Confessions of a Barefoot Podiatrist

 

– The MOVEMENT Movement with Steven Sashen Episode 129 with Paul Thompson

 

Paul Thompson has been a podiatrist for 10 years, and despite having worn orthotics for most of his career, he kept getting aches, pains and started feeling old until he realized there was a better way. He’s tired of the over-prescription and over-reliance of orthotics in the industry and is on a mission to help people know there is a new (yet old) natural solution.

 

Listen to this episode of The MOVEMENT Movement with Paul Thompson about being a barefoot podiatrist.

 

Here are some of the beneficial topics covered on this week’s show:

– How natural movement and the benefits of being barefoot are not taught to prospective podiatrists.

– Why podiatrists should be more focused on helping patients than selling orthotics.

– How the joints in your foot are meant to move and traditional shoes prohibit that.

– Why minimalist shoes and being barefoot allows people to gain strength in their feet they didn’t have before.

– How simple strength exercises can have a great impact on your running form.

Connect with Paul:

Guest Contact Info

Instagram
@thebarefootpodiatrist

 

Links Mentioned:
thebarefootmovement.com.au

 

Connect with Steven:

Website

Xeroshoes.com

Jointhemovementmovement.com

Twitter
@XeroShoes

Instagram
@xeroshoes

Facebook
facebook.com/xeroshoes

Steven Sashen:

If you have allergies, you go to an allergist. If you have some, let’s see a good one, something going on with your ear, nose or throat, amazingly, you go to an ear, nose or throat guy. So of course, if you have something wrong with your feet, you go to a podiatrist. What if that’s the dumbest thing you could possibly do? We’re going to find out by talking to a podiatrist. So this is going to be a lot of fun on today’s episode of The MOVEMENT Movement, the podcast for people who want to know the truth about what it takes to have a happy, healthy, strong body, starting feet first because those things are your foundation. We break down the propaganda, the mythology, and sometimes the flat out lies you’ve been told, about what it takes to run or walk or hike or play or dance or to yoga or CrossFit, whatever it is you like to do and to do that enjoyably and efficiently and effectively.

 

And did I say enjoyably? Trick question, because I know I did because that’s the most important part. Look, if you’re not having fun, do something different until you are, because you’re not going to keep it up anyway if you’re not having a good time. I am Steven Sashen from xeroshoes.com, your host of The MOVEMENT Movement podcast. And we call it The MOVEMENT Movement, because we that includes you, it’s easy, it’s free, don’t worry about it, relax. We’re creating a movement about natural movement, letting your body do what it’s made to do, because that can be better for you. And the way you can participate, the movement part, the part that you’re involved in is go check out our website, www.jointhemovementmovement.com.

 

There’s nothing you need to do to join, you can opt in and get emails about upcoming episodes. You can listen to the previous episodes. You can find all the places you can grab the podcast or find us on social media, et cetera, et cetera. In short, you know what to do like and thumbs up and share, et cetera. If you want to be part of the tribe, just subscribe, so let’s get into it. Paul it is a pleasure having you here. I know you heard my wacky intro, why don’t you tell people who you are and what you do.

Paul Thompson:

Thanks for having me here, mate. So I’m a podiatrist, like you mentioned, I’ve somehow coined the term The Barefoot Podiatrist many years ago, and I’ve run with it. So essentially I’m a podiatrist who specializes in barefoot rehab, or getting people back to a barefoot state, a natural state in short.

Steven Sashen:

And so Paul Thompson, you didn’t even say that part. So Paul people can probably tell from your accent you’re from Texas, is that correct? Did I get that right, Texas?

Paul Thompson:

No, it’s more, I’m kind of Southeast Asia… Australia.

Steven Sashen:

So thank you for doing this at this… What time is it where you are now?

Paul Thompson:

We’re running it around 8:00 AM.

Steven Sashen:

Oh, okay, not so bad. If you were getting up at 4:00 in the morning, I would thank you profusely, but 8:00 AM I’ve been up for hours by that point. So the big question that I want to ask is talk to me about traditional podiatric training. What do people learn when they’re becoming podiatrists about feet and more specifically about natural movement, or is that just not even part of the curriculum?

Paul Thompson:

So I did my uni training around 15 years ago, I want to say, and back then natural movement wasn’t a thing. So podiatry training we learned about the feet and some muscles in the feet, some bones in the feet, back-

Steven Sashen:

I’m just thinking it’s sort of like when you get on an airplane and they say, “Welcome so and so to Los Angeles.” You go, “Oh crap, I’m on the wrong plane.” I wonder if there were people who went to podiatry school, it’s like, “We’re going to be talking about the feet. ‘Feet, oh my God, I thought this was going to be proctology school.'”

Paul Thompson:

Funnily enough, the first half year of the university degree, there was nothing to do with feet. It was how to talk to people, things you can and can’t say to a patient, it was really broad. I walked into the first few classes and that’s what I thought, I was like, “Am I in the right school? When do we learn about feet?”

Steven Sashen:

Now I’m dying to know what things can you not say to a patient?

Paul Thompson:

Well, it’s probably changed now, but back then it was common sense stuff. I think it was just that common sense, that people that didn’t have common sense of not calling people fat, just using words, the politically correct terms. You couldn’t say, “Your feet are sore because you’re fat.” You had to say, “Well, there could be some-” I can’t remember that was a long time ago, but it was quite a funny semester I must admit. I clearly took a lot away from it.

