The Resource Doula

The Truth About Feet with Podiatrist Andy Bryant

March 10, 2023 Natalie Headdings Episode 28
The Resource Doula
The Truth About Feet with Podiatrist Andy Bryant
Show Notes Transcript

Show Notes

On today's episode, I chat with Andy Bryant about natural podiatry, common foot issues like bunions, and the best way to set your kids up for a lifetime of foot strength. Andy has been a podiatrist for over 20 years. For much of that time he was in a traditional practice but through yoga and self discovery he started strengthening his own feet. Too good not to share, he now has a practice based around helping his clients win back their natural foot function through exercise but even more importantly, habitual changes to lifestyle and footwear!

You're listening to the Resource Doula Podcast, a place where we provide information to help you make informed healthcare decisions for yourself and your family.

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Natalie:

On today's episode, I chat with Andy Bryant about natural podiatry, common foot issues like bunions, and the best way to set your kids up for a lifetime of foot strength. I'm Natalie and you're listening to the Resource Doula Podcast, a place where we provide information to help you make informed healthcare decisions for yourself and your family. Andy has been a podiatrist for over 20 years. For much of that time, he was in a traditional practice, but through yoga and self-discovery, he started strengthening his own feet too. Good not to share. He now has a practice based around helping his clients win back their natural foot function through exercise, but even more importantly, habitual changes to lifestyle and foot. Hey Andy, welcome to the show.

Andy:

me, Natalie.

Natalie:

Absolutely. Okay. I'm really, really curious. I wanna start out asking you what made you want to be a podiatrist in the first place, and then how did you transition to more minimal footwear? The barefoot life?

Andy:

it's a, um, that's a long story. So I'll start, I'll start and start. So when I was at school, still in high school, I think I wanted to be a physiotherapist, which is like a physical therapist there. Um, but it took a lot of high marks. And so I don't think I had those marks to tell you the truth. Um, and then, um, I did a work experience. So we go and sit in with a physical therapist and there's, there was a podiatrist there as well, and she's like, oh, come watch this. I'm doing a toenail surgery, which is where you dig out an ingrown toenail. And I'm like, oh, that's amazing. So then I was kind of fascinated by that and went into podiatry. Um, at university as well. And it's different here compared to the states we do, it's more like an allied health compared to a, um, being a, a doctor. So more like a physical therapist. Um, but while I was studying it, I'm like, oh, I don't think I really wanna do this. But I noticed that I enjoyed teaching other people. And so I did my honors, which was an, uh, sort of a research and clinical based honors, honors where I got to teach the undergraduates. And, um, I really enjoyed that. But then I started, um, also working and enjoying working and earning money, I guess. And before I knew it, I was in a, um, in a partnership for like nearly 20 years of very mainstream podiatry. and that was, uh, we had our own little orthotic lab. We, we did all the normal podiatry things. Um, and then I had, I was a serious cyclist and had a few, um, concussions from falling off, and I wasn't allowed to ride anymore, so I went to a yoga class. I don't even know why I just went there for exercise. Someone had said, oh, you should go. And, um, well, um, apart from all the other benefits of doing yoga regularly, I noticed that my own feet were getting stronger. And I had a big running background and been in orthotics for 20 years myself. And I like had a lot of ideas around why I needed them and, um, what all that meant. But just noticed that my own feet were getting stronger. I was also starting to go to the gym for the first time in years and, and people were trading barefoot there and I was questioning all this type of stuff and I was still just doing mainstream podiatry. Um, and then, Just thought, well, why can't I get my clients to have stronger feet rather than supported feet? And that probably was the trigger for me leaving that business partnership because that wasn't gonna change there. And so I went out on my own and that really just opened the flood gates for me to be able to practice as I want to. And um, yeah, so for the last three years, I've just been practicing as I want to, as. Natural podiatrist or a podiatrist that promotes less is more like trying to get people moving down to wearing less on their feet and strengthening their feet, rehabilitating their feet as you would any other part of the body. And so it's just been this natural progression from like one extreme to almost the other. But I think I probably even to start with, went into this extreme of like, everyone has to be barefoot and now I'm coming back to meeting them where they're at, you know? So I feel like, um, I'm becoming a better practitioner and almost full circle. Um, that's the point of telling you about that education staff at the start, I've just started a. Something called the Better Foot Project, where a physio here in Melbourne as well. And I, she's really focused on feat, uh, teaching other allied health professionals how we look after feet because, um, it's really poorly done. And, um, so we're starting up a course, so I'm going back to being that educator that's just gonna be on weekends, but who knows where that might lead me. Yeah. And

Natalie:

No, that's amazing.

Andy:

um, now most of my work is educating people as to how to be or what to do as opposed to them relying on me. So I do feel like I've come that full circle and I'm back to being an educator more than anything else. Yeah.

Natalie:

Hmm Hmm. I think that echoes, I mean, I've had a lot of different practitioners on this podcast, and most of them are kind of focused around the perinatal space where they have clients who are. Pregnant or postpartum, and they're transitioning into more of the education, like taking, having the client take more responsibility for their health. And I think that's a huge trend with just wellness in general right now in the world. Um, do you feel like it's more common for natural podiatry and foot focused people in Australia versus the us or

Andy:

No, I don't think so. Not at all. Um, but I think it's more common for people to want to be looking after themselves. And so I, I deal with clients that want to, uh, that are motivated to look after themselves. I don't deal with the ones that want a quick fix or that want me to manipulate their fee or to rely on Aho. And so you definitely have a, a market or a type of client, but that, that, um, space is growing as in. A lot of the public are, are more aware to wanting to do it themselves or be not reliant upon a health practitioner. Here in Australia, there's a, as podiatrist where there's a huge reliance upon the orthotic and orthotic, um, income. and, and so, um, it's definitely not the case that there's more natural podiatry here than, like I could name on one hand how many natural podiatrists there are in Australia, or maybe two hands lucky. Um, but in the States it's probably quite similar. And maybe it's a chiropractor or a physical therapist that's doing the work that I do. Um, and, and there's like two podiatrists that I can think of that might practice like I do, which is a bit sad because in um, the states, it's a big surgical. Um, surgery and orthotics are the big part of podiatry and, but you know, the guy that I'm thinking of is Ray McClanahan. He, he, he's, um, devised these things called correcto, which are to spaces, and he, um, He's been trying to do this for like 25 years and trying to encourage other people to do it and, and he's just been, you know, just so patient and now that people are on board with this, I can just imagine how excited he's, but he could also, he, he's also very understanding that it's a very long, slow burn. Cause he's been trying to do this stuff for 20 to 25 years and he, he's got a great practice set up around it so it can be done. Yeah.

