 Two pointers, right? So let's talk about barefoot training and barefoot running. And I want to make sure there's a huge distinction between the two, right? Because the demand on your foot is way different, way different. We're talking about running, you're talking about ground and pound, constant ground reactive forces for every step you take. When we're talking about barefoot training, we're talking about some static areas, we're talking about proprioception, it's less demand with certain activities. Now, with that being said for either or, you should never, never, I mean, they say never use never, but for this time never, just completely dive into it. Everything has to transition to it. So I'm big on research, everything I practice is based on research based evidence. And one of my favorite articles took 10 experienced runners of 20 years and said, you know, listen, we're going to just transition your minimalist shoes and see how you do. Okay, all 10 got injured. Every single one, nine of them, eight of them had stress fractures in their metatarsals. One had a stress fracture in the calcaneus and one had a planar fascial rupture. And the point of the study was showing that even these experienced runners can't take on the load of a quick transition, right? With barefoot training, it should be a simple step. And it's hard to be the doctor giving this advice because you have to be your own judge because the line between benefit and injury can sometimes be a very thin line. So yes, barefoot training can help with proprioception. I mean, your barefoot doesn't get better than that. It can build intrinsic muscles, things you don't use when you're in footwear all day. It can do all that. But that line, when you overdo it and hurt yourself is very thin and sometimes it's undefinable. So it's hard for me to make that recommendation. If someone comes to me and says, Dr. Moe, can I barefoot train? I say, sure, everything within reason. But I don't know what's going to be too much for you to handle. It's hard to make that assessment. And that's when the trainer makes that assessment with them. That's when you be your own judge and make that assessment with them and things of that nature. Now, barefoot running is a completely different realm. I mean, that's very demanding. And most of the articles will vote against it. There's not many pros into going to that transition right away. The one article that said the vibrums, you would see some benefit from it even then had to be longer than a 10-week transition period. So even for people who are pro minimalist, pro-vibrant and all that, and that's fine, just know that this is a long whole approach. This isn't something you should jump into ever. When minimalism got introduced to our neighborhood, all I saw was stress fractures. I just thought I was the stress fracture king and people were bringing their friends. But then I realized, no, people were ditching their shoes and went on this craze. So everything within reason is my point here. Yeah. I really like that aspect, how we're approaching it. And one of the things that we see so often like fads, right? You see, oh, barefoot's great. Let's only run barefoot or carbs are kind of maybe bad when you eat really sugary ones. So let's never eat carbs again. We don't always progress properly and we pendulum swing so far. And so what's running in my mind is how can we transition in a way that maybe isn't just you know, more load or more intensity, but we're transitioning in the way that we're going from a very soft maybe matted surface to a soft turf to a rubber to a hardwood. Maybe we're transitioning from very cushiony shoes to Chuck Taylor's or something more barefoot like. Is that a way to possibly transition an athlete? And so how do you kind of think about that and see it going forward? To be honest, I couldn't have said it better myself. That's that those are tactics only an experienced person would know when you talk about transitioning from soft to hard or hard or and so forth. That's that's that takes experience. And I want to say sorry, but trial and error to realize, oh my God, maybe we shouldn't just do it on hard platform right away. Maybe we should actually do it on padded platform and so forth and so forth. Now, we talked about this and I have no shame saying that medically speaking makes sense. But obviously, I'm not equipped with the training or the modalities or the physical aspect of that. My job is to make that recommendation to give you the signs of when you're overdoing it might be. And that's when I seek help. I have I have absolutely not enough pride to tell a trainer or a physical therapist or a coach. I'm going to let you make that transition for them, because let's be honest here, the textbooks in Padayatri school don't really teach you about that. They just teach you about the causes, the effects and what we can do to prevent things. We necessarily don't go through the matters of what exercises or routines to go through to transition from one to another. But what we do know is