Steven Sashen:

It’s funny, you mentioned that though. So I got a degree in film and they make you take an acting class, and the first semester of the acting class is mostly just embarrassing yourself in front of your classmates. And the second semester is learning what not to say to actors, like, “Don’t say to an actor, can you do that again, but be happier.” Because that makes actors want to punch you in the face. So I guess the beginning of podiatric training in film school, very similar learning what not to say to your clients.

Paul Thompson:

Well, I guess everyone’s so scared of being sued or punched in the face, that I guess they have to teach that now. Because maybe too many podiatrists were getting punched in the face, I don’t know, I haven’t looked into that.

Steven Sashen:

Well, so then since they weren’t teaching about natural movement, what were they teaching was it all just… I can’t even imagine what it was like. And eventually we’re obviously going to get to the transition from what you did, to become now The Barefoot Podiatrist.

Paul Thompson:

So in Australia podiatrists are slightly different to America, we’re not surgeons. In America, we’re more physical therapists or allied health is our terminology here. So podiatry school has two main kind of branches, there’s the general kind of podiatry, skin nail kind of conditions that we treat, in grown toe nails, all the gunky stuff that people grow on their skin, so that’s kind of a big part of it and then we do biomechanics. Now biomechanics is part the movement side of podiatry, which is why most podiatrists probably get into podiatry, wanting to be a sports podiatrist and do all the cool things, your things that come along with that, with sporting teams and the likes. Now biomechanics training it was cool, we were really well trained actually in biomechanics and how the body moves, and how muscles work with joints and tendons.

 

And we kind of learn all that stuff, but all roads lead to an orthotic. So we did one, maybe two I could be wrong, but there was no more than two classes on exercises. And the lady who ran the exercise component like a magician, she’s magic, she knew her stuff. And at the time a lot of my peers, we didn’t take what she was saying seriously, because a lot of the other academics in the degree almost put it down a bit. Not bad mouthing her, but almost like, “Well, it’s good to know some of that stuff, but really here’s, the devices you’re going to be using to fix people.”

 

So it was kind of almost shoved to the side a lot, and it wasn’t until years later that I actually reached out to her again and went, “Wow, thank you, some of that stuff has actually clicked. And I’m now down this rabbit hole, and kind of pretty much doing what you were telling us to do back then full time.”

Steven Sashen:

What was her response? Because I could imagine one of two, I can imagine one would be, “Wow, because I was aware that people were completely dismissing what I was saying, but I knew that maybe one day.” Sort of like I talked to Phil Maffetone who for people who don’t know, he’s a very well known running coach, distance coach, and he’s been talking about minimalist footwear and barefoot running since the ’80s. And when I became friendly with him 10, 12 years ago, I said, “Do you feel like vindicated that people have caught up to you or mad that it took this long?” He goes, “That one.”

Paul Thompson:

That is good, that’s pretty much what she said. No. At this point, I was doing what I’ve been doing for a while, the barefoot stuff. And she actually got me to go up and teach at the uni a couple of workshops to see what I was doing, and try and get that message through to some of the 4th year students that were about to graduate. And to answer kind of your earlier question of has that curriculum changed and more natural movement now, it hasn’t. So I went into to teach this workshop, so I was kind of there all day teaching tutorials and workshops to these 4th years. Running them through the basics of just natural movement, and why we need to look at other paradigms as well to fix the same problems, and just come at it from a different angle.

 

And most of the questions, pretty much all of the questions were, “Well, how does this work with an orthotic? But the research says,” something to do with an orthotic. They really tried to pull me down and these are 4th year students about to graduate. And a lot of them by the end of the day were opening up, and seeing that there was merit in trying to fix the problem, not just bandaid the problem. But that’s four years of conditioning of putting every patient into a supportive shoe, essentially an orthotic and then getting them on that subscription for orthotics for their lifetime.

Steven Sashen:

I have a friend who was studying to be a physical therapist, who when they got into the section about feet called me and said, “Did you know the guy who came up with orthotics was a chiropractor, who just made up the idea of positioning the foot in a particular way with no evidence behind it?” I said, “In fact, I actually did know that one.” She goes, “That’s kind of shocking don’t you think it?” I’m like, “Yes it is.”

 

But what people realized is that you could sell this product year, after year, after year, after year by doing so. Obviously, people don’t know the history of orthotics and the… The original idea actually was like a cast for your arm if you broke your arm, just a temporary measure to allow some tissue to heal, but not something you’re supposed to wear all day every day. So that combination of not knowing the history of it and seeing the monetary potential, how much do you think that was just influencing the way people were thinking from day one?

Paul Thompson:

I’ve always said if we weren’t allowed to prescribe orthotics, so if my job was to say, “You need an orthotic, I’ll write the prescription,” but I make no money from that, I reckon we would see a gazillionth of a percent of what’s out there now in orthotics. It’s become an industry and unfortunately that’s the world, you go to a optometrist, they want to sell your glasses because that’s how they make their money. You got to a dentist, they kind of want to put you in braces or something… it’s kind of a bit of a broken system I feel. And I know it’s the way it works and it’s like I’m not trying to change the world. But it is a broken system when you’re going to the person who is trying to tell you need something, but also takes the money from that. It’s kind of like a used car salesman, they’re going to tell you it’s what you need that car and take the money, even though they know when you drive up the road it’s going to break down, you’re in a conflict of interest.

