Slab Flab Flip Flops Cause Foot & Knee Problems

FOOT & KNEE PROBLEMS CAUSED BY SLAB FLAT FLIP FLOPS

Below are a collection of recent media pieces on the concerns of wearing slab flat flip flops, which are creating health problems for wearers at ever younger ages. PêcheBluTM flip flops with arch support, cushioning, solid traction, and study construction that moves with the foot go a long way to solving many of the health problems discussed below. Please take a look and educate yourself on slab flip flops vs. PêcheBlu™.

Slab Flat Flip Flops Cause Foot Problems

Nov 06, 2007 – New York City– Ever wonder if there is more than a casual correlation to people complaining about aching feet, sore knees, and lower backs and the huge increase in daily wear of flip flops? Many of those suffering are not only middle aged boomers leading active lives, but also kids who wear slab flat flip flops as basic casual wear. For athletes, such foot problems are resulting in missed games as well as lack of peak performance due to foot fatigue and pain.

Stephen Horney, MPT, a physical therapist who often treats skilled athletes at the US Athletic Training Center in New York says, “I see a lot of problems caused by wearing unsupported footwear, like slab flip flops. And not just foot pain,” he adds, “but knee pain, too, which can often be the result of improper support.”

Footwear with no arch support often causes knee pain first since an unsupported foot changes everything from the bottom up. A foot and arch that is not properly supported will often cause the foot to over-pronate, which can lead to mal-alignment causing problems in other joints most commonly the knee (Patellofemoral pain syndrome) but also in other joints such as the first toe (Hallux Valgus) as well as anterior hip pain.

To take a step, the foot needs to find a neutral position to gain the rigidity that is necessary for propulsion. Horney explains, “Flat footwear like slab flip flops offers no foot support at all, which means the muscles and tendons of the lower leg and foot must supply all support for any movement. This constant excessive load can lead to overuse and inflammatory conditions such as shin splints and contribute to such conditions as plantar fasciitis (inflammation of the sole’s connective tissue where it attaches to the heel), inflamed Achilles tendons, all of which have now started appearing in young people, which used to be less common.” Slab flip flops also make feet work harder to re-grip the soles with every step, which adds to wear and tear.

Horney’s contention that the huge increase in kids wearing flip flops is creating foot problems is verified by the statistics. There were some 11 million physician visits in 2003 for foot and ankle problems, including 2 million for sprained ankles and some 80,000 ankle fractures.

For the human body, everything starts with the foot. If there is no proper support, there is no way to properly support the rest of the body as you move up the chain: knees, lower back, shoulders, and neck. It’s the old song, the shin bone’s connected to the knee bone. Walking puts up to 1.5 times bodyweight on each foot. Strenuous exercise can increase the load, with an hour of jogging generating an estimated million pounds of pressure.

Despite the advances in shoe technology and the many sports models on the market, kids use flip flops as part of leisurewear as much as baseball caps and jeans. “Flip flops are part of the new uniform,” says CEO Stephen Cohodes, who started PęcheBlu™ Flip Flops. “We see increasing numbers sold and estimate over 220 million pairs flip flops over $15 will be sold in the US next year,” meaning the true number is much higher if you include all the dime store pairs available.

But Cohodes points out that his patent pending PęcheBlu™ is a new kind of flip flop company, one that has taken sports shoe technology and applied it to flip flops. “We added arch support, heel wells, cushioning, improved traction on both top and bottom, and a molded shape that conforms to the shape of the human foot. We wanted to make our flip flops the best of both worlds – a sports shoe base with the comfort of a flip flop strap.”

He points out that many kids don’t see the difference between a slab flip flop and a PęcheBlu™ flip flop, “They buy based on color or price, without considering the long term affect on their feet, something they would never do with their sports shoes.”

Slab flip flops are made from rolled sheets of flat rubber and stamped out with a cookie cutter, while athletic shoes, including PęcheBlu™, use multiple molds to shape the form of the shoe to the fit of the foot. “Clearly using molds is a much more labor intensive and expensive process than stamping something out flat,” says Cohodes.

PêcheBlu™ Vast Improvement

Physical therapist Horney likes the PęcheBlu™ flip flops and thinks they are a vast improvement because they offer good arch support and thick cushioning. However, he cautions, “Even a really good flip flop like PęcheBlu™ can’t provide the support of a complete shoe and are not meant for running or sports use. As far as recreational flip flops go, these are the best I’ve seen”

“If you want to play touch football,” he adds, “don’t do it in flip flops. Otherwise, we’ll see you in rehab for the next six weeks.”

There is one additional point that Cohodes wants to stress. Continual wearing of slab flip flops also can jeopardize athletic performance. He asks, “You wouldn’t play baseball with a tired arm, so why start a match with feet tired from slab flip flops, where a tenth of a second can mean the difference between first and last place?”

His point is that athletes need to be smart about limiting foot fatigue and what they chose to wear. Clearly, he wants them to consider PęcheBlu™.

Flip flops are the oldest shoe style still worn, with designs having changed little in thousands of years from Ancient Egypt. “Modern sports competitors would never consider competing in sports shoes of the 1920’s let alone with ancient Egyptian footwear, but that is what they do wearing flat slab flip flops,” says Cohodes. “It’s time for a change.”

http://www.tribbleagency.com/?p=442

USA TODAY

Trouble afoot with flip-flops – Your Health

Kim Painter, June 2007

Aching feet: It sounds like one of those middle-aged problems.
But these days, Dallas sports podiatrist Marybeth Crane is seeing "whole soccer teams of 16-year-old girls" complaining of the sort of foot pain she used to see mostly in "older, fatter" people.

The culprits aren't the girls' soccer cleats or even the high heels they break out on prom night. Instead, Crane blames their flip-flops — the flimsy, slip-on, toe-thonged sandals that girls and young women nationwide have adopted as their warm-weather, everyday shoe uniform.

"Flip-flops were never meant to be everyday shoes," says Crane, a spokeswoman for the American College of Foot and Ankle Surgeons (www.FootPhysicians.com). "They were meant to wear from the locker room to the pool and back."

Marlene Reid, a podiatrist in the Chicago area, agrees: "Flip-flops are great for the beach as an alternative to being barefoot." For the rest of life, she says, "there are better choices."
The problem, foot doctors say, is that flip-flops offer little cushioning and no arch support, and they force their wearers into an unnatural, toe-gripping, foot-slapping gait.

Among the possible consequences:
•   Sore arches and heels, which can progress to chronic conditions, including inflamed Achilles tendons and plantar fasciitis, inflammation of the connective tissue between the heel bone and the toes.
•   Heel calluses (from the pounding).
•   Hammer toes (from the gripping).
•   Irritation between the toes (from the toe thongs), which can lead to nasty fungal infections.

Of course, flip-flops aren't the only popular shoes that can hurt your feet. Pretty little ballet flats and sky-high wedges, if worn too often or in the wrong circumstances, can cause just as much pain as classic trouble-makers such as stiletto heels, experts say. Even sensible, low-heeled, wide-strapped sandals can harm your feet if you wear the same pair every day from June to September.