transitioning right away from a sneaker to a hard service barefoot is detrimental to the patient hands down. And again, the fine line between benefit and injury is yet to be discovered and is individually dependent, right? So taking a 17 year old boy and taking a, you know, grown 28 year old man athlete, they're going to be able to withstand different things. Everybody's intrinsic muscles are different. Everybody's soft tissue padding, you know, between the intrinsics, the bones and the skin is different. And everybody's demands are different. So it's tough to say what's the most ideal or give a generic way to transition for everybody. It really is an individual approach, but absolutely transitioning from a sneaker to cushion to a little rougher and then progressing is by far the most ideal way to get that done with hands down. I can't imagine anybody arguing that point. Yeah. And my, I like that approach, if you know, I don't know, I don't know either. I have no idea what the best way to do it is, but we know that, you know, it sounds right, but let's be logical in our progression, regardless. And then let's really keep an eye out for signs and symptoms of overtrading or excessive use that might lead to, you know, bigger issues down the road. And we're talking about bigger issues down the road, right? Unfortunately, people do get hurt. And we do have sprain. Most people do have injuries. And going back to that, going back to that proprioceptive aspect, can you dive a little more detail into specifically how that works between our brain, our body, and what recommendations you might have for an individual who's trying to improve their proprioception? Yeah. So proprioception is key. For me, I never send a script. And I'll use this word never without saying gradual, progressive to proprioceptive training. So let's say you get an ankle sprain, right? So my standard ankle sprain protocol for, let's say, you know, they come in different grades, the grade one is usually the most standard. People get it all the time. It's nothing. But if mistreated, it can be something. You come to me with a grade one sprain. I'm either putting you in a protective brace or a boot for seven to 10 days. And then we're doing what's called functional rehabilitation. So we're going to begin with passive range of motion. It's going to be a, you know, movement here and there. And then we're going to graduate to active range of motion. Now you're really asking your ankle to get back into business. And then the last but not least, when everything's strong enough and ready to go, we're going to do proprioceptive training because to me, that's the most demanding. So you described it before, proprioception is your, the way your body sees itself in space. So you close your eyes and you try to stand still and you notice you're moving, you're swaying, your proprioception isn't the greatest, maybe, or you're trying to balance yourself on one foot. And you realize, you know what, I can't really do this. These are the physical demands that really dictate things. And you explained it perfectly, honestly, from the proprioceptive aspect. So your body's all connected. It's all neural transmissions and symptoms and they just link together. So let's say you injure a ligament, you sprain your ankle, you injure a ligament, right? That ankle was, has its own memory or own sensation and was designed to function a certain way. When you injure it, whether it be a tear, a sprain, or a rupture, it loses some of that potency, right? It loses some of that memory it once had. And what we're trying to do with proprioception is regain it and maybe even advance it a little bit. That's why proprioception should be a modality used pre-injury even because it's been proven through research that proprioceptive training drastically decreases the re-injury of a patient. So when we talk about prevention is the best medicine. I would say it again, preventive is the prevention is better than the cure. Propioception training should be part of every athlete's modality. You're talking about increasing muscle mass, you're talking about being quicker, balance, balance, balance. It's really going to affect the way you move. It's going to be affecting the way you play and so forth and so forth. So yeah, I can't dwell on that topic enough. I really can. So one of the things that kind of comes up when we talk about proprioception and how our body is talking to our limbs neuro-mechanically, that neuro-transmission, there's an awesome study showing people doing a depth jump. So jumping off of a box. So now they're open chain because they're in the air. And as they're about to hit the ground, the ones who are well trained actually had co-contractions and their muscles around the ankle joint to stiffen it. So for people who aren't seen my hand, visualization, see what happened is the guy jumps off the box. The ankle has to become stiff. So the body sends neurological impulses to those muscles and says, Hey, I want to have opposing muscles contract really hard. So we take