Steven Sashen:

Let piss people off.

Paul Thompson:

Have we not already?

Steven Sashen:

I like that you brought up the glasses analogy, because when I found out that I needed glasses, which I’m not wearing because I’m fine at computer distance. I had a friend who is an optometrist or an ophthalmologist, I can’t remember which, doesn’t matter, anyway. And so I needed a pair of glasses and I said, “Can get me a deal on these frames that I’m looking for?” He goes, “Oh yeah, absolutely. Call my office and just tell them that just I sent you and just to give you our price.” And so these frames, I was looking at retail $500, guess what his cost was and there’s still profit built into that? Guess what his cost was on a $500 pair of glasses?

Paul Thompson:

250.

Steven Sashen:

$70.

Paul Thompson:

Oh.

Steven Sashen:

So let’s piss people off on the orthotics side, so the average orthotic cost X and what is it… or it’s sold to the patient for X, what’s the practitioner getting?

Paul Thompson:

So it’s changing a lot currently, supposedly because of all the shortages in people and suppliers and things, but it depends where you are.

Steven Sashen:

In a normal world.

Paul Thompson:

So roughly, let’s say a cheap pair of orthotics in more rural, let’s go Sydney, say in Sydney prices up there, you’re looking at around 800 bucks for a pair of orthotics in Sydney.

Steven Sashen:

Oh my God.

Paul Thompson:

More regional, maybe closer to five, 600, cost on that could be anywhere from 200 to 300, depending on the lab you use.

Steven Sashen:

Wow. And even that, I literally can’t imagine how much money the lab is making.

Paul Thompson:

Well, the lab would be killing it. Well, the materials aren’t absurd. So here’s the other thing with orthotics that just drives me nuts. Old schools orthotics, yes, I could see value in paying 500 bucks for an orthotic. They’re handmade from go to woe, you manually mold the cast to get that mold. So the practitioners kind of doing something and trying to get the right position, and they know what they’re trying to create with their hand. That goes to a lab, or old school the podiatrist would make it in house and it was all handmade. These days it’s printed, most of them are printed. I even know some labs that it’s scanned, you scan the foot. And when it goes to their lab, the computer system picks the closest template to that foot.

 

So it’s not even a 100% custom, it’ll go, “Well, that foot has this size of this width and that kind of deep of an arch from the scan. Our closest template to that is template C.” Print it out, they throw the cover on, send it to the podiatrist, podiatrist might have to make a few modifications in just grinding a few bits and pieces to make it feel more comfortable when it hits your foot, that’s it. So now, and this is where I get really cranky with podiatrists because back in the day… I believe orthotics have a place it’s like saying plasters cast for your arm, don’t have a place. If you have an injured foot there are times structurally or whatever that it can be a really good thing.

Steven Sashen:

Absolutely.

Paul Thompson:

I still prescribe them every now and then for certain patients, there is a time and place if done well. Now as a podiatrist, we held a really good way of doing it, we were the masters in orthotics. Since it’s become this whole scan technology, did I say scan or scam anyway, scan technology, I thought I slipped up there.

Steven Sashen:

I appreciate it.

Paul Thompson:

Since we started scanning the foot, it’s now opened the door to every man and their dog who are trying to sell orthotics. I know a physio up north of us here who advertises, “Why do you know go to podiatrist? You can get this all in house one stop shop. And we use the same technology and orthotics that your local podiatrist does,” and he’s not lying. It’s just he might have a different way of prescribing it, maybe he doesn’t understand how podiatrists prescribe. But it’s true, he’s using the same software, the same scanning device, the same lab, so it’s the same orthotic. He’s charging a little bit less and incorporating that into some rehab with his physical therapy and why wouldn’t you go there? You know what I mean? I feel like we’ve shot ourselves in the foot. Hence why years ago I started jumping into this barefoot thing, and it made more sense to me and I wanted to fix people. I wanted to get off that bandwagon of fighting with other industries, with my own industry.

Steven Sashen:

Were you concerned if you dropped the incessant prescription of orthotics, that it was going to dramatically affect your income?

Paul Thompson:

Well, but even through university I didn’t like orthotics. I had this really love, hate relationship with them, I could see there was a time of place and I understood that. Through uni there was this competition in house, that used to take place amongst the students, it was kind of driven by one of the main lecturers who owns an orthotic lab. So all the orthotics from the university went to his lab, he was one of the teachers at the uni. Now we had to make one or two pairs a year ourselves as part of our degree, physically make them from scratch, the rest you could prescribe through the lab. So there was this kind of it wasn’t an official award, it was a in house kind of joke award that we would see who would make the most orthotics that year, who was the orthotic guru.

