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Published on August 08, 2016

You may not need a calendar to tell you it’s AugustYou may not need a calendar to tell you it’s August

Right about now, your hips, knees and feet may be aching a bit, and the source of discomfort may surprise you. Look no further than your feet for the answer.

“Typically in the summer time, people tend to wear less supportive shoes. The basic lack of support tends to lead to problems,” said Falmouth Hospital’s Chief of Orthopedics Joseph Chase, MD. “However, symptoms associated with wearing summer shoes typically take time to develop. As a result, we don’t tend to see an uptick in complaints until right about now.”

Flat shoes, particularly inexpensive flip-flops, can be problematic. This is especially true for people who spend the rest of the year wearing overly cushioned, supportive shoes.

“Wearing flip flops for long periods of time increases the incidence of developing plantar fasciitis, which is inflammation at the base of the heel,” said Dr. Chase. “When the weight of the body reaches down to the top of the arch it causes stress on the foot. If there’s a lack of support, the stress can start causing symptoms.”

Plantar fasciitis is the most common complaint of wearing flat, unsupportive footwear. But, it is by no means the only one.

“A lot of times we’ll have people come in with problems in the knees, hips or back. When working them up, we always look back,” said Dr. Chase. “I recently had a patient with a meniscal tear. She was on vacation in the spring in Florida and she wore flip-flops for 10 days straight. She said she knew something in her knee changed.”

Why are Your Feet Hurting?

So what is it about wearing flat shoes that causes these sorts of problems? Having grown up in Sandwich, Dr. Irene Davis, the Director of the Spaulding National Running Center at Spaulding Hospital in Cambridge believes there is a simple explanation.

“The problem with summer footwear is that people just go at it without giving their body time to adapt. Since we spend most of our time wearing bulky, cushioned footwear the sudden change over to sandals and flip flops requires a period of adjustment.

“With cushioning and arch support, your muscles don’t have to work so hard and you tend to slam your foot to the ground. You then take those mechanics and the weakness to the foot and you switch to a sandal without cushioning and arch support, and guess what? You start to have problems.”

What You Can Do to Prevent Injury or Pain

Dr. Davis recommends taking time to prepare your foot for the changeover. She advocates wearing minimally supportive shoes or going barefoot as much as possible all year round. In doing do, the muscles have a chance to gradually adapt.

She also recommends conditioning your foot as summer approaches by doing exercises that strengthen the foot and lower leg.

“Heel raises while standing on a stair, first double leg and then single leg will help build up muscle strength over time. Jumping rope is another easy exercise which can be done at home that is really effective,” said Dr. Davis.

Wearing flip-flops or sandals should be limited to occasional use, added Dr. Chase.

“The real thing to be cognizant of is don’t go for a five-mile walk in flip flops. They are fine for going to the beach or short distances or limited periods of time.”

And if you start to feel pain or if your body begins to feel different, he warned not to ignore the signals.

“You should pay attention to what your body is telling you. It might be time to think about switching footwear – or get evaluated to see if something is going on. The longer you let pain to go on, the tougher it is to correct it,” said Dr. Chase.

One note of caution that both Drs. Chase and Davis agree on is that people with certain medical conditions like diabetes should avoid wearing minimal footwear altogether.

“People with neuropathy should not wear sandals or any shoes that expose their heels and toes in any way,” said Dr. Chase. “If you have diminished sensation in your feet from neuropathy, you can get a cut or a laceration and that can get infected. Same thing with getting a pebble in your shoe. Open footwear is high risk.”

Here are some tips from Dr. Chase and Dr. Davis on how to keep your body healthy while wearing summer shoes:

  • Not all flip-flops are created equal. Even though they cost a bit more, buy ones that have some cushioning or support.
  • If you must have inexpensive flip-flops, buy two pairs at the beginning of the season, and change them halfway through.
  • At the end of the season, throw them out.
  • If your budget allows, opt for leather sandals. They tend to have more support and hold up over time.
  • Try conditioning your feet throughout the year by exercising your feet and by going barefoot when you can.
  • If at any time you begin to feel a change in your feel, knees, hips or back, give your flip-flops a rest. Wear a more supportive shoe until symptoms diminish.
  • Seek medical help if your symptoms persist. The earlier it is treated, the faster it will resolve.