A few tips for making it through the summer with feet that look good and feel good, too:
•   Spend most of your time in sturdy shoes that offer heel and arch support. "If you can take the sandal or ballet flat and twist it into a little ball, that's a sign that they can't take everyday wear and tear," Crane says.
•   Stick to heels — or wedges — of 2 inches or less, except on special occasions. A wedge may feel more stable than a heel of the same height, but it can put just as much pressure on your feet, knees and hips.
•   Wear the right shoes at the right time. "If you are going to be involved in a sport or walking all day, wear shoes that are made for that," says John Anderson, an orthopedic surgeon in Grand Rapids, Mich., and spokesman for the American Orthopaedic Foot & Ankle Society (www.aofas.org).
•   Switch shoes daily, if possible, especially if you live in a humid climate. Even very comfortable, sensible shoes can grow fungus if they don't get a chance to dry.
•   Buy shoes that fit and feel comfortable the first time you put them on. "The concept that you just have to break in a shoe is a fallacy. If the shoe is not comfortable, don't buy it," Anderson says.
•   Put some sunscreen between those sandal straps. "People put it on their legs, completely forget their feet" and end up with badly burned feet, says Christian Robertozzi, a podiatrist in Newton, N.J., and president of the American Podiatric Medical Association (www.apma.org).

NEW YORK POST

MANDAL WITH CARE

By DR. ROCK POSITANO, June 26, 2007

HOW are 20 percent more men in 2006 like Jesus? And no, this isn't a joke.

According to market researchers NDP Group, that's how many more men bought sandals last year, compared to 2005.
But while the "Jesus sandals" of the '70s were relegated to bearded crunchy types, today's "mandals" have a broader, hipper appeal. And as women know, where fashion goes, pain often follows.

Doctors in the American College of Foot and Ankle Surgeons reported this week that "along with the growing popularity of men's sandals come more aches and pains for male feet."
Complications include heel pain, most often a result of plantar fasciitis. The plantar fascia is the thick band of tissue that extends from heel to toe on the underside of the foot.

When it gets inflamed - which often happens when people wear nonsupportive footwear (like sandals) on hard flat surfaces (like sidewalks) - it's called plantar fasciitis and is extremely painful.

Doctors are also seeing more Achilles tendonitis, wherein the tendon along the back of your ankle does not stretch properly and gets inflamed. Again, the condition can be caused by wearing flat sandals that put excess stress on the tendon. Again, super-painful.
Big-toe trouble is also a looming sandal problem. Stress fractures and breaks in the skin and bones are serious complications for anyone, and stub injuries are common where the tip of the big toe is traumatized, sometimes leading to fractures and toenail trauma.

Open-toe shoes in general make a person more susceptible to these types of injuries, which are extremely painful. Sandals expose more of the skin to sidewalk hazards, insect bites and abrasive surfaces.

A pesky foot injury that is minor to an average summer stroller could readily expand to a life-threatening condition of infection. More skin area, more risk.
How to minimize risk? First, and foremost, be aware that foot pain is never normal and acceptable in a sandal (or any shoe) for the first wearing or the hundredth. If there's pain, there's a problem, and no amount of "breaking in" should be tolerated. Take the sandal back. If you don't, it will be very expensive in the long term . . . and terribly painful.

Next, buy the right fitting sandal. The surgeon's group recommends looking for a sturdy, cushioned, supportive sole fashioned with padded straps.
Ask your foot and ankle surgeon for advice. Sandal-type shoes may not be a good fit for individuals who have predisposing musculoskeletal foot issues such as heel and ankle pain and a flat or high-arch foot.
Summer is here, and so is the longing for comfort and style. Sandals (or mandals) are a real summer pleasure - but a pleasure with a need for concern and smart selection.

Dr. Rock is the director of the NonSurgical Foot and Ankle Service at the Hospital for Special Surgery in New York. His column appears every Tuesday.

CBS NEWS – THE EARLY SHOW

Flip-Flop Fallacies: Dr. Michael Loshigian Explains Why You Shouldn't Wear Flip-Flops All The Time

JULY 3, 2007

CBS: Shorts, short-sleeve shirts and flip-flops. These all are part of a typical summer outfit for both men and women. However, a foot care expert says that you might want to reconsider your summer footwear.

Dr. Michael Loshigian, a podiatrist and foot surgeon at New York's Mount Sinai Hospital and spokesperson for the American College of Foot and Ankle Surgeons (www.footphysicians.com), discussed the dangers of flip-flops on The Early Show.

Flip-flops are meant for short walks to and from the beach, not for everyday use. A thin bit of foam rubber that separates your feet from hot sand, sidewalk or pavement isn't meant to be your everyday footwear.

Statistics prove that the lack of arch support from these sandals increases the likelihood of a foot injury.

"The American College of Foot and Ankle Surgeons has an increase in reported injuries every spring and summer directly related to wearing (flip-flops) too much," Loshigian said. "So people develop strain in their heel and their arch. Ankle injuries, ankle sprains and ankle fractures are actually becoming more common."

The thong that goes between your toes can also be a problem. Loshigian said, "In people, especially those who have sensitive skin or circulatory conditions and conditions such as diabetes that make their feet more prone to injuries and infections, this can be a point of irritation that can lead to infection."

While using a skeletal foot, Loshigian was able to clearly show the weak support that a flip-flop gives. "The standard beach flip-flop is very flat and really supports the arch very little," Loshigian said. "This is part of the reason that these sandals are really not good for long-term wear."

There are safer alternatives for those in need of comfortable summer footwear. As examples, he displayed a pair of sturdy sandals and the popular Crocs.

When choosing a safer sandal, Loshigian said you should look for a good tread pattern on the bottom of the shoe. The inside of the sandal should be molded to fit the arch and cup the heel. Having a strap around the back of the heel adds additional support.

CNN

PAGING DR GUPTA BLOG: The issue of flip-flopping

Friday, July 27, 2007

I recently spent some time at the beach, trading a suit and high heels for shorts and flip flops. When I returned home my feet and lower legs were killing me. It didn't take an expert to figure out that the cute sandals were to blame.

Apparently, I'm not the only one complaining about the trendy footwear. Podiatrists are seeing more and more patients with pain in the Achilles tendon, heel and balls of their feet. One doctor attributes most of the problems to the increased use of sandals and flip flops. The thin-soled shoes don't have the proper arch support and cushioning to protect the feet.

For those of you who aren't willing to compromise on comfort and style, there are some ways to relieve the pain. Stretching your calves can help sore feet and leg muscles. Ice and over-the-counter anti-inflammatory medications might provide temporary relief as well.

The best treatment might be to choose a better type of sandal. Find one with good arch support and cushioning and a little bit of a heel. A 1/2 - to 3/8-inch lift will help keep the calf muscle flexible and reduce that aches and pains.

