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Salem Community Hospital.... Extended wear of flip flops carry risks

June 15, 2008
Salem News
Almost everyone has at least one pair of flip-flops, which have become part of the typical summer wardrobe for men, women and children.

Flip flops are trendy in appearance, especially for young people, and are easy to find and affordable. However, medical experts report an increase in the number of foot-related problems directly related to wearing flip-flops for extended periods of time.

“These types of shoes were originally designed to be worn short distances, such as when walking through the sand, while at the pool or in the shower,” explained Podiatrist Joseph Francisco, D.P.M. “A thin layer of foam rubber that separates the feet from hot sand or a sidewalk isn't meant to be everyday footwear.

“The main problem with flip-flops is that they do not support the physical structure of the foot. Most flip flops offer little to nothing in terms of arch support, stability or shock absorption.”

Foot Injuries

Foot-related injuries due to flip flop wear have been on the rise. Statistics show that the lack of support from this type of footwear increases the likelihood of a foot injury, with the heel and the arch of the foot being most commonly affected.

According to the American College of Foot and Ankle Surgeons, the popularity of flip flops among teens and young adults is responsible for a growing epidemic of heel pain.

“Adolescents and young adults between the ages of 15 and 25 are reporting increased heel pain, which is unusual for this age group,” Dr. Francisco added.

“A contributing factor is that they wear flip-flops with thin soles every day to school, to work or when at home. Heel pain is also becoming more prevalent in younger people who are overweight, not physically active and who wear this type of footwear that doesn’t support their feet.

“In addition, many people don’t realize that there is new bone growing in the heel even into the mid-teen years. Flip-flops don't cushion the heel, so repetitive stress from walking can inflame that heel bone growth area and cause pain and tenderness. Pain often occurs after two weeks of wearing flip flops, as can swelling and inflammation.”

Dr. Francisco continued, “This type of heel pain can usually be reduced or eliminated with simple treatment methods, including stretching exercises, ice massage, anti-inflammatory medications, and custom or over-the-counter shoe inserts. However, heel pain that occurs from inflammation of the Achilles tendon, bursitis, arthritis, gout, stress fractures, or irritation of one or more of the nerves in the region could be a symptom of a serious medical condition that should be diagnosed and treated separately.

“In addition to heel pain, there are other areas of the body that can be affected by wearing flip flops, such as the back or hip, when a person tries to over compensate for foot pain or injury. Related flip-flop problems include inflammation of the Achilles tendon, painful pinched nerves, sprained ankles, broken or sprained toes, cuts and scrapes, plantar warts, Athlete's foot, or callus build-up on the heels and toes.

“Another problem area for flip flop wearers involves the thong strap that goes between the toes,” Dr. Francisco advised. “People with sensitive skin, circulatory conditions or diseases like diabetes are more prone to skin irritations and infections. The thong strap can be a point of irritation that may lead to an infection.”

Flip Flop Do’s and Don’ts

A safer solution for summer footwear is to wear sandals or shoes with reasonably strong soles and arch support. “Thicker soled sandals with supportive arches may not be as stylish, but can help a person avoid heel pain,” Dr. Francisco concluded. “When choosing safer sandals, look for a good tread pattern on the bottom of the shoe. The inside of the sandal should be molded to fit the arch of the foot and cup the heel. Having a strap around the back of the heel adds additional support.”

Flip Flop Do’s:

- Look for flip-flops that hold the American Podiatric Medical Association’s (APMA) Seal of Acceptance, as they allow the most normal foot function. Choose those made of high-quality, soft leather to minimize the potential for blisters or other kinds of irritation.

- Gently bend the flip-flop from end to end, ensuring that it bends naturally at the ball of the foot.

- Wear a sturdy pair of flip-flops when at a pool, the beach, in hotel rooms or in locker rooms. Always wear a shoe that fully protects the foot when doing outside activities like mowing the lawn or weed eating.

- Make sure that your foot doesn’t hang off the edge of the flip-flop.

Flip Flop Don’ts

- Don’t re-wear flip flops year after year. If they show severe signs of wear, discard them.

- Don’t ignore skin irritation between the toes, where the thong strap fits.

- Don’t wear flip flops while walking long distances.

- Don’t play sports in flip flops, as it is easy to injure the foot or ankle.

- Don’t wear flip flops while driving, as they can get stuck under or slip off the pedals.

Joseph Francisco, D.P.M., is a podiatrist affiliated with the Ankle and Foot Care Centers’ office in Columbiana, 750 East Park Avenue, 330-482-1960.



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