 

And I just didn’t like it, I would prescribe my minimum that I had to do. And people would be like, “Why aren’t you casting them up, cast them up.” It was like the term you would cast the foot to get the mold for the orthotic, “Why don’t you cast them up?” I don’t need to. “But you only on X amount.” It became this kind of in house joke, which I didn’t think was that funny. Years later running into people that’s all they talked about, “Oh, we’re turning over about X amount of orthotics a week.” It’s like, “Well, is that really that cool?” If I’m turning over X amount of patients a week and rehabilitating X amount of patients, I feel like that’s a cool conversation rather than talking about how many devices you’ve prescribed.

 

So that kind of turned me off a lot to begin with, that whole competitive side of it, and made it feel to me like I wasn’t doing justice to the industry. And that’s when I started looking into fixing myself and getting myself out of the orthotics I was in, because that’s the only way I could keep up my numbers with everyone else was to keep prescribing myself some, because I felt bad giving them to patients. And when I started fixing myself, that’s when I kind of stumbled across just a whole new world of information and mentors started popping out of the woodwork, that I started coming across.

 

My main one was a chiropractor actually, who really got me looking at joint movement and getting that foot moving and mobile again, and from there I just couldn’t look back. It was kind of like when your eyes open, you’re like, “Now I can’t sort of go back into that world.” So the money side of it yes that’s a concern, but it’s not why I go into podiatry.

Steven Sashen:

Well, it also occurs to me if you’re not prescribing orthotics all the time, and if you are genuinely trying to rehabilitate someone, that’s a whole different kind of business building that one has to do, because you’re not just getting them in and keeping them in year after year with a new prescription every year. So that’s a completely different way of thinking about how you’re building a practice I imagine.

Paul Thompson:

I guess my downside is I try and get rid of those patients too. So I know some physical therapists locally that will do exercises, but it’s almost like they try and keep people on that wheel of keeping them as long as they can doing exercises in house. For me I really want to try and empower the individual, and teach them how to do more of this stuff themself. I want be as least hands on as I can with people is how I approach rehabilitation. And obviously help people and do hands on stuff, mobilizing feet and strength work, and manual therapy where we need to. But my approach and my kind of philosophy is if we can empower that person to understand what’s happening with their own body, then they can start looking after themselves and making better choices to fix their own feet, or at least manage their own feet long term. They’re not going to rely on me, which from a business point of view is probably terrible, but it helps me sleep at night.

Steven Sashen:

Well, if it makes you feel any better, we’ve had a number of people say, “The fact that you have a 5,000 mile sole warranty on your shoes is really stupid. Are you replacing shoes more often?” I go, “No, I want to have people have a better product and a better experience.” So same idea. I want to get back into your story about the transition, sort of what you discovered and what that transition was, but before we go there, I had two questions that popped into my mind. One is I imagine some people come to you and they really are looking to be taken care of, rather than having to take responsibility for themselves. Do you encounter that and if so how do you handle that?

Paul Thompson:

I do. So I think, not even I think I know, a lot of people are still… we’ve been conditioned as humans in this society we live in, at this time on earth to be looked after. If we feel sick, we go to the doctor, we expect our doctor to give us something to make us better. If it doesn’t make us better, we go back and they give us something else, we don’t take any responsibility for our own health anymore, and that’s not just with the doctor, that’s everything. If you want to get fit, you kind of join the gym, hoping that gym’s going to make you fit. You can still take responsibility at the gym, but you know what I mean? We kind of want that quick fix and hoping that thing that we’re purchasing is going to make us better in some way. I get it every day, most people come in here wanting to know how I’m going to fix them. And through educating and you kind of pick up on that vibe as well through talking to people how much they’re going to do on their own.

 

I tend to find the people that really don’t want to take any responsibility. Don’t tend to hang around long and not in a bad way, they’re normally very polite and will just say, “Look, I don’t think this is for me this barefoot kind of exercise approach. I really want orthotics, is this something you can help me with, or can you send me someone’s way if they’re local.” I still want to help people. So if they’re local, sometimes I’ll just do that to help them get out of pain and get them back into life. If they’re not local I get a lot of Zoom patients, then I’ll try and source someone locally for them to help with that. But you can only help someone that wants to be helped, so I don’t take it to heart anymore.

 

Quite often what happens, I’ve had people that have begged me for orthotics because they just didn’t have time to do the exercises or whatever. Normally it’s like two, three years later, I’ll see them again, “Remember what you said these orthotics just kind of worn out. They haven’t been that comfortable and I kind of can’t wear the shoes I want to wear and this and that. Is there still an option to look at those exercises?” And normally by that stage they’re ready and they actually go at it, hopefully, out of their own and do really well. So I still feel like even the people that aren’t quite ready at the time, just by sinking that seed in and educating a little bit, it’s still there. And so most of them, at some point they’re going to go, “You know what this method isn’t working, I really want to try a different approach.” And I’m seeing more and more of that now, after years and years of talking about this.

Steven Sashen:

Well, I’m going to tell you where this is going. So the first thing I want to do next is hear about what it was like when you made this transition, to what you’re now thinking of as the barefoot podiatrist, what that means. And then the second thing I’d like you to talk about, I know you can’t prescribe just a generic protocol, but if somebody were going to come see you, what are the kind of things that they end up doing or walking out then having to do, just so they get a sense of what’s doable. And I guess maybe there’s a third thing, which is for people who are not seeing you privately yet, anything that you would recommend that people do to take this first step, pun intended, with natural movement and foot health. So that’s your transition, what it’s like when people come to see you and what you want to give someone to pun intended walk away with. I’ll try and remember all three of those, by the way.