out some of the slack and then Achilles tendon that might be there. It stiffens the structure because it's bracing for impact. But at the same time, it allows for a performance benefit because you hit the ground quicker. The Achilles can act to transmit force. So you have more free elastic energy to jump higher. So we're talking about proprioception and neuro-mechanical coupling. All of those things play a role too. It's how our body is preparing to move, how we're about to strike the ground and how all of those timing, we talk about how complex the foot is. It's not just the fascial system. It's not just one muscle. It is the whole foot acting in harmony to hit the ground, propoles, I guess, propole. Well, I can say that, propel yourself upward and transmit the forces that are going on in your movement. Now, in regards to how the foot is functioning in athletics, people harp on over and over again. We want to have a stiff foot that's able to be elastic and spring-loaded kind of like if we were to be a pogo stick so we can store elastic energy. So if we're like Russell Westbrook coming down the line, we take one aggressive step, our foot's active and contracted, and we're able to propel ourselves upward to finish at the rim. How does that kind of understanding and those aspects of the foot fit into determining not just the foot type and what exercises for proprioception we should do, but maybe that rehab process itself and how you see it kind of going forward. And maybe I know you're not a physical therapist, but your knowledge of the foot is, you know, top of the line. How you see that going forward and whether or not someone should be doing some type of specific exercises or movement patterns to help re-educate that system outside of what people might assume proprioceptive being, you know, balancing on a ball or, you know, different balanced exercise, but something more dynamic. Yeah, even with the dynamic thing. So repetition, right? When you talk about Russell Westbrook and that step he takes and then just explodes, that's something they repeat constantly. Don't think that sometimes it's innate and they just know these things are Antonio Brown. If you look at these athletes, they're applying medicine to their training daily. There's a method to the madness and that's what I'm trying to explain to people. Yes, some people are born with God gifted ability, but some people had God gives ability and do nothing with it because they weren't given the prior to proper guidance or the proper training and so forth and so forth. And the reality is when you're talking about in a dynamic proprioceptive sense, you have to train your body and your mind to do certain actions. So that step and that jolt is a repetitive measure. You know, we're talking about muscle memory here. So you're going to begin and go, and then you're not even going to run all the way. You're going to come back and start it again. You want to make sure that first step is on point and then go and then bring it back and then keep going until you get it right. So what they'll do when an athlete gets injured, they'll look and they'll say was it faulty mechanics? Was it something we couldn't prevent? Because sometimes you can't prevent these things, but if it's faulty mechanics, they'll try to fix it. And we see this in baseball all the time, right? Where people are evaluating his swing and the whole knot. You think the swing is just upper body or it's just hips. It comes all the way from the bottom of the base of the foot, right? You know, you're kicking your off leg. You have the back leg stable. Everything is taken into careful consideration. Now, unfortunately, we're not all blessed with the individual attention that we all need. But if you maintain consciousness in what's going on with yourself or have someone evaluate you like a professional or a coach or physical therapist or whatever it may be, they could kind of help guide you into the right pathway. I hope that kind of makes sense to your question. If I'm general public, I'm an athlete. Are there any things I can do at home to better understand my foot so I can identify whether or not I need to see someone like yourself, see a physical therapist, or are there any warning signs that should we are telling me, hey, my footwear, is it best for me? It's tough to say, right? Because we never seek treatment unless we need it, right? I don't go to the doctor unless I'm sick. I don't go to the ear doctor unless my ear hurts or I go deaf. And I don't see a foot doctor unless my foot's in pain, right? And chances are if your foot's in pain, sometimes it may be late enough. What we're trying to do is get to a point where you never have to see me for anything serious, right? So my recommendation is always just to get an evaluation. I mean, if you're insured, obviously, but it doesn't hurt you. It doesn't cost much of your time to go and do so. And I have people that come through my practice regularly and they'll come once a year and they'll say, hey, how's it going? And runners do