, whoa, whoa, what? And I did with them. I've done this a few times.

Actually, my favorite was a guy who ran a hedge fund or a private equity firm. He said, I love what you're doing, but I can't invest in you because I can't wear your products. I have planet fasciitis. I'm getting surgery next week.

I said, I got a sneaking suspicion because you know, there's probably as well as someone who has planet fasciitis symptoms and giant air quotes, but you can see from a mile away, they have super tight calves. And that's really what's going on. I can spot that one. I said, do me a favor.

Can you just stand on your toes to lift off your heels and stand on your toes? Yeah. And I said, does that hurt? He goes, no.

can you just like run in place to stay on your toes and he goes, and he does it, he goes, yeah, I said, is that hurt? He says, no, I said, do you know why? He says, no, I said, well, could you keep your plan of fashion in a strong position? You're not screening anything right now.

Can you just lean forward while you're doing that up and down thing? He leans forward and starts running and just looks back and goes, oh my God. I said, yeah, so you don't really have a problem if you know how to move correctly. And he looked me kind of crazy.

And this is not the only time that I've had to say this. I said, yeah, just because I look like this doesn't mean I don't want to talk about. And I hadn't had the surgery anyway, which is floored me. I've seen that happen a few times.

I'm not going to ask you something that's saying something. Is your story actually reminds me, I don't know if you've ever asked Irene Davis how she went from teaching PTs how to make orthotics to becoming the preeminent researcher in natural movement. I said, you know, what was your come to Jesus moment? Because it was actually just a process.

But one of the biggest thoughts that she described having was that when people came into her to see her as a PT for almost anything they would come in with, her goal was to get them moving as quickly as possible for every joint except anything having to do with feet and just like, wait a minute, that doesn't make any sense. So it was a similar thing of like something just doesn't jive, but I need to back up even further. Why podiatry? Because the only thing that seems weirder to people to say, hey, I got into this particular area of medicine would be if you had said proctology.

So why podiatry? Oh my God, my reason is so ridiculous. I was in fitness and I was training. One of my background is also for rinsics.

So my bachelor's and the original path I was going to take was going to be like CSI for rinsics. I had a free ride for a PhD in forensic science and I moved to New York City to do that. So I was in the lab, pipetting DNA. Everyone's out, it's gorgeous, it's summer and I'm like, oh my God, I hate my life.

I call this with pipetting. And then I decided to leave it and do something more like full body fitness movement because that was my original passion. So I quit, became a personal trainer, still in New York City, New York City. And then I started getting injured.

So I was like, okay, why can't use my body as my tool? I need to use a little bit more up here. Started looking at medical schools and applied to all allied health as well. But the stipulation was I need to be able to still do a little bit of fitness because that just fed my soul and I needed to live in Manhattan because that fed my soul.

And then really what that left was there's only a handful of schools that are in New York City that I could be in Manhattan. The podiatry school here in New York is in Harlem. So I was able to still see clients, still live in the city, have that part of me and my spirit of who I am while pursuing that degree. So it's really not a passion for me.

And you had a bonus if you're going to school in Harlem of looking like everybody else in the neighborhood. There you go. So I went to Columbia for grad school and same idea. I used to love hanging out in those neighborhoods.

So not only all of our consumers, but in 1981, I first moved to Manhattan. And I was one of the handful. I think there's like four of us who were white break dancers. That was a whole other story.

This has been when break dancing was actually a thing that people did instead of fighting. So it was a blast. That was a crazy ass time. Okay.

So we led with this whole thing. You became well known by promoting a program for women who want to wear high heels. And this was the whole thing of like podiatrists and Dorsey's high heels. I will let you have free reign to clear the air so that people don't want to come and strangle you.

Yeah, I know. Please. I know I was like, oh, there's already like the people who want to like care my name apart. But so catwalk confidence is a program that I started in 2009.

So I was just graduating. Podiatry school had been in fitness for a long period. And pause. This couldn't have been more perfect timing because this is my barefoot like kids.

So launch this program, but it was a workout and it was a workout for women who wear heels. The workout was barefoot. So you're still endorsing heels and like, come on. I know, honestly, the endorsement of like podiatrists and Dorsey's heels, even though I wasn't, I was just saying like, Hey, if you're going to wear heels anyway, I'm going to give you the tools to how to strengthen your feet, strengthen your core, align your body.

These don't mess it up as much as you might kind of blindly wear these heels every day. And then I created a program called Stiletto Recovery, which was the recovery side of how to undo the damage. The New Yorker magazine did a story on me and this program and it was very much like podiatrists and Dorsey's high heels. And in the story, they were like, Oh, yeah, it's analogous to like drug users and you're giving them needles.

I'm like, that's a good analogy. Thanks. But yeah, no, I got ripped into I had the Dean of my school pulled me from several speaking engagements. And I got hate email from other podiatrists saying you're an embarrassment, you're single handily ruining this profession.

That's ridiculous. If it were for high heels, half those people wouldn't have been in business anyway. Yeah, I know. I got some serious hate mail and like just shit from it.