Natalie:

Mm-hmm. I think it's hard to convince anybody that they need to work if they're expecting just passive modalities or passive

Andy:

percent. Yeah. Yeah, that's right. Yeah. And so like an example of that is that I would explain to someone, I could manipulate your feet or give you a, a massage and you'd feel better and be like, oh, that made me feel better. And then you'd want again next week. And then you'd have to keep coming back every week. Or I can teach you how to do it yourself. And that's far more powerful. So that's what I do. Yeah.

Natalie:

Yeah. Amazing. I'm glad that there are people like you who, who want to do that. I think there's, there's less money if we're talking business wise in. Maybe, I don't know. I, I'm not, you know, I'm speaking for myself. If, if I were to give somebody, um, like done for them programs rather than empower them to create their own programs as an exercise physiologist, right? And teach them how to exercise, then they rely on me forever and ever. And I get more income that way versus like, go and do your thing So I.

Andy:

are more likely to talk about you if you've empowered them to look after themselves and be more positive about that. So I would, I would I say that I'd rather 100 clients that I see once than 10 clients that I see 10 times over, and I think that's a better business model as well, because, You've empowered people that are gonna talk about you. So you're gonna get, have this bigger spread if you lose one of them because of whatever, you know, because they move away or whatever. You've only lost 1% of your clientele. If you lose one of the 10, you've lost 10% of your clientele. Um, and so I, and there are osteopath and, and some podiatry practices here as well, and definitely chiropractic practices that are all about. Coming back over and over again and buying into that model of care. And like, I'm the opposite of that. Like, I do get people in for reviews, especially if we need to progress their exercises. Um, that's just to be expected, but there's definitely not a an over servicing, a especially in that manual therapy. Um, yeah.

Natalie:

Yeah. Yeah. I think that happens a lot here. I talk to clients who are, I have to go to my chiropractor, you know, three times a week for Six weeks.

Andy:

And as I sometimes wish I was an exercise, I had exercise physiology up on my, um, you know, on my board out the front because then people would expect that of me. Unfortunately. I mean, fortunately people now know tend to book in to see me. It's a bit of a weight, so they have to have a bit of a more serious problem because if it just happened yesterday, They're not likely to wait three or four weeks to see me. Um, and so they're more likely to wait because they've been told about the way I work. But you know, when I started this I was like, oh, if I just, if everyone just knew I did exercise physiology work, basically, um, then they would expect that. But when they come in expecting an orthotic and to be kind of pampered, then it makes it harder. But it has changed a bit now. Yeah.

Natalie:

Yeah. Yeah, it's interesting. A whole, whole new world. I feel like

Andy:

Well unfortunately it shouldn't be, but it's, yeah. Yeah,

Natalie:

Right, right. One of my Instagram followers was asking, why aren't more podiatrists recommending minimal shoes? Like, it makes so much sense. Like once you can, once you see it, you can't unsee it. right? So why is that the

Andy:

Such a good question. And so when I was at podiatry, podiatrist not knowing about this, and there was a big boom of minimal shoes around 2010, and that was like, um, I was already out for 10 years and I had, I remember people coming to me and asking, can I wear this shoe? What, what, what, what does this mean for my foot function? And um, I would say things like, and I don't know what, I think I got this from uni, I assume I would say things, oh no, the foot muscles are too small to be able to train. Like we just didn't know how to train them. And so we have to rely upon, um, support. I just can't believe that would've come out of my mouth. Now that I think to think that our foot needs support, the thing that was like we were born with that is totally adapted to our. Environment. You know, there's a few arguments about that as well. But yeah, so that's what most podiatrists are still saying, that you can't exercise your feet enough. Or they'll say that a stiff shoe and an orthotic is better for your foot. Like it optimizes the foot motion. But, um, the foot's motion is not meant to be optimized in, in one way. It's, it's not meant to be like, One track thing, it's meant to be adaptable and, and if I turn left my foot, my left foot does something different to my right foot. And if I go uphill and downhill and you know, like our foot changes with every step. and, and if we're trying to make it the same with every step to optimize it, it just doesn't make any sense. And so, um, yeah, but I was that podiatrist, I was saying exactly what we'd been taught. So I think the answer to that is to your Instagram follow it. Is that it's what we're taught, unless you question what you're taught, which is hard to do, like is you spend all this money, you get a degree. It's, it's like ingrained upon you.

Natalie:

right.

Andy:

only if you have personal experience and, and nearly all the podiatrists that are this way aligned, have some personal experience of, you know, having to redefine what their own foot function is and then finding this way of treating. Yeah. But there are some mainstream ones that are really coming around, at least in the wide toe box. And I, and when it comes to a. the one negotiable that I won't negotiate on. It must have a wide toe box. And so, um, some podiatrists that are mainstream are seeing the benefit. They even call it an anatomical toe box, which I think is quite funny because that means all the other toe boxes aren't anatomical and

Natalie:

right.

Andy:

label this small subset of shoes as anatomical and the rest as like normal. You know, that doesn't make any sense to me. Yeah.