Paul Thompson:

Please do I’ve already forgotten the first one.

Steven Sashen:

I had to say all three of them otherwise I’d forget, because that’s the way my brain works. So wait I’m going to do you, patient and a call to action. All right. Now I know what that means. You first.

Paul Thompson:

So with the transition from you mean just like how has that looked?

Steven Sashen:

What did you do? What was the thing that was that kind of revelatory… For Irene Davis who we’ve talked with on the podcast and talked about, who was teaching people how to make orthotics, she was at the university of Delaware and then suddenly realized, “Wait when people come in to see us as a physical therapist we want them to move as much as possible pain free, but then we’re mobilizing their foot. What? That doesn’t make sense.” And that led her to start investigating, and that led her to becoming the number one researcher and minimalist footwear in the world. I guess the easiest way to put it is what’s your version of that story?

Paul Thompson:

So for me, I had been in orthotics, like I said, for years and years. And I had a ACL torn years ago through a snowboarding thing that happened, let’s not talk about that, that’s still a bit raw.

Steven Sashen:

Because I tried snowboarding when there was no snow and that didn’t work out very well.

Paul Thompson:

So I had a knee issue, constant issue with my Achilles and my plantar fascia forever, almost since a kid, I was in orthotics as a kid then went years without them, as a podiatrist, started back down that road. Had shoe reps in every other week, giving us shoes, that’s what they do to try and get us to sell their shoes, which is fine. But I tried everything and I was always in pain, I was never comfortable. And it wasn’t until my eldest son had been born and we were over in Hawaii, and I was walking on the beach with him, him in my arm. And I just started getting that pain in my foot again, just like, “Oh.” And I remember just sort of looking at him, hear I am in one of the most beautiful spots in the world, with this brand new little baby thinking, “I’m going to be this great dad, that’s going to be chasing this kid in a few years.”

 

And here I was with a sore heel as a podiatrist, which is kind of like, really. And at that point I was like, “Something needs to change.” The orthotics, the shoes, hadn’t worked. I’m missing something here. How can I even fix my own feet when I’m a podiatrist and here I am trying to help other people’s feet day in, day out with the same issue. And I went down these rabbit hole then, researching, reading and just trying different things on myself, I was just patient zero. First I tried minimalist shoes for me, which back then I think I started with Nike Free was the first one, with obviously no…

Steven Sashen:

Not even a minimalist shoe, but that’s the way it was positioned.

Paul Thompson:

It was more minimal than what was around at the time.

Steven Sashen:

It was more flexible.

Paul Thompson:

More flexible. Well, it had a smaller drop as well.

Steven Sashen:

A little bit, I still had a big flared hee. But I remember when I got a pair of those, it was just miraculous how much I could feel because the soul articulated more, and that was really cool, but it was still pretty built up and all the rest. But that one thing of just having more, especially laterally, more flexibility laterally was I remember really walking down the street and being amazed by that.

Paul Thompson:

Well, the same, so it didn’t fix my feet definitely. But that feeling of like, “Whoa, this shoe moves how I like.” I surf, so I’m always on the beach barefoot anyway, and I like that feeling in my feet moving, it’s just that it was causing a lot of pain before. So that just got me interested in, “Well, what is this kind of whole flexible Nike Free thing that they’re kind of playing with. There must be something behind this, if Nike’s going down this road, at that point is what I thought.” And the more I dug at this I realized, “Why I have been locking my foot up?” There’s all these joints in there and joints are meant to move, half the muscles in my feet were weak as all hell and I’d never really used them.

 

My balance was shocking, here I am like a late 20s early 30s surfer, snowboarder and my balanced sucked, how does that happen? And the more I just dug into things and started asking questions from people I knew and they put me onto someone else, and it just kind of took years and years, but eventually my knee pain went away and it wasn’t that long actually. But my knee pain went away, my knee started moving like it used to, my balance improved, my foot pain disappeared. And I was able to run around with my child at the time, a lot more freely and happily, and I couldn’t go back. So it was just this whirlwind of learning, and then with patients asking me what I was doing, all of these different shoes I was wearing and whatever, then I wanted to post stuff about it.

 

So at the time Instagram was a platform and Facebooked it. I was kind of just on for private stuff. And I just started posting stuff on the clinic page for patients just saying, “Well, look, here’s some exercises.” I didn’t really have any fancy software at the time. So that was a way of me just going, “Look, I’ve put some of these online, just jump on this page and have a look and you can do these exercises, that’s what I want you to do.” And it kind of started to grow and people in my industry started to get wind of what I was talking about, anti-orthotic and pro exercise and I got smashed. I had one of the biggest orthotic labs in Australia ring me, and pretty much told me they were going to shut my career down.

 

I had people from the board also tell me to watch what I was saying, that there’s people from the top of the podiatry board seeing what I’m doing and talking about, and that I could be in breach of certain things. And at that point I remember going home to my wife just going, “I’m getting smashed.” I was getting really worried, here I am with my little business and it’s not that big, other than now but it’s just me and my little band, we’re just doing our thing, and I was just posting some stuff that I believed in, it was nothing too out there and here I am getting pumped. And I thought at that moment, will I either step back and just not put this out there, which I almost did.

