Dr. Mark Cucuzzella is a Professor at West Virginia University School of Medicine. As a US Air Force Reservist he designs programs to promote healthier and better running with the US Air Force Efficient Running Project. Mark has presented running workshops on over 50 military bases. You can view modules on his Efficient Running website. He has been a national-level Masters runner, having competed for over 35 years with more than 100 marathon and ultra-marathon finishes. Mark is a two time winner of the Air Force Marathon and has a marathon PR of 2:24. As well as being the race director of Freedom’s Run race series in West Virginia, Mark is director of the Natural Running Center, an education portal designed to teach healthier running. He is also the owner of Two Rivers Treads – A Center for Natural Running and Walking in his hometown of Shepherdstown, WV. Mark’s innovative work and story has been featured in the New York Times, NPR, Outside Magazine, Running Times, Runners World, Air Force Times, the Washington Post, JAMA, and other medical and media outlets.
Listen to this episode of The MOVEMENT Movement with Dr. Mark Cucuzzella about the importance of using the right barefoot shoes and eating the right diet.
Here are some of the beneficial topics covered on this week’s show:
– How barefoot running provides many benefits including better running form.
– Why you should transition gradually to minimalist shoes.
– How minimalist footwear helps strengthen your feet over time.
– Why it’s difficult to find funding to do studies on minimalist footwear.
– How proper running form involves posture, arm position, and rhythm.
Connect with Mark:
Guest Contact Info
Facebook
facebook.com/mark.cucuzzella
LinkedIn
Linkedin.com/in/mark-cucuzzella-25042413
Links Mentioned:
drmarksdesk.com
Connect with Steven:
Website
Twitter
@XeroShoes
Instagram
@xeroshoes
Facebook
facebook.com/xeroshoes
Episode Transcript
Steven Sashen:
If you are a barefoot or minimalist runner, you have probably tried to talk some of your friends into also becoming a barefoot or minimalist runner, and they have probably provided some resistance. Well, on the podcast today, we’re going to be talking to someone who might have met more resistance today you’ll ever hear about, and we’ll get into the specifics. But let’s dive in on the MOVEMENT Movement podcast in today’s episode. I’m Steven Sashen, your host for the podcast, where we will discover the truth about what it takes to have a happy, healthy body and strong as well starting from the feet first.
We’re going to get rid of the mythology, the propaganda, sometimes the outright lies that you might’ve heard about what it takes to walk, to run, to play, to CrossFit, to do yoga by letting your body move naturally. Hence, the MOVEMENT Movement. In fact, we’re creating a MOVEMENT Movement. We want natural movement to be the obvious, better, healthy choice the way natural food currently is, and we want you to be part of that community. And so, if you want to be part of that community, you know what to do.
Go to jointhemovementmovement.com, where you’ll find all the different places that you can interact with this podcast, and you can like and share and subscribe. And if you’re on YouTube, hit that little bell so you hear about upcoming episodes and leave reviews and all those things you know how to do. I don’t need to explain it to you. So, let’s jump in.
I’m very, very happy. Today is not one of my normal rant days. We get to talk to an old friend of mine, Dr. Mark Cucuzzella. And Mark, I don’t want to even do your intro because I won’t do it justice. So, do you want to tell people who you are, what you do, where you are right now, and then we’ll jump into the whole natural movement story with you?
Dr. Mark Cucuzzella:
Well, I’m in God’s country here, Steven, the other God’s country. You’re in Boulder? Still in Boulder? So, I’m in-
Steven Sashen:
Right outside of Boulder where I’ve got … Actually the problem with being in Boulder is you’re right up against the foothills. You don’t get to see them. So, we’re right outside. So, we have that incredible vista.
Dr. Mark Cucuzzella:
And away from all the people. So, I’m in West Virginia, so we’re a town of like 3,000 here. It’s what maybe Boulder used to be probably before you and I were born. So, I would say my claim to fame is I’m a friend of yours. I remember when we first met.
Steven Sashen:
Yeah, yeah. Blah, blah, blah.
Dr. Mark Cucuzzella:
Taking a ferry out to Governor’s Island at the New York City Barefoot Run.
Steven Sashen:
That’s true. My god.
Dr. Mark Cucuzzella:
I think that was the first time I met you. We talked on the phone for-
Steven Sashen:
Was that seven years ago?
Dr. Mark Cucuzzella:
I think it was more than that. I saw a picture that my kids looked about nine years younger than they do now. So, it was a while ago.
Steven Sashen:
Hold on. You may know this, but I’m-
Dr. Mark Cucuzzella:
2010 or 2011, something like that.
Steven Sashen:
Yeah, I’m going to confess to something that I did there. So, I wanted to be one of the sponsors of the New York City Barefoot Run. It was the first big barefoot run that anyone was-
Dr. Mark Cucuzzella:
And you just had your little do-it-yourself kit then.
Steven Sashen:
Well, all we were selling was a do-it-yourself kit, and I wanted to be one of the sponsors and the guy who was putting the event on who’s now a friend of mine, said that I couldn’t be because one of our now competitors was already a sponsor and was actually a good friend of his. And so, they didn’t want me there competing. So, I just showed up with a suitcase full of do-it-yourself sandal kits and was just selling them underneath a tree.
Dr. Mark Cucuzzella:
Yeah, I remember. Oh, gosh.
Steven Sashen:
And then they slapped my wrist, “You can’t do that.” And I just totally feign innocence. I went, “Oh, really? Oh, man, I didn’t know.” I totally knew. I was just trying to get in there and do what I could. So, I was hustling. That’s what I was doing. I was hustling.
Dr. Mark Cucuzzella:
You were hustling. And I learned about your sprinting days. So, I got to learn a little of your backstory. If you’ve disclosed you’re a standup comedian, I’m like, “How in the hell did you get into this field,” because your videos at that time that’s some funny video.
Steven Sashen:
I’m the one interviewing, I’m not going to be answering questions about me. So, let’s do you on that. I mean, well actually, I’ll do the quickest how. The quickest how is simple. I got back into sprinting. I was getting injured. Someone suggested I try running barefoot. By doing that, I learned why I was getting injured and how to stop getting injured. I wanted to have that natural movement experience as often as I could. So, I started making sandals based on this 10,000-year design. I had 10,000-year-old design idea. And then you remember Michael Sandler, right?
Dr. Mark Cucuzzella:
Yes.
Steven Sashen:
So, Michael had a book that was coming out called Barefoot Running, and he said, “If you had a website, I would put you in the book.” So, I rush home and I pitched this idea to my wife who tells me it is a stupid idea that won’t work. And I said, “Yeah, you’re probably right.” So, after she went to bed, I built a website. And here we are nine and a half years later.
Yeah, it’s gone from a do-it-yourself sandal kit to a wall full of shoes and sandals that people use for everything from taking a walk to running ultra-marathons and speaking of the wall full of shoes and sandals, wait until you see the new stuff that’s coming out for 2020. And for those of you watching or listening, Mark will have access to this before you do because he’s going to be at certain trade shows. But dude, this stuff is super, super amazing. But again, enough about me. So, I introduced you as a doctor. What kind of doctor are you? Tell the humans.
Dr. Mark Cucuzzella:
So, my day job is taking care of hospital patients in a small rural community hospital where 24 bed, it’s called a critical access hospital serving a rural community. Then I also do a lot of work with type 2 diabetes, kind of in the same way you and I are trying to fix people’s feet and get rid of the injuries. I try to fix what they eat. Diabetes isn’t really druggable, but it’s foodable so we try to treat them with food. This is type 2 adult type diabetes. Type 1 is different. So, we have a whole cohort of people here getting rid of sugar, which should be pretty obvious, losing weight and coming off of medication. So, it’s a little disruptive.
Steven Sashen:
Talk about disruptive weight, I’m going to hit you with this question then that came out of nowhere. So, what do you know about and what do you think about the rice diet and wait-
Dr. Mark Cucuzzella:
I’m not sure what the rice diet is. Are we talking just rice as in rice product or does rice stand for something like R-I-C-E?