Natalie:

Right, right. It's, it's funny, I think like once I switch, I've been in minimal shoes for about five or six years now at least. Um, and like I just look at conventional shoes. I'm like, that isn't even cute anymore. Like, it doesn't, you know, it doesn't even look appealing because I know the damage that it does and it's so apparent, which is, yeah, just wild,

Andy:

in a little cocoon of clients and family and everyone wearing minimal shoes. So if I go down to the local shopping center or um, somewhere where there is not that environment, I'm kind of freaked out by all the squish.

Natalie:

Yeah,

Andy:

But then I had to catch myself, cause I bought a pair. I, I got sent a pair of groundings and they've got like a regular fit and a wide fit. And I think they sent me the regular fit. And I was like, wow, they look so good. Oh, I love these, I love them, they look so good. And I wore them just for the movie, so I was hardly even standing up. Um, and my big toes both got sore just from having the, for like three hours.

Natalie:

Hmm.

Andy:

and then I was like, wow, I thought they looked so good, because they look more like a, a traditional shoe, you know? And this is like me who's preaching all this stuff, and then I'm still falling into that trap of thinking, oh, that looks better. Do you know what I mean? So you have to be anyway. Yeah,

Natalie:

Yeah. Yeah. It's like a paradigm shift, I think

Andy:

right. Yeah.

Natalie:

Um, so you talked about the, the different ways that the feet have to move, like their optimal movement. Can you kind of run us through like what is an ideal gate pattern and how the foot lands and interacts with the ground when you're walking and then also when you're

Andy:

for sure. So, um, in walking we've got this perfectly rounded heel. It's designed for taking the weight of, of landing. And so there's this some theories of people, um, that say that we should be, um, midfoot striking when we're, um, when we're landing, when we're walking. But ideally we should, we've got this massive fatty pad, like I've dissected a fatty pad. And it's like a fiber thing. It's designed for taking load and we've got this perfectly round circuit surface. So when we land, I think should land on the heel. Um, and then if you follow where the thick bones of the foot are, so they're here, here, and here. Our weight should flow from the heel. Up through there, across to the big toe and then out through the big toe. And so that's, um, and that happens when we pronate. So pronation is a very good thing. Like we're designed to pronate. This is our foot being unlocked and flexible, accommodating to any surface. Um, and then when we load up a, the big toe and ideally a straight big toe. it triggers all the muscles. There's four layers of muscles here. They do this big contraction. They squeeze and lock the foot together so that as we push off through our big toe, our foot are rigid lever. So we go from this mobile adapter to a rigid lever. And so, um, that's how we're meant to walk gen, like for the purpose of this podcast, that a very simplified version when it comes to running. Ideally, like I, I don't even e even in walking, I don't really talk about foot strike or where we're meant to strike too much. Our foot strike is a product of the way the rest of our body is moving, and also this is in running and walking and also the terrain. So I went up, um, recently, the World Cross-Country Championship. So this is a elite, the best in the world. We're running here in Australia. I drove like eight hours to watch them and there was a steep downhill. And they're all in running spikes, which are very minimal shoes, just about, except for the week of the tow box. So they're running in running spikes, and to watch them go downhill, they're running like, like two minutes, 30 a kilo, a kilometer, or maybe, what's that? Uh, almost four minute mile pace. So they're running very fast.

Natalie:

Yeah.

Andy:

they were going down the steep hill landing on their heels. And like there's, people say, oh, should never run on your heels when you're running, um, land on your heels. But this is a product of their environment. And then when they went uphill, they were up on their toes when they were on the flat and running at an even pace. Maybe some of them were sort of heel striking and some were midfoot striking, and somewhere like it depends on their morphology, the way their body's built. but probably at that level they're all landing with their foot close to under their body. So their posture is in a really good position. And so we're more worried about when we're running an overs strike, a foot that goes out in front of us a long way because that's more likely to lead to a heavy heel strike and a lot of breaking force up the rest of the leg. So, um, I try not to think too much or definitely don't cue how we should run on our foot, but we'd be queuing how the rest of the body should land and ideally the foot lands close to under us. Cause then it. Creating a spring as opposed to a break out in front of us. And I guess it's similar to walking, um, because when we walk uphill, we're gonna meet more likely on the toes downhill, more likely on a hill. So it really is, um, quite similar to walking and the further we put our leg out in front of us. The more breaking force there is compared to having good hip extension. So pushing our hip back behind us and that gets our leg pushing from behind that pushes us forward more efficiently. And I guess, um, this where sitting a lot comes in when we sit a lot, we get tight in the hip flexes and we lose that hip extension. And so we're more likely to be pushing our foot out in front of us acting as a break. So like, it's not just the foot, it's more about the rest of the body.

Natalie:

Hmm. I like that holistic approach. So sit less is what

Andy:

Uh, yeah. Sit less or sit in different positions that make you, um, move your hips into different places. Yeah, yeah,

Natalie:

and then so if somebody is like, oh, I al always have tight hip flexors and I can't seem to get my glutes to engage, what would

Andy:

