Blog_Header_New_1120x494_02

The trouble with your flip-flops

August 08, 2017 | UC Irvine Health
flip flops 264

Flip-flops are so So Cal.

They’re on our feet around the house, at the beach and in the mall. We wear them out day and night, walking and biking, and sometimes even donning them where we shouldn’t, like in the local mountains on a hike. We Southern Californians love our flip-flops all day, every day, year-round.

“Sandals are fine for a short walk or to the beach,” says Dr. Andrew R. Hsu, a UC Irvine Health orthopaedic surgeon specializing in foot and ankle conditions. “ But using flip-flops as your go-to shoe year-round can definitely lead to problems.”

There are a number of ways you can get into trouble.

Exacerbating existing conditions

Flip-flops can aggravate foot conditions like plantar fasciitis, arthritis and tendinitis. When he started practicing at UC Irvine Medical Center, Hsu was surprised at the high prevalence of these conditions among habitual sandal wearers, compared to what he saw in his former practices in Chicago and Charlotte, North Carolina.

Contracting fungus and bacteria

Foot and toenail fungi contracted when wearing flip-flops should be enough to make people take care to protect their feet, especially when they’re in dirty, moist environments or frequently in public places where others’ germs can flourish.

The role of other conditions

Wearing flip-flops can be a problem for people with diabetes, older people with thin skin and people with rheumatoid arthritis or immunosuppressive disorders. When sandals dig into the web space between toes, they can cause blisters and sores, so it’s important to routinely check the feet. People with diabetes who often cannot feel these types of injuries can be in particular danger, since small wounds or blisters can become infected and can lead to possible amputation.

the trouble with flip flops infographic

How your flip-flops can injure you

  • Fall injuries. Unprotected, feet in flip-flops are commonly injured by dropped objects or being stepped on.
  • Stress fractures. Stubbed toes and fractures can result from banging the foot into or tripping over objects.
  • Slips and falls. Flip-flop wearers can suffer more serious injuries by slipping on wet surfaces and not having a proper grip on pedals while driving.
  • Excessive pressure on balls of feet. The foot doesn’t have much cushioning and support in a flip-flop, therefore excessive pressure is placed on the balls of the feet, known as the metatarsalgia.
  • Broken bones. A foot slip and twisting injury could result in a break in the fifth metatarsal – the long bone on the outside of the foot that connects to the little toe, one of the most easily broken bones in the foot.
  • Tendon inflammation. Your foot sliding back and forth in an ill-fitting sandal can result in inflammation and tendinitis of the flexor tendons, because the toes constantly have to flex and grip the sandal while walking.

Stress fractures can result from walking too much on concrete. One of Hsu’s patients even developed multiple stress fractures from prolonged walking on hard surfaces while wearing thin flip-flops. Hsu notes that real trouble can occur when wearing flip-flops for athletic activities, as the sandals provide little to no foot stability.

“We like to say that the feet are the roots of the tree. So, if your feet are pointed in the wrong direction, or not supported, your trunk will have to point in the wrong direction, too,” Hsu says.

"If you’re naturally flat-footed or high-arched and don’t have any support, your altered foot position will throw off your ankles, which will throw off your knees and your hips and your low back."

What to look for in your footwear

“Ideal footwear for people with any foot condition is stiff, well-cushioned, and has a good arch built in,” Hsu says. “ Unfortunately, the vast majority of flip-flops are the complete opposite of that.”

Some sandals do provide the necessary support for frequent use.

They’re typically the higher-end brands like Teva, Merrill, Clarks and ECCO, Hsu says, adding: “The best ones have multiple points of security around the ankle and foot, are made out of soft, durable, breathable synthetic material and have textured rubber soles.” 

Related stories