Steven Sashen:
No, you got to look this up. So, the rice diet was, and there’s a woman who Elaine and I adore named Denise Minger, M-I-N-G-E-R. She wrote a book called Death by Food Pyramid.
Dr. Mark Cucuzzella:
Yes. I’ve heard her speak.
Steven Sashen:
Denise was the bell of the ball in the paleo and low carb community because she was a diehard raw food vegan in her teens and then was having a bunch of problems. And then she-
Dr. Mark Cucuzzella:
Disaster.
Steven Sashen:
Right. She went the exact other way. And then of course was eating just like nothing but meat and everyone loved her. And Denise is a smart science researcher. So, she decided to look into counterfactuals opposite stories of what people were telling to see if there was any validity to them. And one of the things she looked into was the rice diet. The rice diet was something that was administered, I don’t remember the guy’s name. He was at Duke University, which is where I went.
Well, I’ll cut to the end of the story. He was kicked out of this and they stopped really doing the rice diet because this particular diet that I’m about to describe is so difficult to stay on that he was literally whipping people to keep them on the diet. Now, while I was at Duke-
Dr. Mark Cucuzzella:
Does not sound like a good idea for my patients.
Steven Sashen:
No. No, no, no. But wait, but we’ll get to the interesting part in a second. While I was there, one of the people who was there to do the rice diet was Buddy Hackett, the comedian, Buddy Hackett. And he one day in his big Cadillac drove over my foot as I was going through a crosswalk and he ran the stop sign and ran over my foot. There were Domino’s Pizza guys who were making $1,000 a night by surreptitiously delivering pizzas to people on the rice diet. But that’s not the important part.
The important part is the rice diet. And I might be getting this a little wrong, but the gist is correct. All you eat is white sugar, fruit juice, and white rice.
Dr. Mark Cucuzzella:
Sounds disaster.
Steven Sashen:
Yes, it sounds that way, but it was the exact opposite. It cured people, literally cured people like morbidly obese, type 2 diabetics cured them of diabetes, dropped them down into reasonable BMIs. I mean, people who went from 400 pounds to 150 pounds, kept it off, had no problems afterwards. And the fundamental idea is that it was basically forcing your pancreas to go, “Oh, geez,” and start working correctly. But it’s definitely not for everyone. Really, really hard to be on.
But her point, the point that she makes in actually a blog post that she did on her blog, and I don’t remember the name, but you’ll have to look up Denise to find it, is that she has this theory that what works for human beings when it comes to diet, especially when you need a big intervention for health reasons, is either going extremely low fat or extremely high fat. And the in-between thing is where we have problems. And I know that you’re a low-carb, high-fat dude.
Dr. Mark Cucuzzella:
No, I would actually agree with Denise and I think it would make sense. So, basically, if you did anything to someone who’s eating the western diet, which is two thirds of it is processed oils, vegetable oils, added sugar and refined flour. So, anything you did to detox you for 30 days, 60 days. So, you could not eat, you could eat meat, you could be a vegan, whatever you did just to get you out of that mess. But then ultimately you got to eat food again.
Steven Sashen:
Absolutely.
Dr. Mark Cucuzzella:
Your stomach has taken out, right? Same thing.
Steven Sashen:
Absolutely. This is the interesting thing about the rice diet is that they maintain these results once they transition back to regular food. And I can tell you something from my experience just for the fun of it, and again-
Dr. Mark Cucuzzella:
It may have broken their food addiction, like when they transitioned back to real food.
Steven Sashen:
Probably, probably. I’ll tell you something fun. So, as a sprinter, I don’t know any sprinters who are on low-carb diets or any power athletes who were-
Dr. Mark Cucuzzella:
I don’t think they should be.
Steven Sashen:
Right.
Dr. Mark Cucuzzella:
Power.
Steven Sashen:
I’ve never heard of one, never met one. The only time I went super low carb, I called the guy who was monitoring me while I did it after a couple of weeks and I said, “Hey dude, I just did something in a workout that I’ve never done before.” He goes, “What’s that?” I said, “Bailed. I couldn’t get off the floor.”
Dr. Mark Cucuzzella:
Oh, hell yeah. Yeah. You’d have a very difficult time doing a glycolytic workout.
Steven Sashen:
Exactly. But about a year and a half ago, I deliberately went on a very high-carb, very low-fat diet just because it’s closer to what I’ve been eating my whole life anyway, and I was curious and it had a really surprising side effect. I completely lost my desire/cravings for sugar. Yesterday was my birthday. They brought me all these cakes. I’ve had slivers because it’s just too much, which is really interesting. And I’m not on that diet any longer, but that was a year and a half ago and something changed in my system from doing that. It was fascinating. But that’s not why we’re here. Although that was really fun.
Dr. Mark Cucuzzella:
So, eat real food. So, the bottom line for those less.
Steven Sashen:
Absolutely, eat real food.
Dr. Mark Cucuzzella:
You don’t have the junk food and the rest of it, it all sorts itself out, but you’re someone who’s on the more lean, insulin sensitive side. So, you’re a well person. When you take people who I see are on the sick spectrum, they’re a little bit different than you metabolize the sugar, Steven. So, they have to kind of experiment a little different. They’re already so far down the road of sickness, their reset is a little bit tougher.
Steven Sashen:
I know. We can do that all day long.
Dr. Mark Cucuzzella:
But we could talk about more of the running stuff and shoes.
Steven Sashen:
Well, to that point, so your day job is playing doctor, but also, you have another day job as well, which involves the location that you’re in right now. So, would you tell the humans about that?
Dr. Mark Cucuzzella:
Yeah, so this is part of my job, too. So, I do a lot of sports med, running rehab, gait analysis, trying to get people to solve their plantar fasciosis, resolve their running injuries. And we have a store here called Two River Treads. We’re at year nine now, which is kind of cool. So, we were the first store, I think there’s none other kind of popped up on the radar. So, we were the first store that really opened as a true natural footwear store. Meaning when we opened was kind of when you started your business and we started chatting because we had no shoes with elevated heels, narrow toe box, structured shoes.
So, all the shoes that we opened with worked functionally with a human foot. So, some were more minimal than others. So, when we opened, I think Vivobarefoot was around. Vibram was just starting to kind of get on a rage. Newton Running was around. Saucony made a shoe called the Kinvara. New Balance made a shoe called the Minimus, and that was it. That was the wall.
Steven Sashen:
That was it.
Dr. Mark Cucuzzella:
And then Lems came along. They used to be called Stem. So, that was the first lifestyle shoe. Then the sandals started coming along, Luna and you guys, Xero Shoes. So, yeah, now it’s all the wall’s full of multiple brands. And within brands like your spectrum, you got the boots and the lifestyle shoes and the sandals, but all built on the same principle.
Steven Sashen:
Well, one of the things that I’ve noticed, and I’m curious what your take is from the retail side, when you talk about the Kinvara, which is gone, when you look at the Minimus, which has changed from what used to be a good minimal issue to not, what have you seen from the retail side about how brands are dealing with the whole idea of true minimalism and how the general public is?
Dr. Mark Cucuzzella:
Yeah. So, I think everything pendulums kind of shift from one direction to another and then they end up back in the middle where they should be. So, when we opened our store, not everyone was convinced the world should be super minimal and I wasn’t either. A lot of people do need some protection, but everyone needs to strengthen their foot. So, the Kinvara had cushion. Newton had cushion. Some folks were dabbling in Vivobarefoots, which had a shoe called Evo, which had no cushion. Minimus had a little cushion.
So, you’d see where people are and what their goals were. We never put people coming out of a big bulky Asics Tiger into a FiveFinger. That would be silly to do that. And I think that’s where people had trouble.
Steven Sashen:
Well, I’m going to pause there because this is a conversation I’ve had with Irene Davis as well. And Irene actually will put someone into a shoe like ours right away, except that she’ll do it after they’ve done a bunch of strengthening a bunch of other things first.
Dr. Mark Cucuzzella:
Exactly. Do it correctly.
