What if a pair of shoes could change the way you walk in just five steps? 👟
In this episode, I sit down with Italian designer and researcher Franco Salvatelli, whose work in diabetic foot care and limb-salvage research has been published in leading journals like Diabetes Care and Foot & Ankle International.
After 25 years of clinical research, Franco developed the BBACK Shoe—a footwear system classified as a medical device in Europe and designed to improve posture, stability, and foot function. (Future of Medical Shoes)
As a podiatric surgeon who has examined thousands of feet and tested countless shoe technologies, I was skeptical. But after putting them on and walking across my office, I could immediately feel the difference.
In This Episode, You’ll Discover:
- Diapason Technology – A tuning-fork inspired mechanism that provides proprioceptive feedback to improve posture and foot positioning
- 25 Years of Limb Salvage Research – Design principles originally developed to help prevent amputations in diabetic patients
- The Vascular Connection – How foot deformities like bunions may affect blood flow and biomechanics
- Heel Stabilization – Why most shoes get the heel counter wrong and how proper stabilization reduces forefoot pressure
- The Pro-Dynamic Method – A three-part system: stabilization, fork rolling point, and re-equilibration
- Italian Design + Medical Engineering – Premium design with serious biomechanical innovation
The “Foot Aging Syndrome”
Franco introduces the concept that modern surfaces—concrete, asphalt, and hard flooring—can accelerate foot aging. His solution: pro-dynamic footwear designed to help your feet function the way they were meant to.
My Honest Take
After four months of wearing these shoes in clinic, at the gym, and daily life, I’m genuinely impressed. The stability, proprioceptive feedback, and comfort are noticeable almost immediately.
Special Offer
Get 10% off your order with code POI10
👉 https://bbackworld.us
Whether you have foot pain, circulation concerns, diabetes, or simply spend long hours walking or standing, this episode may completely change how you think about footwear.
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Author Biography
Franco Salvatelli
Franco Salvatelli is a distinguished Italian shoe designer, biomechanics researcher, and the innovative founder of BBACK (Be Back), a revolutionary footwear company based in Milan, Italy. With over 25 years of clinical research and design experience, Franco has established himself as a leading authority in the intersection of footwear biomechanics, diabetes care, and lower limb preservation. Franco’s career began with a singular mission: lower limb salvage. He spent decades generating clinical evidence on the effectiveness of offloading techniques and amputation prevention strategies for people with diabetes.
His meticulous research approach led him to coordinate two landmark prospective randomized studies conducted between Italy and the United States. These studies, published in the prestigious journals Diabetes Care and Foot and Ankle International, have directly contributed to changing international guidelines for diabetes foot care management—a testament to the clinical rigor and real-world impact of his work. Through his extensive research on foot aging syndrome, Franco recognized that everyone—not just patients with pathologies—faces challenges from walking on modern artificial surfaces. This insight sparked his “second chance” project: BBACK.
The company’s flagship innovation, the Diapason technology, employs a tuning fork-like mechanism embedded in the shoe to deliver proprioceptive information that improves posture, stabilizes gait, and optimizes foot positioning. BBACK shoes are classified as medical devices in Europe and are undergoing FDA approval processes for the United States market.
Franco’s unique approach combines evidence-based therapeutic design with the sophisticated aesthetics expected from Italian craftsmanship, creating footwear that serves both medical and lifestyle needs. His vision is to keep people moving better in their world, regardless of their health status, age, or activity level.
Show Notes from this episode
00:00 – Introduction and Special Offer
- Introduction to Franco Salvatelli, Italian shoe designer with 25+ years-experience
- BBACK: More than a shoe – classified as a medical device in Europe, coming to US
- Exclusive Discount Code: POI10 for 10% off at bbackworld.us
- Technology preview: “Diapason” – tuning fork-like device providing proprioceptive information
- Benefits: Improves posture and structural foot positioning
01:40 – Franco Salvatelli Introduction
- Italian design excellence comparison: Ferrari, Lamborghini, Maserati
- Dr. Barrett’s personal experience: Noticed exceptional quality within 5 steps of wearing BBACKs
- Connection through mutual colleague Dr. Ronconi (biomechanics expert)
02:27 – Franco’s Background and Mission
- 25 years of clinical research in diabetes foot care and amputation prevention
- Primary goal: Lower limb salvage
- Research credentials:
- Coordinated two prospective randomized studies between Italy and United States
- Published in prestigious journals: Diabetes Care and Foot and Ankle International
- Contributed to changing international guidelines for diabetes foot care management
05:00 – Current Vision: Pro-Dynamic Footwear
- Target: Foot aging syndrome management
- Philosophy: Keep people moving in modern artificial surface environments
- Innovation focus: Creating solutions for better movement in today’s world
- Development of the Be Back project
05:32 – The Name “Be Back” – Dual Meaning
- First meaning: “Back to better life, back to a new life, back to a better world”
- Second meaning: Franco Salvatelli’s personal return after 5 years
- New project designed for everyone, not just medical patients
- Addresses multiple needs: movement, aesthetics, design, performance, sport
- Franco’s “second chance” at life project
06:28 – Not Just Orthopedic Shoes
- Dr. Barrett emphasizes: Despite limb salvage background, these are NOT orthopedic-looking shoes
- Design: Among the most stylish shoes available (Italian design pedigree)
- Analogy: Beautiful exterior (car body) with high-performance technology “under the hood” (engine)
- Technology suitable for specific medical conditions AND general population
07:39 – Technology Presentation Begins
- Franco begins detailed presentation of BBACK technology
- Focus on proprioceptive mechanisms and biomechanical innovations
[Technology Deep Dive Section – 08:00-30:00]
Note: Detailed technology presentation covering:
- Diapason system (tuning fork mechanism)
- Proprioceptive feedback enhancement
- Micro-oscillations for balance and stability
- Foot positioning optimization
- Biomechanical principles behind the design
- Clinical evidence and research data
- Comparison studies with traditional footwear
31:40 – Vascular Perfusion and Hallux Valgus
- Dr. Barrett recalls important study shown in presentation
- Key finding: Blood flow restriction in lateral plantar artery with big toe deviation (hallux valgus)
- Clinical significance for diabetic patients:
- Diabetic peripheral neuropathy patients already have vasculopathy
- Vascular compromised feet
- Orthopedic deformities (like bunions) further exacerbate vascular risk
- Combined effect significantly increases amputation risk
- Question: Has restoration of vascular perfusion been studied with BBACKs?