I would, I would tell'em to, let's have a look at your environment, and most likely they're gonna be either driving a lot, sitting in one position, a lot. So I've got a, like a bit of an in here in Melbourne with, um, some homeschooling families because they're more likely to be on board with this type of footwear type of idea. But what I'm noticing is that I'm seeing kids like, especially boys, nine to 14 years of age and they're a bit obsessed by gaming. Um, in fact, I had a family come in recently. Who are permissive parenters, which means they just let the child do what they want. And the boys have decided they're gonna be gamers. And so they're gaming like for 10 hours a day, and one has got abducted hips. So his feet are flared out like this because he's just stuck in a sitting position all the time. And the other one, whenever he tries to exercise, he has ankles. So it's not my job to control their gaming, but it's my job to educate that child, not the parents as much as to what a body at that age should be doing. And it's like six to eight hours of movement a day rather than sitting. and um, and the parents unknowingly. Provided them, these boys with a, this is just a, a snapshot of, um, that, in a way to answer your question with an ergonomic desk for gaming. So this is a desk that means they don't need to move at all. You know, they can be comfortably sitting there in one position for te probably six hours, you know, until they get hungry and get up and move or whatever. So they've actually designed a position so. The screen is perfect, that everything's in perfect. Like they've even got their feet at rest. And so I'm like, I'm all for your game. Go for it. Game yourself, but let's do it from the floor, because then you'll move, um, every three minutes because it's uncomfortable, and then your hips will start adjusting and doing all these different things that they're meant to do, rather than being stuck in the same position. So to answer your question, if someone said they had tight hick flexes and couldn't engage their glutes, I would say, let's look at your envi, your daily environment. That's probably where the answer's gonna be.

Natalie:

Hmm. Yeah, I like that answer. Yes, I would absolutely agree. I'm always telling people to get down on the ground, take your shoes off, move around. Cuz it's, it's really the sum of what we're doing all day rather than the. Half hour or hour in the gym. Right.

Andy:

exactly. Yeah.

Natalie:

Um, okay. Speaking of kids, I had a couple questions on kids, um, feet and growing and so like, what would you say if you were to have a baby today and you wanna set them up for the best success for their feet strength, their foot strength, their hip strength, everything, how would you start, how would you go about that? What would you do and what would you not

Andy:

with a newborn, um, like obvious, I'm, I like the closer they get to and from when they're standing, I have more realm. So that first, um, 10 to 14 months is a bit negotiable for me, but I do understand that, um, tummy time and that strength of, um, of using their body. And being on the floor, even at that age, is so important as opposed to being in some cocoon that is just holding them in the same position. Like it just gets their whole body and those slings and those reflexes moving. Um, and so, uh, that's till then, but once they start walking, and we're lucky here in Australia. We get sent to a maternal child healthcare nurse, which is someone you visit every month to start with, and then every two months and every three months until the child is four. And so when the child starts Yeah. Which is, it's a great service. It's a community service. And when the child starts walking, um, the message that the pediatricians, these maternal child healthcare nurses, um, everyone gives is that the shoe should, that, that if you're going to put a shoe on a child, it should be a wide. Flat and flexible shoe. A shoe that just mimics them being barefoot because this is best for increasing ception. That's our ability to know where we are in space. Um, our muscular strength and bones within the foot and the rest of the body, our balance, all these types of things are benefited from wearing as little shoe as possible when someone starts. So that's what I would definitely advocate. I would not advocate any exercises or any, like making a child do anything. And if your child is late walking, but crawling really well, that's probably a good thing. You know, like, it's like we really want to encourage children to develop at their natural rate rather than pushing them to do stuff. You know, like I see parents that are lifting their kid up and holding them, getting them to stand early, and then they're worried that their feet are all over the place. It's. they're just not ready to do that. They'll do that when they're ready, you know? Um, just if you give them the opportunity and that play, you know. So, um, definitely not exercises is, I don't advocate for any exercises for that, um, age. And then, um, so that, that's footwear and movement. And then when, what, what happens here in Australia, and I I say it's similar, there is they go off to kindergarten or, um, play school. Um, you know, playgroup or whatever, and kids get put into the, their little Nikes, their little asic added as the trendy shoes. And this is immediately putting a heel on the shoe. It's putting a, a squishy toe. It's putting a big cushion, which is like, um, uh, putting sunglasses instead of putting sunglasses on to protect from the suns, like putting a blindfold on or expecting your child to learn how to speak if you put earmuffs on them the whole time you are, you are just basically doing a big noise canceler on the soul of the. And, and, and so then the body is not getting this react, this ability, ability to react to its environment. And that happens here, I know from about three or four or even younger. And then we wonder why we have foot problems for the rest of our life. You know, when you are basically taking and other musculoskeletal problems, like it can't be good for a developing need to be in a heel healed shoe that tips the whole body forward and you have to push your knees back. Um, so that's my take on kids. Like it's the. Easiest time to put them in the correct footwear because that's, they're not used to anything else. In fact, they hate, they hate having any cushioning on there cause they, they wanna feel the ground intuitively. Um, and then like my kids were lucky, they got into something called Tiptoe Joey, which is a, a brand from here in Australia and Brazil. um, because I knew that as a podiatrist. But then once I saw their feet rolling in, um, at four and five, I put them in orthotics and stiff shoes. I'd send my wife to the shops and say, make sure the shoe is stiffer here and only Ben's here. That's all I knew. But when they were, they're now 13 and 15. So when they were eight, and 10, I just dumped their, I used to make the orthotics for them. I just like you're outta them. We had a holiday where they were barefoot all the time. Their feet still don't look ideal, but the way they look doesn't matter. Like there's no research to say that a foot that tips in or has a flatter arch than the next foot is gonna be any worse off than the foot that looks normal cause there's no such thing as normal. there's no research to say that putting that orical, that stiff shoe is gonna ha prevent them from having issues down the track or in any way, shape, or form. So I just like did this big turnaround and at age in 10, my kids just got used to minimal shoes immediately. And most kids would like, they don't need to be transitioned. They just go like that. So if your listeners are going, oh, my kid's been in a heeled, cushioned, stiff shoe for four. It doesn't matter. They'll be, they'll, yes. It's such an early phase. It's, I think once you are 2025, you might find it harder to transition because you've been in it for 15 to 20 years. But um, yeah, that's

Natalie:

Okay.

Andy:

problem. While they're still growing, they're easy to adapt. Yeah.

Natalie:

That's good news. That's awesome. I'm amazed that the nurses and the, the pediatricians are encouraging the minimal footwear

Andy:

Yeah. Until they're three or four. And then, um, they change the tune. They need support.