Steven Sashen:
Yeah. Well, that’s it in my argument again. In fact, I did an episode about this, that the whole idea of transition shoes is just complete nonsense that was made up by companies who weren’t going to go to a true minimalist shoe and they wanted something to sell. They wanted to capitalize on this idea so they made up this concept of transition shoes.
And from my experience just now with hundreds of thousands of people, if you do, you can make that switch directly. But you just need to build up slowly. And I don’t want to say intelligently, you just need to be paying attention rather than just, “I’m going to put on a new shoe and away we go.” In fact, this is kind of begging the question that I asked you is that one of the things that I noticed is that some of the bigger brands, including Vibram, they kind of positioned the whole idea of natural movement as, “Just put on this new shoe, you’ll be fine. Everything will work great.”
Dr. Mark Cucuzzella:
Yeah. You need training. Exactly. So, what you’re saying there is actually really important. So, I would do exactly what you said. So, the people that were broken ran horribly, shin splints, stress fractures, I would get them to try to run completely barefoot on the street.
Steven Sashen:
Yup.
Dr. Mark Cucuzzella:
Not a lot, 50 meters. That’s the only way to really retrain the gait. But then say you had someone who came in who was an efficient runner, already wasn’t hurt, was in a big bulky shoe and preferred a little cushion. Sure. They just pick what’s comfortable. But if someone really had injury issues and wanted to fix those injury issues, you can’t just put a transition shoe on and hope it all goes away. Yeah, they really need to. That’s how I discovered it, too. You’ve seen me running. I’ve run barefoot on the streets and it teaches you something every time you go out because your feet give you messages.
And then you see what does the person want to do. Not many people are truly willing to just … They’re all type A, Steven, as you know. Okay. I know you’ve had eight stress fractures in the last year. I want you to run 15-minute miles barefoot as slow as you can.
Steven Sashen:
It makes them crazy
Dr. Mark Cucuzzella:
Like you’re crazy. Then they do it and then they’re like, “Oh, my god, this works.”
Steven Sashen:
Well, it’s funny, the story that I used to tell, I haven’t told it in a long time. It’s been so long that I’m blanking on the name of the woman. It’s a couple here in Boulder and they’re both Olympic distance runners and when she had I think two kids, maybe three kids, and then after having kids went back and became an Olympian again.
And when she was pregnant, some people keep working out when they’re pregnant. She just couldn’t. She would just take the whole time off. And after she would have the baby, she would get back into training again. And the first month was just walking and then the second month was walking interspersed with really slow long distance, not even very long, and it would take nine to 10 months just to get back up to speed again.
It’s like if this is what an Olympian does to get back to up speed, why do you think you can do it way better, faster, and different? And people just think that they can make these massive changes instantly. And granted, there are a couple of people who do and they just ruin it for the rest of us. But it is amazing that people are … The lack of patience is fascinating. It’s like, “I’ve been doing it wrong for my whole life, but I should be able to figure this out instantly.”
Dr. Mark Cucuzzella:
Yeah, and we really try to teach patients similar to folks who need to lose weight. They need patience and do it correctly. But that was probably Kara Goucher up there with Adam Goucher because she lives in Florida.
Steven Sashen:
No, it wasn’t Kara. It wasn’t Kara.
Dr. Mark Cucuzzella:
All the Olympians live up there.
Steven Sashen:
I know. Dude, when I go to the track-
Dr. Mark Cucuzzella:
Training your ligaments, too. After pregnancy, all the fascia is loosened just that easy, slow jogging versus walking. You’re training that spring again, but adding very low stress. So, that adaptation. But then when they finally decide to dial it up, the fascia’s ready to go and they won’t get hurt. So, that probably does take a year, I would guess, after delivering a baby to get everything back to normal tension like for fascia, because it’s all detentions. The interesting research experiment, when is the fascia back to the point that it could take the stress that it did prior to pregnancy in the same way?
Steven Sashen:
And I wonder if it could be accelerated with something like prolotherapy or anything where you’re-
Dr. Mark Cucuzzella:
Just healthy diet, eat bone broth, stuff for your collagen. I don’t know.
Steven Sashen:
Interesting. So, one of the question in this same vein, what was your experience and also what’s your take … So, let me try this in a different way. So, one of the things that really put a crimp in the whole idea of natural movement was of course when there was the class action lawsuit filed against Vibram because they made an unfounded medical claim saying these things wearing these will make your feet stronger, which there wasn’t some explicit study that showed that, but there was enough dots you could connect where obviously, if you’re going to use your feet, they can get stronger. If you don’t, they get weaker.
Dr. Mark Cucuzzella:
And there actually are studies now showing that, which is interesting.
Steven Sashen:
I know. I know. Well, there actually was then, too. There was a study that came out years before Vibram on the Nike Free, which was about as minimalist as a pair of stilts, but regardless, it was more flexible than previous shoes. And the study showed that by wearing that shoe, you built intrinsic and extrinsic foot muscle strength compared to a regular shoe. And I think that’s probably one of-
Dr. Mark Cucuzzella:
Yeah, it was an advertising error. And unfortunately, I mean they didn’t lose. They just settled. They didn’t lose.
Steven Sashen:
Exactly. No, I never said they did.
Dr. Mark Cucuzzella:
They weren’t wrong. They didn’t lose. But the media took that in a way that was completely opposite and it was a minuscule amount. I mean, I forgot what it was.
Steven Sashen:
It was $3.75 million after about a year and a half. And so, it was absurd. And my theory, and I talked about this in a previous episode,
Dr. Mark Cucuzzella:
That’s nothing in a lawsuit for a major company.
Steven Sashen:
Pennies. Yeah, the toning shoe, the claim that if you wear these toning shoes, it’s going to make your butt look better, I think that case settled.
Yeah, it was settled for like $120 million. So, whole different game. But regardless, I’m curious, obviously I now know what your take is on the case itself, but what did you see, again, since you have a retail facing presence, what did you see as a result of that and how have you dealt with that? Because people still bring it up.
Dr. Mark Cucuzzella:
Yeah, and it didn’t really affect our business, Steven, because just as we were chatting, we just basically try to teach people how to run. And I’m out here in West Virginia, so I mean people aren’t following the Google search minimalist blogs. They just come in and want to get in a shoe and they don’t come in … What’s kind of nice about being here is I don’t think I’ve ever had some … Because we’re not like in suburbia running culture where no one’s come in and said, “I’ve always worn Asics or I’ve always worn this.” They just try on shoes. They’re not so brand wedded.
Yeah. And I mean maybe, I don’t know if someone said this, “Trust me, I’m a doctor” or something. I’ve seen that on people’s shirts. And for some reason, our staff here, they’re well-trained, highly-educated staff. And so, we take time with people. We listen to them. We look at their feet. We show them where their problems are. They try shoes on. And if they don’t like it, they can bring it back in 30 days. So, I mean, I think that’s how it worked. It didn’t really affect us at all. I think what we’re doing was right. And it’s no different now than it was nine years ago because this is all just the basics.
Steven Sashen:
It’s interesting the-
Dr. Mark Cucuzzella:
Work on posture, work on your gait, slow down, don’t train so hard.
Steven Sashen:
Oh, my god. I try to get runners to take one day off and do some strength training and they act like I’m telling them I want to sell one of their children.
Dr. Mark Cucuzzella:
And I do my strength training and we have kettlebells here in the store. Heck yeah. Learn all that.
Steven Sashen:
I made a video. I’m going to have to point you to my favorite new exercise device. We have one here in the office. It’s called the kBox. It’s an Exxentric flywheel device. Have you seen one of these?
Dr. Mark Cucuzzella:
No. No.
Steven Sashen:
Oh, super cool.
Dr. Mark Cucuzzella:
Would be cool for my store? We’re always looking for cool stuff.
Steven Sashen:
Oh, it would be very cool in the store. We’ll talk about that after we get off the show. Yeah, it’s super cool in the store because it’s … Well, we’ll get into that. That’s a whole other-
Dr. Mark Cucuzzella:
Okay. If it fits in your backpack and take it.