My feet and legs are feeling much better these days, but I can't help thinking I'd rather be walking on the beach in my flip flops than sitting at my cubicle in high heels.

Boston Globe

In the News: Schools Tell Kids to Wear Flip Flops to the Beach,
Not Class

By Noreen Gillespie, June 19, 2004

NEW CANAAN, Conn. -- Toes are really, really in.
In the halls of New Canaan High School, the onset of warm weather means one thing. The squealing squeak of sneakers has been replaced by the shuffling and thwacking of flip flops smacking against the tiled floors.
This is flip flop freedom.

But for school administrators who typically spend the spring months battling against skinny-strapped tank tops, too-short shorts, tiny skirts and other skin-baring apparel, the flip flops aren't so cool. But it isn't an issue just of exposed skin. They're dangerous -- and schools across the country are deciding to outlaw them.

The footwear sported by the teens is as varied as the interests of students who wear them. Some girls wear spiffy black ones with embroidered flamingoes on the straps. Guys wear flops stamped with college logos. There are hearty athletic styles with bulky soles that retail for around $30; skinny rubber ones sell for about $2.

But the appeal of them all is pretty simple.
"They're effortless," said C.P. Allen, a flip-flop wearing student at New Canaan High School. "In the morning when you're rushing to get to school on time, you don't have to put your socks on."

Once confined to sandy beaches, pool decks and shower stalls, the boring rubber flip flop has undergone a design revolution. Now one of the must-have staples of students' wardrobes, everybody is flopping around -- except where they can't.
In Knox County schools in Tennessee, a ban has been in place for about four years. Sandals are allowed, but flip-flops just aren't stable shoes, officials said.
The hallways at Farragut High School in Tennessee are crowded because the school is holding about 600 more students than it was originally designed for, said Ed Hedgepeth, the school's former principal and now a district official. That makes it easy for a student going down the stairs to stomp on a flip flop, causing the wearer to trip.

"That's a safety issue," he said.
The flip flop bans differ from state to state, and district to district. Some administrators have chosen to forbid flops for all students, while other districts let schools set individual policies. Some schools just ban them in the winter.
There is no formal flip flop policy in place in New Canaan. But when an enterprising high school business class started a booming flip-flop business and wanted to go across the street to the middle school to boost sales, they were told the school didn't want to encourage students to wear flip flops.
"They believed if they let us sell them, they'd be endorsing flip flops," said Steven Rashin, a 16-year-old junior who is president of the mock company. (Rashin, by the way, prefers Nike flip flops. He confessed that the Toegoz brand his company sells flung off his feet too easily -- though that's not the case for everyone. The mock company has sold more than 300 pairs of the flip flops.)

Greg Macedo, principal of New Canaan's Saxe Middle School, said there are usually a few flip flop related injuries like a twisted ankle or stubbed toe reported to the school nurse each year. Although the school hasn't officially banned them, students are strongly encouraged to wear other shoes, he said.
There is no research that shows long-term wear of flip flops in children causes problems, said Samuel Berkowitz, an assistant professor in the department of orthopedic surgery at the University of Connecticut. But he recommends sporty-style sandals with a supportive sole as an alternative, he said.
For the most part, the thin, "dollar-forty-nine item in the drug store" type of flip flop don't provide enough support, he said.

"I think it's good common sense if you're going to be walking minimally, they're fine," he said. "If you watch kids, they wear them as their primary shoe gear during the summer months. They're horrible and they get more horrible the more you walk."

In Austin, Texas, where temperatures are accommodating for flip flop lovers all year round, school officials talked to parents, teachers and students before putting in place a new dress code this year. Students didn't like a lot of it, but they particularly did not like the flip flop ban.
To school officials, flip flops send a carefree message that conflicts with students' purpose in the classroom. While it also was a safety decision, the dress code changes were meant to instill a business-casual style of dress in school to influence decorum, said John Moore, executive director of educational support services.
"Flip flops are designed for the beach. They're not really designed for school wear," said Moore.

Courier Press

Flip-flops fit fashion nicely, but they trip up foot doctors

By CHELSEA SCHNEIDER, Friday, July 21, 2006
Before slipping on a pair of flip- flops, know that some doctors say those shoes can be harmful for your feet.
And on a summer day, wearing the sandals for a long walk is even worse.
Local podiatrists say the sandals are fine for shuffling around the house. For serious walking, though - going to the mall, grocery store or amusement park - sneakers are better.

The thongs aren't feet-friendly because toes must grip the ground so the shoes don't slide off. Muscles work harder when a person doesn't wear tie-on shoes. That's when injuries can start, said Dr. Jane Koch, a podiatrist with First Podiatry in Evansville.
She sees more patients in the summer, when people wear flip-flops more often. Putting the shoes on in May and keeping them on until August can cause arch strain and heel pain.

"People think in summer their feet need to breathe," Koch said. "It's true with all sandals. They think they are doing good allowing their feet to breathe, and that's not the case. Flip- flops are OK in moderation, but just don't wear them all the time."
Koch sees patients ages 10 to 25 for foot troubles usually caused by wearing sandals.
Dr. Brandt Dodson, a podiatrist with the Welborn Clinic, isn't a big fan of flip-flops for two reasons: The sole is the entire shoe, and they offer no protection for feet.

Birkenstock sandals offer more support with a firmer sole and are an alternative to flip-flops if a person wants to wear the sandals, Dodson said.
Flip flops are inexpensive and can be coordinated with a lot of clothes.
And when it comes to fashion, how it looks is more important than if it hurts, Katie Vanover of Owensboro, Ky., said.
Vanover has around 30 pairs of flip flops. She wears them in winter and doesn't mind the blisters she gets between her toes.
"I put a Band-Aid on and go," Vanover said. "As soon as I can wearshort sleeves, they're on all the time. You don't have to deal with socks. I'm sure in the long run it's not good for your feet, but I don't worry about it."

Nicole Osborne buys flip- flops with more support when her daughter asks for a new pair.
"I don't want her feet to hurt," Osborne said. "Ones that are bouncy, I usually find, give her more support."
Her daughter, Samantha Schuh, packs a pair of tennis shoes for gym class and throws on a pair of flip-flops for the rest of the day. She doesn't like how sneakers make her feet hot, and flip-flops are more in style, she said.

"I wear them in winter," Schuh said. "Everyone thinks I'm crazy, but I do. I think they're more comfy."
Wearing a tennis shoe, at least a part of the time, will help feet out, especially on hard surfaces, Koch said.
"I think I've really noticed flip-flops within the last three years," Koch said. "They've just been everywhere. For people without foot problems they are fine for a while. Obviously they are not a good choice of shoe, especially when worn over a long period of time while doing a lot of walking."

OC METRO BUSINESS

The flap about flip-flops: Cool comfort comes with a cost.

By Kathryn Atkins, SEPT 13, 2007

Southern Californians, and for that matter, many people in the world today, love their flip-flops. They’re comfortable, airy, cool and stylish. For the most part, they’re an inexpensive footwear choice. And they’re easy to find – one can buy them at grocery and drugstores, online and at gift stores. Their greatest asset is that they’re exceptionally speedy to slip on an off. So what’s all the flap about?