32:33 – Franco’s Response on Vascular Studies
- Current research: Studies underway to measure vascularization improvements
- Discovery from offloading device research: Many “neuropathic” feet also have vascular compromise
- Critical design element: Lever effect of the rocker sole
- Rocker design must include proper rigid support (dangerous without it)
- Diapason fork provides: Control of rocking motion + avoids hyper-pressure on forefoot
- Essential for patients without sensation
33:30 – Common Shoe Design Mistakes
- Industry error #1: Heel counter too large (back of shoe)
- Industry error #2: Heel can slip out
- Be Back solution based on foot aging syndrome research:
- Heel must be very well stabilized
- Proper heel stabilization allows better forefoot control
- Three key principles:
- Stabilization and control
- Fork rolling point for re-equilibration
- Pro-dynamic method
34:25 – Neuropathy-Vasculopathy Connection
- Dr. Barrett explains critical concept many don’t understand
- Pressure-induced vasodilation: Occurs in plantar skin cutaneous tissue
- Effect of neuropathy: Impairs ability to shunt blood to areas of demand
- Important clinical point: You CANNOT have neuropathy without vascular issues
- Even if patient “doesn’t have vascular disease,” neuropathy creates vascular dysfunction
- The two conditions are inseparable
- Franco agrees completely with this assessment
35:19 – Discount Code Information
- Code: POI10 (Pod of Inquiry 10% discount)
- Website: bbackworld.us
- Private area on website for entering promotional code
35:38 – Franco’s US Market Strategy
- Goal: Enter US market “the correct way”
- Strong personal connection to United States
- Spent part of his life in US
- Conducted studies there
- Current priority: Collect customer feedback from real people (not just patients)
- Building scientific evidence base in US territory
- Working with Dr. Barrett and colleagues
36:41 – Emphasis on General Population
- Franco stresses: Product for “people,” not “patients”
- Designed for everyone, not just medical cases
36:46 – Website Confirmation
- Official US website: bbackworld.us
- Link will be in show notes
- Discount code: POI10
36:50 – Dr. Barrett’s Personal Testimonial
- Predicts: Users will have “love affair” with shoes by about the 5th step
- Personal experience confirms fantastic technology
- Aesthetic appeal: Shoes look great, attract questions
- “Be Back talks for itself” – natural word-of-mouth generator
- Looking forward to more technology developments and clinical studies
Key Takeaways
- Be Back is a medical device (Europe), not just a shoe – FDA approval process underway for US
- 25 years of clinical research in diabetes foot care and limb salvage informs design
- Diapason technology (tuning fork mechanism) provides proprioceptive feedback for better posture and foot positioning
- Critical for diabetics: Addresses both neuropathic and vascular issues simultaneously
- Foot aging syndrome – the primary target condition, but benefits everyone
- Three key design principles: Stabilization/control, fork rolling point, pro-dynamic method
- Neuropathy = vascular impairment – Cannot have one without the other
- Common shoe mistakes: Heel counter too large, insufficient heel stabilization
- Stylish Italian design combined with serious medical technology
- Available now in US with POI10 discount code at bbackworld.us
Clinical Significance
For Diabetic Patients:
- Reduces forefoot pressure (prevents ulceration)
- Improves vascular perfusion (may restore blood flow in deformed feet)
- Provides stability without sacrificing mobility
- Evidence-based design from published research
For General Population:
- Improves posture and gait mechanics
- Enhances proprioceptive feedback
- Addresses foot aging syndrome (affects everyone)
- Supports natural foot function on artificial surfaces
Research Background:
- Published in Diabetes Care journal
- Published in Foot and Ankle International
- Changed international diabetes foot care guidelines
- Ongoing vascularization studies in progress
Discount & Ordering Information
Website: bbackworld.us
Discount Code: POI10 (10% off)
Significance: Exclusive Pod of Inquiry listener discount
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