Steven Sashen:
Not quite.
Dr. Mark Cucuzzella:
Not quite.
Steven Sashen:
But it fits in the backseat of your car and gives you all the resistance you could possibly need for all the exercises you would want to do.
Dr. Mark Cucuzzella:
Oh, man, I’m in. Let’s talk.
Steven Sashen:
Yeah, they’re super cool. We’ll talk. So, onto other things. So, one of the other things that I know you do rather than just asking you about this, and this is the teaser that I did at the beginning of the episode, you have done a bunch of work with because … Oh, so let’s back up. Not only are you a doctor, but you have military credentials.
Dr. Mark Cucuzzella:
Yeah, just retired after 29 years.
Steven Sashen:
Congratulations, Air Force doc. And I know that because your email has that built into it. So, one of the things that I know that has been a big concern/mission of yours is to get people who are in the military for whom running is a big deal to do that safely, more effectively, more efficiently with fewer injuries. Can you chat about that?
Dr. Mark Cucuzzella:
Yeah, actually I just wrote a book, it came out last year called Run for Your Life and that would explain the whole story. But yeah, injuries in the military, whether it’s Air Force, Army, Navy, Marines, the musculoskeletal injuries are huge, costing the taxpayers, you, listening, billions and billions of dollars of direct cost of the care and lost duty days, early retirements, disability payments, and it’s all self-inflicted. Meaning if you go to combat and you get injured, I mean that’s kind of the cost of doing business.
But if we’re supervising you being hurt, doing physical training, we call it PT, physical training, but most of these injuries are happening under supervision of cadre leaders, fitness trainers. So, it’s broken. And I kind of went on a six-month assignment. They assigned me, left my job for six months to kind of dive into the fitness test, the failure rates, the injuries. And I came into that with some hypotheses and I learned a lot of new things, because I wanted to just throw everything away that I thought was true and kind of look at people I traveled to like 50 bases, but I describe it in the book.
But it’s all the basics of what we teach here. Slowing down, aerobic development, proper form. We’re still working on the shoes and we’re getting really close. I have a good colleague down at basic training. So, now we’re looking at getting a neutral shoe with a little drop and a little bit of cushion and lightweight. So, we are close because the military still gives these 18-year-old enlistee, this big 15-ounce bulky trainer that’s posted and you would hate it. I couldn’t run a step in the damn thing. And we wonder why they hate to run.
Steven Sashen:
So, this is the thing that I was teasing at the beginning. I mean, you would think that given the literal and figurative cost of all of these injuries, that the military would be highly, highly motivated to make a change for something that works. Now, I’m going to throw out a quick thing. I know that Irene Davis, who’s a mutual friend of ours, who’s a doctor at Harvard, Irene was trying … She’s great.
Irene was trying to get funding for a study through the military about to see if switching to minimalist footwear would be helpful and they wouldn’t give her grant money. It’s like, “Why wouldn’t you want to spend a couple of dollars to find out something that could be better for people?” And they didn’t do it. So, again, you would think that they would be highly motivated to find better solutions, but that doesn’t seem to be the case.
Dr. Mark Cucuzzella:
You would think. But this is how it is really I think in any institution, whether it’s in healthcare, large hospital systems, the DOD, the US Military. Changing institutions is very difficult. What does it take for an institution to change? I mean, I think that’s the unanswered question. So, if you take million Army troops that do this this way and this is the way it’s always done, for that kind of big … It’s like turning a school of fish.
Steven Sashen:
Right.
Dr. Mark Cucuzzella:
It’s slow change. So, you and I are like, “Why didn’t this happen yesterday? It’s crazy. Look at the data. All these people are getting hurt.” But you’re talking about changing an entire culture.
Steven Sashen:
Yes, so?
Dr. Mark Cucuzzella:
Yeah, I’m like that. But it’s cool because now, we have made change in basic training. The footwear is the last domino to fall. So, they slow down dynamic warmup. We teach running form. All the stuff that you and I are teaching outside of, we don’t have the right shoe there yet. But man, that’d be the holy grail. Forget the shoe.
And then we start to look at data. Then, okay, well what are we doing? Is this helping? Because you got to get data, too. But yeah, people are listening. It’s just not as fast as you would think. That’s why it’s working at a small hospital is nice. We got sugar drinks out of my hospital. It’s a 24-bed hospital. But if I walked into a 3,000-bed hospital and wanted to do that, they’d throw me under the bus. I’d be like taking away their human rights or something. But it’s all wisdom of the crowds and the people that help change.
Steven Sashen:
It’s interesting. One of the things that I found, and I’m curious if you’ve had the same experience, is the one place where I’ve had no resistance. And what I mean is that I just keep hearing from this particular group of people over and over about how they made the switch to minimalist footwear and even our original do-it-yourself sandal kit is special forces. Those guys are like, they can do whatever they want. They recognize it. And I’m amazed that it hasn’t just filtered down from them given their experience.
Dr. Mark Cucuzzella:
A little bit. But you have to look at those folks, and I’ve worked with them with running clinics. So, they’re elite athletes, perfect form, perfect strength, perfect biomechanics. They could deadlift you and I and your wife.
Steven Sashen:
Dude, I could deadlift you and I and my wife.
Dr. Mark Cucuzzella:
Okay, I can’t, but they would … Okay, think of Jeff Vernon.
Steven Sashen:
That’s a whole different story. For people who don’t know, Jeff Vernon is a friend of ours from TrueForm Running. They make this awesome curve, non-motorized treadmill. And Jeff is a beast.
Dr. Mark Cucuzzella:
280 of pure muscle.
Steven Sashen:
Yeah.
Dr. Mark Cucuzzella:
You and I stuck. Yeah, so these guys move perfectly. So, they move perfectly. So, the Vibram FiveFinger or whatever type and that Silstar, there was that one picture of the, I think it was a SEAL or some other special ops guy jumping out of the helicopter with his dog in the FiveFinger. Maybe we could find that one and post it in and out of water.
So, that shoe, the original KSO was like the rockstar shoe for those guys because all they do is they ask the person who has survived X number of missions, “Hey dude, how do you do that? Why are you wearing those FiveFinger things?” He explains it simply, “Well, they make my feet feel good. I can run through water and knock it shot.”
But look at, there was an article yesterday in the Military Times about the military now looking at low-carb diets. So, which group of the military do you think have been on low carb, paleo type of diets since before the word “paleo” even existed? The special forces guys, because that’s how it works. So, they just ask the cadre, the guy who’s the senior instructor now who has been on X number of missions.
And it was fun talking to those guys seven or eight years ago on this topic because you just, “What do you guys eat when they drop you out of a plane and you got to go mark a target and come back,” and maybe that’s two weeks later and they carry nuts and jerky and things like that. They didn’t understand that well, that’s like a low carb keto thing.
Steven Sashen:
Yeah. They just needed the most calories in the smallest amount of space.
Dr. Mark Cucuzzella:
Yeah. And they didn’t understand that ketones gave you mental clarity. They just knew that it worked for them and they weren’t hungry or hangry when they have to have … I mean, yeah, they have to have this immense attention and clarity, but yeah, it works for them. But now they’re looking, Jeff Volek is studying that, but that’s not a study. They’re just individual. But everything is learned from human experience and science matches up. It’s just physiology. But again, they’re different animals.
If I took an 18-year-old new recruit, how do you think those guys move? Do they move like a SEAL or do they move like your average high school kid who’s worn big, bulky shoes? They run horribly. So, those folks need to be trained. And it’s hard to train a thousand people at a time in running form. They have 12 TrueForm Runners now at Air Force basic training, which is really cool. Each division will run on the TrueForm.
Steven Sashen:
So, when you’re working with them or when you’re working with people in your store, and I’m going to ask you to modify this slightly for people who are watching/listening, what do you teach people or how do you teach them to make the gait adjustments that are basically back to what’s natural? What people have actually done is gone from natural to something unnatural and now they’re unlearning and relearning. So, what’s the process that you do for that?