Flip-flops – also called zoris in the old days, or beach sandals, or thongs – can be hazardous to your health. They will not cause cancer but they may land you at the doctor’s office or at least with aches, pains and conditions you didn’t bargain for. According to the American Podiatric Medial Association (APMA), “… flip-flops just aren’t good for your feet.”

Supply and demand

No doubt, the number of pairs sold and the sheer scope of the range of styles would have you believe flip-flops are a successful invention. The footwear industry in 2005 was sized by NPD Group, Inc. at $42 billion, and consumers purchased 1.4 billion pairs of shoes. And in particular, from a 2005 release: “…men’s thong footwear is on the rise. Sales of men’s thongs (sandals) in department stores have increased fourfold since 2002. In fact, 10 of the top 50 best selling styles in 2005 were thongs.” An online survey of 560 women ages 18-54 showed that 66% owned at least one pair of flip-flops.

Prices for flip-flops are all over the map, ranging from 99¢ at Old Navy to $99 or more at Nordstrom. Bridal flip-flops, white with Swarovski crystals on the straps, sell online for $145. San Clemente-based Rainbow leather flip-flops retail for around $40. They’re part of the “uniform” for many college kids these days.

Indeed, flip-flops are widely worn for all occasions. A Southern California bride had her bridesmaids all in black flip-flops just last year, while the members of the Northwestern University women’s lacrosse team created their own flap by wearing flip-flops to the White House to meet President Bush in 2005.

But overall, while the prices might be low, the health cost of flip-flops can be high.

Wearer discretion advised

Dr. Christian Robertozzi, president of the APMA, states that most “flip-flops offer little in terms of arch support, foot protection, and shock absorption. Tendonitis, arch-pain, and sprained ankles are just some of the problems flip-flops can cause. Daily wearing can lead to plantar fasciitis (inflammation of the tissue along the bottom of your foot that connects your heel bone to your toes), stress fractures, and transmittable skin conditions.” Blisters and sores may result from uncomfortable straps, ill-fitting thong dividers between the toes, and/or materials that do not let your skin breathe properly.

Dr. Michael Loshigian, a podiatrist and foot surgeon at New York’s Mount Sinai Hospital and spokesperson for the American College of Foot and Ankle Surgeons (ACFAS), states: “Flip-flops are meant for short walks to and from the beach, not for everyday use…The ACFAS has seen an increase in reported injuries every spring and summer directly related to wearing flip-flops too much.” Teenage wearers have started to show up at doctors’ offices with foot problems usually seen in older people.

“Flip-flops make every pathological state of the foot worse,” Dr. Steve Naggs, a podiatrist in Clovis, New Mexico, explains. In other words, flat arches become flatter, heel calluses become more pronounced (from pounding and lack of cushioning) and hammer toes (in which the toe curls up and arches) can worsen from the gripping motion needed to keep the flip-flop from slipping off. Dr. Naggs also sees many victims of foot trauma, from toes being rammed or from something dropping onto an unprotected foot.

Podiatrists recommend that we not wear flip-flops at all. Short of complete abstinence, we can reduce short- and long-term harm, and more serious health hazards, by using common sense, reducing wear time and alternating with safer shoes.

Collateral damage

Know your wardrobe conventions. Corporate settings and the White House may not be appropriate for flip-flops. Consider the dress code and don’t commit a flip-flop faux pas.

Six ways to elude flip-flop injuries

1. Wear flip-flops for short durations. Disneyland is not the place to wear your favorite pair.

2. Choose flip-flops with arch support. The Rainbow brand is an example, as is Reef – the latter having a bottle opener in the sole in some of their styles.

3. Consider alternate constructions. Sandals with straps and/or closed toes like Teva offer more protection and reduce chances of trauma and injury.

4. Do not exercise or play sports in flip-flops – Even a quick pick-up basketball game can lead to dire results if played in flip flops.

5. Look for brands with thick, patterned soles to thwart slipping, foot punctures and excess heat transference.

6. Slather sunscreen on the tops of your feet and between your toes to prevent painful sunburns. OCM

http://www.ocmetro.com/NEW_SITE/metro091307/health.php

McClatchy Newspapers

Make sure those flip-flops won't cause difficulties. Be smart and strappy

By Don Mayhew, Monday, May 28, 2007
Fresno Bee At the Good Feet Store in Fresno, the foot of a skeleton display illustrates how summer footwear such as sandals may cause problems such as soreness and injury by not offering enough support.

It's nearly summer, when the living is easy and your feet have to work twice as hard.
When the weather warms, your toes want to get out and play just as much as the rest of you. But sandals, flip-flops and women's little strappy high-heeled shoes all pose potential problems for your feet.

Dr. Johnny C. Benjamin, director of Medical Specialty Procedures Surgery Center in Vero Beach, Fla., says he's not against wearing airy footwear.
"You just have to be smart when you do it," he says. "Especially in cold-weather climates, people are cooped up for several months a year. Now they get spring fever and just want to get out and enjoy life."
Benjamin understands. But he says people don't consider the drawbacks of casual open-toed shoes, and before long, they're developing unexpected aches and pains and wondering where it all went wrong.

Taking your measure
Larry Schneider, owner of Good Feet stores in California, says casual summer shoes cause problems when they don't fit right.
"Make sure somebody actually measures your foot," he says. "You'd be surprised how many people come in here, and they wore size 10 when they were 25 years old. Now they're 50 years old, and they still think they wear size 10."
It's not just the length of your feet but their shape that matters. Good Feet specializes in arch support, and Schneider says there are all kinds of variables when it comes to finding the right fit.

"You and I may both have a size-10 foot," he says. "But the distance between your heel and the ball of your foot may be different than mine."
Even when they know their size, some women are tempted to go smaller when choosing a cute pair of heels.
"They look great," Schneider says, "but you're stuffing your foot into a shoe that doesn't fit, and you're all on your toes."
As for stilettos, Benjamin says that while they may be popular, "they're not real good for your feet."

"It's stressing all of the weight, basically, on your tiptoes," he says. "If a person could imagine walking on her tiptoes for six to eight hours a day, how much stress would that put on her foot?"

Benjamin suggests that women who want to wear stilettos do so for short stretches by wearing sneakers during commutes or even while sitting at their desks.
"When you actually have to go to that meeting that you're going to, that you're trying to look so fabulous for, now's the time for the stilettos," he says.
Keep in mind that the wider the heel, the more balance you'll have, and the less weight will be distributed solely on your toes.
"Get as wide a heel as the fashionistas will allow," Benjamin says.

The perils of flip-flops

Ross Nishijima, a podiatrist, says flip-flops also should not be worn all day.
"I wear them all the time, washing the car or going to the store," he says. "They're great. You just slip them on, and off you go. (But) there's not much support in that type of shoe.