And then I got on Oprah. Yeah. So I got that engagement and then it was on the doctors and today she'll be because of this program. Well, you know, getting on Oprah, it couldn't be more perfect for podiatrists and Dorsey's high heels.

I have a friend who's a big deal psychologist who's been on Oprah number of times and I said, how do you prepare for being on Oprah? And he said, I think of the most innocuous thing that I possibly teach and then I think of the most incendiary way I can possibly say it. I said, well, give me an example. He said, okay, here's one that I did for Oprah.

Having a fair can be the best thing that ever happens for your marriage. And so that was how he's introduced and the audience goes insane. And his whole point was that, you know, if you have an affair, it's clearly that there's some glitch going on. And if you acknowledge what that really is that led to this could be the kind of thing that transforms relationship and they all like calm down.

But you know, it's like you've got to do something that's going to be the key moment. In fact, it's funny. You just wanted me to just when Lane and I were on Shark Tank, when we taped the show and it's actually still on the show, Barbara Corcoran's opening line to me was, you know, I hated you from the moment you walked out here. And what she said in what you don't see on the show, because they ended up, she spent like five minutes saying how much he hated me from the moment I walked out.

And then she goes, says, five more minutes saying, Elena, how can you be married to him? What's wrong with you? You're married to him. And all I kept thinking is, oh my God, this is such good television.

So it didn't end up like that. We got off, we got on. Yeah. That'd be the perfect lead.

It's like, you know, oh my God, I hate you. So that was awesome. So it's an interesting thing. This is kind of funny because while the podiatry community may have gotten up your belt about that, I can't imagine it's any less so when you're endorsing natural movement.

So you just went from, you know, frying pan to whatever that fired, frying pan or whichever way that goes. Yeah. No. So when I then was like, okay, yes, this is a barefoot workout and let me make it more applicable to the wider audience.

Then I kind of like switched the branding to be, I'm a podiatrist that endorses barefoot movement. I'm anti-arthotic. I'm anti-supportive shoe, all of that, which is very polar as well, not as polar now in today's age as back then. But I still had the same thing.

My skin was thick and I was like, hey, I'm the black sheep anyway from the high heel thing. I'm going to just go with it. My ammo is just to be the black sheep with an impenitry. And now I got tons and tons of shit when I first started speaking the natural movement in the barefoot.

Same thing, people would question and say stuff about my name and whatever. Now the younger generation or people who are just a little bit more open are now integrating or emailing me and say, you know, hey, Emily, how would you approach this? Can you actually tell me a little bit about what you do? And they see that I've built a practice in Manhattan and I don't take insurance.

And my recurals are around the world. People fly in to see me because of what I'm doing. It's not who do I'm making it up. I have great results with my patients.

And they're starting to see that now. There's a guy that I met on Blanken and his name is first name is Darrel. I can't remember his last name. He's a podiatrist.

He's one of the sort of let's call it top orthotics guys in the country, which I know is a bit of an oxymoron in the barefoot natural movement community. But being he's one of the people people turned to about how to do that. And how to do that better than average. I mean, when I talked to him about how he actually does diagnose people and what he doesn't prescribe, he's way more rational than almost anybody that I've met.

That said, there's two things that were fun. One is he told me a story of a podiatrist, he knew who went to Kenya in the 50s or 60s to study the army who did a lot of other training barefoot because they didn't have shoes. And his report was basically one sentence, a podiatrist will go broke in this country. And he was trying to make the point about the value of natural movement, which didn't go to wearing well.

The other thing was fun. This was at the International Thought We're going to do it. And he looked at me like I was crazy for a moment and was like, oh yeah. And then actually he goes up to Irene Davis and says, you know, I got these shoes and I really like them.

I think I'm going to wear them with an orthotic. And he was saying that to see if her head would explode. And her response was, that's cool. Just start shaving it down, shaving it down, shaving it down to your rivet.

And he's like, huh. So I love the idea that this whole like it's so crazy that we have to promote that natural movement is good. And it's just insane. And I'm curious if you have any understanding or have a historical basis, like how did the podiatry community get so far opposed that?

So far into the whole post-ematotics, et cetera, where everything is somehow pathological. Because I know I have a friend who studied because he becomes a physical therapist. And she would call me like every day when they were doing foot and ankle going, did you know that this whole thing was made up by a chiropractor who had no evidence whatsoever? It's like, yeah.

So what's your take on how it got where it is and what might have happened to you? And I was like, oh, I'm not going to do that. And I was like, oh, I'm not going to do that. And I was like, oh, I'm not going to do that.

And I was like, oh, I'm not going to do that. I'm not going to do that. I'm not going to do that. I'm not going to do that.

But I can feel the real, real class, and their way and what we're trying to make is how it got where it is and what might have to happen for it to become, ironically, for podantcious put themselves out of businessacked by realizing that for most, what they're treating natural movement is a better option. Right. So there is sadly when you go to podiatry conferences and within school and it's a whole energy within the profession, it's a little bit fear based and it's a profession that's on the defense. And partly why they're on the defense is that so many podyches have an Napoleon complex and then even if they're surgeons, they kind of feel like in the OR, I'm the foot surgeon, I'm not the, you know, so it's just constantly within their own ego and their own thing.