Dr. Mark Cucuzzella:
Actually, pretty damn easy, not to be an advertisement here for TrueForm. I’m not funded by them in any way, but we give people some cues. We teach them posture. We teach them arm position. We teach them rhythm, just the basics.
Steven Sashen:
So, let’s pause there. So, talk about when you say teach them posture and teach them arm position, say more about what that is specifically.
Dr. Mark Cucuzzella:
Yeah, so running. So, think of if you had a really tall one of those really long foam rollers, like what the 36-inch foam rollers. If you throw it down to the ground, it’s going to ping bounce back up nicely. If it’s all bent and grumpy, you throw it down to the ground, it just doesn’t come back, or a super ball. So, a good posture is going to be the body’s in alignment starting at the feet, jumping ropes. So, think of if you were to jump rope as effortlessly as possible, you don’t want burn calories jumping rope. Just imagine you had to jump rope for two hours, what’s the most efficient position? And you’ll find it.
But it’s just tall and a lot of people are in that backseat because they’ve been wearing heels. So, they’re in that kind of shoulder back position. So, we kind of teach them and to compensate a little bit forward, which feels weird, but they have to feel that. So, teach them the basics of posture.
Rhythm is just the spring. So, we get them jumping rope. Now, if their feet are all kind of jacked up and the toes are caved in and the arches are collapsed and they hit the ground here, they’re kind of like that. So, okay, let’s get your foot in a better position. Let’s widen out your toes. Short foot posture, now spring. Okay, now how that feel? That’s the rhythm.
Arm position’s pretty easy. We even use this little sling. It’s like a little yoke that attaches your thumb almost right to your chest. As soon as your arm flies too far in front and I’m sprinting it probably you need to because you’re generating power.
Steven Sashen:
Actually, no. If you look at sprinters-
Dr. Mark Cucuzzella:
Keep your hands tight sprinting like tight.
Steven Sashen:
You look at sprinters, the final hand position is, I mean they call it cheek and it’s literally-
Dr. Mark Cucuzzella:
Okay, same thing.
Steven Sashen:
So, it’s very similar. Actually, it’s a little different because with distance running, it’s similar in kind of where your elbows are because of the amount of force that you’re generating or sprinting, don’t want your elbows coming too far forward, but your hands are basically coming sort of up here more rather than-
Dr. Mark Cucuzzella:
Driving a little more. Yeah, we’re just trying to teach people to … Irene David puts a great land soft and land stable. So, you want to kind of soften the landing, but you have to be stable. So, we get them to get that body position. But then we put them on the TrueForm Runner and for those we could link to it, but it’s a little slightly curved treadmill. It doesn’t have a motor, so you have to make it go. So, if you overstride, think about, you got a little curved treadmill, Fred Flintstone style, you have to make it work.
If you’re super tight in the hips or you’re overstriding, it just comes to a stop. You can’t make it work. So, then just like maybe you’re going to a driving range, you can’t watch a video and go hit the ball. You got to go slow and practice and you got to feel it yourself. So, we start people super slow, make a few adjustments, and they usually, “Whoa.” They’ll find it. You get out of the way. Don’t over coach them. Give them a few cues. Get them to try to fire their glutes. Open their hips.
So, if they can’t make it move, we’ll use the little sled drill where you attach a bungee to their waist and get them to sprinting drill, like drive away. So, that, okay, you feel that using the glutes. Or if they’re super tight in the hips, we’ll have them do some mountain climbers. Now, get back on the TrueForm. You’re trying a few little tweaks.
Steven Sashen:
So, I’m going to pause there and just highlight something. So, what you’re just talking about with mountain climbers and the sprinting drill for people who are listening/watching or back to the whole idea of firing your glutes, it’s an amazing thing. One of the biggest muscles in your bodies, your glutes and then your hamstrings, your lats are also there, too. But ignore those for a moment. These are things called prime movers. They are the things designed to make you move and for many reasons, it’s the one set of muscles that people don’t seem to use when they try to run or walk even.
And it’s not that you can’t, it’s just that you’ve sort of turned it off enough and you need to feel that again to have that sense of, “Oh, that’s what it means to use these things.” And so, both of these drills, the only way you can move forward if you’re having some resistance, you have to lean forward and you have to push out of the back. If you put your foot too far in front of your body, you can’t pull hard enough. These muscles are designed for pulling.
Dr. Mark Cucuzzella:
Like in pulling a tire. We even have a little tire with a little strap, like a webbing strap. And this is fine. Just put it out on the curb and kids can-
Steven Sashen:
No, no. You just made me think of something. The last time you and I saw each other at the running event, this trade show for running shoe stores, there was a guy opposite me who had a tire to drag and he had-
Dr. Mark Cucuzzella:
Oh, really?
Steven Sashen:
Yeah, he did this elastic thing that made it so it didn’t bounce too much. And I watched all these distance runners who could barely pull the thing. And so then I had him give me the heaviest tire that he had, and I’m a sprinter and it’s like wing and just not a problem.
Dr. Mark Cucuzzella:
Yeah, he could sit in the tire and you would still pull.
Steven Sashen:
But again, it was just because for sprinting, you have to use your glutes and your hamstrings. There’s no other way. But there’s a lot of people who are distance runners who are, they would call themselves accomplished runners. They’ve found a way to move.
Dr. Mark Cucuzzella:
Yeah, they’ve compensated,
Steven Sashen:
They’ve totally compensated and they’re not-
Dr. Mark Cucuzzella:
They need another gear. These people have another gear. They could get so much better.
Steven Sashen:
Yeah, agreed
Dr. Mark Cucuzzella:
If they wanted to. I mean, people come into the running store just wanting to get healthy, get off medications. They could care less about using their glutes in their 5K time, but then another group actually wants to get well and compete and win. So, I just want everyone not to get hurt. And when people run correctly, it’s more fun. It’s like, “Wow, this is fun.”
Steven Sashen:
Well, in terms of not getting hurt as well, I mean it’s another reason to actually learn to use your glutes since that’ll support your lower back. And so, for people having back injuries, actually using your body correctly can help with that as well. These things work if you let them work.
Dr. Mark Cucuzzella:
They work.
Steven Sashen:
What a shock.
Dr. Mark Cucuzzella:
Yeah. So, people should just check out. I think the TrueForm Runner now has a model that’s a little less expensive. It’s the same kind of quality, but it’s a little more light that you could have for a home TrueForm. We’ve had several people purchase them for home through-
Steven Sashen:
Yeah, I was actually talking to Jeff about that just the other day. In fact, I’m trying to get him to give me one. But yeah, it’s a great device and it is one of those things you get on it. And if you’re not putting your body and your feet in the right place, it clearly feels wrong. And then when you get things aligned, it suddenly gets easier. It just feels more fun. I mean, it’s a really great thing.
Dr. Mark Cucuzzella:
Then go outside. I think, gosh, I mean everyone had something like that who was having issues run for three to five minutes on the TrueForm. Just like you’re going to a driving range, get the seven iron blade and just get your swing dialed in, then pull out the big Bertha. So, just warm up on it, get the rhythm. And then most people, I prefer being outside then go outside. But it’s a good thing to do that with, too.
Steven Sashen:
There’s a guy that I talked to a couple of weeks ago, a friend of mine here in town named David Clark, who’s a crazy amazing ultra runner. And he did a 48-hour run on a treadmill and it was just on a regular treadmill. I can’t remember. I think we talked about TrueForms and I know he’s used them and loves them, but I wonder what it would’ve been like if he’d done that.
Dr. Mark Cucuzzella:
It’d be hard. It’s a little more work on the TrueForm.
Steven Sashen:
It takes a little more effort, yeah.
Dr. Mark Cucuzzella:
But that’s part of it. You can actually get a lot of work without a lot of load. So, say you really want to do some strength running without loading, and there’s a guy in South Carolina actually got some data on it. So, the faster you go with that, yeah, you use a lot of metabolic equivalents, but the load on your joints compared to going to the track and running 200 meter repeats, far less.