 

And then I thought, “Well, if I’m pissing people off, they shouldn’t be worried about me.” Who am I? I was no one, I am no one. I’m a little podiatrist here with no followers, what are they worried about? And it then just got my backup and I went harder and posted more, and started speaking more publicly, public speaking at events. And eventually a lot of the naysayers kind of just fell off, but this kind of tribe started to follow. And it’s kind of grown to where it is now to the point that I did get to speak at the uni.

 

I’ve spoken at lots of different events with the most being around 700 people at this wellness event down in Melbourne a few years ago. I’m glad I took that plunge. And as much as people didn’t want me to put this information out there, it felt right and it felt like I needed to do so, that’s how it grew and now that’s what I do.

Steven Sashen:

I love it. And so when someone comes to see you, this is the second part, what’s that experience like? What do you do to kind of evaluate what’s going on? What’s the conversation about the introduction about natural movement and exercise and strength, rather than getting posted with an orthotic.

Paul Thompson:

So I get two types of patients, generally, either people that know what I’m about and are already all for it, they’ve seen it online. A lot of those people have already bounced around multiple podiatrists, physical therapists, potentially chiropractors, they’ve had a lot of different treatments and that used to scannings and they’re like, they’ve tried everything, “What am I going to do? What can I possibly do?” Or I get people that just have no idea, they’re here because they’ve got a soft foot and they go to the podiatrist. And I find they’re actually harder because you need to educate, and really explain more about what’s going on to people that somewhat get it and have tried everything, they’re ready, they want that fixed. Now often when people come in with pain, they’re surprised that I’m not that interested in the pain.

 

They’ll want to talk about the pain forever, I’m like, “Well, that’s cool, we can give that a name if you want, but I want to see how you’re moving.” So we do a full functional assessment, I want to see how that person’s moving, what their foot is doing with the rest of their body, how the hips are moving. Just lots of different movements, stepping up, stepping down, squatting, lunging, single leg partial squats, lots of different movements depending on their age and ability. But I want to see as many movements as I can to work out where the breakdown, or where the dysfunction is in these movement patterns. Now what I’ve found is a lot of these injuries I see that are chronic, they’re not because you’ve done something silly and injured. You’ve tripped down a gutter, you know you’ve sprained your ankle that’s a different sort of treatment.

 

These ones that are these foot pains, these knee pains, these back pains, hip pains that have been there for years and nothing seems to work, that’s biomechanics, that’s the way you are moving and loading that tissue incorrectly and it gets sore, it gets burned out and sore. So I assess how people move and then generally once I’ve done all that, it starts to make sense to them, when I start saying things like, “Your foot’s doing this, your hip’s not doing this when you’re walking, which is loading this tissue that is now the breaking point, which is why you’ve got pain. But I can sit here and treat your pain all day like you’ve had for the last six, 12 months at other places, we’re not going to get anywhere. We need to change how you move.” And that normally clicks, and they kind of get that and can see it’s common sense once you see it.

 

And from there, we’ll either do manual therapy to work on some of the pain because if they’re in pain it can be hard to sometimes fix movement anyway. But a lot of the stuff I do is exercise based, but it’s neuromuscular exercise based. So not so much strengthening or flexibility, even though there is some of that in there, it’s more drills to try and get the brain to use those patterns again. It’s like if you have a really strong bicep, but your hand doesn’t work, you’re not picking anything up. So it’s getting that hand and that arm to actually work together again, getting your brain to know when to grip, when to let go so that you can actually pick up a bag or whatever, the foot’s the same.

 

We want those muscles, tendons, ligaments, nerves to start feeling again, to start getting some input for the brain to actually start lighting up those areas, but in a sequence that it works together, it’s not just on and kind of like jammed on and then it becomes another problem. It comes on and off and moves and adapts to the train under people, so it’s really simple type of movements, but it works, once that brain connects then it becomes a more subconscious pattern.

Steven Sashen:

I love that you used the word brain a 100 times, because this is the thing that people forget is that’s the thing that’s controlling the movement. But there’s also a feedback loop from the muscular skeletal system, and you got to make one of them shift and the other is going to kind of go, “Oh.” So the relationship between this, I remember the first time I met a guy named Thomas Hanna, who he brought Feldenkrais’ to America, and I had a session with him and he got my body to move. Basically, my arm had been kind of locked in place, gymnastics injuries. And he got my arm to move in a way that it hadn’t moved in years, somewhat passively, but I could feel my brain going, “Oh that, oh right, I forgot I could do that.” And that was all it needed.

Paul Thompson:

Yeah. And that’s the problem, because when I started my own personal rehab kind of mission, for me it was all about strength and mobility. It was like, well, it made my feet stronger and more mobile, why wouldn’t I be right, that’s kind of personal training 101. And it helped, it definitely helped, but it didn’t change how I moved, didn’t change how I walked. And it wasn’t until I put the ego aside and went, “Right. I’m not going to try and get stronger or go for maximum range of motion without control. I’m going to learn how to control these movements within the range I’ve got and then increase that range with control.” Because most of the issues I see it’s people in positions without control, that’s when we get hurt.

Steven Sashen:

Got it.

