Warnings and Advice for Wearing Flip-Flops This Summer
Flip-flops are as much a part of summer as fireworks on the 4th and long afternoons at the beach or by a pool. However, flip-flops can also mean an afternoon spent in the ER or winding up limping painfully for several weeks. In a recent press release issued by orthopedic doctors at the Mount Sinai School of Medicine in New York City, flip-flop use poses two problems: they offer little to no support for the arches and no protection for exposed toes.
Flip-flops are typically nothing more than a thin layer of rubber or plastic designed for convenience and for protecting tender soles from bits of yard or beach debris—which is fine for casual, temporary foot wear. However, where most people wind up in trouble is exceeding causal use by wearing flip-flops all day long. Wearing flip-flops all day long means that your feet are not getting the normal support and cushion they need to remain healthy.
One result of lack of support is the risk of developing arch pain or plantar fasciitis—the most common cause of heel pain. The plantar fascia is a long, flat band of ligament that connects your heel to your toes and provides support for the arch. When poorly supporting flip-flops are worn for extended periods of time, the ligament becomes overly stretched, weakened and inflamed resulting in pain on the bottom of your foot. Ignoring the pain and continuing to wear flip-flops can cause tears to develop in the ligament and worsen the problem.
Another problem associated with poor support is poor absorption that not not affects the feet, but can also affect the bone-to-bone joints in the ankles, knees, hips and even the vertebrae causing severe back pain.
Face it, open-toe sandals and flip-flops are an open invitation to insult and injury. Small breaks in the skin and cracks in the nails can allow bacteria and fungi easy access to your toes that in the least can lead to discoloring fungal infections under the nails that are nearly impossible to get rid of. The biggest problem with under-the-toenail fungal infections is that it takes weeks or longer of anti-fungal medications that are not only toxic to the nail fungus, but toxic to the liver as well and often contraindicated for patients on other types of medications.
Injuries from exposed flip-flop shod feet range from simple stubbed toes to ripped-off nails. Typical injury examples seen in adults include a nail snagging on a wood patio step, impalement with a sliver under a toenail, or (my favorite) weed-whacking trauma. Children are more prone to experience scraped toes and lost nails from their flip-flops slipping off of the pedals of their bicycles.
Another concern is excessive sun exposure to the skin of the feet. Sun-related skin cancer can develop anywhere on the body that is not adequately protected from UV-ray exposure. An SPF-30 or higher sunscreen is recommended for the feet while wearing flip-flops.
However, in spite of the potential for injuries this does not mean that flip-flops should be altogether avoided—just use a little common sense and heed the following Do’s and Don’ts of flip-flops as recommended by the American Podiatric Medical Association (APMA):
• Do shop for a flip-flop made of high-quality, soft leather. Leather minimizes the potential for blisters and other types of irritation.
• Do gently bend the flip-flop from end to end, ensuring it bends at the ball of the foot. Shoes of any kind should never fold in half.
• Do ensure that your foot doesn’t hang off of the edge of the flip-flop.
• Do wear a sturdy pair of flip-flops when walking around a public pool, at the beach, in hotel rooms and in locker room areas. Walking barefoot can expose foot soles to plantar warts and athlete's foot.
• Don't re-wear flip-flops year after year. Inspect older pairs for wear. If they show signs of severe wear, discard them.
• Don't ignore irritation between toes, where the toe thong fits. This can lead to blisters and possible infections.
• Don't wear flip-flops while walking long distances. Even the sturdiest flip-flops offer little in terms of shock absorption and arch support.
• Don't do yard work while wearing flip-flops. Always wear a shoe that fully protects feet when doing outside activities such as mowing the lawn or using a weed-eater.
• Don't play sports in flip-flops. This practice can lead to twisting of the foot or ankle, as well as sprains and breaks.
The APMA also advises consumers that when shopping for a pair of flip-flops to choose only those brands that carry the APMA's Seal of Acceptance. According to the AMPA website, their Seal of Acceptance evaluates footwear, materials, insoles, hosiery, and equipment. The Seal is awarded to a product after the Committee on Podiatric Seals, a standing committee of the American Podiatric Medical Association, scientifically evaluates and determines whether the product allows normal foot function and promotes quality foot health.
So, for a safe footloose and fancy-free summer this year with your feet, buy a good quality pair of flip-flops, limit the time spent wearing them to only a couple of hours per day, avoid all activities where exposed toes are at risk of injury and enjoy the feel of summer on your feet.
This page is updated on May 3, 2013.