this religiously. I mean, runners will have no issues and still see me because they know the impact of an injury does to their training. I mean, a runner runs for sport. If they get a stress fracture, that's six weeks. We're talking about muscle atrophy. We're talking about loss of endurance. We're talking about a detrimental effect to them. So they come and they just want to see me. They want to make sure their sneaker is okay. They'll come with like three, four pairs. They want to make sure if they need orthotics, they'll get customs, regardless of the cost. They take their job very seriously. And that's why it bothers me when people say, oh, you want to pick up a sport? Pick up running. It's easy. It's so cheap. It's not cheap. I mean, they buy the best sneakers, the best gear and the whole nine yards, and it's definitely not easy. I'll tell you that much. I mean, the impact that has on their foot, ankle, knees and hips. I mean, I see it every day, but the best way to really assess is to get an evaluation. And believe it or not, many people besides podiatrist, just like you mentioned before, are more than equipped to let's say, hey, I think you should see one, you know, from coaches to trainers to physical therapists and so forth. That's the best way. But as far as like home remedy to see your foot type and whatnot, it's tough to say because you may think your, your foot type is normal and you may see me and I say, no, that's a high arch. You have a really high arch. So you want to get an expert opinion or expertise on it. That's the best way. I'd be steering the general public wrong if I said anything differently. No, that's a great way of putting it, right? Let's take care of bodies. Let's be proactive and let's find a way to, you know, not jump to conclusions, but also not ignore it as well. And, you know, intentionally, I put this question last because it's a little irony to it. The forgotten big toe, right? No one wants to talk about it. No one mentions it. It's a single joint. It's way down there and we don't think much of it. Obviously, it plays a huge role in how we function. If you give me some insights into the big toe itself, how it affects our body, how it affects our movement pattern, I'd love to hear some of that. So the big toe is super crucial and the loss of big toe, I mean, we talk about ankle range of motion and the importance of dorsiflexion. You could kind of say the same thing about the big toe and I've done enough big toe surgery where I can tell you and vouch for how important and vital it is to the foot. So the big toe, the main two functions in my eyes, now there's many functions, but the two main functions for it is one, it's a big shock absorber. So you hit the ground, the heel hits first and the last thing to kind of fall off is your foot. So when energy transfers, it transfers from the heel and it's going to go all the way to the front and there's certain parts of gait or your cycle or your running where about 80% of your body's weight is on your big toe joint alone. Now, if you don't have the proper range of motion in that big toe, it's either going to flatten out and get arthritis or it's going to send it to the next joint to absorb it. And that's why sometimes the lack of first toe mobility the too much first ray mobility will lead to second metatarsal fractures, stress fractures, which is the most common fracture. The big toe is a crucial joint in the foot complex and should not be neglected. It's actually very important for an array of sports for progression of running and just day to day walking. And the thing, the bad part about the big toe is once you hit to a certain point, it becomes progressive. And that's the unfortunate sequence. I just had someone come the other day who is already developing arthritic changes in the big toe. And we're going to develop orthotics, we're going to get them stiff shoe gear in the front so they're not bending as much. But the reality is I prepared them to let them know chances are this is going to progress. And eventually it tends to get to a point where you do need surgery, whether we clean it up, whether we put an implant or what we do is call the fusion and you lose that joint permanently. So I would definitely take caution in the big toe. You want at least 65 degrees of motion in the big toe. And that's something you could look on YouTube and see what's normal. It's something you should do in the morning before you even hit the ground. Not to sound like weird, but this is normal activity that I do before I hit the ground. I'm moving my ankle, I'm moving my toes, just getting the body ready for the day to begin. I mean, when you're sleeping, you're not stretching out anything. It's kind of lax. The ligaments are lax, the capsules are lax. And when you first hit the ground, sometimes you're not ready for that. And that's the one of the biggest things that I actually see is plantar fasciitis. Oh, doc, when I wake up and I hit the ground in the morning, I'm just going crazy. And the reality is is your body's not