Paul Thompson:

Where you have this whole overpronation thing, is there such things overpronation, look at some of the islanders, they’ve got the flattest feet in the world and don’t get injured. But then we have people who might have flat feet and are full of pain, it’s how much control you’ve got in those positions, same as with your shoulder. You have people that can get in these crazy weird positions, for one person they can control that movement, they’ve got the strength, the mobility, but the control, the motor control to maintain that position safely and they’re fine. Someone else gets in that position blows their whole shoulder out and they’re in for surgery or something. So for me now I realize the control piece is a huge, huge part of what we need to do to rehabilitate people.

 

And that’s where things like your shoes play a huge role, it lets people start to control those movements. Like yes, there’s proprioception and strengthening and all these great things that we do need for healthy movement. But it allows the brain to start using its own infrastructure to control that movement, not be thrown into these whipping effects with those big chunky heels or motion control, when we don’t want to control motion, but we do, but not from an external device. You want to be able to do that from within, but like you just mentioned before it starts at the brain. If the brain doesn’t know how to control those movements, we’re going to get injured.

Steven Sashen:

So that’s the perfect segue for if we want to give people an experience, something to try, something to play with on their own, as we wrap up our conversation, what would you like to give them as something to take away? I know I’m putting you on the spot.

Paul Thompson:

Yeah. Look, it’s hard because there is a lot of variables based on people conditions.

Steven Sashen:

And it occurs me, I’m not even necessarily suggesting… When I thought to ask the question, I was thinking what movement thing might we want to share? But I’m willing to go somewhere else where the thing to do would be read the following paper, read the following book, talk to the following person, wherever you can think to go for what a next step might be for someone.

Paul Thompson:

I think next step is, and it depends where you are in your journey as well. If you haven’t been out of a traditional shoe that’s where you’re still at, then you want to take it a little bit easier. It can be as simple as getting your old shoes off, going for a walk on the grass, but simple things to reconnect, let’s just go with feet. Typically, in a consult or working one on one with someone, I’m working on foot, hip and breath as a connection piece, we’re trying to get all three working together for the most part, plus other things, but that’s kind of the key points that I tend to try and get that control over.

 

So you could start with your feet with simple things like toe yoga, big toe up little toes down, big toe back down little toes up and switching. If you’re a barefooter then that’s probably going to be quite easy, if you’ve been out of shoes and your feet have more of that connection. But for someone with not very much connection to their feet, that simple act of just trying to control movement of the toes again can be huge.

 

People freak out that they can’t do that, and need to use their hands to kind of just get that motion going again. Short foot is another exercise, it’s got a quite a bit of research behind it, as to whether it helps functionally or not, who knows. But it is definitely another one that just starts to get that connection piece of trying to get your brain to use some of these muscles without load. It’s literally just trying to get the arch of your foot to contract. So you kind of squeeze in the metatarsals or the ball of your foot back towards your heel, to activate some of those intrinsics, that can be a nice one to start with as well. But otherwise if you are more progressed in your journey, single leg work like walking, running, there’s a lot of movements we do that we’re on one leg.

 

And for a lot of people we don’t have stability and control on one leg. So lots of single leg work on balance beams, balance pads on the flat ground. Take away the ego, I find a lot of people, especially around here, a lot of surfers they want to get on the bouncy ball and stand there, and be doing these crazy movements. And it’s like, “Cool. That’s, that’s really impressive. Can you just stand on one leg on the ground for me?”

 

And they’re like, “Oh yeah, yeah, sure.” And they can’t. And it’s like, “Well, you’ve trained yourself to stand on these weird objects, which is great, but we still live on earth. We still live on this flat concrete world now that we need to be stable.” So lots of single leg work, but with good alignment through your foot ankle, knee tracking over your foot where possible, and trying to use your foot and hip muscles to control and stabilize that movement. Not locking the knee out or hyper extending the back to try and get balanced, we want to be balanced with control through the foot and the hip.

Steven Sashen:

I think that’s a great thing to give people to think of, is if you are trying to balance like just standing on one foot, to pay attention to what the hip is doing, to pay attention to what the glutes are doing, rather than just focus on the foot. Because it’s easy to think that balance is all on the foot, but obviously there’s other components to it. Do you know about the old man test?

Paul Thompson:

No.

Steven Sashen:

So the old man test, I saw it on TikTok in the first time I ever got on TikTok. You put a pair of shoes and a pair of socks down in front of you, stand on one foot and while standing on one foot, put a sock and then shoe on obviously the other foot, and then switch feet and then put on the shoe and sock or sock and shoe. If you look on Facebook or on our Instagram, you’ll see, So I put on a shoe and a sock and then I took off the shoe and the sock, and then I did it again blindfolded.

 

Now I’m hopping around a little bit, I wasn’t obviously as stable, but I pull it off shoe and sock blindfolded. And it’s pretty funny because the first time I put on the sock and I had to hop around. And when I went to grab the shoe, I grabbed the wrong shoe and put that on my foot and it was like what the hell that feels weird, it’s like, “Oh, okay. I get it.”

Paul Thompson:

What’s that?

Steven Sashen:

I haven’t seen anyone else do it blindfolded, I was hoping it was going to get more attention.

Paul Thompson:

That could be a challenge there.

Steven Sashen:

It is a challenge, but no one’s taking me up on it.