Natalie:

Hmm. Hmm. Here it's, it's like put them in shoes as as soon as you want to

Andy:

away.

Natalie:

Yeah. There's, there's not like instruction on to, you know, to keep them in minimal footwear, which is, which is sad, but hopefully we're changing that Um, I did have a question about socks. Specifically. Does sock wearing limit movement with adults and especially babies and

Andy:

think for babies, it definitely has their bone. They don't have bones in their feet, they're just cartilage. So if you're putting a tight sock on, this is not helpful for the way their foot move. So if you're gonna put a sock on, which is reasonable, especially where you live. Um, You wanna stretch the sock out first and make sure it's got some root to play. You don't want a tight sock. I personally wear to socks, which is the um, and once you start wearing to socks, it's very hard to go back cause everything feels constrictive to wear spaces under your normal socks. even just a few times just around home and then your normal socks get a bit stretched and then there's more space. Um, I think socks do, like we are resilient bodies where our bodies are resilient. They can do a lot and put up with a lot, but I still don't think any clothing should restrict our movement. Like if I have to wear a shirt, that means I can't put my hand above my head. Um, I feel restricted. If I have to wear that all the time, my shoulder would end up being restricted. So I can still do it, but I'd rather wear clothing. Socks included that let my feet and body just move the way it's meant to.

Natalie:

Amen to that

Andy:

right.

Natalie:

Yeah, I think about all of the, I mean, I'm speaking for women specifically, but we tend to get the tighter shoes, right? The more narrower shoes, the more restrictive clothing in general, whether it's dresses or, um, workout gear, right? Like all of the, the tight tank tops. Leggings. And I just think like my brain goes to like, what is that doing to the pressure in your abdomen and your pelvic floor and what is that doing to your feet? And so yeah, I'm all for freedom. Freedom of movement and clothes.

Andy:

I used to go to work in a shirt and pants and a heeled stiff shoe, and now I'm, I'm like, if I just wear shorts and a t-shirt the whole time, if people don't think I'm professional, I think I'd make up for it by being professional in other ways, you know? So it's fine. Yeah.

Natalie:

Absolutely. Yeah. Um, okay. Something you said. Um, Gave me another question. So there, there was a question about, um, maybe a kid who's having trouble walking, so they should be walk, should be quote unquote, should be walking. Um, and the general, um, advice is to put them in more solid shoes that have a toe lift at the front to help them kind of learn to walk Um, what would you recommend in

Andy:

Well, like it's, it depends on their age really. Like if they're, if they should be walking by 18 months of age, it's probably right. They sh they probably should be walking by then. And I think you to look, to look at it locally by changing their shoe is probably missing what's actually going on. There could be so many other different things going on. And so you gotta get to the, the core of that. Um, I had a client who had a stroke when she was about 18 months old.

Natalie:

Oh wow.

Andy:

And so, um, she's had to relearn to walk. This is a, so this is a really good example. Um, it's probably the best time in your life to have a stroke just about, because your neurological system is still quite underdeveloped and you've still got so much growth stuff going on that you're gonna catch up pretty quickly. And, um, and so the physical therapists and the occupational therapists were all about putting her own brace. and, and stiff shoes. Cause she had a bit of a foot drop, like her foot wasn't. And um, and mom was like, oh, I don't think this really, this doesn't ring true for me. So she sought me out, you know, and, um, We, we got her doing, not foot exercise, but being barefoot. She lives near the beach, so just like playing barefoot, being in barefoot shoes and, and what we see now, cuz she'll always probably have this damage to some extent. What we see mostly now is over summer when she can be really barefoot a lot and really, and moving her whole body a lot. Her movement is so much better than over winter when she's in more of a closed in environment and not moving. And so we're seeing, and maybe as she a gets older, it will flatten out a bit because she'll be doing activities during the winter a bit more and a bit more resilient. But, um, that was a great example of if you're gonna get something stronger, we, we should expose it to something that makes it stronger rather than something that stops it. And so if we put a brace around something just cause it's not moving and expect it still to move better, we're just, I think we're gonna become reliant upon that brace.

Natalie:

Mm-hmm.

Andy:

is, um, a six-year-old with high, a high diagnosed hypermobility disorder, but unusually has really high arch feet and came to me after being in the public system. with Children's, children's Hospital, um, with orthotics. And the mom had been doing really well with exercise for her, um, sim for her same hypermobility disorder. Um, and, and said, oh, you know, my daughter's in orthotics. Do I still, does she, should she need to be like, is if she's, if she's like me, shouldn't she be benefiting from exercise? So we took her orthos out, put her at a minimum, a minimal shoe, and then over. She did far less exercise, so she wasn't doing her gymnastics, wasn't doing her dancing, wasn't at school. Just more relaxed. And we noticed one of her feet really changing the way I moved compared to the other almost. And then when I test how strong she could get out of. That pro pronated position when pushing off, she was really struggling. And that's like the heart mobility disorder really having an effect on this one foot. So we've gone back to using an orthotic in a minimal shoe, not an orthotic that's super stiff, just something that kind of reminds the muscles in the area. Let's do a job here. It's almost like the way I I explain it is, you know, you see the tennis players, the elite tennis players, or even just the people down the road, um, with tape on their arms. It's not changing the way. there are moves, but it might bring awareness to the muscles in the area to change it. And so, so we're using an orthotic for six months and we're gonna reassess and see how our foot's going. And so it's not a life sentence. So even if they had to go into those shoes and got them up walking and gave them confidence, it doesn't mean they should be in that shoe forever. Like let's just use these tools if they're helpful to get someone over a little landmark, but be doing the rehab in the back.

