Episode 201 | Oct 15, 2026

Foot Health as the Foundation of Longevity, With Dr. Courtney Conley

When was the last time you thought about the health of your feet? Despite their essential role in movement, balance, and longevity, foot health is often overlooked in conversations about overall wellness. This week on Health Coach Talk, Dr. Sandi welcomes Dr. Courtney Conley, a leading expert in foot and gait health and bestselling author of Walk, to explore why stronger, healthier feet may be one of the most important foundations for healthy aging.

“We are supposed to walk long distances and be very efficient. A walking gait stimulates your musculoskeletal system, your foot and ankle in particular, your nervous system… It’s this stimulus that really keeps our bodies moving and working efficiently.”

Dr. Courtney Conley

Dr. Conley’s passion for foot health began with her own experiences as a childhood dancer and competitive triathlete. After struggling with bunions and foot pain that interfered with her ability to move, she became determined to understand why the feet receive so little attention when it comes to strength and rehabilitation. Now, with nearly 25 years of experience treating foot and ankle conditions, Dr. Conley is challenging conventional approaches to footwear and foot health. In her conversation with Dr. Sandi, she explores how everyday shoe choices, particularly narrow toe boxes and excessive cushioning, can affect foot function, stability, and strength. She also shares practical insights into strengthening the feet through simple exercises, improving balance, and recognizing the powerful connection between walking, physical health, and even social connection.

For health coaches, this conversation offers a valuable perspective on an often-overlooked component of lifestyle medicine. Movement is a cornerstone of healthy living, yet foot pain, weakness, and instability can create significant barriers to staying active, especially as we age. Dr. Conley highlights how small, sustainable changes, from choosing footwear that supports natural foot movement to incorporating simple toe-strengthening exercises and daily walks, can help individuals build greater confidence in their movement. Her insights also reinforce the importance of meeting clients where they are, introducing changes gradually, and supporting habits that promote long-term mobility and independence. With walking offering benefits that extend to cardiovascular health, cognitive function, and emotional well-being, this episode is a compelling reminder that some of the most meaningful steps toward better health begin from the ground up.

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Transcript

Dr. Sandi: On this podcast, we have talked a lot about brain health and heart health and gut health, for example, but we have not talked about foot health. In fact, when I look at what’s out there, what’s talked about on podcasts, very seldom do we hear much about foot health. And that’s why I was so excited when I came across Dr. Courtney Conley. And she has a book out called “Walk,” which I got, and I just thought this is wonderful. There was so much information about how to take care of your feet, how the right shoes are so important, the wrong shoes might be doing us in, even the wrong type of sneaker. And so, I was thrilled when she agreed to be a guest on our podcast. So, I know you are going to enjoy this interview.

Let me tell you about Dr. Conley. She’s a national bestselling author, international educator, and she’s one of the world’s foremost authorities on foot and gait health. She lectures around the world. She has been on the top podcasts. She holds a doctorate in chiropractic medicine, and she has a practice. She serves as head of patient care at Total Health Solutions and Total Health Performance in Lakewood, Colorado. So, I know you are going to really enjoy my conversation with Dr. Courtney Conley.

Welcome to the podcast, Courtney.

Courtney: Thank you so much for having me. I’m excited to be here.

Dr. Sandi: Let’s start off with you have an amazing background, but what was your interest in feet? Why are they so important and so ignored?

Courtney: I was a dancer as a child. I was in pointe shoes for quite some time. I transitioned into the triathlete world. So, I was running, and feet were always my Achilles heel, if you will. I had bunions at a very young age, and movement has always been my therapy. And I don’t think we realize that when our feet hurt, that there’s really nothing that stops you more in your tracks. We can get along pretty well, even low back pain. There’s a lot of research. Patients with chronic low back pain, walking, moving is the best thing for them. When your foot hurts, you really get stopped in your tracks. And so, I was finding that if my movement was compromised, my mental health was not good. My physical health would decline pretty rapidly. So, I went on this mission to learn about it.

I ended up in chiropractic school. And at the time, what we learned was, when the foot hurts, here’s a foot orthosis. And if it hurts more, recommend them to surgery. And so, when I got out of school, I worked in a couple of orthotic labs, and then I thought to myself, this doesn’t make a lot of sense. Why are we talking about strength training and power training everywhere else in the body, but when it comes to the foot, which is our…probably what I believe to be one of the most important parts of creating resiliency in the human body is being ignored. So, that’s what brought me here. Here we are.