So having that, you have to then be like, okay, I'm kind of in survival. So I need to think of how do I keep my patients, how do I get more out of these patients? There's tons of lectures around practice management and the profitability of orthotics that it literally is like every single patient should have an orthotic. If you see 20 patients a day and you can do, let's say, five orthotics a day, what is that?

25 a week and you get a $500 profit on each one. Go about, you do the math, right? It was really put in and then the younger generation essentially is fed that garbage and then things, okay, for me to make money, I need to see this as a money maker so I have to push it and I've seen that through when I was part of a larger group, now that I don't take insurance, I don't know my own thing, I just don't care. But they would incentivize us for every orthotic I would make, every MRI that I would order, every ultrasound that I would do, like any additional billion that I could do, I would technically, that's probably totally illegal.

Well, it's incredible. I'm not a conspiracy theorist, but what you're saying is going to feed people who, you know, people lying, well, Western medicine, you know, Western medicine is never going to be good, but this is what people think happens to hear that that's actually what happens. I guess what I will say is that medicine is still a business, right? And people don't realize that or people don't want to think that.

Well, there's another thing, I mean, I have this conversation with people often when they criticize Western medicine, as if that's an actual thing. I go, first of all, Western medicine doesn't know how to do everything. I say, well, if you go see any good doctor, they will never say that they know how to do everything. They're going to say, here's what we're going to do to try and figure it out.

But most, what most doctors are treating most of the time is that 80% of things where they can actually make a difference. And that other 20% that outlying stuff, you know, you can't know everything. And these are complicated, confusing things, these crazy ass bodies. There aren't simple answers for a lot of this stuff.

And we want simple answers and we want someone in authority, ideally, I don't know why white coat means authority to tell us something where we just know what's happening. It's something I know about myself. I am in a way much happier if I see a medical practitioner for something where they go, oh, yeah, you have this thing and it's undeniable. You see it on the films and it's like, oh, the sense of calmness because it's been diagnosed and there is a treatment protocol is a real thing.

I'm actually going through it now because I've got a compromised spine. In fact, later today, I'm going to get an injection into my lumbar spine just because I've got like clearly all this inflammation going on. I'm relatively convinced that it's not going to help for various reasons, but it's what I've got to go through for my insurance company to pick up the tab on the things that I might need later. And so now I've actually got the funny thing where it's not giving me that sense of calm because I know what's going to happen next so I don't really know.

At the same time, I'm taking the appropriate steps. So it's a weird, weird relationship with simultaneously wanting an authority figure to give us an answer when there's not a simple answer and then not trusting if they give us a simple answer. You know, one thing with my patients is what I've always done from the beginning is very much go through my thought process. So when I'm evaluating, I'm trying to get to a diagnosis, especially in the beginning when I was younger, you know, nukin on the block, I was a little like, ah, just fresh out.

I would go through every possible thing that it could be and why I'm ruling it out and I would say it allowed to the patient, partly to educate them, but also one so they wouldn't sue me. So that's the energy of medicine also, like you can be suited, like there's this, that's the reality to it. Now I do it very different and I go through it more for the education, because I'm much more confident and obviously you've just been around the block a little bit more. But then when I go through all my treatment options, I never, I just say, these are all of your options.

These are the benefits of them. And then there is surgery down here, right? So I have to list it as an option and I can't tell you which one to do. You have to make the decision for yourself.

I can give you the benefits of each and the risks, but ultimately it's your decision. And they totally want me to be like, well, what would you do if it's your book? Well, you know, and you just, you have to do that to really put it in the patient's hands. In some cases, they don't like that.

And I've been to doctors or I've had patients that will be like, you know, one thing I knew and then all of a sudden I'm getting this injection and then there's like, and they didn't know the process was just happening faster than they could even like, from the end. And I don't like to create that energy with my patients. That's a tricky one. I just had a flashback before I went to the World Masters Track and Field Championships.

This is nine, 10 years ago. I suddenly had this weird thing in my foot. I just felt like a little bump and I didn't know what it was. It was really painful.

I went to the anyway, they took some films and it literally looked like, I don't know what the geometric term for a square rectangle. So not a two because it's square edges, but I mean literally it looked like, you know, square and it was like, I don't know, maybe two, almost two cent, no, no, no, no, I was going to say two centers. That's not right. And like three millimeters kind of square.

It was this crazy thing. It looked like an alien implant and the doctor is looking at it going, yeah, I have no idea what this is. I don't know what's causing it. I don't know what to do.

What do you think? Oh my gosh. And I said, well, I can't have surgery now because I'm about to leave for international track meet. So let's just revisit this in a little while.

And then I forgot that at this part, it happened like in one day, it just showed up and then a couple weeks later, it disappeared. No idea. Absolutely no clue. And I actually sort of like that because the story of it, because it was just a real conversation about, we don't know, we got to try and figure something out.