ready. The tendon, the ligament has been completely dormant this whole time. And now all of a sudden you're asking for, hey, let's start our 5,000 step day today. Okay. So just be conscious. Little things like that go a long way. You'll be surprised. And are there any mobilities, big toe mobilizations you can do, stretches for someone who might have a deficiency in big toe range of motion? Sure. Yes. Absolutely. Absolutely. Physical therapist. I'm going to give all the credit to them and the rehabilitation teams. They're the pioneers in this. I mean, I look at videos all the time because I'm marveled by the things they come up with. They have like rollers and platforms and they're isolating the big toe alone and they're getting your foot to kind of go over the big toe. So it's recreating that motion without demanding the big toe joint itself. So two things you can do, you could ask the big toe to move up itself, or we could kind of cheat and ask the toe to move the foot to move over the big toe, stimulating dorsiflexion. So there's an array of folks MPJ mobility exercises. And I have sent them to PT's in the past and seen success. So, you know, I'd be wrong to take any credit for their doing. There's definitely, but to answer your question, mobilities and exercises to increase that range of motion. Yeah, that's, it's so important because again, like your demonstration of that, you can stretch the toe in isolation, or we can put in a position of how it's functioning when it's a closed chain, meaning your foot's on the ground and how it's actually interacting with the other joints. And maybe there's a progression that the PT's might take. I don't want to speak for the PT's where we're first moving in isolation, but they're moving in a more specific manner. And I mean, that's been like, it's a great theme to kind of talk about this in this kind of conversation because we've been talking about the specificity of proper progression and identification. And that is in regards to if I'm loading the foot, let's be specific, but also progressive in the right way. Now specific is contextual to where you're at now. Right. You might say, oh, but being barefoot on a basketball court is the most specific for me. Well, technically, yes, if you play hoops, but maybe you're not ready for, you know, ladder drills barefoot yet on a hardwood surface. So let's be progressive and specific and let's let them counterbalance each other. So we actually progress and develop function and the way we want it to properly function. Yeah, I couldn't be, honestly, I couldn't agree with you more. And that's why when I mentioned the ankle rehab, I always specifically write passive range of motion. This is the easiest form of motion we could demand of our body and then graduate to active range of motion. Now we're really demanding different things from our joints and then do proprioceptive training. It's sort of this ladder of progression, right? Because you don't want to do too much too early. You don't want to be that guy, you know, that rookie at the gym who I'm going to bench press 250 my first day. I'm just going to do it. I'm going to go for it. And all of a sudden you're out of commission for the next three months. It's the same aspect in the foot. I know it gets neglected. You know, people stretch their chest before they do a chest workout, but no one ever thinks I'm going to stretch my ankle and foot before I hit the gym and run. But reality, it just takes one bad problem in your foot and ankle to realize, man, I really wish I never had to go through this. And I hear that all the time. You know, so you want to stretch your Achilles, be religious about it. You want to move your ankle. You want to move your toes. And you want to get a proper evaluation because again, the key is longevity. And if you I'm telling you the American sports medicine saying 50% of all injuries are in the foot and ankle severe or moderate or, you know, slight, take it take it seriously. Yeah. Yeah. Yeah. I couldn't agree more. Take it seriously. Should be a serious quote people actually reflect on because we look at a lot of our body and we give it, you know, maybe certain areas a lot of serious thought, you know, if you're a gym goer, you're going to say, oh, or athlete, you know, I know my, my quads are important to jump high. So we're going to take that really seriously. And then sometimes, oh, we'll do three ankle mobs and that's an afterthought. I know like, let's really seriously look at how our body is functioning and have intent behind taking care and being proactive and preventative about how the body works in conjunction with each other and all those pieces. And that way we can, you know, not have to ideally go see you under a knife. You know, like, that's, that's what we want. Yeah. It's not, it's not pleasant when you, you know, it's not pleasant when you have to tell a patient you see, you know, I just had a senior from high school who believe or not just had a Jones fracture. And I kind of had to tell him it's over. It's