Steven Sashen:
Well, it’s also, like you said, since you are the one moving the treadmill, even with perfect form, it’s not just gravity making it move. You’re having to use your glutes and your hamstrings. And the first time I was on one of those, I got off and banned my whole posterior chain from my calves through my hamstrings through my butt. It was just on fire. If he doesn’t send me one of a free treadmill after this contest, I don’t know. I don’t know what’s going on.
Dr. Mark Cucuzzella:
Maybe he send you a little demo there for your studio or something.
Steven Sashen:
Yeah. Well, we’re doing a little renovation, so we’re going to have some room so we can get people on things like that. We’re really excited about that. So, anything else you want to add?
Dr. Mark Cucuzzella:
trade some shoes.
Steven Sashen:
Dude, he’s already got five pairs of my shoes, so that’s the easy part. We’ll think of something. Anything else that you can think of in terms of just the tips and tricks for getting started with really starting to understand and experience natural movement?
Dr. Mark Cucuzzella:
Yeah. So, the other thing, if you’re not afraid to do it, and I don’t think anyone should be, so we’ve got this beautiful smooth sidewalk right in front of the store. They just did a whole streetscape thing. It’s part of the reason we moved our store here from our past location and today is a beautiful day. Take your shoes completely off.
And we do a lot of little run clinics and just go run softly down the sidewalk in your bare feet and people start smiling. It’s like, “Wow, this is cool.” It just shows them that they can land painlessly in their bare feet, but they go super slow. So, it teaches them like two lessons. For one, it’s okay to do this just down to the curb and back and super soft and it’s super fun.
Steven Sashen:
You hit my favorite thing. I often say, “You can spot a barefoot runner from a mile away because they’re smiling.”
Dr. Mark Cucuzzella:
Yeah. If they have a grimace on … If someone has a stress fracture, wouldn’t make them do it. But most people who are just learning how to run, again, a little plantar fasciosis, they can do that.
Steven Sashen:
I want to come back to plantar fasciosis in a second, but before I do that, the whole idea of running and landing softly, Irene and I talked about this. I’ve seen people do something that I never imagined they would do. They’ve read or heard somewhere that you’re supposed to land on your forefoot. So, the thing that they figure out about how to land softly while landing on their forefoot is still reaching their foot way out in front of their body and pointing their toes and kind of gently getting their foot down, but then kind of pulling the ground underneath them. I’m assuming you see the same thing, and I’m curious what you do.
Dr. Mark Cucuzzella:
I think, people just will learn. They just need to practice. The body will teach them. So, certainly if you had even a minimal shoe on, you could stab into the ground really hard while moving forward and create a lot of friction and friction’s bad. But if you had a shoe on, like everyone who has wear patterns on their shoes are creating friction. But if you take your shoe off and imagine we’re going like 10 minutes a mile or something and you’re going forward at 10 minutes a mile and you stab your foot into the ground going forward, you’re going to leave some skin on the pavement.
But gently just let that foot land softly and just get a little bit of push back. You’re kind of bringing it back at the speed you’re going forward. You can’t overthink this. You have to feel it. Your body will naturally just let your foot do the right thing, but you just have to go do it. But start really, really slow, really, really slow.
Steven Sashen:
Yeah. I say 20 seconds, 30 seconds tops.
Dr. Mark Cucuzzella:
Yeah. And they feel it and let the heel come down. Don’t prance, just let the heel come down, whether you touch gently and roll from the heel or touch gently on the forefoot and then your heel touches. I don’t think there’s any one place. The best runners have the most variability when they film them through races.
Steven Sashen:
Well, I’m going to argue that one because I mean, there is variability, but there’s two factors to that. One is that a lot of these runners are training in a higher heeled, padded shoe and then racing in a racing flat. So, they’ve already developed a certain movement pattern. And the other thing is just when you look at video analysis, it’s very deceptive because watching where someone lands on video is very different than what happens on a force plate where you see where they’re actually applying force-
Dr. Mark Cucuzzella:
Where they’re loading. Yeah, like what part of-
Steven Sashen:
Exactly.
Dr. Mark Cucuzzella:
I mean, I don’t know. I’ve read stuff. You’ve read stuff. And it’s probably, it depends is always the answer. But if you watch the elite pack at the Boston Marathon for example, so at mile seven, Tom had some amazing video. Yeah, they’re touching and they’re touching on their heel and they’re rolling forward because at mile seven, they’re just trying to cruise along and try to conserve energy and they’re just going to probably mix it up. And I kind do the same in marathon races going down a hill, you modify a little bit and touch and roll.
Steven Sashen:
Absolutely, for downhill, totally different thing.
Dr. Mark Cucuzzella:
Yeah. So, it’s hard to know when you see that film, is it completely flat, tracks flat, but what you see is about a mile to go or half mile to go, those who are still in the money, the rest of them are done. Those in the money, then they get on the ball of their foot just like the last lap of the track. So, not all of them, but most of them would. When you see it, that’s like the last lap of a 10,000-meter race. Because then they’re all in at that point. And they could care less that they trash their fascia because they’re applying so much power because it’s half mile from the finish.
Steven Sashen:
Well, you just raised another point that I’ve also commented on, which is people love to use elite athletes as the example for, “Hey, here’s what you should do.” But these are often people who are just trying to find the best way to make a living, frankly, to win a race. And they don’t have a lot of concern for, “Will I be able to do this when I’m 40 or 50 or 60?” And the other thing is when someone says, “Well, so-and-so this particular marathon or does the following,” and I say, “I don’t want to be the one to break the news to you, but you’re not 105-pound Kenyan.”
Dr. Mark Cucuzzella:
Yeah, true. I mean, so yeah, we’re talking about the elites. For the average runner, I don’t have them focus that much on what part of their foot hits the ground. That’s why I like the TrueForm. I just want them to develop a movement pattern that’s correct, that’s soft. You can’t pound into the motorless treadmill. It stops. Most people prefer a little bit of cushion because that’s like they’re making a couple changes coming out of you.
Steven Sashen:
Actually, I’m making growling noises, but it’s not just for the fun of editing. How do I want to put this? There’s cushioning and there’s cushioning, let’s say it that way. And there’s also what feels good when you’re just standing there versus what feels good when you’re running or what affects your running and what doesn’t affect your running. And these things are all very different and there’s been a lot of confusion I would argue about what’s good. I mean, when I watch people go into a store and they put something on their feet and they go, “Well, I like all the cushion, it feels really good.” It’s like, “Well, yeah.”
Dr. Mark Cucuzzella:
Yeah, you have to run in it. So, yeah, too soft is a bad thing. And we teach them that.
Steven Sashen:
Tempur-Pedic mattress feels great. You don’t want to do pushups on it. Same thing about running.
Dr. Mark Cucuzzella:
We actually have people stand on an Eric’s pad, which is super soft, and they’re like, “Oh, this feels good.” But how would that feel at mid stance?
Steven Sashen:
Yeah, it doesn’t work.
Dr. Mark Cucuzzella:
Eric’s pad for those listening is like a PT pad when you’re doing ankle rehab. It’s like a big soft-
Steven Sashen:
Yeah.
Dr. Mark Cucuzzella:
Teaches you kind of to train your body to deal with instability, which is not what you want when you run. You want to land on stable surfaces.
Steven Sashen:
Yeah, the whole instability training thing is another one that makes me crazy. It’s like, “Hey, you’re training to be unstable.” It’s like, “No, actually you can get stronger if you train stable because then you can-”
Dr. Mark Cucuzzella:
Still run on some trail and that’ll teach you.
Steven Sashen:
Yeah, exactly.
Dr. Mark Cucuzzella:
Honestly, but maybe this is good for business, Steven, but to be honest, but most people don’t want to buy two pair of shoes. I don’t know why, but they go buy a racing bike, a training bike, they all buy all this other crap. Shoes are inexpensive and yours last 5,000 miles.