Dr. Sandi: Yeah. This is so true. And I have taken dance on and off as a child, never very good, but I always loved it. And I still do. I take ballet sometimes up to three times a week and tap…classes for people over 55. But I can see that…and one of my teachers used to be a professional dancer with The Joffrey and she just…her feet are just ruined from all those years of dancing.

So, often, we think, okay, we have bunions, we need surgery, and we go to those extremes. You have so many resources in your book for things to do, starting with our choice of shoes. And many people I know for years, I…those pointy toed shoes and high heels and the narrow toe boxes, or I bought into the really…those shoes that are…have so much cushioning in them. And then I switched to barefoot shoes. But can you talk about some of the common mistakes that you see people making just with their shoe choices?

Courtney: Yes. I’ve been treating patients with foot and ankle pain close to 25 years. And so, one of the reasons I wanted to write this book was we need to really educate on what is going on with our footwear. I was finding that in my patient visits, I’m spending 30 minutes with my new patients just on educating them on footwear. Because I do think that if we had this conversation, that we would be able to eliminate a lot of the problems that we see.

First and foremost, the widest part of our foot should be our toes. And there’s a reason for that. When we’re walking and we push off in terminal stance, there’s multiple times our body weight going through our forefoot. That’s why you see most of the injuries at the foot occur in the forefoot. So, you will start to see structural change like bunions or hammertoes. Things like neuromas are very common because the foot, instead of being wide and strong and stable, has gotten weak over time because we don’t pay attention to it. And also we’ve been putting it into footwear that doesn’t respect the anatomy of the foot. If you were to look at the majority of your shoes in your closet, I think you will see a tapered toe box.

Dr. Sandi: For sure. Yes.

Courtney: We could get into the history of footwear, but you can read some about that in my book. But we really have gone from fashion overriding function. And that has to do with urban planning, socioeconomic status in the 14th and 15th centuries. There’s multiple reasons why. But we were warned, hey, if you guys keep doing this, you’re going to see problems in your footwear. But as you’ve seen, when companies have a lot of money and there’s a fashion behind it, we can go south pretty quickly. So, you’ll see the tapered toe box. You brought up a very good point about the maximal cushioning.

Dr. Sandi: Yeah.

Courtney: There’s always a tradeoff. And when people go to the store and they say, “Well, my foot hurts,” and they put on this super cushy shoe that has a big old rocker on the front of it, and they walk around the store, the very first thing you’re going to say is, man, this feels good. And I always caution people. There is always a tradeoff. Maximally cushioned shoes, while they might feel very comfortable, there’s a couple of things we need to consider.

On the bottom of the foot, there are thousands of receptors, sensory receptors that are designed to help us feel. Think of the foot as like a sensory organ, and it feels different parts of terrain. It feels the ground. And that gives us information on how to stay upright and balanced, on how to walk, on how to recover from a fall, on how to stay balanced and prevent falling. And so, when we have all of this cushion, you’re really interfering with that sensory information. That’s problem number one.

Problem number two is, when you put these shoes on, they’re basically rocker for you. It’s that old concept, if you don’t use it, you’re going to lose it. And we start to see a decline in the strength of the foot, and in particular, in the toes. And we’ve seen a lot of Karen Mickle’s research, and there’s really cool studies looking at grip strength versus toe strength. And a weakness in toe strength is a predictor of falls as we age. So, it’s a very big conversation that I really want to educate on because changing into some footwear could be a very low-hanging fruit for a lot of our patients if done correctly.

Dr. Sandi: Yeah. You bring up such good points. And in my age group…I’m 76, and all of my friends wear these maximal cushion shoes, and they think they’re great. And I started to talk about it. Are you aware that you can’t feel the ground? You can step off a curb, you can lose your balance because…and there’s people I’ve gone up to in the gym that I’ve been talking to, and they look at the kind of weightlifting that I’m doing. And they say, well, how do you do that? And I said, well, look at my shoes. They’re basically barefoot shoes. I can feel the ground. And I once…I do have some of those old maximal cushion shoes left over and tried them on one day and, wow, I can’t feel any…I don’t even feel safe doing a deadlift in these shoes. I’ll just take them off and do it barefoot instead. It would be better.