"For most people, if you're not going to wear them for long, fine. But walking, hiking, a day at Disneyland, they're probably not appropriate."
People often wear flip-flops where they know their feet will get wet. Benjamin says moisture can lead to fungi, so daily washings and, especially, drying, are essential to healthy feet.

Flip-flops also have little stability. Benjamin says running in them is a bad idea.
"But a person just thinks, 'I'll run here,' or, 'I'll run there real quick,' for a few short steps, and your foot slides out of the sandal, you go down and end up with a nasty ankle injury," he says.

Another accident waiting to happen: "Cutting the lawn with a lawn mower while you're wearing flip-flops," Benjamin says.
"You've seen it done a million times. Not a great idea."
Wearing appropriate open-toed shoes has never been easier, Nishijima says. There are comfortable sandals designed specifically for walking and golfing, among other activities.

Schneider's store sells sandals with removable insoles, making it easier to offer customers inserts with the proper arch support.
Summer footwear is all about comfort and style. But Benjamin says while you're looking good, make sure you don't have one foot in the grave danger of developing a chronic problem.

"If you're trying to get out and enjoy life and nature," he says, "use some common sense, so you don't end up trading your sandal for a cast."

Quad City Times

When it comes to our feet, why do some of us refuse to toe the line?

By Lindsay Lyon, The Indianapolis Star, Friday, August 11, 2006

As flip-flops smack heels through every town, mall and beach this summer, podiatrists are shaking their heads.

“Flip-flops are the number one culprit when it comes to people and foot ailments,” says podiatrist Wendy Winckelbach. “They’re great when you’re in a public gym or shower and want something on your foot for protection, but they’re not designed for you to run all over town in.”

Seemingly harmless, podiatrists say these rubbery thongs make avid wearers more prone to injury. They slip off easily, don’t absorb much shock and make toe stubbing and ankle rolling inevitable. Overuse can cause tendonitis, blistering, arch pain, sprained ankles and stress fractures. They can exacerbate existing problems like bunions and hammertoes.

Winckelbach has seen the ills these flimsy kicks bring about. One patient in her 20s was feeding a city parking meter when her flip-flop slid off the curb. She twisted her ankle and snapped the bone.

“Flip-flops just don’t offer a lot of protection,” Winckelbach says.

A recent influx of such ailments and injuries prompted the American Podiatric Medical Association to issue a news release urging people to ditch their flip-flops for more supportive sandals. Included were the results of a survey conducted to discover how many women value comfort over fashion. Just 33 percent of those asked chose comfort.

“We’d like that number to be higher,” says Dr. Harold Glickman, immediate past president of the APMA. “I realize what time of year it is, but we’d like to see more women think of comfort and shoes instead of flip-flops.”

Foot relief isn’t on 12-year-old Samantha Nichols’ mind. The Greenwood, Ind., girl says she owns about 20 pairs of flip-flops that she decorates by winding furry fabric around the tops. She wears them when she can.

“I don’t care if there’s snow on the ground, I wear them anyway ... if my parents will let me,” Samantha says. “It’s because they’re really cute.”

Glickman exhaled deeply when he learned of Samantha’s loyalty to the shoes.

“That’s about the craziest thing I’ve ever heard,” he said. “That’s the best way to get frost bite, really hurt yourself and inflict severe damage on your feet.”

Strolling through a mall, Texan Anita Hill, 53, says she wouldn’t bash her favorite footwear.

“I’m not going to talk bad about my flip-flops,” Hill says. She has dropped anywhere from $1.99 to $40 for a pair. “I bet I’ve got like 30 pair in 26 colors. Some have high heels.”

Although Hill swears by her collection, she admits her toes sometimes get sore from gripping the bottoms too intensely.

Shoe stability test If you can wring a shoe out like a wet towel, it doesn’t offer adequate side support. If you can fold it in half like a pancake, then there is not enough bulk to the sole. Shoes should be pliable, where the ball of the foot falls, but not at the mid arch. Most flip-flops won’t pass this test.

Daily Herald

The flip side of summer footwear

BRITTANI LUSK, Thursday, July 12, 2007
You don't have to look closely to find the familiar shape and hear a constant clip-clop: In the office, on the beach and even under wedding gowns. Flip-flops are quickly becoming a summer staple.

However, wearing the wrong kind or wearing them too long could cause foot pain now or as feet age.
Scott McKell, a podiatrist in Orem, said flip-flops can cause problems.
"They just have no arch support or cushioning," he said.

Last year, McKell had a patient fall from a pair of tall flip-flops and break three bones in her foot.
Most injuries are not that severe, but McKell said he is seeing more and more people with ailments such as plantar fasciitis -- a pain in the heel of the foot -- stress fractures, hammer toe and bunions due to the shoes.
Douglas Stoker, a podiatrist from Salt Lake and a member of the board of trustees for the American College of Foot and Ankle Surgeons, said the shoes should not be worn all the time.
"Flip-flops were not meant for walking," he said.

Even if you do try to walk in flip-flops, Stoker said most people have to use their toes to grip the shoes, and that's not good.
"Any shoe that doesn't let you walk normally is not a good shoe," he said.
The sandals were meant for recreation, not prolonged use.
Young people are wearing the beach shoes all the time. Emily Howell, 22, of Payson even wore them while she got married. She likes them because they are simple.

"They're easy to get on and off. That way, when I'm late for work it's just fast," she said.
Flip-flop fans also said they're good because feet can breathe in the summer heat.
"My feet just get sweaty, and so I just like putting them on because you don't have to wear socks or anything like that," said Sher'l Cameron, 18, of American Fork.
McKell has been seeing more and more young people come in for the ailments. In the summer, his average clientele of 30- and 40-year-olds mixes with teenagers.

"I think we're seeing more and more kids," McKell said. "It's kind of in now to be a little bit more causal."
Dan Lueken, 30, of Provo said he wears flip-flops six out of the seven days of the week because they are comfortable and cool, but he has never hurt his feet because he doesn't wear them when he should be wearing more stable shoes.
Cameron said she is clumsy in the shoes.

"Flip-flops just flip all over the place. You just always fall all over them."
She doesn't wear flip-flops to work because she said it is dangerous.
Stoker said people shouldn't wear flip-flops to school or work, but they were fine for goofing off at the park.
Many young people have heard about the dangers of flip-flops, but aren't worried.

"I've heard that it's not very good for your arch support, but whatever. I'll deal with that when I'm older. I like them now," said Ashlee Langer, 22, of Provo.
McKell said young people could develop problems from wearing flip-flops too often.
"I think that's a huge potential problem," he said.

Stoker said that people at risk for hereditary foot problems such as hammer toes can make those problems worse. Another problem is potential injury. Stoker said it's better to have an object fall on a foot in a shoe rather than exposed toes.
Young people don't have to swear off comfort forever. McKell said he owns a pair of flip-flops. A more expensive pair with arch support could help. Cheap three-dollar pairs won't give the support needed.

"If you're addicted to flip-flops, make sure you get a good pair that have good arch support in them," McKell said. "It makes a huge difference."