And it was just an honest conversation. If I had seen certain kinds of practitioners, I won't label them by profession to protect the, not necessarily innocent, they would have said, oh yeah, well, I know exactly what it is. Here's what you do. And then six weeks later, it might have gone away on its own anyway.

And they would have claimed it was because of that when that could have been totally placebo. So Lena might tell me for telling the story, but I'm going to tell it anyway. She was seeing every sort of alternative care practitioner, she possibly could because she was having just like some bad period ramps for most of her life. And then finally after seeing a guy for a while and paying him a lot of money, he just threw his hands up and said, well, you're clearly not following the protocol.

And if you know Lena, if someone gets her protocol, she is on it. She just does the plan. And she got really mad. And he said, well, why don't you go see this internist?

It was the first time she had seen an actual MD, like maybe ever, not ever, but certainly for a long time. He does her blood work and says, you basically got no progesterone. Why don't you just take this pill and see how that feels the next day? She goes, well, I'm fixed.

Yeah. And just had no idea. So the whole, just the whole conversation about how medicine does work compared to how people think it should work is the part that I find so compelling, especially in a situation like yours, where you're bucking the status quo or more accurately trying to change the status quo, which is what we're all trying to do. And hopefully, I do think you may be right that it's these kids today who are going to be the thing that moves it because they're not walking in with the same preconceptions or they're walking in with a kind of anti corporate mentality that makes them open to maybe what this guy's saying.

We're not going to write off everything, but maybe we can think for ourselves and literally reality. And obviously the natural movement story is simple. Your feet are supposed to bend a movement flex and feel. Yeah.

You know, the other thing is that I get podiatrists who see the way that I treat, they understand the natural movement. They might even do it themselves, but they then say, how do you integrate this into your treatment for your patients? They can't connect that dot or that bridge where I'm like, I just included in literally every patient's protocol. If I do give our thought, it's what I do in some cases, I always then include release your feet on a natural basis, use correct toes, get into shoes that are naturally moving this way, get sensory stimulation, try to have it be part of the bigger picture, which is what obviously all these other docs should be doing as well.

I think physical therapy is doing a really good job with that. What's the glitch for them? How do they not see this as something to do? I don't know.

They just don't know how to integrate it. You know, go ahead. I was going to say almost I do a lot of stem cells in my office. When I was part of my other group where there were like 10 of us doctors, I was the one that was doing most of the stem cells.

It's a fee for service injection. It's not a heart-buying insurance. It's $70 plus per injection. They're like, how are you selling this?

I was like, well, one, I believe in them. Two, I just included with all of their list of treatment options. Because I believe in it, I spend time explaining it and educating the patients. If you don't believe in it, which is what you were saying, if you don't believe in the stem cells, you don't believe in natural movement, then you're going to have a harder time integrating it into the recommendations to the patients.

Like the patient can tell if you're like, oh, yeah, by the way. You could do this thing. I would hear some of that to be like, oh, yeah, by the way, do the short foot thing. And they'd be like, short foot.

And they're like, yeah, Google it. Right. There's a weird variation that back in 2010, I was part of a panel discussion about barefoot running. And every medical practitioner on the panel had no experience.

They'd never run barefoot. In fact, at one point, I just said, if you've run barefoot on the pavement for at least a mile, raise your hand. And I was the only hand that was up. And these guys are getting advice was hard blood advice, it was ridiculous advice based on not only no experience.

And I'm not suggesting that every doctor has to have the experience of what they're telling but they had, but they weren't referencing anybody who ever had experience with this. One of the guys was saying, well, it's going to take two years to get strong enough to be able to run barefoot. It's like, well, who do you know who spent two years training for this? You're just making this shit up, which I found utterly amazing.

And people were like nodding their head and go, whoa, back up. So the trust thing is definitely a part of it. And of course, it works the other way. People can be very confident about things that are iffy at best.

I'm curious just to take a tangent on the stem cell thing. I'm curious what your experience slash the response rate has been because I'm just think of the people that I know who've had stem cell treatments for various things where some of them have great results, some have had no results. I remember I had my shoulder put back together a couple of years ago. And when I did, you should have gotten stem cells.

Like, you should have seen the MRI of my shoulder. It was not really hanging on to the rest of my body at all. It needed to be reconstructed, not just injected. So tell me about that.

I would love to hear your experience. Yeah. So I've been doing stem cells. I started with PRP and now I do placental and umbilical cord stem cells.

I've been doing them for the past five years. I have neither placental nor umbilical cord. You don't need one or to have. Don't worry.

Don't need a placent. Donate a placent. You don't need to preserve your children's or your newborn stem cells. You don't have to do that.

But essentially they are donated stem cells. And my success rate with them is around 90%. What kind of things are you treating? Yeah, for plantar fascial tears, you want to be highest.

So I want to pause there. So for actual plantar fascial tears, which you're diagnosing, I want to separate that from what most people will call plantar fascialitis, which often is something totally different. Yeah. So I would have a confirmed partial tear of the plantar fascia.