But, yeah, they just are not… It’s a false sense of they feel good. They’re comfortable. And I don’t even think they’re comfortable because they have…they don’t have the widest toe box anymore, those varieties.

Courtney: Yeah. I love so many things you just said. I love when I go to the gym, and you’ll see people with their foot on the ground, especially when you’re lifting heavier things. You have to feel stable there. I understand that if we’re traveling and we’re walking on concrete surfaces and you’re going to be in a city, you do want some protection underneath the sole of the foot. But there’s a different conversation with how much do we actually need? So, it’s the least amount of cushion necessary to be comfortable. But all this…where the industries are going with all this maximal cushioning, I just don’t think is necessary.

Dr. Sandi: Yeah. Now, I’m so with you. And can you comment also on the wide toe box? I recently ordered a pair, one of the brands that you recommend in your book “Walk.” And these are so comfortable. And years ago…I have a lot of talks coming up from the stage. And years ago, I think, well, I have to have the right shoe to match the outfit, the heel. And I never wore super high stilettos, but still, it was…they were high heels. And now, I said, no way. I wear sneakers everywhere. I have informal parties to go to, I don’t care. I’m going to wear my sneakers with my wide toe box so I can dance all night.

Courtney: I tell my daughter, smart is the new sexy. When you can be smart from the ground up, that is such an important thing. People don’t realize the importance of the big toe. The evolution of the big toe and the strength of the big toe is so very important in propulsion when we’re walking, in balance when we’re standing.

And there is a difference between a wide shoe and a wide toe box shoe. So, a lot of companies will put the width of the shoes. So, they’ll say, this is a 4E or this is a 2E, and they’ll put the width at the ball of the foot. So, when someone puts their foot in there, they’re like, oh, this does feel bigger. But it takes that big toe, and it angles it in.

When the big toe is straight, it gives the foot integrity and structure when we push off. If I start compromising what this big toe is doing, or I go in the position of a hallux valgus or a bunion, and then I go to push off, it’s going to create an instability in the foot. And then you start to see diagnoses like plantar fasciopathy, which I think is an evolutionary mismatch diagnosis.

I don’t think there should be that many people running around with heel pain. Our foot was designed to handle multiple times our body weight when we’re walking and even more when we’re running. So, if we give the foot the environment that it was designed to be in, then I do think these diagnoses like bunions and plantar fasciopathies and all these posterior tibial tendinopathies, I think that we would see less of that because we’re loading our foot appropriately.

Dr. Sandi: Yeah. That’s so important. I wish I knew this years ago, like bunion. On and off, I’ve taken tap, and I’ve recently started again. I’d love to hear your opinion. Something like tap where you are moving, you are making music with your feet, but you are doing heel drops and you are doing cramp rolls, you’re moving your feet. And so, thoughts on dance for…beneficial for your feet.

Courtney: I can’t tell you how happy that makes me to hear. My trainer actually does a tap class. And she has so many people in her class. And there’s so many benefits to that. You’re moving your foot in all different directions. The auditory sound. So, you’re training so many parts of your sensory system. I’m a very big fan of all of that. And I think the cognitive training that you get from things like that in the choreography, remembering different years, so important.

Dr. Sandi: Sure. Yeah. Especially the warm up exercises, and you are just tapping your toes, and then you’re doing your heels, and then you’re coordinating both of them. And I just feel I’m doing foot exercises. And I actually had to buy…looking into buying a men’s size because the toe box and tap shoes are so narrow. But I had read that if you get a men’s size, the smallest men’s size, maybe it’ll be wider. But they do make these taps now that you can put over a sneaker.

Courtney: Oh, that’s cool.

Dr. Sandi: Which I have as well so that you can actually feel comfortable if you can’t fit into tap shoes easily.

Courtney: Yeah. One of the exercises I’ll often give my patients is called a soleus tap. So, they can either do it when they’re sitting or when they’re standing, but it’s literally just tapping the heel, tapping the heel so that they can get contraction in…I feel like everybody that’s walking on this planet should be doing some type of calf work. That calf is very important to train as we age for many reasons, but in particular, to make sure that we can maintain power, and when we’re walking, have good gait speed at brisk pace.

