The flop side: Armed with new research, podiatrists take a stand against flip-flops

As versatile as they are comfortable, the rubbery sandals are worn by the young and old, the fashion conscious and fashion oblivious. People don them with suits, three-piece and swim varieties.

Too bad, then, that podiatrists and researchers say flip-flops hurt our feet and lead to lower-leg injuries.

Researchers at Auburn University, studying the biomechanics of flip-flop use compared against that of athletic shoes, found that the distinct change of gait among sandal-wearers puts strain on the arch, ankle, even the hips and lower back.

"There's a larger angle in your ankle in flip-flops," said Justin Shroyer, the lead researcher. "That could be because people are gripping with their toes so the flip-flop won't fly off. ... So you've got this battle going on between muscles on top and on bottom, what your foot does in tennis shoes as opposed to flip-flops."

That confirms an earlier study by the American College of Foot and Ankle Surgeons, showing a rise in flip-flop-related heel pain among patients ages 15 to 25.

Podiatrists took these findings and, well, ran with them. They say flip-flops — and even more stable forms of sandals — should be worn only for short durations, not as a primary footwear. Unlike more stable shoes, flip-flops do not absorb the impact of steps, forcing the arch, heel calf or back to bear the brunt of the force.

So, it's perfectly fine to waddle from the pool to the car in flip-flops, but not so great to wear them to work for eight hours.

Amanda Dubbs, a Cape Girardeau resident, doesn't wear flip-flops to her pharmacy job, but only because it's against dress code. Otherwise, she said, she's in them "anytime I'm not at work."

"It's like walking on gravel," said Tracey Vlahovic, associate professor of podiatric medicine and orthopedics at Temple University. "Think about how many steps you take in a day and how much jarring that is. Over time, that has to affect you in some way."

But with the low price and large selection, flip-flop advocates aren't likely to give up their footwear.

Allison Schwent, home in Cape Girardeau for the summer, said she pretty much lives in her flip-flops. Walking around the University of Missouri-Columbia campus or West Park Mall, Schwent likes her open toes.

"If I'm exercising, then I'll wear good shoes, but it doesn't really matter to me if I'm just walking around," she said.

Even the most tightly wound podiatrist isn't suggesting a ban on flip-flops — or even a warning label. Even Auburn's Shroyer admits he wears flip-flops "frequently" during Alabama's sweltering summers.

They merely want the public to be aware of potential problems and perhaps buy a higher-quality sandal (with arch-support molding and harder tread) than the 10-buck flimsy drugstore model.

Americans spent $7.4 billion on sandals in the past year, down from $8.1 billion in 2007. They rank third behind dress shoes and athletic wear, according to the NPD group, which tracks consumer spending.

Tracy Basso, a Davis, Calif., podiatrist and past president of the California Podiatric Medical Association, says he has treated flip-flop wearers for pain conditions such as plantar fasciitis — inflammation of the tissue along the bottom of the foot that connects the heel bone to the toes.

"I especially see it with pronated feet or semi-flat feet," says Basso. "The arch is falling, the foot rolls in. That's a patient that would have problems with flip-flops and needs support."

"But unless you have predisposing foot problems, I don't have strong reservations about sandals," Basso said. "But to the degree that a family has within their budget to buy a better or more supportive sandal, I'd do it. But they tend to be expensive."

High-end brands, such as Teva, Merrell and Bite, can cost $36 to $104. The advantages of those flip-flops, Basso said, is that you can safely wear them for prolonged periods.

"The support is there, just like an athletic shoe," he said. "Those cheapie sandals don't protect in any meaningful way. Might as well go barefoot."

Sam McManis is a writer for the Sacramento Bee.

Southeast Missourian features editor Chris Harris contributed to this report.