So it's confirmed. That's one of the most common pathologies that I treat. Different ligament injuries, plantar plates is a huge one as well. So under the second toe, you can tear the ligament, which is called plantar plates.

I do a lot for that. Different ligaments in the ankle, tendons, fractures. So there's different things. And my success rate is 90% because of the patients that I choose.

So I will not do it on anyone. What you described in the list of things that you're treating is mostly soft tissue damage. Oh, yes. Outside of the fracture, but I don't see a lot of factors because I don't do it here.

I probably just, but yes, it's primarily soft tissue injuries. You can use them for like knee arthritis, shoulder arthritis, foot arthritis, meaning like the big toe and the ankle. They're just slightly different joints than the rest of the body. So the success rate of those is much lower.

I've had some patients try to have them done for like the midfoot and the midfoot arthritis. I'm like, I would have sent in there taking your money as he sent you what it is. Because the success of that's not going to be high. But part of my 90% success rate is the patient that I choose, it's very specific.

And then to my post injection protocol is very important. So I have them, let's say a partial tear of plantar fascia. I'll do two injections. So one injection, two weeks apart.

So two injections total. And during that entire period, they are in a camwalker. So I have to mobilize them during that period. They can do soft tissue release to the calves, but they cannot stress that area.

After the four weeks, they transition into a stiff, sold shoe. Hoka is what some patients will choose. It's just an example. It doesn't mean I like it, but it's just a example.

I'm just saying it's a four-letter word. It's just an example. I had to, I totally said that because that shoe is my example. But a stiff shoe.

And then we do a night splint and we slowly start to kind of decrease them out. I will put a lot of them in an orthotic as well. And then the third month, we start to get them kind of triple wave of support and the control. But let's say it was a runner.

A runner that I had a partial tear of plantar fascia, I would say you would expect being back at your same kind of distance or stress of your foot within five, six months. What I love about what you just described is actually the way that people should, and by people I mean all people should think about orthotics or posting or anything where you're mobilizing your foots. If you have some sort of real damage and when you're doing the injection, you're basically they're already damaging to begin with. And the injection is kind of a piece of that puzzle.

It's like you need to heal. It's like, you know, use it for healing then get out. What you just described is a very obviously sensible protocol for dealing with actual and actual injury, actual damage, and then making the transition back by getting stronger and getting back into it. And it's something that people just don't get.

I don't know if you've ever seen it. I have a post on our site. Oh, I don't remember. If you go to zeroshees.com and search for orthotics, you'll find it.

I know I have a shortcut for it, but I can't remember. And it's mostly reviewing an article that was probably the New York Times. It's written by one of my favorite science writers from the Times because she's a brilliant and B has my favorite name in the world. Her name is Gina Colotta.

And Gina did this great thing about orthotics, where showing that they only worked about 10% of the population. No one knows which 10%, no one knows why. And a custom made orthotic is no better than a doctor's soul's insult. But there were a number of people in there including probably Genonig from Canada who said, yeah, you're supposed to use an orthotic to help with rehab and then get out of it and start moving again.

And most people just forget that second part. So I love the protocol you described. People should basically apply that to almost any other situation they're in when they have real injury of healing and then building up into strength again instead of pretending that you need to continue to support something over and over. Yeah, you know that New York Times don't quite do you remember it, but I will go back because I want to reference it and pull it in and share it again with my network is I just did a presentation one day to a group of the Dorpus.

So like two prescribers, I guess if you want to people who feel choose. Yeah, they make shoes and they still and they have an orthopedic bent to the way they do it. Right. And I was speaking to them and I was speaking to them the way that I think of footwear.

But I had shared with them about orthotics and plantar fasciitis just specifically that condition that there's absolutely no difference between a customer orthotic and any off the shelf prefab. Yeah. And that was one that they're not prescribing orthotics, but that's interesting that you would mention that and then I had seen another reason article around that it's just like for these pediches that are trying to sell 500 plus dollar orthotics for plantar fasciitis. There's no research.

There's no reason. Well, here's my favorite thing about even the Dr. Scholes insults. They did something that is the most brilliant and bibrillion is simultaneously mean evil marketing thing I have ever seen in my entire life.

If you go into Walmart or I think they have a target to so Dr. Scholes made this kiosk where you step on a force plate and it tells you here's something about your foot and it's going to prescribe one of the dozen or so or insults that they have like paying right next to the thing. Here's the brilliant marketing thing. After you step on this thing, it says something like please wait while we calculate which product is right for you.

And then there's like a 10 second countdown timer. It's a computer. It doesn't need a 10 second 10 second figured out. It just literally makes you think that it's thinking about you and give you some personal recommendation because you're a unique snowflake one of 17 snowflakes that are on the wall next to you.

And it really makes you go wow it's really like thinking about me. And of course the joke is the ones that it custom recommends are like twice the price of the ones that are just hanging right around the corner on the shelf. It's unbelievable. Mind you by prefab because I have to clarify this for any of the listeners.

Prefab I do not mean Dr. Scholes. That is not what I'm going to be. But I'm just going back to you that buying something off the shelf.