Daily Mail

Flip flops can damage your health

By JULIE WHELDON, 09:27am on 3rd August 2006
Perfect for hot weather, they have been the fashion hit of the summer.
But doctors have warned flip flops can be as bad for your health as they are for your career.
Business chiefs said last month that wearing them to work was an invitation to be sacked.
Now medics have joined the attack by saying they can lead to joint pain, shin splints and twisted ankles.
Mike O'Neill, a Windsor-based foot surgeon who regularly treats patients with flip flop injuries, described them as 'dangerous'.
'Wearing flat shoes stretches the calf muscles hugely if the wearer is used to wearing a heel,' he said. 'It strains the Achilles tendon and the back of the leg. Pain can start to develop after two weeks.'

He said the single thong between the toes offered the wearer 'no support'.
Doctors recommend that flip flops should be saved for the beach and replaced with shoes with backs or proper straps to hold the foot in place. Figures show that 55,100 men and women went to hospital with flip flop-related complaints in 2002.
Harley Street foot surgeon Barry Francis says he sees six patients a week with flat shoe injuries. 'The problems are down to overuse,' he said. 'When people wear flip flops all the time they are constantly scrunching their toes up into a claw.
'That can cause problems such as tendonitis and even shin splints. People go to work in them and stand in them all day. They are also extremely unstable so you are more likely to trip over and hurt yourself.

'Every shoe fashion causes problems to an extent although this one seems to be taking a while to subside.'
Another doctor reported a spate of injuries among women wearing another 'danger' shoe: the high heel.
'Women are dressing differently and a lot of them are coming in with high heel shoe injuries,' said Dr Rupert Evans, of the University Hospital of Wales in Cardiff. 'It has definitely been caused by the good weather, women being out and about and drinking more in the evenings.
'If a woman is tipsy and wearing a high heel she will be unstable. In the event of a fall the damage will often include a dislocation of the ankle, torn ligaments and even a break. These injuries are the equivalent of a serious injury from a rugby tackle.'

A spokesman for the Royal Society for the Prevention of Accidents said: 'In this hot weather having your toes in the open air is obviously very attractive but people should be aware of what they are doing and where they are going as they are not suitable for every situation.'

Iowa City Press-Citizen

Increase Seen in Flip-Flop Injuries

Podiatry Update: Flip Flops not good for your feet, 6/28/06

An Iowa podiatrist says flip-flops not only cause pain but also can lead to foot injuries. "Flip-flops are dangerous because they don't cover your feet, so when you trip, fall or bump into something, you're more likely to get cut"

"People will miss a step and fall because there's no support, and they'll end up with ankle or foot fractures. It's also not uncommon for people to come in for toenail injuries after wearing flip-flops," she said.

Many flip-flop wearers suffer from lacerations as well as foot pain. "Flip-flops have no support for the heel or arch of your foot, so they can cause pain, tendonitis and swollen joints and muscles," adding that she sees an increase in arch and heal pain from mid-summer to early-fall because of the increase in flip-flop wearing.
Each summer she sees patients for injuries that occurred while wearing flip-flops, along with several patients who have pain directly related to flip-flop wearing. She recommends wearing sandals that have support and cover most of the foot. "The only time I would recommend wearing flip-flops is in a community shower to prevent fungal infections," she said. Flip-flop-related injuries and pain caused directly by the sandals have increased in the past 10 years that she's been in practice.

Source: Angela Meng,

Central Florida Channel 13 News

Flip Flops Flap

Thursday, March 22, 2007 8:55;47 AM
People wear them while doing everything from pushing baby strollers to playing frisbee.
"They're comfortable, said flip flop fan Nuria Curras.

“On a hot summer day, it's nice to be able to air out your feet a little and just feel the breeze through your toes,” Gregory Pearcy said.
But wearing flip flops can lead to injury.

"We do see some blisters and injuries and ant bites because of use in the backyard from flip flops, but most things we see as foot and ankle surgeons are from injuries, sprains, fractures, things like that,” said podiatrist Dr. Robert Duggan.
Duggan said the biggest problem with flip flops is that we tend to catch the flip flop on something and get hurt because of the way the sandal is attached to the foot.

"There's usually a little bit of material that comes between the big toe and first toe and we'll be able to drag the shoe along with us,” he said.
Duggan said it's not the flip flops fault. That the injuries tend to occur because the person is wearing flip flops at the wrong time.
"It's usually a very good shoe to use for beach activities and for walking around in our neighborhood, maybe not so good for gardening or athletic events,” Duggan said.

Duggan said you should look for flip flops with arch support and cushioning. Improper cushioning can cause us to change the way we walk.
"We actually turn the feet out,” he said. “That changes the alignment of the leg to the low back and repeated use or a daily use of that can increase some of the pain we have in the low back or knee and hip."

Duggan said when it comes to flip flops, size does matter. He said you need to make sure your sandals fit properly and don't slide forward when you walk.
Despite the potential for injury these flip flop fans say they aren't worried.
That's your health and fitness, Nancy Gay, Central Florida News 13.

North Texas Daily

Students' shoe choice potentially harmful

By: Victoria Smithee, Posted: 9/6/07

The campus bookstore might be selling items hazardous to students' health.

According to an article released by the American Podiatric Medical Association, flip-flops might be a dangerous choice of footwear.

"Flip-flops offer little in terms of arch support, foot protection and shock absorption," said Christian Robertozzi, president of the American Podiatric Medical Association, in a press release from the association. "Simply put, flip-flops just aren't good for your feet."

Robertozzi also said in the release that flip-flops can lead to foot-related problems like tendonitis, arch pain and sprained ankles.

Jaret Walker, a Denton podiatrist, said during the summer months, he usually sees about two flip-flop injuries per week.

"There are many more patients that come in with foot and ankle conditions who don't know which shoe caused their problem, so I'm sure the actual number is much higher," he said.

Walker said flip-flops offer no arch support, and this can easily cause the foot arch to be strained.

"The flip-flop is inherently unstable," he said. "Flip-flops slide off the person's foot when walking, and there is no ankle stabilization."

The human body relays a message to the brain about where the foot is in relation to the ground. This allows a person to judge each step, Walker said.

"Your brain cannot account for the position of the moving flip-flop, thus causing bad steps and falls," he said.

Walker said he agrees with the recommendation to pick an improved version of open-toed shoes. He said he wears an updated version of flip-flops that are more secure.
"Save the true flip-flops for specific days in which the activity level will be very low," he said.

Garland senior Jason Hart wears flip-flops almost every day, and he doesn't plan to stop wearing them, "unless I notice a change in the way my foot felt," he said.

Hart said flip-flops are convenient to wear because they are so easy to put on and take off but knows they might not be high quality.

"They're pretty cheap, so they're not very durable," he said.

Greenville junior Hannah Boshart said she wears flip-flops daily because they keep her feet cool.

Boshart said she probably won't stop wearing them after finding out they might be unsafe.

"I bet heels are more dangerous for your feet," she said.