But I think if everyone got a true minimal sandal or shoe and something that they might take on the trail and mix it up and then go out, it’s a recovery day, go out and it’s not on a big sharpie trail, go out and run in sandals or run barefoot super, super slow, and then the next day you want to load it up a little bit and you just, no kidding, you want to pound the ground a little bit, put on something with a little bit of cushion, whatever your preference is.
Steven Sashen:
This is something Irene says as well.
Dr. Mark Cucuzzella:
It would help them.
Steven Sashen:
Irene says, “Look, if you’re going to be an overstriding heel striking runner, get some cushioning under your heel. I don’t recommend that you stay that way, but if that’s what you’re going to do, then do it.”
Dr. Mark Cucuzzella:
Yeah. And Golden Harper, I like how he explains it. You’ve got three feet of spring, which is pretty much your hip down to your arch or an inch of cushion. What do you want to utilize?
Steven Sashen:
Yeah. Well, my version of that, I say, “So which do you think is going to be more effective? A piece of foam that starts breaking down immediately upon use that is basically tuned to a particular weight and speed of which you are neither, or an almost instantly infinitely adjusting spring-like mechanism that evolved over a very long time to handle pretty much anything you could throw at it.”
Dr. Mark Cucuzzella:
I’ll go with the latter.
Steven Sashen:
Yeah.
Dr. Mark Cucuzzella:
But I’m a distance guy, so I’ve got 120,000 miles on my legs or even more.
Steven Sashen:
But I’m a sprinter. I’ve got 120,000 tons of force on my legs.
Dr. Mark Cucuzzella:
Yeah. Hell yeah. It’s probably pretty equal when we added up, because you’ve put nine Gs on your frame. How many steps are 100 meters?
Steven Sashen:
For an elite athlete for Olympian, 41 to 43. For me, I think-
Dr. Mark Cucuzzella:
Sorry about that sneeze.
Steven Sashen:
I think I was somewhere in 48 the last time I checked, but I’m not sure. And that doesn’t seem like much five or six steps, but I mean it’s everything.
Dr. Mark Cucuzzella:
Yeah, it’s high intensity ply metrics. If you had to do single leg bound for 10 steps, one leg bound, most people would trash themselves.
Steven Sashen:
It’s completely insane. But I can’t think of doing anything else. So, backing up to your comment, I have a plantar fasciosis, which most people think of as plantar fasciitis. So, would you do me two favors and talk about why you say -osis and not -itis? And also, what from a natural movement perspective is the way that you talk to people who come in presenting those symptoms for whatever they’re going to do to deal with that?
Dr. Mark Cucuzzella:
Yeah, so -itis, just going into medical terminology means a true inflammatory condition. And most of those things are going to either be infectious or autoimmune. For example, something like rheumatoid arthritis is an autoimmune attack. You’ve got hot red, swollen joints. There’s actually active damage going on. So, an -osis is more a degenerative hit and repair type of process. So, most back disease is degenerative. So, there are occasional things like discitis, which are infections or things like that.
But so most plantar fasciosis is degeneration, thousands and thousands of steps and micro tears in the plantar fascia and it hurts. The repair process becomes dysfunctional, but there’s no active attack on it by your own body’s immune system or infection. So, it’s an -osis. Doesn’t sound sexy, doesn’t sound druggable, right? Because the industry wants you to think it’s an -itis, which is druggable by an anti-inflammatory.
Now, the truth about those are they will inhibit the body’s repair process. The body has this innate repair process, like you say, how many years have we evolved? You know more about this shit than I have. How many hundreds-
Steven Sashen:
That’s all I got.
Dr. Mark Cucuzzella:
How many zeros of years. We’ve evolved with a pretty reparative, a lot. You cannot treat a degenerative injury. I mean you can’t treat it to make it repair faster. You can only support what’s going on and reteach it while your body repairs it. So, people think you can kind of treat these injuries, like you take something, you inject something, put some magic widget and it’s going to heal faster. That’s absolutely not true. Ice it, hot tubs. Nothing will make it heal faster. That’s just the way it is. Drugs will make it heal slower and they have their own list of side effects.
So, when I was in college, to share a story, so we all were broken. I was running in college and we took all these anti-inflammatories and aspirins and it was like my freshman year, and I’m wondering, behind you is a white wall. And my roommate looked at me one night and he says, “You’re looking kind of pale. You’re okay?” And I said, “I don’t know. I feel like shit.” I’m like, can’t keep up in practice anymore. And I got this stomachache. I don’t know what it is. I just felt like shit. But you’re a knucklehead 18-year-old college.
And he calls his dad, who’s a pharmacist. He says, “Yeah, my roommate doesn’t look too good. He looks kind of pale.” And his dad says, “Well, is he taking any medicine?” And he asked me and I’m like, “Well, I’m not taking any medicine, but they give me the stuff at the trainer’s room.” And they asked me what it was and it was some kind of ibuprofen, anything. And he said, “Well, he better go down to student health.”
And I went down there, my hemoglobin was six, which is a third. So, I’m going to practice with half to a third of my blood volume, but at least I was like, “Oh, at least I’m not psycho or something.” And then they did the upper GI, you swallow the chalk and I had hundreds of holes in my stomach and duodenum. That was a rough year. I mean, I lost all the iron.
And it took a while to get back to just feeling well again when you’ve lost because it took a while to lose all that blood. But I see the hospital pay, but that’s another, just don’t take ibuprofen if you’re listening and if you’re taking ibuprofen for a running injury, don’t repeat that. If you’re taking ibuprofen for a running injury, stop right now.
Steven Sashen:
It reminds me when I lived in Manhattan from ’83 to ’93 roughly, and I lived right around the corner from a health food store and I was in there every day and there was these two, I now say young guys, they were in their 30s. They were older than I was, who ran this health food store. And one day I’m checking out and they had some packet of some supplemental thing sitting on the counter by that register. And I was looking at the ingredients, more energy, more vitality, more whatever.
And I’m checking it out and one of them slaps it out of my hand and the other looks at me and goes, “You don’t need that. You need a nap.” And it’s the same thing for runners, like, what can I take for this? Time off.
Dr. Mark Cucuzzella:
Time off.
Steven Sashen:
And sleep. Sleep is powerful. You need to rest a little bit. So, when people have a fasciosis, and anyway, I did a thing about plantar fasciitis.
Dr. Mark Cucuzzella:
Share the eBook out.
Steven Sashen:
We did in a previous podcast. But there’s a story that I tell of a guy who said, “Well, I’ve had plantar fasciitis for 20 years.” You can’t have an inflammation for 20 years, that doesn’t work that way. So, what do you say to people or what do you do with people when they come in presenting plantar fasciosis, Jesus, symptoms?
Dr. Mark Cucuzzella:
Say that 10 times.
Steven Sashen:
slow.
Dr. Mark Cucuzzella:
You look at their feet, that’s the victim. But what’s going on? We use a ton of Correct Toes, because if you have a hallux valgus, which is the big toe pointing in, yeah, your foot’s just going to kind of roll in, and that puts a lot of sheer stress on the tib posterior and which is the muscle that acts kind of as a sling on the inside of your ankle. So, years and years of constant stress. So, that muscle is going to become dysfunctional. So, when that muscle’s not firing correctly because it’s overstretched and overstressed, the plantar fascia is going to take the load.
So, trying to get them into a neutral foot posture and aware of that, we use an insole. I love this insole called Barefoot Science and it’s not a support, but what I think you’ve seen those. Oh, my god, they’re magic. It’s like a three-quarter insole, but it has a little pod that sits under your arch. It’s almost like a metatarsal pad, but it just cues you when you’re letting your foot collapse down to just help you kind of just reshape and lift your foot. So, it’s kind of teaching you to use a short foot posture when you’re walking and get that foot more neutral.
So, over weeks, they actually add a little more of that pod, which again, doesn’t support the foot with an external.
Steven Sashen:
It’s actually doing the opposite. It’s poking.
