Summer sunshine often means sleeveless tops and shorter hemlines, but it also heralds the re-emergence of another seasonal staple: the flip-flop.
The strappy sandal — and its distinctive slap on floors or sidewalks — has been a mainstay in American culture for decades, but its ubiquity has been bemoaned by podiatrists and other experts. Many say the flip-flop is a particularly poor option to keep your feet shod during the summer, pointing to common injuries like stress fractures or blisters that plague many wearers during the warmer months.
“When you only have something between your toes to keep the shoe on, you have to curl your toes excessively,” podiatrist Howard Osterman told the Washington Post in 2011. “You have to spend all day firing your muscles to keep the shoe on the foot.”
The result of all that foot stress, he and several other experts agree, is a litany of injuries that could otherwise be avoided.
Of 198,437 emergency room visits reported in 2014 because of footwear, about 25,300 were associated with flip-flops, according to the Consumer Product Safety Commission on Emergency Room visits. Those injuries might range from mundane stubs or cuts on toes to more serious issues like stress fractures, tendinitis, or for the particularly clumsy or unlucky, outright sprains.
The most common injuries from excessive flip-flop wearing, according to the American Podiatric Medical Association, involve stresses on the bones of the foot or its muscles. Stress fractures, for example, result from repeated stress on the foot’s bones because of a lack of arch support, and muscle problems like plantar fasciitis result from tissue inflammation that can be exacerbated by the thin soles on flip-flops that cannot adequately cushion the foot.
The flip-flop, according to the few studies investigating its impact, can also change more than the physical condition of your feet. A then-graduate student at Auburn University conducted a 2008 study of flip-flops that found the shoes change wearers’ gaits, sometimes even after they stopped wearing the sandal style.
But a 2010 study that examined osteoarthritis related to different types of shoes suggested that flip-flops might help reduce the stress placed on impacted knees compared to harder-soled shoes like clogs. (That study found little difference between wearing flip-flops and barefoot walking.)
The flip-flop was never intended to be the day-long summer option it is now. Though the structure of a sole strapped to the foot has persisted since ancient Egyptian culture, the modern flip-flop only became widely accepted and adopted in the 1960s, according to Feet and Footwear: A Cultural Encyclopedia: Soldiers brought back a similar style of shoe from Asia after World War II that was quickly picked up everywhere.
But podiatrists, acknowledging the unlikelihood that people will toss their flip-flops permanently, suggest wearing them in moderation. The American Podiatric Medical Association recommends flip-flop wearers replace them frequently, avoid them for more than short walks and choose different shoes when playing sports or gardening.