Dr. Sandi: Yeah. I feel that in my ballet class as well, where you are pointing and flexing, and really working the feet during the barre portion at least. So, what are your thoughts on some of the simple exercises that people can do at home? How would you get started or you’re a health coach listening and you want to talk to your clients about this is possible you can strengthen your feet?

Courtney: Yeah. I’ve thought about this for a long time. I think, with social media now, people get overwhelmed. And they’ll be like, and now, this woman is telling me I need to strengthen my big toe. Yes, that is what I’m telling you. But there’s easy ways to go about doing that. I think, first and foremost, take your shoes off. Look at your feet, pay attention, stand barefoot and see how your feet feel the ground. You should be pretty stable. You should be able to feel three parts of the foot, the ball of the big toe, the ball of the little toe, and the center of the heel. And oftentimes, we’ll have patients that can only feel certain parts of the foot.

From there, we’ll have them do simple foot introductory drills. Can you lift just your big toe, keeping the four toes down? Can you lift the four toes and keep the big toe down? It’s like toe dexterity. And the reason that’s an important place to start is, often, people who cannot do that, that is the side where we will see things like heel pain, ankle pain. It’s almost like there’s a disconnect between their brain and their foot.

And so, we start with just driving some of this information to their brains. You should be able to lift up all of your toes, spread them so that you see daylight in between each individual toe. That’s intrinsic strength of your foot, being able to splay your toes. This is important. This is important when we go to walk. So, those are little introductory drills that we’ll start with. You’d be surprised how difficult that can be for some people.

Dr. Sandi: As you’re saying this, I’m doing and following along with you. And I always stand. So, I have a standing desk, and I stand when I do my podcast interviews. And often, I will, in meetings, just do those kind of exercises for strengthening my feet while I’m doing my work. Yeah.

Courtney: Incorporate it throughout the day. I’ll wear toe spacers. I have bunions on both of my…which is what got me into this. So, I have toe spacers that I’ll wear on my feet all day long. It keeps my toes splayed. They fit in my shoes. So, I’m strengthening my foot throughout the day.

Dr. Sandi: Yeah. And what are your thoughts about these shoes that are…the toe shoes that…any benefits for wearing those types of shoes?

Courtney: Yeah. I mean, this conversation of functional footwear is not new. In 2007, Vibram came out with the Vibram FiveFingers, and it made sense to a lot of people. They’re like, yeah, this makes sense. I feel more grounded. I always explain this to my patients. The concept makes sense, but you have to understand, if you have been wearing very aggressive footwear, foot orthotics for a very long time, you haven’t strengthened your foot or even looked at your foot for years. When you go from zero to a hundred, it’s going to be too quick. It would be like saying to someone in the gym, I want you to squat 100 pounds today and 200 pounds next week. You can’t do that. It has to be small doses.

So, with the FiveFingers shoes, if that’s where you’re going to go, more on the very minimal side of the shoe spectrum, great. Start small, 5 to 10 minutes a day. It’s like a strength training exercise for your foot. So, be smart about it. See how your foot feels. Oh, you’re a little sore the next day. Back off your time a little bit, but slowly keep implementing progressive loads. And I think you will be very pleased with what you see on the other end of that.

Dr. Sandi: I absolutely agree. So, I have one of those. I’m friends with Mark Sisson. And so, I have the Peluva. When I first got it, I could not get into them. My toes were…I couldn’t spread my toes.

Courtney: Yeah. You have to spread your toes.

Dr. Sandi: Half hour to get my toe into the shoe, and then would walk around and it would be painful. And now, the shoes are worn in. So, that helps, but also I am so much better at separating my toes that I can get into them more easily. And often, I’ll wear them around the house and I wear them for weightlifting as well because I love to just really feel the ground beneath me.

Courtney: Yeah. And Mark did an excellent job with the Peluva because he did the five fingers, but he put a little bit of cushion underneath the foot. So, it’s like you’re getting the benefit of the toe splay. But for a lot of people where the thin inflexible sole was a problem because that’s the hardest part of a minimal shoe to get used to. If you have just a little bit of comfort there, not enough for your…you create instability, but enough to keep you comfortable, I think that’s a nice introduction to this conversation.

Dr. Sandi: Absolutely. What do you think about Pilates for foot? So, they always do footwork at the beginning. Any benefits there that you have found in the research for strengthening feet or toe work when you do the heel drops on the bar of the reformer, for example?