Natalie:

makes total sense So much

Andy:

Iry is generally said, here's a methodic and you need it for life cause you've got something wrong with you. And I don't really think there's many people at all that's got something, anything wrong with them. They just have a unique set of symptoms or way to move and we just have to embrace it. And maybe there's a few little spots that need a bit of work and we can do that with exercise generally.

Natalie:

Yeah, no, I agree fully. I did have a question from someone who has a diagnosed hypermobility disorder, um, which is interesting as an adult. Um, and they were wondering what, so they've been in minimal shoes for several years now. Um, have. Been active, have been really focusing on nutrition and all of that, um, to get to the place that they want to be, but they're still having some pain with walking. Um, they didn't specify like what specifically, but blisters on the feet and pain. Um, so is there anything more they could be doing potentially maybe like a softer orthotic or

Andy:

yeah, for sure. Like there's, it doesn't have to be all or nothing. And I think this is what I mentioned before, like I was probably gung ho like everyone needs to be in as minimal as possible. But um, as long as you're embrace, like if there's a spectrum of natural foot function, And, um, being in, uh, super rigid orthotic in a hawker shoe is, is like one end of the spectrum, just next door to a moon boot basically. Um, and the other end of the is like barefoot all the time. Just finding where someone's at and I try and just move them in this direction. So for that person, maybe they've gone a bit far in that direction, you know, too far down the, um, minimalist too quickly because we know with those hypermobility conditions that they're very slow to change. But exercise is still the key. It's a hundred percent still the key. And so we don't wanna throw the baby out with the bathroom and say, these shoes are terrible. We just need to go, okay, we might have had a bit too much of this. Let's just, let's just regulate the dose and, and meet it, meet it with some exercise and meet it with some habitual change and, you know, make sure like we're looking at all those different fronts rather than it's just about being sensible. It doesn't have to be all or nothing. Yeah. And that person may never get to, um, you know, a 5K barefoot walk on the beach. Um, but. you know, so, and, and that's okay. As long as they're okay with it. If they wanna get there, they can. I think if people are driven, like people come and say to me, I wanna run a marathon barefoot. I'm like, okay, if that's what you wanna do, these are the hurdles we have to cross. And like some people will do it easily. Other people have got more hurdles to cross. It just depends on what you want. Yeah.

Natalie:

No, that's a really good reminder. It doesn't have to be all or nothing. I think a lot of times in health we assume that if I'm gonna do this, I'm gonna do it all the way. I'm

Andy:

Health and social media. Health and social media is definitely that way. Inclined. Like the, the things that rate well are the big. Um, red Cross and the big green tick. And if you're doing this, you're wrong. And if you're doing this, you're right. And, um, that's not, um, dealing with the human in front of you. And I think the people that do that Red Cross green tick are more than likely not seeing humans in pain in front of them. Because when you've got a human in pain in front of you, the chips are on the table and you have to come up with something that helps them. And, and that's not always gonna follow those, um, green ticks and red crosses.

Natalie:

Yeah. Agreed. Agreed. Okay. I have to go back to kids for one more question. Um, somebody asked specifically for shoes that are flexible but solid enough for cold weather cuz we get pretty. Pretty chilly up here,

Andy:

it's a really big, um, question. And I, coming from Melbourne, Australia, I'm probably not best place to answer that because like our coldest would be zero degree morning, you know? Um, but still then I still want a nice boot on my foot when I'm walking the dog.

Natalie:

right? Right. Yeah. No, I mean that's pretty cold. zero is cold.

Andy:

So, um, then, um, you should look those people, whoever listening to this and, and wanna answer that question, like, VI Bare would have some great brands, BAA Shoes, baka have some great shoes, and Zero, they're the big three shoe producers. And then there's all these little nuanced ones. But someone like Anya's Reviews, it's a N Y A S, although I said that a's reviews on a social media post the other day. Um, asking, answering the same question and someone. She's not from the cold like I am. She doesn't know what she's talking about. I'm like, well, why are you asking me then? I'm from Melbourne. You know, I didn't say that. I never answer negative comments. Um, anyway, so I think she's probably got some really good resources there.

Natalie:

She's amazing. I actually had her on the podcast

Andy:

very good. Yeah.

Natalie:

Yes, yes. She's

Andy:

So, um, she's got some great resources and there are a few others that have some really good resources. I think one called Barefoot Universe. They are in, they're in Europe, so that should be cold enough for people and some parts of Europe. And then there's also the Barefoot Shoe Review and the Barefoot Shoe Guide. These are like the big four, you know? Yeah. They've all got their, their lists and you just have to go in there and find out what you want and, uh, spits out the answers. There are 140 barefoot shoe brands, so it's very hard to isolate.

Natalie:

Yes. Yeah. And everybody has their own preferences too, I feel like. And. Yeah. Okay, cool. Thank you. Um, a couple questions about bunions. I got a few actually. So if you could talk about what bunions are, what causes them, and then the main question is like, how do we fix them? Or do I need surgery? When is surgery necessary? That kind of Yeah.

Andy:

I'll just get another prop. Okay.

Natalie:

Perfect. I love props,

Andy:

So, um, I'll go through this. This is how I explain it in the clinic. I have a, um, a zoom call after this with someone in London. So she's, she'll be hearing this, um, exact same thing that I'm telling you now cause she's got a funny, um, so, um, these two bones, the first and the second metatarsal are often, um, pretty parallel. Someone with bunions, the genetic, there's two genetic factors that I like to really bring out to point. Um, uh, that's a, a wider toe base. Okay? So if we took an x-ray of someone with a bunion and nearly always wider here, okay? That angle,

Natalie:

Hmm.

