ANKLE & FOOT
One of the joys of summer is the ability to wear lighter clothing and that includes shoes. Summer favorites are flip flops. They can be purchased just about anywhere. They are affordable and come in a multitude of styles and options. Many people find that switching over from warmer and more supportive shoes to these lightweight summer wear comes with a price. Flip flops don’t provide support to our feet. Wearing flip flops can worsen and even cause foot pain and issues.
A study in the Journal of the American Podiatric Medical Association in 2016 noted that people who wear flip flops take shorter steps when walking. This changes the normal walking stride. Wearing flip flops also increases the angle of your ankles during stepping which changes the normal function of the foot muscles. When wearing flip flops your feet move in new ways, toes are taking on more pressure and force as they try to hold the shoe on the foot. This creates a muscle imbalance. The result is overworked tendons and arches. Below are some foot ailments that can be attributed to or increased by flip flop wear.
PLANTAR FASCIITIS: This is the most common ailment from wearing poorly supported shoes according to the Journal of Family Medicine and Primary Care (2022 July 22). The need for over gripping of your toes to keep the shoe wear on along with the lack of arch support can inflame the plantar fascia ligament and soft tissue on the bottom of your foot creating this painful condition.
METATARSALGIA: Pain at the balls of your feet. This occurs as your toes try to grip to keep the flip flop on as you walk. Your foot muscles must work out of turn and without support. The balls of the feet are forced downward. This can inflame the metatarsal joints of the feet causing metatarsalgia.
HEEL PAIN: The lack of cushioning between your heel and the ground with repeat steps can create excessive shock causing heel pain during initial heel strike.
TENDONITIS: Foot fatigue with long time flip flop wear can cause irritation to the tendons of the foot. Repetitive strain can cause tendonitis. This can worsen with time and turn to tendinosis which is a degeneration of the collagen inside the tendon. This chronic condition is more difficult to treat.
BONE SPURS: Long term wear of flip flops can put pressure on the arch of the foot and create inflammation of the tissue as previously stated. With time bone spurs can build. Bone spurs are spike like shapes that form from calcium. This is the body’s way of reinforcing the stressed tissue but it backfires creating painful bone spurs.
BUNIONS: These bony bumps form on the base of the big toe. The great toe will move in an outward direction which is called hallux valgus. Bunions can occur from dislocating the metatarsophalangeal joints of your great toes. Flip flops create more force through the great toe. With the constant motion of walking on a flat shoe the body weight is forced to shift to different parts of your feet setting up the big toe for worsening of bunions.
HAMMER TOES: This is a foot condition where the toe has an abnormal bend in the middle joint, the proximal interphalangeal joint. Wearing flip flops can cause and worsen this condition due to the overuse of the flexor tendons of the foot which is required to maintain the flip flop on the foot.
ANKLE SPRAINS: Lack of support will increase the risk of tripping, falling and spraining your ankle.
OTHER COMPLICATIONS: When your feet are moving in new and different ways due to this footwear the rest of your body is also forced to change. The flip flop is thin, flexible and does not absorb forces of the foot. The forces taken with each step will move up the weight bearing chain. Therefore ankle, knee, hip and back will be receiving more force which can create pain.
In addition, if you develop foot pain you will change your gait to accommodate this pain which can affect your posture and other joints above the foot.
I LOVE MY FLIP FLOPS!! WHAT CAN I DO?
As a physical therapist, I have seen a multitude of these conditions during my career. As a flip flop lover, I have experienced the symptoms caused by flip flop wear.
Here are some suggestions for safe summer feet.
• Invest in higher end quality sandals, preferably with an arch support and a backheel strap.
• Wear your flip flops for short durations and for events when you won’t be walking a lot. For instance, the beach or a yard party.
• Bring a pair of comfortable supportive walking shoes with you or perhaps leave a pair in your car. This allows you the spontaneity of changing summer plans and walking distances with comfort.
• Foot massage: Roll your foot on a tennis ball. Self or professional foot and leg massage.
• Stretching: Stretch your calves (gastrocnemius and soleus muscles), hamstrings, feet and toes.
• Strengthening: Toe extensions, toe flexion, toe abduction, heel raises, toe raises
• Remember your feet take on the weight of the body. Comfort over fashion. You can buy new shoes, but your feet are forever. Take care of them!