over. You know, I'm sorry, you know, this is recruiting season and he wants to play AU and travel and whatnot. And it's, it's not pleasurable for me to do that. So my idea is prevention is the best. Let's, let's make sure you don't get to that point. Sometimes we can't avoid it. Sometimes it's just inevitable, but there are certain things that we can do. And if so, we should do. And that's why I think evaluation is crucial really. And if you really are serious about your, your niche and your training and your sport, then you got to take this full, full throttle. Don't think these athletes who made the NBA or the league, they didn't take it seriously from the things they put into their body, whether it be food from the trainers they saw and the, the exercises they do, everything has a method to their madness. And if you want to look at these players who've had the longest careers, they put a lot of money into their bodies, right? We know LeBron James spends a million change on his body every year. I forget, I can't, I'm starting to blank out on the Pittsburgh Steelers player who quoted to saying, I take 15% of my paycheck and put it towards my body. James Harrison. James Harrison. Yes, yes. And it's, it's, it's not like by mistake because you get to a point where you understand, yeah, this is what's needed for me to make it to the next level and differentiate me from the average Joe, because we've all been to the park and see people who were phenoms and go, oh, you know, they should be doing something with it. We'll put them in a professional setting and you're like, oh man, maybe they're not that good after all. So take this serious. If you're serious, you've got to go full throttle all the way from head to toe, no pun intended. No, that's a great message to have. I know we're wrapping it up here a little bit, Doc. And I want to ask you one last question of where can people find out more about yourself? How can we hear more from you? We're in the street. There's a website coming out. I think I heard something like that. I'm not sure. Maybe a little birdie told me some blog coming up. We're going to hear more about you. Where are you located? So if you want to come talk to you, come meet you, you, how do you do that? And give me your Instagram handle as well. Sure, sure. So my practice is located in Grand Central New York. My Instagram handle is simple NYC foot doc. My email is attached to the Instagram handle. Believe it or not, I religiously take time every day to answer any emails or inquiries just because it doesn't hurt me to reply. I'm not that demanding where I don't have time to reply to 10, 12 people a day. I'm open to all different types of questions or any inquiries about anything really. I genuinely enjoy my job. So I love the discussions. I'm a bit of a nerd when it comes to this. And then as far as the blog, we're working on a blog put together to talk about things we just talked about today. And what I want to say informal, but formal manner, right? You know, we're sitting here just kind of shooting at me and you, but the substance we talked about is legitimate. And that's, that's the beauty of your conversation and this platform you're doing. And the blog is going to be in the similar demeanor. It's going to be worded simplistically. It's going to be straight to the point. It's going to be about a minute to two read. So be on the lookout for that. And any suggestions on what you guys want to read about? I'll write about, it's that simple. And everything is fact based and research evidence. That's just the way it goes through things. I mean, if it's not research based then I won't write about it. So what's the name of the blog too? Is it up yet? What will be the domain name? How do I search to find it? So it's not up at the moment, but when it is, all the details will be on the Instagram page. So I just put out a little skit of what people wanted to hear. I got a bunch of different suggestions from sports injuries to Liz Franks. Believe it or not, everything that was suggested I'm starting to realize was on this show. So I just lost a lot of my material talking to you today. But yeah, it's going to go up. I'm working on it. It's a work in progress. I'm hoping within the next week or two to launch my first one and then make it like a weekly ordeal. And then whatever people want to hear, I'm more than glad to put it out there. Yeah, go check them out guys. It's awesome to get this wide variety of information on the foot, detailed in ways that you might not have thought about. At NYC foot doc is his hand on Instagram, great page. It's only growing more and more every day. I'm excited for the content to come out. Dr. Mo, thank you. Really appreciate it, man. It's been awesome. Thank you for taking the time. It's my pleasure. Honestly, I really appreciate you guys. And I hope we work together again in the future. Oh, I'm excited to get you back on soon. All right guys, thank you for listening. Really appreciate it. That's what I'm going to do with you. Say goodbye. Take care all.