Flawed Footwear

Flawed footwear
While convenient, flip-flops cause strain, other painful health issues

Janie Boschma Issue date: 9/8/08 UW-Eau Claire Spectator

When the weather is warm, it's nearly impossible to find a college-aged student without flip-flops.

But, despite their popularity, the soft-soled, thong-strapped sandals cause more problems than they're worth, doctors say.

Freshmen Samantha Kopet and Shelby Mikutowski said they wear their flip-flops daily, for everything from walking to class, running errands, shopping at the mall and heading to the beach. "Actually, we wear them a lot more than we think," Kopet said.

The most significant consequence of regular flip-flop wearing is plantar fasciitis, said Dr. Jay LaGuardia, director of Stucky Chiropractic Center, 2105 E. Clairemont Ave. Plantar fasciitis is the inflammation and "tearing away" of the tissue on the bottom of feet that connects the heel to the toes, LaGuardia said. That tissue, the plantar fascia, forms a foot's arch.

Plantar fasciitis occurs when the lack of arch support in flip-flops causes the foot to rotate inward (or pronate), which collapses the arch, he said.

If left untreated, he said plantar fasciitis can develop into a heel spur, a painful build-up of calcium on the heel. "Most people have some pronation or flattening of the arch," LaGuardia said. "Flip-flops cause the foot to pronate further."

Like many of LaGuardia's patients, Mikutowski and Kopet said they wear flip-flops for three main reasons: they're convenient, cute and comfortable. With so many colors and styles available, senior Maggie Mattson said they also make a great accessory. "You can dress them up or wear them to the beach," Kopet said. "They're very versatile."

LaGuardia said he has an easy way to tell if one of his patients has been wearing flip-flops too often. If the sole of the flip-flop is more worn on the inside and the outside looks like it's still new, he said there's a good chance they have developed plantar fasciitis. A normal foot would put more pressure on the outside of the sole, he said.

People who have naturally low arches are most likely to develop foot pain from frequent flip-flop use, said Dr. Mark Herr, an orthopedic surgeon with Luther Midelfort's Orthopedic Center, 1400 Bellinger St. He specializes in foot and ankle surgery.

To avoid getting "flat feet," senior Ben Rud said he makes a point of buying high-end brand flip- flops with better arch support. He said he probably wouldn't stop wearing flip-flops until he finds them too painful.

LaGuardia said buying flip-flops with some arch support is still not ideal. "They do tend to have arch support, but remember that's generic arch support," he said. "It's better, but it's still not great." LaGuardia said flip-flops also create spinal misalignment. Since the body is so asymmetrical, he said there is always one foot that pronates more than the other does. La Guardia said the pelvis then tilts to that foot. The imbalance places extra stress, wear and eventual pain on the hips, lower back and spine, he said.

Mattson said she likes flip-flops because they're more comfortable than her other shoes, especially because then she doesn't have to wear socks. "I don't like my feet being constricted," she said. "(Wearing socks) is against my policy unless I'm going for a run."

Rud said flip-flops' biggest appeal is the ability to take them on and off quickly and easily. The problem with flip-flops, Herr said, is that because they're so easy to slip on, they also easily slip off - making it much easier to sprain an ankle, especially on rough terrain. Rud said his flip-flops stay on pretty well unless he's walking uphill and the sweat from his feet makes the flip-flops slip off. Wearing flip-flops requires pinching the toes together to keep them from falling off, Herr said. This creates extra pressure on the toes, in turn overworking the inner muscles of the foot, which then causes additional strain on leg muscles and the knees to compensate, he said.

For people who already experience foot and leg pain, flip-flops only make matters worse, LaGuardia said. "The big thing is if they already have problems with feet or knees, they should stop wearing them right away," he said. Besides internal injury, flip-flops leave the tops of feet and toes completely exposed, Herr said. As a result, wearers are much more likely to get hurt from stubbed toes, infections or broken glass.

Herr said flip-flopped feet are more prone to skin cancer, because the sandals also don't provide any protection against the sun. Many people wear flip flops all summer, but never think to apply sunscreen on their feet, he said. Rud pointed out the dark tan lines on his feet from his flip-flops' straps this summer. He said he doesn't apply sunscreen there, because after his feet burn once, his skin blends into a tan. "The word 'cancer' is one of those words that makes you think," he said. "I just haven't given it much thought."

However, Herr said flip-flops aren't entirely terrible. They're ideal for protecting feet from fungus in public showers, he said, and their lack of heel prevents friction irritation to Achilles tendonitis. Herr said wearing flip-flops only occasionally shouldn't cause harm, but wearing them as everyday footwear is definitely going to create long-term damage. "Walking around your house is perfect, and maybe walking around campus is fine," he said. "At the same time, I think there are better shoes."

LaGuardia said flip-flops only provide one real advantage - convenience. He compared them to soda, another product that is popular because of its convenience, but causes nothing but health issues. As soon as wear patterns (heel, toe indents) develop on a flip-flop, LaGuardia said it's time to throw them away. Because he said plantar fasciitis is just the beginning of a long list of health problems.

For now, though, most college students are just not that concerned. "We're young," Kopet said. "I'm sure we'll regret it later."