Andy:

that's genetic factor one, big genetic factor one, genetic factor two is mobility. So we've seen more women, um, With bunions than men for two reasons. They're more likely to wear squishy shoes, like you said, but also they're generally more flexible. And so a big stiff toe on a, you know, a big, strong stiff man is less likely to become a bunion compared to a woman that's got a flexible toe. So the flexibility of the joints. and that space are the two genetic factors, so we cannot change them. Generally speaking, if those people never wore a shoe, they'll just have a nice broad foot like this. Okay? And we know that in uns communities there is less buttons. So people that don't wear shoes don't get buttons so much. Then we look at the environment. So the environmental factors. So we've got genetic factors and then environmental factors, genetic factors, uh, those two that I mentioned. Environmental factors are the footwear. So when, if this, if this big toe is meant to be a hinge like this, a straight hinge, as soon as we put it in a shoe, this is the dog ate this one, sorry. Um, that, that's the inside. Yeah, there's that hinge. So there's one side of the hinge, there's the other, and there's the straight big toe. So a shoe like this, even your common running shoe or walking shoe, whatever, they nearly all push your big toe side. So when you add. and this to a shoe, that's where you get a bunion. Okay. And so, um, we see an a bunion. We don't see ex, there's a bit of extra bone growing there, but mostly it's just a joint, kinda almost dislocating. So the joint comes out like this. And so when they do surgery, um, they cut this bone and straighten it. Okay? And then bring, and they take, maybe they fix up the bone here, but generally they bring this alignment back to there. They may pin it for a while. There are muscles on the inside and muscles on the outside. This is the outside of your body. Inside of your body. Um, this, these ones get weak and loose, and these ones get tight. And strong. So they might release those muscles and tighten these ones. That's what they might do in surgery. But as soon as we cut into the foot, it's never the same. It's like a, it's a huge deal, like cutting into any other part of our body, but possibly even a bigger deal when it comes to the foot. So it should always be the last option. and you can, if you can rehab or try and rehabilitate your foot before surgery and you still end up having surgery, you're gonna come out of that surgery in a far better position because of the rehab you did before. And most foot surgeons don't advocate for any rehabilitation after it. You know, they'll just be like, oh, just walking or just stay off it. So it's like going in for knee surgery and not having rehabilitation as an exercise physiologist, you would understand this is just like craziness. So, um, nearly every button that I see. I think maybe two a year. I say, look, you're probably gonna need surgery because there are four stages of bunion. There's this like stage one, stage two, stage three, stage four You know, like, so when it's stage four and there's no, I can't those muscles to activate, I'm like, okay, let's do the rehab with a view to probably having surgery. but generally we try and give you exercises to strengthen this and to, and, and mobility work to loosen this off because that creates balance here. We go back to the ankle and see what's creating more force at the big toe joint. So we change, uh, we try and strengthen on the inside of the ankle as well. Sometimes people have some weak stabilizers here, so their big toes flapping around. So we work on that and then we go up to the hip and look at, see how fast that rate of the foot rolling in is because we can control that from the hip. So we're looking like all the way through. And if you look at, um, a's reviews, she and I didn't article together explaining exactly this.

Natalie:

Oh, nice. Okay.

Andy:

Um, and so we're kind of looking locally, um, integrating into the way the foot moves and then integrating into the way the whole body moves. But all of this is. A waste of time if you don't change the environment. And so that's why I'm so passionate about shoes because if we keep staying in this shoe and don't change this shoe that's straight here with a big toe, we end up doing all the work and then just undoing it in this shoe as opposed to just doing this. And so my wife has a very good example, probably four years now, she's been in minimal shoes, um, had foot pain her whole life, never liked to exercise. I made her orthotics for like 20 years and she'd still had foot pain. She never complained about it. It was just like her lot in life, you know? Um, then I found about all this, about all this, and then told her about it all and changed her shoes. And I give her exercises to do. I give her toe spaces, I give her, um, like a mobility work, footwear. And she does none of it except for the footwear. Like not one single exercise. Never. Like I put the toe spaces on her for her. Oh no, get them off. Get them off. Not one. she will, she wear toe socks now, but um, only changed her footwear and we've seen like a stage two become a stage one and be far less painful. Unlike if she does a lot of her feet, they'll still get sore. Um, but far less compared to what she used to deal with, um, just because of change of footwear. Cause we change the environment. So she's got those genetic factors. If I look at her mom and her dad, they've got similar feet. but then, but when you take away that environmental factor, it makes a huge difference. Um, and a funny story about that. She went out with her friends and they're kind of close friends, but not that close. And she probably wanted to look a certain way because she's gonna, people that she wasn't totally comfortable with. And so she put her old boot on, which was a heel like this and squishy like this. And she got from the bedroom, which is one end of the house in the front door, and then she took it off. She's like, oh, I can't do this. And she put her grand on. Yeah. So, um, yeah.

Natalie:

Aw

Andy:

there you go. I think that's a pretty good summary of bunion.

Natalie:

That was amazing. Yeah. I do have one question cuz a couple of people asked about pinky toe bunion. So bunion on the outside of the

Andy:

Yeah. So it's called, it's called Taylor's Bunion. It's like this, that bit there, um, this bit here. It's called a Taylor's bunion. Cause Taylors used to sit with their feet this way to do the mill, and they'd get this Taylor's bunion. And so it's the same effect. It's, it's not, Debilitating. Cause we don't need to use that joint as much as we need to use this one. Um, but generally there's a muscle here so we can strengthen that one, loosen these ones off, create an environment that pushes the toe up, make exercises to try and strengthen that area. Yeah. But mostly the environment.

Natalie:

Excellent. I'm amazed at how much can change with just the shoes without any rehab. I think your wife is basically an experiment. You

Andy:

She's, she's.

Natalie:

use her as a social experiment.