Courtney: You’re talking a lot of my favorite things here. I think the Pilates can be wonderful. It’s in an environment where when someone says take your shoes off, you’re like, okay. It’s important. That reformer, you can…for people who have…it’s more difficult for them to do single-leg calf raises standing, you can get a lot of loads on those reformers. And they’re hard. Don’t let it fool you. A lot of those exercises can be very difficult, but I love the concepts there of strength training from the ground up.

Dr. Sandi: Absolutely. And so many of these things can be brought into the home now and are available. A lot of calf raises. We do that at the barre, but you can get a very inexpensive ballet barre and do an online class and just keep doing these relevé all the time to strengthen your calves.

Courtney: It’s in the book. I have a little chart. There’s a research study that looked at per decade of life, how many single-leg calf raises can you do? And I always…it’s one of the assessments I’ll do in my office with everybody. I don’t care if you’re 10 or you’re 90. We’re seeing how much power, what can you produce below the knee? And like I said, I’ve been doing this for quite some time. Very few people have hit those marks. And it’s just an indicator that we are having the conversation of strength training now, way more so than even when I was in my triathlon days. We didn’t talk about strength training all that much. It was swim, bike, run, and rack up your miles. So, I’m excited to see the conversation start to go towards strength. I want people to also realize that happens from the knee down, too.

Dr. Sandi: Absolutely. So, what would be a good number for you for the calf raises? Where should we aim towards or with age range?

Courtney: With age range, if you’re in your kind of 30s, we want to be around 28-ish single-leg calf raises. Each decade, that drops just a tad. So, I’m in my 50s. I turned 50 this year, and my goal is about 30 single-leg calf raises. For my runners, it is a non-negotiable, 30 to 35 single-leg calf raises. Because if not, especially in a running gait, you’re putting…that’s a lot of load, a single limb support over and over again. And I’m always amazed when these runners come in and they just cannot produce power out of their foot. We shouldn’t be scratching our heads going, I wonder why there’s an Achilles tendinopathy here, or I wonder why they have foot pain when they cannot produce power from below the knee.

Dr. Sandi: Yeah, it’s so important. I do them in dance, but even when I’m doing my…I’m working at my standing, I will often do…gosh, I call them relevé.

Courtney: Yeah. Me, too.

Dr. Sandi: Because it feels like I’m dancing…

Courtney: At the airport. I have my backpack on when I travel, and I’m waiting in line. I’m like, might as well just get some calf raises in.

Dr. Sandi: Absolutely. Sometimes on a plane, when I go to the restroom, I will do heel drops. And they’re just so efficient, and people ignore that. And another area I think where there’s often ignored, we think of endurance training, cardio, strength training, but balance. And as we get older, it’s such a challenge. So, how can what you do…how important is it to build foot strength? You touched on this with the big toe. But if you’re trying…if you’re balancing on one leg and…I try and close my eyes and see how long I can last, but you really have to be tuned in to your foot.

Courtney: Oh. There is some really neat research looking at abductor hallucis. So, that’s the muscle that straightens the big toe. So, I know we have clinicians on here. That muscle is made of slow-twitch fibers, which means that he’s a postural stabilizer, very important for stabilizing that big toe and creating balance. So, again, when we compromise function of the big toe, we’re going to see changes in balance. I’ll often have my patients tie a band to a desk or something that’s stable, and balance, but put the end of the band right underneath the ball of the big toe. So, not the nail bed, the ball. And so, then they would be balancing here. They’d have to anchor down their big toe without letting that band snap. I’ll have them do it 60 seconds twice. You should hear the words coming out of their mouth because their foot’s cramping, and their hip is cramping, and their foot is cramping. You don’t realize how difficult that might be when you really focus and say, okay, my big toe is a very big player here. So, I think that’s a really important thing to pay attention to.

Dr. Sandi: Such an important point. Yeah. Thank you for sharing that. So, what is next for you? What are any new projects? What are you working on? What excites you? What new research is going on?

