The Ills of Flip Flops

Nothing says summer quite like flip flops. What would summer be without them? On that first warm day of each season, I love to set my cooped up feet free, don one of my many adorable pairs, and hear that ‘flip flop’ noise they make with each step. But after I started suffering from lower back and leg pain that seemed to coincide with warmer weather and the relegation of my more supportive shoes to the back of my closet, I began to ask myself if once again I would have to make a choice between fashion and comfort.

After beginning physical therapy for my ailments, I offered my theory to my therapist, and he agreed that with my weak arches, wearing flip flops constantly could have been a culprit in the pain I was experiencing.

According to Lawrence Rubin, DPM, “The flimsy construction of flip flops provides zero support to the feet — something that is unhealthy to almost all feet.” He encourages the regular use light-weight athletic shoes with built-in arch supports. Timothy M. Axe, DPM agrees. He offers the good, the bad, and the ugly on flip flops:

The good: flip flops provide basic foot protection to the bottom (plantar) foot. They may help prevent catching fungal infection and warts in public showers. Flip flops are good for short periods of time, quick errands, and periods when the wearer is not doing a lot of walking.

The Bad – flip flops offer no support for the arch, no shock absorption, no heel cushion, and not much protection on the top and sides of the foot. They lead to greater risk of toe injuries, puncture wounds, cuts from foreign bodies, and possible insect or snake bites. They are not good for sports. Flip flops accentuate any biomechanical deficiencies of the foot. They may also affect balance and may lead to falls particularly in older patients.

The Ugly: There are an increasing number of cases of plantar fasciitis (arch/heel pain) and tendonitis in the foot and ankle, particularly in the 15-25 year old age range, where typically we do not these problems as much.

In case you weren’t convinced yet to ditch your $5 flip flops from Old Navy just yet, Dr. Stephen Arbetters, a podiatrist in Newton, Mass, added:

“In a normal flip-flop the front of your foot has to work harder to keep the flip flop on. That can lead to tendonitis, arch pain and hammer toes.” This means that even some of the flip flops that offer arch support may not necessarily be much better for your feet. Just because they feel comfortable, doesn’t mean they are providing the support and protection you need.

“For all the shoes seductive sponginess, 99 percent of them provide no support. So they can stress other joints, causing pain in the knees and back. Flip-flops also don’t absorb shock and they are unstable which makes it easier for the wearer to turn an ankle.” Arbetters sees many patients who wear flip-flops with conditions such as plantar fasciitis, an inflammation of the tissue on the bottom of the foot.

Podiatrists weren’t the only people I spoke with who had an opinion on the matter. I also heard from Aliesa George, a Pilates instructor and personal trainer who spends her days working with people to improve their posture, strengthen their core, and create proper muscle function through simple foot care exercises, awareness about good shoe choices, and improved shoe tying techniques.

George reiterated the notion that flip flops offer no support, and added to the discussion more on the mechanics:

“Most feet that I see wearing flip flops are rolled in at the ankle which causes the arches to continue to drop or flatten to the floor. Over time this reduces the mobility of the ankle, and will lead to knee, hip, and back issues because the base of support (the bottom of the feet) are not functioning and being held in proper alignment for the rest of the bones to stack correctly on top of them. Since our muscles attach to the bones and act as a lever and pulley system, if the bones aren’t lined up correctly, the lever system for correct and proper muscle firing for exercise and everyday movement will be compromised. If this compromise occurs daily, with every step you take, all you are doing is reinforcing bad posture, body alignment, and improper muscle firing patterns for movement. With time, the ONLY thing that can occur is pain and injury.”

I personally thought all of my problems could be solved by switching from flip flops to Mephisto Helen sandal with support for arches and a cork footbed. But as Aliesa George could probably have told me, a little extra support in the arch was not enough. “The toe muscles are working incorrectly with every step you take in flip flops (this holds true for every pair of strapless shoes.) The big toe and second toe are constantly squeezing together to hold on to the shoe. Not only do the first two toes squeeze together to hold a flip flop on the foot, but all the toes curl under to “grab” the shoe and keep it on during the swing through phase of each stride. This is the exact opposite of what the toes should be doing when you take a step!”

While George reminded me that she is not a shoe expert, she suggested that if you do want to wear sandals, look for options with a strap that goes around the ankle to help hold the shoe on the foot. She has also written a book on foot care exercises called Fantastic Feet. You can also purchase a combination kit that comes with the book and all the tools you need to do the exercises.

So now that you are thoroughly depressed (if you’re like me) over the prospect of eliminating an icon of summer, there is a silver lining. First, Dr. Jonah Mullens, a podiatrist with the Pacific Foot and Ankle Institute in Palo Alto, Ca., offered an everything in moderation approach suggesting “you can wear something a little less than sensible 20% of the time if you commit to comfortable shoes the other 80%.”

For that 20% of the time you still really want to wear flip flops, based on my research, there are definitely some that are better than others.

The makers of Beech Yoga Sandals cite Prevention Magazine which touted the sandal as a “better Flip-Flop for the way the sandal promotes balance and stability.” Owner and creator Gayle Trenberth says “Yoga Sandals® stay secure on the foot while walking and allow the tendons and muscles in the feet to work in freedom with proper heel support. Yoga Sandals® help keep feet flexible and enforce a basic principle of yoga which is to spread the toes to achieve optimal grounding and proper body alignment to master the standing poses.”

Some other brands that offer a little more cushioning and support support are Rainbow Sandals, Reef Sandals, and the FitFlop Thong Sandal the makers of which actually claim gives you a workout while you walk.

If you want to take a step in the right direction, but aren’t ready to close your feet in, try sandals with ankle straps like these Merrell Savannah sandals or Dansko Women’s Serafina Sandal

If you’re like me, and ready to throw the towel in all together on sandals, but still want a light weight, cute summer shoe, try these Privo Acacia mary jane shoes. I have a pair, and they are really comfortable and look great with jeans and shorts, and even some of my sportier skirts.

At this point in my life, I have more of an appreciation of my body and am interested in doing what I can to take care of it. I figure I don’t need to accelerate the decline of my body by wearing shoes that don’t offer the support I need to maintain a strong and healthy back and legs.