Yeah, but no the ones that are I will tell you the ones that are some of the best off the shelf is power step. Oh really? That is power step. I heard the what I want to why.

The placement of where they put their arch and how aggressive or not aggressive they are so they are just kind of like middle of the line with the arch height so the correction that they are trying to achieve and the materials that they use. So the control that you get is a ziliency and then the fit for it. Where some of the other ones Dr. Scholes uses very cheap materials and a lot of silicone.

Oh shock. I know. The rise. But some of the other ones like super feet and you know there are so many of these other ones.

Everything has to do with the placement of where the arch is and what they consider to be their standard of control of template. My favorite thing about the whole office well about the orthotics in general. My favorite thing is it's the same prescription for two totally different diagnoses. You have flat feet, you have no heart.

You have high arch and you have no heart. It's like, whoa, back up. How does that make any sense whatsoever? I mean, I can maybe come up with an argument for how it may but I'm having a really hard time.

I can't think of any other example where you have two totally different presentations that give the exact same diet prescription. Yeah. Well, I've been practicing for 10 years and I've never, never written orthotics, custom orthotics for a high arch foot. Oh, interesting.

So considering that there's so many people. I think people who have high arch feet, even more than flat footed people think they need support. Why do you think that is? What the hell and why have you never done that?

So a high arch foot is typically thought of as more rigid. Right. So now you're going to put a rigid thing on a rigid. Yeah, yeah.

Yeah, I know. And then most likely they're going to go into a rigid shoe. So I was like, rigid, rigid, rigid, rigid. That just makes no sense.

Like your goal with a high arch foot is typically more in the directional that's mobilized. Let's get them kind of. Oh, no, you're preaching on the choir. I'm just like, this is one where even more than someone who's flat footed, I just can't figure out how they got this idea that they need to exactly rigid on rigid.

Right. That's why I have no idea. I mean, I pull every high arched patient who has orthotics out of them, which doesn't make sense. If you were using, let's say, like a plastic or like kind of these softer materials and you're saying, like, oh, the rigid foot hurts the person because it feels like they're walking on their knuckles.

So let me push in that foot. That would be a valid argument. That's interesting, actually. Yeah.

It's funny. It's funny because in that situation, what you're doing is getting some protection to the places that are getting higher impact forces. You're not supporting the thing that's causing that problem to begin with, which again would make more sense, but that's just not what people do. Yeah, which is why I have no idea why I've never ever and I will never because it doesn't make sense.

And I think a little bit of there's some research around like a plantar-facial offloading technique that you can use with arch supports with custom orthotics with a supinated high arch foot. But I'd much rather go through my off-facial lease and talk to you work and mobilize the hips and kind of value. I want to back up a giant step because I don't know why I just remember this. I heard, I don't know if this is true, but I heard that some major chiropractic organization is sponsored by an orthotic manufacturer.

And so this is partly why all these chiropractors are trying to get everyone into an orthotic. Not only because they're taught here's an additional way of making money, but it's partly indoctrinated because the overarching organization that they belong to, that's what they believe in, is similar vein. The American College of Sports Medicine. One of their biggest sponsors is a footwear company.

I shouldn't mention their name, so it rhymes with libidus. And there's a rumor that I was asked not to come back to this year's American College Sports Medicine event because of things that I said that then last year, which was just things like, hey, for all those claims you're making, do you have any proof, which didn't go over well apparently? But I find it really funny because actually there's actually an article about how to pick a running shoe from the ACSM that basically recommends getting something like what we do, getting something that lets your toes spread, that actually lets your foot move, that gives you all the things, but then there's a few things where they kind of catch the language. I think just to not upset their corporate overlords.

So I don't know how much influence the split edus business model it has over the people who are in the ACSM, and I wonder about that work out of things for chiropractors. Is there anything similar like that on the podiatric side where there are? Yeah, of course there is. I remember medicine is business.

No, I remember, but I just don't expect it to be like top to bottom. Yes, so the shoe that is one of the biggest sponsors for the American Academy of quadiatrics sports medicine and APMA is New Balance. New Balance is the recommendation that literally when I was going through school and then through residency and rotating through different residency, so I was still a student, but hearing more than just my circle speaking, they would be like, oh yes, you need to get shoes. New Balance, New Balance, New Balance, New Balance, New Balance, every person.

And I was like, do you know other manufacturers in New Balance? Do you like a new balance for yourself? Do you think for yourself? And then the same frustration of your plant officially is stretch your calf going against the wall and you...

Right, yeah, yeah. And I'm like, one, I hate that calf stretch because you don't position the cocanias, right? You're actually not even stretching them. You're like, yeah, you get your post-tib and then you can irritate someone's post-tib-tib.

I was like, think, don't just vomit out what you were taught in school. And that's cool. This is an interesting point. So Irene Davis and Brian Hidershite and Chris Powers do an event for physical therapists called Science of Running Medicine.