Dr. Mark Cucuzzella:
It’s doing the opposite. It’s teaching the muscles to support the foot, but they ultimately walked their way out of plantar fasciosis. And I don’t have a randomized trial of this, but I could give experience. I think we’ve probably sent out a couple thousand pair of Correct Toes and probably at least a thousand pairs of these Barefoot Science insoles for plantar fasciosis. And people have 30 days to bring them back if it’s not working. So, we say, “Try this 30 days. If it’s not working for you, bring it back.” And they know where I live. It’s a small town. My email’s probably.
Steven Sashen:
Hunt me down.
Dr. Mark Cucuzzella:
I’ve not yet seen a single one of those insoles ever, ever, ever come back. And people come in and they’re like, “Oh, my god, thank you. My plantar fasciosis is gone.”
Get them in a functional wide toe box shoe. So, you’re looking at just fixing the foot and all the little widgets. So, if you have a standup desk and get some kind of roller, just golf ball. So, some of that stuff’s pretty effective, too, just to try to break up all that kind of disjointed fascia and restructure it.
Steven Sashen:
So, for someone who wants to try and start doing something today, other than what you just said of standing up and getting a golf ball under your foot, for example, but either they’re not going to order some other gadget like Barefoot Science. I don’t mean to use the word gadget in a derogatory fashion, but if they want to start doing something today, they’re just around their house. What else would you recommend?
Dr. Mark Cucuzzella:
I think they have to look at their own foot and have some awareness. If they have a collapsed foot, then they’re going to have to train their foot to be in a more neutral position. So, it really varies I think person to person. Because they could have a tight heel cord. So, we see a lot of people saw someone in here yesterday who was having plantar fasciosis, but trying to get down into a deep squat, she couldn’t even get close because her Achilles, calf were so tight.
So, if that’s super tight, if you can’t get down into a deep squat and you want to go run hard, I think you’re going to be a setup for plantar fascia or Achilles. You’d go run easy. But if you try to load it up a bit more your gait, too.
Steven Sashen:
Not that you’re preaching to the choir, but again, I did an episode about plantar fasciitis and you’ve said the same thing I said. But to that point, in fact, if people find that episode, some of the references that we’re making I pointed to there, so that’d be useful.
How do I want to put this? One of the things that you and I have talked about over the years is trying to get together or put together some sort of organization, kind of an umbrella organization that would be able to communicate the real value of natural movement. We’re up against a lot of propaganda, a lot of marketing from companies that are worth billions and billions of dollars who have a vested interest in not letting people think that natural movement is even possible. That’s my way of putting it.
What do you see as the way that we can turn this screamingly obvious idea that your body works if you let it into common wisdom?
Dr. Mark Cucuzzella:
I’m looking at our new Dalai Lama, right? I’m staring right at you. Here you go. You’re the dude. So, you and Ray McClanahan, I mean, I just think you guys have such an amazing fund of knowledge and communication. So, Ray McClanahan has developed Correct Toes, Irene Davis, and to be able to communicate to people like videos and social media education courses. I teach CME courses, which are continuing medical education. Ray has now a series of seminars geared to healthcare professionals and it’s kind of cool.
So, I get invited now to podiatry meetings to talk about this when I used to be kind of a foil. They bring me in as someone to throw things at just to have an interesting argument. But it’s nice. Just present the science in a humble way.
Steven Sashen:
I can’t do that humble way thing. I can’t do that very well.
Dr. Mark Cucuzzella:
Yeah, you’re too in people’s faces. But you could tone it down if you had to go speak public in front.
Steven Sashen:
Not a lot. Not very much. Hold on.
Dr. Mark Cucuzzella:
Maybe you’re not the guy.
Steven Sashen:
Wait, wait. Last year at the American College of Sports Medicine, I was on this panel discussion against some guys from Brooks and Adidas. And Adidas is one of the sponsors.
Dr. Mark Cucuzzella:
I listened to that one.
Steven Sashen:
Yeah. Well, suffice it to say, I was not invited back.
Dr. Mark Cucuzzella:
And Tony was on there, too. Tony’s a little more diplomatic, but he is another really good spokesperson.
Steven Sashen:
No, Tony, this is Tony Post from Topo Athletic, formerly the CEO of Vibram. And no, Tony is definitely more diplomatic and if you watch the video of the two of us, and if you’re listening, you can find it at xeroshoes.com/acsm. That’s M as in Mary at the end. You’ll see there’s times-
Dr. Mark Cucuzzella:
How did they let you it in the first place. I’m surprised.
Steven Sashen:
I know. But there’s times where I say something or do something and you can see Tony, you know he knows that what I’m saying is true, but the way I’m saying it just makes him very mad.
Dr. Mark Cucuzzella:
He’s cringing. He’s like, “No, look, have to be respectful.” He say, “Well, this is how I see it. You may be right, but …” You just have to.
Steven Sashen:
I can only do that for a certain amount of time and then I just lose the ability.
Dr. Mark Cucuzzella:
You’ll lose it.
Steven Sashen:
Yeah.
Dr. Mark Cucuzzella:
You need folks like you in the game to make it fun and disruptive. And then Tony’s a little more diplomatic.
Steven Sashen:
He’s a lot more diplomatic. Basically, the difference between me and Tony is Tony has way more friends in the footwear industry than I have. So, he’s trying not to upset his friends. I don’t know these people. And even more than that, I mean to not be glib about it. There’s ways of being diplomatic and there’s times where I can do do that, but it also just frankly infuriates me.
I don’t like it when people make money by lying to other people. I don’t like it when people are doing things that they know are not good. I know I’m not going to mention names. I know the CEOs of a couple of footwear brands who know that what we are talking about is true and will never do it, and I find that morally reprehensible, and I’m going to call it out. And again, I’m not mentioning a name now because I would only do it with that person in front of me so they could defend themselves, but I find it completely unacceptable.
Dr. Mark Cucuzzella:
You see the same thing in the nutrition space. People won’t join you on public debate, but they’ll on internet say things that you’re not saying, but it is what it is. It doesn’t bother me.
Steven Sashen:
Yeah, I want to be part of the conversation and it’s fun. The thing about being part of the conversation is what we’re talking about is, I mean, I’ll say it in the most entertaining way I can. It’s the truth. And so, you become really invincible when your back is against the wall. The wall is true, versus something that’s just a theory or philosophy or something that’s really easy to disprove. And then you just watch people and see how they respond to it. And I understand why they don’t respond well. I just don’t think that’s appropriate.
Dr. Mark Cucuzzella:
I got a hard stop at about 4:00, so.
Steven Sashen:
I’ve got to do the same. So, let’s use that as our way out of here. Mark, first of all, thank you so much. Secondly, if people want to get in touch with you and for any reason, obviously Two Rivers Treads and that’s tworiverstreads.com, I’m assuming?
Dr. Mark Cucuzzella:
Yeah. And my book, Run For Your Life, the website is runforyourlifebook.com. And we’ve got a lot of videos of all the things we talked about. Shoes and the foot.
Steven Sashen:
In fact, people ask about what does it look like to run barefoot well, and one of the things that I often do is point to videos of you running barefoot. You’ve got impeccable form, and you’re actually running at speed barefoot, which most people don’t think is even possible. And I don’t like to point to videos of me. They think it’s all blah, blah, blah. But to find other people who are doing this successfully is important. So, I want to thank you for everything that you have done in our creating a movement.
Dr. Mark Cucuzzella:
You’ve got my Prios here so I can skid away with West Virginia. I can wear those to work, and they look kind of like casual work shoes.
And the boots. The boots for the wintertime are awesome, but sandals, I wore your JFK 50 mile, I wore the sandals.
Steven Sashen:
Thank you. Thank you. I can’t tell you how much we appreciate your support. And so, find Mark, find his book. It’s all amazing information. The videos are spectacular. So, I want to thank you all again for being part of this conversation and the MOVEMENT Movement podcast. Again, go to www.jointhemovementmovement.com, where you can find all the places that you can find us, where you can like, and share and subscribe and review and comment. If you have any questions or if you want to suggest anything for the show, just send an email to [email protected].
And of course, as I love to say, if you want to be part of the tribe, please subscribe. And as always, live life feet first.
Dr. Mark Cucuzzella:
Awesome.