Andy:

you know, like all the naysayers will go, oh, that's only one person. I'm like, well, that's clinical evidence. And clinical evidence has a lot to say. And generally speaking, um, people think that natural, what I do is a bit like, um, Like cowboy podiatry. But if, like, if I look at any research in any other field, knees, hips, shoulders, backs, it's all about strength and re strength and conditioning. That's where all the research is going. Podiatry is just like in the dark ages. And, um, so I don't have any problem practicing the way I do. If anyone ever said, oh, you are negligent, I'd be like, well, here is the body of evidence that, um, suggests that can be transferred over to what I do. It just doesn't. Um, To pay as well, but I just charge a lot for my time and have a lot of clients because I have a, a, a broad spread of word of mouth because people like what I do. So it does pay as well in the end

Natalie:

Yeah. Yeah. Hmm. Okay. Um, that was amazing. Bunion summary. I learned, I learned some things. so can you tell us some of your favorite resources? So if somebody wants to learn more, and you can, you could pump your own Instagram account and all of that as well, but what do you like to refer to for people

Andy:

I, I really like, um, so I think social media's been a wonderful advocate for, um, this movement. Um, but you kind of have to wade through some of that black and white stuff and realize that there's a bit of gray in there. My account, uh, I would say is pretty, uh, up to date and reasonable and. Um, I, I really do cover myself. I never keep it, um, black and white now, um, that's just my name and podiatrist. Um, a's account is really good in terms of, um, footwear, like highly recommend that Gait Happens is another one that's, um, I think I mentioned before. Um, that's, that's like that higher level, like really, um, more intense, um, scrutiny on the way someone moves. But that's super interesting for. Um, and then you can also look into like vivo, barefoot, and correct toes. They've got really good resources for this type of thing. Yeah. Um, I was gonna say something else as well. Oh, there's something called the Healthy Feet Alliance, and that's like a group of us that have come together. I think, I don't know who started that, but, um, they've got an approved practitioner's list. And so like I get asked for online consultations all the time, and they're okay to do, but it's better to do them in person. So you can go to that and see their approved practitioner list and there's someone an hour away, you know, if, if they're, if they're legit, you shouldn't have to see them over and over again. You should see them. They set you up, they check in with you. Like it shouldn't have to be that, that you're reliant upon seeing them. So that's a really good resource. Healthy Feet Alliance. Um, they're doing some really good

Natalie:

new to.

Andy:

that space. And the Foot Collective as well. They've been a big support of mine. Um, they're also very black and white in their message, so you, you gotta take that with a grain of salt. But generally speaking, they, they have good resources and they've got good online. online, uh, like so like exercise, things to do for your feet. And the last one I should mention is Lilian Home, h o l M. She's a, um, she's called hypermobility doctor. Do you know her? Anyway, so

Natalie:

I actually do, yeah.

Andy:

For, for, because I do deal with a lot of people with, uh, hyper mobile and even just to give them a sense of then they're not the only one dealing with this sensation that's going on in their body, you know? Um, and that level of pain and that constant, um, reminder that they have that condition going on. So she's got a great Instagram PLA page, but also her blog as well is really good. I just send people there rather than me explaining all that, that pain, that pain science type of stuff. Yeah.

Natalie:

Yeah. Amazing, and I'll link all of those in the show notes so everybody can find those easily. Um, okay. I have two questions that I ask every single guest. We'll wrap up with those. So first one is, what's your number one piece of advice for our listeners? What do you want everyone to know?

Andy:

Um, uh, can I give you two things?

Natalie:

Yes, you can.

Andy:

foot doesn't, the foot doesn't need support. Generally speaking, it can support itself and to take your shoes off and not be scared to go barefoot.

Natalie:

Succinct and beautiful. I love it, Okay. Second question is, what is your favorite wellness habit that you incorporate into your own daily life?

Andy:

Um, like almost constant movement as in, uh, I hardly ever sit still, so, and it's not like I'm. Being busy or, um, moving vigorously, but I'm moving very regularly from one position to the next, and I combine that with a nap nearly every day.

Natalie:

Amazing

Andy:

10

Natalie:

gonna adopt that. I love

Andy:

yeah. Naps. 10 to 15 minutes of most days. Yeah.

Natalie:

and if you are not watching this, Andy has been on the floor this entire podcast recording. He's been moving around doing different shapes with his hips sitting in different positions. It's, it's, he's really truly practicing what he preaches. So, um, okay. Can you tell us one last time where listeners can find you online, what you offer, if you do any online services, and then Yeah.

Andy:

um, on Instagram, I'm and Andy Bryant underscore podiatrist. Um, and I do do online, but I mostly try and find someone near you for you. So you can always just shout out and I'll just lead you to a list of people that might be near you. Um, And then, but, but some people are a bit far away from that. So I do do online consultations, which work pretty well to tell the truth. I do a movement screen and get a full history, and then we just, you know, chat like you and I are now and, um, come up with a, that type of thing. Um, I'm, I work in Melbourne, Australia, I. Work out of a little practice called Mount Wave Podiatry and Melbourne Natural Podiatry. Um, so it's amazing how many people might listen to this or listen to podcasts and then they end up being only like five kilometers away or something and they're like, oh, that guy's just around the corner. So if I didn't say that, I'd be missing out as well. So there you go.

Natalie:

Awesome. Well, Andy, thank you so, so much for being here and spending your time and energy with me. I super appreciate it and I know all of our listeners are going to be very excited for this episode.

Andy:

for having me, Natalie.

Natalie:

My top takeaway from my conversation with Andy was that just like anything in health, minimal footwear isn't all or nothing. I know I definitely need that reminder often in my life as I like to do things only a hundred percent or not at all. I really appreciate his. Practical approach to foot health, as well as his love of educating his clients and online audience as well. So if you don't follow him on Instagram, be sure to remedy that as soon as you can. I've linked all of the resources he mentioned, as well as his site and social pages for you to follow in the show notes for this episode. Please remember that what you hear on this podcast is not medical advice, but remember to always do your own research and talk to your healthcare team before making any important decisions about your wellness. If you found this podcast helpful, please consider writing a five star review in your favorite podcast app. Thanks so much for listening. I'll catch you next time.