And it's an opportunity for them to get CEUs and for them to learn about what these three people in particular are thinking about the cause and treatment of running related injuries. And Irene has an amazing protocol for diagnosing what's going on and then treating what's going on by doing gate retraining and various other things. And I said this to Brian, I don't remember if I told this to Irene, but I told this to Irene and I said, the challenge with what you're doing is that you're requiring the practitioner to have a really good understand, have really good eyes basically, to really be able to see what's going on and understand what's going on well enough to do a good diagnosis and then create a very personalized treatment plan. And those two things are either at the very least difficult to do, I'm considering to do, but for some people not possible because some people just don't have good eyes.

They just don't see movement well or they see the effect, but they don't understand what the possible causes could be. They don't look further up the chain. And this is a problem, you're asking people to be smarter than they possibly are. And I think that my dad was a dentist and his line, the people who graduated in the lower 50% of the class were in the lower half of the class and they still became dentists.

I would never go see any of them. They're not good practitioners, but it still says DDS after their name. Or actually the joke is, what do you call the guy who graduated last year's med school class, doctor? So this is another interesting thing, just about the whole medical profession, if you will, is that in any profession, the majority of people who are doing it are not going to be the best, they can't statistically.

And then we're asking them to do things that not only can they maybe not do, but they probably don't know they can't do it. So here's the crazy-ass question. How do we change this? What do you see as the way to move forward?

I open up every one of these episodes by talking about creating natural movement is the obvious, better, healthy choice. How do you see that happening? Because obviously we have this goal. What do you, what's your take on that?

What I can say from a podiatry level is that it has to start changing within the schools, the way that the next generation of podiatrists, obviously work with feet. So that's a lot of the people who buy your shoes or purchase any footwear are getting recommendations from the internet, from movement specialists, from people who support natural movement, but then they'll go to the doctor who will say, no, you have this and you should never be barefoot, you should never. So they get the conflicting information. So we need to stop the conflicting information.

Okay, so good luck on that one. I know that way. But as much as you can so that the 95% kind of trend of what's said within the podiatry community is the same old structure. You need to have a little bit of an openness to the role of natural movement.

So that's where I was going actually in my thinking is the only way the school is going to change is if there's enough people who are responsible for the curriculum getting the value of what we're talking about. Exactly. You've got a backup step. Yeah.

Yes. So I approached where I went to school. Now every school is very different. And the other thing with medicine that the listeners should understand is that medicine is very historical.

It's very political and it's very historical. So the New York school is very traditional. New York City people can make a liberal city. It's actually very, very, very conservative, medically.

So the way that hospitals are managed, the way that schools are run what's actually taught is very, very conservative. So that means that they don't deviate outside of the box very well because it just rustles them and they get nervous and it's people who are like 80 years old that are still running a lot of these programs, even though medicine has changed from that, is slowly trying to change that. I approached my school. Well, I find it disturbing that what you're similarly suggesting is we kill a whole bunch of all doctors.

I did not say that. That's what I said. So what I went in speaking to them about what they need is not just a barefoot lecture, but a lecture on Vasha, like the fashion lines, the integrated movement, how your feet and your feet are how the floor connect to each other. Pediatrists who treats feet, technically treats movement and that actually needs to be changed.

So anytime I speak at a pediatry conference, I actually start by saying I don't treat feet, I treat movement and I have my first slide. We as pediatrists don't treat feet. We're not foot doctors. We treat movements.

Our access points are correct. Movement is the foot. But you have to start changing your mindset as well and know that you have a bigger influence than only treat as the nails and I'm like the shitty part of the body. It's just, you know.

I hate to repeat. That's called it again. I can't think of the word. What somebody does your damn nails.

Thank you. You're saying all these doctors are glorified pedicures. Yes. Or Sharapati.

I mean, that's what Sharapati is. Sharapati is a historical creation or starting point of pediatry. We were Sharapati first, which was like nails and skin and calluses and all this stuff. Oh, that's a snare.

Oh, yeah. Fascinating. Yeah. And then they evolved to pediatry and then pediatry evolved to be more like podiatrists surgeon.

So it's become like a wider, wider scope. But ultimately at that, even if you were still treating calluses, people get calluses and I know why they get a callus because they talk about their movement. Moving. Right.

Right. So we're going to leave before we mention the project that you and I are jointly doing. And actually I'm going to sample. Wait, hold on.

I've got to get off camera to do something. So would you describe what you have created with the Novoso technology and then I will hold up the project that you and I are doing together? Yes. I will hold up.

Yes. So Novoso is the first and only textured insole that is on the market. This is the texture. It uses two point discrimination.

Hold on for people who are just listening. Basically think, you know, flat thing with a bunch of bumps on it. Yeah. Pyramids across the entire top of the inside.

And the pyramid. What was that? That's a pyramid. That means you're part of the Illuminati.

Oh, yes. You know. More than spiritually. Exactly.

Don't take it down that rabbit hole. But the point discrimination stimulates the feet to help increase your foot foundation awareness. The more that you can reconnect to your foundation, that translates to balance posture gates. We have a lot of people if you're thinking of a disconnection with your foot, leads to foot fatigue, foot pain, a lot of the stuff that we were speaking about.

