Are Your Summer Sandals Hurting Your Health?

By Amy McDowell, PT

Many patients who have been advised to use shoe inserts or footwear with good support find it difficult to comply with those recommendations when the warmer months roll around (almost like trying to stick to a diet during the holiday season!). Who wants to wear tight, laced up, heavy shoes when the heat index is going to be 100 degrees?  Plus, you can’t put inserts in strappy summer sandals. – so what do you do?

Most people’s response would be to wear their flip-flops or other flimsy summer sandals.

Every year, I have patients who exacerbate an injury when they transition from their supportive winter shoes to more open summer sandals.  The foot is the first in line for shock absorption for the whole rest of the body.  Any changes in the angle and action of the foot can affect the alignment, distribution of stresses, and ways other muscles work up at the knee, hip, lower back, etc.  If the rest of your body is healthy and well-balanced in terms of strength and flexibility, you have many ways to adapt to changes down at the foot.  However, if you have an injury or condition somewhere else in the body, changing your footwear could affect it.  The best solution is to try to wear summer shoes that support your foot as similarly as possible to shoes you are used to wearing the rest of the year.

classic-footbedIf you wear orthotics, that can be difficult.  There are some companies that make sandals with a biomechanically designed footbed (think Birkenstocks – see image). These shoes are made with a cork footbed which absorbs shock well and has a contour similar to orthotic inserts.  They have even become more fashionable in the last few years, although they have a definite style that isn’t to everyone’s taste.

Another company that has gotten more well-known in the last few years is Vionic.  Their shoes have a footbed which was developed by renowned Australian podiatrist Philip Vasyli.  They make all styles of footwear including sandals, flip flops, athletic shoes, dress shoes, and more.

While most biomechanically correct shoes can be costly, having one pair of well-made sandals that are healthy for your feet and the rest of your body proves to be well worth the investment, especially if you choose a style that is versatile enough to wear every day. A good resource to check out is the American Podiatric Medical Association’s website for other footwear brands and styles that have been awarded a “Seal of Acceptance” by the APMA.

One less expensive way to avoid pain in the summertime is to examine your shoe collection for tried and true winners.

If you have a pair of winter shoes that you are comfortable in, take a good look at the inside of the shoe.  Is the area where your heel sits hollowed out, or is it fairly flat like a floor?  Is the area under your instep built up to help hold the arch of your foot, or does it stay flat?  Is there a difference in the height of your heel and the height of the ball of the foot?  What kind of material covers the inside of the shoe?  Is it cushioned or firm?

When you figure out what seems to work well for you, you can then look for a summer shoe with similar characteristics.

blue-emergency-signA Consumer Product Safety Commission report for 2014 stated that 25,300 out of 198,437 total emergency room visits were associated with flip-flops.

So, what about those infamous flip-flops?  A Consumer Product Safety Commission report for 2014 stated that 25,300 out of 198,437 total emergency room visits were associated with flip-flops.  Surveys of podiatrists implicate flip-flops in many foot injuries.  There are also medical studies that show that wearing flip-flops changes your normal pattern of walking, which could be a factor in not just foot injuries, but other areas of the body as well.

Having said that, flip-flops may actually not be that bad an option for some people.  A study by Dr. Najia Shakoor and other rheumatologists at Rush University in Chicago compared loading pressures at the knee joints of people with knee osteoarthritis when barefoot, wearing flip flops, clogs, stability shoes, and flexible sneakers. He found that the least amount of pressure on the knee occurred with walking barefoot, in flip-flops, or in flexible sneakers.  Dr. Shakoor theorized that the results might be due to the fact that the clogs and stability shoes had slightly higher heel heights, which could contribute to the loading at the knee, whereas the flip-flops and flexible sneakers had no heel elevation.

So, if you have been noticing that an ache or a pain that you had previously been experiencing has gotten a little worse since the weather turned warmer, consider what kind of shoes you have been wearing.  Maybe it’s time to invest in a more biomechanically designed sandal.

Your physical therapist can help you decide what type of support is best for your specific issues.  If you are not currently receiving physical therapy treatment, you are always welcome to schedule a free consultation at one of our ARC locations to meet with a therapist and get more information. We’d love to help!


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