Walker said both high heels and flip-flops have drawbacks.

"It's hard to say which poorly-designed shoe is worse," he said. "Everyday is different, and selecting proper shoe gear to safely handle your activities can keep you from visiting my podiatry office."

Walker said students should use good judgment when picking footwear.
"Flip-flops are fun shoes but come with risks," he said.

CHANNEL 6 NEWS KPVI.COM

Flip Flop Injuries

8/24/07

Flip flops are no longer relegated to the beach. They're worn on campuses and in offices all over the country.
They're trendy and relatively cheap, but podiatrists claim some flip flop fans are paying a painful price.
Dr. Perry Julien, Podiatrist: "When the summer months begin, we get so busy with people with heel pain, Achilles tendon pain, pain on the ball of their foot and in most cases we can attribute that to the use of sandals and flip flops.

Doctor Perry Julien argues many of the thin-soled foot coverings lack proper support and cushioning.
Dr. Perry Julien, Podiatrist: "This sandal has no heel, it has no arch support and it's very, very hard."
Doctor Julien explains low-heeled shoes can cause a strain on ligaments. He prefers his patients wear a shoe with more of a lift, with a three-eighths to half-inch heel.

Dr. Perry Julien, Podiatrist: "Here's an example of a good sandal. This sandal has a little heel height from the back portion to the front portion as well as having an arch across here."
If you're not willing to compromise on style, Doctor Julien says you can always try stretching your calves to help relieve sore foot and leg muscles.

THE CLAUSE

Flip-flops are simple, comfortable and fashionable. However, bacteria and sprained ankles loom on the horizon for avid flip-flop wearers.

LAURA JANE KENNY, staff writer

The infamous high heel has stepped down from its formerly known position as the most dangerous shoe.

New studies show that the beloved flip-flop is just as bad, if not worse, for your health.

An ABC article warns people about the popular and stylish flip-flops.

The adored sandals are bad for your feet due to lack of arch support, lack of ankle support, and the tendency for flip-flops to cause people to trip and fall.

The article featured Dr. Rock Positano, a podiatrist from New York’s Hospital for Special Surgery.

He has found flip-flops to cause more orthopedic problems than any other footwear.

Certain situations call for flip-flops, similar to formal occasions requiring high-heels.

However, like high-heels, flip-flops can cause negative strain on the foot when worn daily and for long period of times.

“Flip-flops have their place. They provide foot protection for things like showering in public showers, pools and summer activities, but they can have their disadvantage if you are trying to do any kind of activity. There is no support and no protection,” APU women’s health nurse practitioner Gidget Wood said.

People who wear flip-flops daily, even if they are Rainbows, are at risk for injury.

The ABC article advises that shoes should be switched out, regardless of the type of shoes, to prevent fungus and other germs. Flip-flops, in particular, should not be worn daily due to lack of arch support and unstable ankles.

Another article was printed in the Daily Mail, a British newspaper, warning readers of the dangers that foot apparel can cause.

The article informed people that flip-flops could lead to joint pain, shin splints and twisted ankles.

“People end up with foot injuries as a result of the lack of protection to the foot when they are trying to do things like play sports,” Wood said.

“Simply put, flip-flops just aren’t good for your feet,” Christian Robertozzi, president of American Podiatric Medical Association said in a release to the press.

The American Podiatric Medical Association (APMA) is a collaboration of America’s foot and ankle physicians and surgeons.

Some APU students can be seen wearing flip-flops in all weather conditions, relentlessly resorting to flip-flops over all other footwear. Some students defend their choice due to the quality of their flip-flops.

“With sandals, as with anything in life, you get what you pay for. If you’re not willing to pay for a good pair of sandals you’re not going to have good support,” undeclared freshman Jenna Lindsay, who loves her Rainbows, said.

Even APU’s beloved Rainbow sandals are being questioned.

Though Rainbows have good arch support and are comfortable, they are not the safest option for footwear.

Due to the single strap on one’s foot, tripping and falling out of Rainbows can cause injuries.

However, students are loyal to their beloved footwear regardless of the warning.

“[Rainbows] are the most amazing things in the world. I love Rainbows because of the arch support. And they are so comfy,” Lindsay, who owns a well-worn pair, said.

Positano treats up to 10 injuries a week caused from flip-flops alone.

He believes women replace everyday walking shoes with flip-flops cause this increase.

Flip-flops not only cause short-term problems, they can also lead to orthopedic issues later in life.

Positano has treated patients for nerve damage that was caused by wearing flip-flops over many years.

“They are easy to put on. It’s less hassle in the morning,” freshman theatre arts major Gavan Wyrick said.

The APMA suggests Wolky, Chaco, Dansko, and The Rockport Company for good alternative to flip-flops.

These sandals not only have better arch support, but straps to better keep the sandal attached to one’s foot.

“[Flip-flops] are the cool things to wear because it’s California. But after doing High Sierra, I would prefer wearing Chacos,” junior psychology major Megan Shelby said.

Students from APU are reluctant to act on this warning.

When informed about flip-flop pitfalls, students said they would still wear them, regardless.

“I have worn then my whole life,” freshman communication studies major Courtney Luke said. “I think they’re cute and they’re fun to wear. They are not very bulky so they are easy to walk around in.”

When informed about the damage that flip-flops can cause to a person’s feet some students will change their decision about flip-flops, without entirely leaving the particular footwear.

“Well maybe I would switch to a more supportive flip-flop. They have nicer ones now, I’ve seen them the ones that curve to your feet, not just the cheap flat ones,” freshman applied healthy major Colton Simmons said.

Rain or shine, APU students can be seen wearing flip-flops.

Even with the hazards, the convenience of flip-flops seem to outweigh the dangers.

http://clause.apu.edu/october26/arts-culture/article3.html

HELIUM

Flip-flops: What are the dangers of this popular footwear?

BY LOREN JAMISON
During the summer months, it's rare to see anyone who isn't wearing a pair of flip-flops. However, the popular summer footwear could be slowly damaging your feet, legs, and back. Although many people consider flip-flops a relief for their tired, achy feet, flip-flops are actually doing your feet more harm than good.

Most pairs of flip-flops have no arch support. This, along with the fact that the footbed is extremely spongy, causes your foot to overpronate when you step down. Overpronation, also know as flat feet, is a condition where the arch of your foot flattens, causing your foot to roll inward (toward the center of your body). Your foot pronates a small amount naturally; however, the spongy material that flip-flops are made of allows your foot to continue to pronate even further. If not corrected, overpronation can cause pain in the feet, ankles, legs, knees, and back.
Another problem with flip-flops is that they can cause you to fall more easily. Because they fit loosely, it is easy to trip on your flip-flops while walking. In addition, the straps often break at inconvenient times, further increasing the risk of falling. Doctors see numerous patients each summer because of injuries resulting from the wearing of flip-flops.