Paul Thompson:

With the like what you said about the blindfolding, so that’s what I was just saying about being on a single leg.

Steven Sashen:

Yeah.

Paul Thompson:

So once you get stable on single leg and you might have the arms, the upper body trying to do things to stabilize you. Once you can be stable, do things like eventually blindfold yourself or close your eyes. But even just turning your head to the left slowly, to the right while you’re on one leg, up, down moving one hand up, down to the side. Because walking, we’re not balanced still walking with our arms kind of like out to the side, trying to stabilize us. We need to be able to balance on one leg and be stable while also mobile on the other side. So when walking, we need stability and mobility, which is why people struggle at walking when there’s a dysfunction, because our brain’s trying to do two things.

 

We’re trying to swing an arm for counter rotation, counter balance, it might be looking because someone’s talked to us in a certain direction, looking up because something just dropped on our head or something, I don’t know. But being stable on one leg whilst being able to move the upper body breathe well, good posture, that’s kind of the next progression. And those simple things can have such a profound effect on your other training, whether it’s gym training, running, whatever it is you’re doing, it all kind of works on that bigger scale as well.

Steven Sashen:

Do you know Jim Klopman… the SlackBlock that we sell on our site, have you seen it?

Paul Thompson:

No.

Steven Sashen:

You have to check it out, I’ll to get you one SlackBlock. Basically it’s some of that like Aerofoam stuff with the… You have to go look at it, just look up SlackBlock on our website.

Paul Thompson:

Yeah.

Steven Sashen:

And what he does, first of all, see there’s has a lot of things you were just talking about. But one of them he’ll have you balance on the SlackBlock on one foot, and then he’ll throw things at you to catch them. And just don’t look at it, just use your peripheral vision, just catch. And he works with golfers and just doing that with their peripheral vision, suddenly their golf swing improves and they’re like, “What just happened?” He goes, “Everything just got more integrated from you having to do these multiple things at one time, and that’s going to translate to your golf swing.” And they’re like, “But it had nothing to do with my golf.” Right.

Paul Thompson:

It’s huge. I ran a workshop a couple of years ago before COVID when we were allowed to have people in a room. And I ran a seniors workshop because I was seeing at the time in the general practice we have here, just a lot more falls. I just kind of was seeing these people hearing of falls and I thought, “I need to just try something.” So I ran this little workshop here, we had about 10 people in the first batch go through. And these people were ranged from 70 to 90. One of these ladies was on a walking frame. When I came in for this first session, I had this plan mapped out of what I would normally do for people, which is quite a little bit intense, and I was just like, “Okay.” I really didn’t think I was going to get that kind of age group, but that’s fine.

 

So I changed it all up and we did just simple, simple things. Just like the toe yoga, like we were just saying, like working on single leg balance, holding on. By the end of this, I think we did five weeks from memory, just 40 minute sessions each week, just going through simple drills. By the fifth week I remember that lady on the walking frame was balancing without the walking frame. She did a lap up and down my clinic without the walking frame and I was like, “Keep using it. I don’t want you to come back in-”

 

But it was insane, it blew me away just what you’re talking about, we were just doing things, they had to stand on one leg and just reach. They were passing a ball back and forward to each other, like a tennis ball, simple things like that, it was fun as well. Like you mentioned at the start, it needs to be fun and it just blew me away, how it changed a lot of these people’s gait.

Steven Sashen:

Yeah. It’s a huge one and very misunderstood. I’m always amazed when I see some elderly person who has balance issues, and a doctor recommends a thicker shoe, it’s like, “Oh, you need more motion control.” No, no, no, that’s a whole thing. Well, I know that you got to go, I’ve used your time, I really appreciate it. How can people find out more about you and what you’re doing and get in touch with you?

Paul Thompson:

So social medias it’s The Barefoot Podiatrist that’s on Instagram and Facebook. Otherwise, my website is thebarefootmovement.com.au.

Steven Sashen:

Well, Paul it’s been a total, total pleasure. I am looking forward to when people are traveling around the world more, and we get to see each other live and in person, where you’ll discover I’m much taller on video than I am in real life.

Paul Thompson:

I’m much shorter.

Steven Sashen:

Perfect. It’s funny you say that, I have one friend we’ve never seen each other in person, we’ve known each other for 20 years. And it wasn’t until two years ago where we both discovered we’re the same height. And it was like, “Oh my God,” neither of us ever thought of that. It was like, “Wow, I pictured you as taller than me. ‘Me too.'”

Paul Thompson:

Perfect.

Steven Sashen:

Anyway. Well, thank you, thank you, thank you. And for everyone else, thank you. Once again, head over to not only Paul’s site, but if you want to find out more about what’s happening with The MOVEMENT Movement, that’s www.jointhe movementmovement.com. You’ll find previous episodes, all the places you can find the podcast, all of our social media channels, et cetera. And if you have any questions or suggestions, anyone you think we should have a conversation with, including people who might think I have my head totally up my butt. And I’m been diagnosed with the case of cranial rectal reorientation syndrome, I’m happy to have that conversation, hasn’t happened yet but it’ll be super fun if it did. But you can drop me an email move, M-O-V-E @jointhemovemenmovement.com. But most importantly, just go out and have fun and live life feet first.

 

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