It can be used for many reasons. But the very rewarding part that I have is when someone hasn't reconnected to their feet in that way for years because of their shoes. Or maybe they have some sort of medical condition and to have them just light up because they can feel their feet again. That's so powerful.

So let me, yeah. Let me do Emily to English translation. Sorry. When you send me these, I told the story in other places including on our website where we talk about this product, you originally sent me this product to check out.

And by the way, Navoso is a check word that means barefoot. And I was, when I received her, when he told me that I was preparing to let you down gently and say, you know, I've tried all these various reflexology insults and things. They don't really do any more. So I got them and I put them in my pre-os and I walked around for a couple of hours.

And I could definitely feel that I was getting more stimulation than I would if I was just in any shoe, including our shoe, which does give you a lot of stimulation. And it's like, oh, that's cool. And then I took them off because I spent most of my time at the office barefoot. And I'm walking around and I feel like my feet were trying to grip through the damn ground.

I mean, they were like so activated. Everything felt like it was like ready to pound. So it was amazing. I really loved it.

That has toned down. I don't want that all the time. But it was just so incredible feeling that there was obvious demonstrable benefits from adding this extra stimulation. And it reminds me, I think we may have talked about this every year and a half.

But it comes out with some bit of research that shows the value of just basically stimulating people. They have some vibrating insoles or the latest one is from the University of Delaware. They put a device around the ankles of people at Parkinson's and it's basically vibrating feet. And it found that they were able to walk better in these stupid ridiculously thick, stiff shoes.

And my response has always been, hey, instead of getting all those crazy things, kick your damn shoes and go for a walk. And my argument would be, in this case with an Novoso product, that if you are going to wear something, some footwear and you want more stimulation for the myriad reasons, you might, this is an amazing way to do it. And then just to give a segue. So we've been selling the insole that you just showed the box of.

Our boxes are different versions. And it's a new version of the box. I like it. No, no, no, no, this is your version of this one.

Oh, that's right. Okay. And then, so that's great. We sell those on our website and people love them.

But people have also asked, what do I do if at summertime and I don't want to be wearing shoes and one of our sandals and I'm going to hold up the Novoso Trail, which for people who can't see, this is our ZTrail Sandal, our best selling sports sandal with the most technology as the footbed. So these are going to be out like the middle, actually within about a week or so from when we're recording this somewhere around the middle of July. So use as a gauge for if you're listening to this and find them on our website. And we are super excited to bring that out and get the results that we expect to get from people who are using that.

So thank you. I've got to do this quickly because apparently there's a meeting that's supposed to be happening in this room soon. One thing we didn't do before, that I usually do at the beginning of every episode and I got totally distracted and forgot is something movement related. So do you want to share a movement related to something that we can do in our last minute or two?

Yes. So I told you what I was going to do, which I'm actually going to do something different, is how, okay, sorry, I know my movement is a simple way to stimulate your feet, core and pallet connection. So I'm going to stack the domes in the body. This is a way to get stable.

So what you can do is push your toes into the ground, which is technically short foot. You're going to lift your pelvic floor, which is for the sake of time, we'll just call it a kegel because it's just easier. So you're going to stop your flow of key while you're pushing your toes down. And then while you're doing that, put your tongue into your pellet.

Your tongue will push into the top of your pellet as you do all three of them. And if you do that, especially standing, you should feel like your body is stable. And essentially what I stacked, what I was stacking or lifting are either the bondas and yoga they call them bondas. They're centers of stability or they're the domes of the body.

Interesting. I'm just doing it sitting, but I already feel just that kind of lines everything up. I like that. Yeah.

And when you put your tongue into your pellet, you stimulate your brain stem, the particular activating system in your brain stem, which turns on your brain. So that's a good one. That's a posture brain hack. That works.

Well, A, thank you for that. B, thank you for all the rest of this. C, we may have to do version two because obviously we can keep this conversation going forever, which is what we tend to do. And D, if people want to get in touch with you, how do they do that?

So I'm on all the social platforms. Dr. Emily Slickill is my website. EBFA is my education company.

And then of course, I'm a post technology. Awesome. Well, for everyone listening, first of all, once again, thank you very much for being part of the movement movement. I'm going to put all these things.

If you have any questions or comments or feedback or someone you want to recommend for being on the podcast, including yourself, perhaps drop an email to me and move at jointhemmovementmovement.com. Again, you can like and share and hit the bell and blah, blah, blah. The point is we want you to be part of this movement, helping natural movement become the obvious, better, healthy choice. So if you do want to be part of that tribe, please subscribe.

And as always, live life. Be first.

Frequently Asked Questions

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This episode is 55 minutes long.

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This episode was published on September 25, 2024.

What is this episode about?

As a Podiatrist, Human Movement Specialist, and Global Leader in Barefoot Science and Rehabilitation, Dr. Emily Splichal has developed a keen eye for movement dysfunction and neuromuscular control during gait.  Originally trained as a surgeon...

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