Instead of wearing flip-flops, you consider wearing a pair of athletic sandals. Find a pair that are comfortable and provide decent arch support. One company that makes a good pair of sandals is Chaco (http://www.chacousa.com). The footbed of Chaco sandals has been awarded the American Podiatric Medical Association's (APMA) Seal of Acceptance. If you insist on wearing flip-flops, here are some tips to reduce the chance of injury:

Don't buy the cheap flip-flops: Cheap flip-flops don't offer the necessary arch support. Find a pair that offers at least some arch support. Chaco sells a few pairs of flip-flops that use the same APMA accepted footbed as their athletic sandals. Avoid wearing flip-flops when you are going to be participating in physical activity: If you are doing anything that requires a lot of physical activity, such as walking or running, don't wear your flip-flops. They can cause you to trip and seriously injure yourself, and they don't provide the necessary amount of foot protection. Don't wear flip-flops for extended periods of time: It's okay to wear your flip-flops to the pool or beach. However, don't make flip-flops your primary shoe during the summer months. If you insist on wearing them throughout the day, don't wear them everyday. Try alternating between flip-flops and other shoes each day.

Flip-flops don't offer the arch support and foot protection of other shoes. They are okay to wear for short periods, such as when going to the pool or when stepping out of the house for a few minutes. However, extended wear can cause foot problems. The problems may not be immediately noticeable, but once they do become noticeable, you may have done permanent damage. If you don't like wearing regular shoes during the warm months, get a pair of athletic sandals with better arch support, and if you can't resist wearing flip-flops all day, try to switch between flip-flops and other shoes to avoid causing too much damage to your feet and ankles.
http://www.helium.com/tm/295713/during-summer-months-anyone

Summer Sandals Can Be A Pain

By Christine Dobrowolski, DPM
Summer has finally arrived. Along with summer comes shorts and tank tops, bathing suits and BBQs, sun and, of course, sandals. Easy to slip on and off and cool enough for the hot summer days, sandals tend to be the main choice for footwear during the summer months. Sandal styles vary, but flip-flops have been gaining in popularity in recent years. Unfortunately, along with flip-flops come foot injuries. The flip-flop style sandal has almost no arch support and little beyond the two flimsy straps on top to keep the foot on the sole of the sandal. The result is overworked tendons and an overstressed arch. Ankle sprains are common injuries for flip-flop wearers, but more chronic problems, like tendonitis and plantar fasciitis can also develop. Flip-flops are not the only culprit, many sandals do not offer much arch support, shock absorption and have little material to keep the foot on the sole. The combination of flip-flops and high heels tends to be the deadliest summer sandal choice. A nice summer evening out can easily turn into a night in the emergency room with a sprained or broken ankle.
There are many shoes and sandals available today which are comfortable, but will not compromise your sense of style. When looking for a summer sandal, following these simple tips:

1. The sole of the sandal should be larger than your foot. Your foot should not hang over the sides or the back of the sandal.
2. There should be enough material on the top of the sandal to keep your foot on the sole and to keep the foot from slipping.
3. The sole of the sandal should be rigid and not flex in the middle. If you can take your sandal and fold it in half, then it is too flexible and it will not offer enough support.
4. Keep in mind that many sandals are not made for walking, but designed purely for style. Owning one pair of sandals for walking and one pair for sitting at the beach or at a BBQ may be a good idea.
5. When buying a sandal for walking, look for a sturdy sole, multiple straps with buckles or Velcro, built in arch supports or an accommodation for a custom orthotic.

The American Podiatric Medical Association (APMA) has a list of shoes and sandals which have been given their approval. For more information on the APMA’s Seal of Acceptance program and their list of shoes and sandals, visit their website at www.apma.org/sealofacceptance.
If you just can’t imagine the idea of parting with your flip-flops or stylish sandals this summer, then consider carrying a pair of athletic shoes or walking sandals in your car for those times when you may be doing more walking. Areas with hills, stairs or slippery surfaces are not appropriate for walking in flip-flops and could lead to injury. If you develop arch pain or heel pain while in your sandals, stop wearing them and visit a podiatrist.
Christine Dobrowolski is a podiatrist and the author of Those Aching Feet: Your Guide to Diagnosis and Treatment of Common Foot Problems. To learn more about Dr. Dobrowolski and her book visit http://www.skipublishing.com.

http://EzineArticles.com/?expert=Christine_Dobrowolski,_DPM

Ottawa FYI Site

Flip-Flops and Foot Problems

August 15, 2001

Flip-flops, once relegated to beaches and pool decks, have fast become a fashion staple this summer, adorning the feet of working women and Hollywood celebs alike. But some Canadian foot doctors say the notoriously flimsy footwear should not be worn every day, and can ultimately cause trouble for tread-weary tootsies.

"There's no support, people who walk in them for extended periods of time might start to experience some arch pain, back pain," said Robert Chelin, president of the Canadian Podiatric Medical Association.

"They're not protective for the foot because they're open, so you're going to end up seeing people stub their toes, things like that."

Flip-flops have been popular in fashion pages this summer, showing up on celebrities like Debra Messing of TV's Will and Grace.

In Canada's most populous city, flip-flop business has been brisk.
"They've been selling out like crazy," said Natasha Putten of Get Out Side, along the city's trendy Queen Street West.

They're easy to put on ... they're light to wear and when it's hot your feet can breathe."
While flip-flops -- also known as thongs -- can still be purchased at drugstores and dollar stores, high-fashion versions have recently entered the market, some adorned with silk, banana leaves, denim, ribbons and rhinestones.

Messing's favourite flips, for example, are studded with crystals and retail for about $150 US.

There's even a Web site devoted to the flip-flop craze at www.flipfloptrunkshow.com

"Flip-flops are ... super popular," said Nic Wong of downtown shoe boutique Groovy. "People seem to like printed flip-flops, with flowers and designs. It's a Hawaiian, beachy look."

But flip-flops, as their name suggests, are also less-than-sturdy.

Earlier this week, one U.S. newspaper reported that doctors had seen a 15 per cent rise in "flip-flop related injuries," like back pain, knee problems and numb toes.

Podiatrists like Lloyd Nesbitt say they're not suggesting fashionistas give up their flip-flops entirely, but do advise discretion.

"My advice would be if people want to wear these, wear them for a shorter period of time," he said.

"People should just not wear (flip-flops) all day long, maybe a few hours here and there if it's really hot and they're not doing a lot of walking."

The shoes, said Chelin, are simply not built for the street.

"A flip-flop to me is something you'd wear around the pool, around the health club or the beach," he said. "It's basically a convenience item. It's not meant to be a long distance walking item." Despite the warnings, however, podiatrists acknowledge they have long fought a losing battle with women who insist on squeezing their soles into the shoe of the moment.

Chelin said he still sees young girls suffering the effects of Spice Girl-esque platform shoes that were popular a couple of years back.

Some doctors have simply accepted the fact that fashion is frequently more powerful than common sense.

"People will wear what they want to wear," said Nesbitt. "Fashion dictates, and so my advice is don't become a complete slave to fashion and try and wear something reasonable part of the time."