Courtney: Oh, gosh. How much time do you have? We only have a couple minutes left. I am looking at writing my second book. When I first wrote this one, I had wanted it to be all on feet. I was like, I’m going to write a book about feet. And then my girlfriend, who wrote the book with me, she co-authored the book. She’s like, maybe we should do it on walking so that we can reach a broader audience. And so, now that we’ve seen the interest about footwear and feet, I’m like, I’m doing this. I’m doing this foot book. So, I’ve been working on that. Writing a book is a very big time commitment. I have a practice in Colorado, and I also have an online education company where we’re…I just got back from teaching in Portugal. The conversation is growing globally, and I’m very grateful for that because I really feel like we can help a lot of people.

Dr. Sandi: Yeah. You do such important work. And as we draw to a close, let’s talk about “Walk.” This is the title. We didn’t talk about walking, but what are the benefits of walking versus some people think they need to run or jog, but what about just walking? What are you seeing in your patients, for example?

Courtney: I want people to think about that we have this resource, this activity that has defined us as human beings. We are supposed to walk long distances and be very efficient. And it’s this stimulus to every single system in our bodies. A walking gait stimulates your musculoskeletal system, your foot and ankle in particular, your nervous system. It calms us down. Your brain. We see all of this research on certain step counts in reducing the risks of dementia and depression, your digestive system. So, it’s this stimulus that really keeps our bodies moving and working efficiently.

And I want it to be in the same conversation is this kind of trilogy of breathing and sleeping. It’s like a non-negotiable. If you look at the step count of that longevity benefit where the research lies, it’s about 7,000 to 8,000 steps per day. That doesn’t mean more is bad. It just means, can we…it’d be like saying to someone, I want you to get six to eight hours of sleep. And everyone’s on board. I want that conversation to be carried over into walking, 7,000 to 8,000 steps a day. And I think we would see a lot of these diseases, cardiovascular, neurodegenerative, cognitive dysfunction, I think we would start to see some changes there. And for the majority of us, it’s about as easy as walking out the front door.

Dr. Sandi: It is. I look forward to my walks. I’ll walk sometimes twice a day. In the Chicago area, the weather can get nasty. So, we have a gym that is very close by, and they have a walking track. And I wish that malls would stay open and be revived because nothing was better than seeing these seniors with walking groups just walking at 7 a.m. when they open.

Courtney: I love that.

Dr. Sandi: They open the mall early for walkers. And I just…one of the negative consequences of the demise of malls is that they are mostly closed and they don’t have that opportunity. I’d love to see walking…a lot of the rec centers and community centers have walking tracks, and it’s incredible to see that.

Courtney: And the social connection. When I was researching the book, was everything on relationship walking, like walking with your spouse, walking with your grandparents, walking with your children. I always tell this story. I have a 15-year-old. And if anybody has teenagers, they know what those conversations are like. It’s like, fine, fine. I’m going to my room. And I just started saying to her one day, I said, Addie, let’s just go take a walk after dinner. Give me 10 minutes. It’s all I want. And so, begrudgingly, she started doing this. But I will tell you, within two minutes of that walk, it’s like the floodgates, this kid. And she’s telling me about her school and her…the boys and her friends. And I think that component of being outside and walking and not sitting across from the dinner table, you really can establish a social connection that you just can’t do elsewhere.

Dr. Sandi: For sure. Without a doubt. It is so, so good. It lowers your blood sugar dramatically. It is a great antidepressant. The research has shown it’s as good or probably better than medication for depression. Just go out and take a walk, and your mood is better, especially when you’re outside doing it.

Well, this has been a fabulous conversation. It is just such a privilege to know you. You are a wealth of information, are so passionate about your mission, which really needs to be spread far and wide. We all need to be walking. We need to be wearing the right shoes and doing the right kind of exercises for…to move our feet.

Courtney: Thank you for all your work, too. An honor.

Dr. Sandi: Thank you. And where can people find you?

Courtney: Yes. My online company is Gait, G-A-I-T, Gait Happens. We have educational resources on there. There’s foot health programs, both for the clinician as well as for the layperson. And then, yes, that book, I wanted that to be a resource for people so that they could say there’s assessments in there, like assess your feet. There’s programs in there that really fit everybody’s walking needs.

Dr. Sandi: Well, I’m a big fan of the book. I have it on my Kindle. So, I got it from the library, the…my local library. It has your book and I checked it out. So, check it out. “Walk.” It is a fabulous resource. So, thank you so much for being with us, Courtney.

Courtney: Thank you.