Guest Editorial: Today's Residency Insight is presented by returning guest editor, Wenjay Sung, DPM. Dr. Sung is a graduate of the Dr. William M. Scholl College, North Chicago, IL., and completed his residency training at the University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania. In this very intriguing piece on the apparent 'evils' of flip-flops, or lack thereof, Dr. Sung is joined by his contributing colleagues; Lowell Weil, Jr., DPM, MBA and Jessica Nowak, BS.
Are Flip-flops the Global Warming of Podiatry?
| |
Wenjay Sung, DPM
|
With summer being the time of year to let toes see the light of day and be free of heavy socks and boots, patients want to know what type of sandal is healthiest for their feet. Many podiatrists and health professionals may have a reflex response to advise against wearing flip-flop, or thong-style sandals, due to the seemingly endless supply of news stories each summer describing the harmfulness of the flip-flop. "Good Morning America", "Oprah.com" & "Forbes Magazine" are just a few of the popular news sources to have covered the apparent "evils" of this style of sandal. But are flip-flop style sandals really as dangerous to foot health as they have been made out to be? One new study, from the Weil Foot-Ankle & Orthopedic Institute, surveying 213 individuals suggests that this may not be the case.
While there are many news articles informing the public of the dangers of flip-flops, there has actually been very little research conclusively linking wearing flip-flops to an increase in injuries, deformities or other medical conditions. One study published in the Journal of the American Podiatric Medical Association identified that in a sample population of 18 patients, 9 study subjects had clinically significant data showing that while wearing flip-flops, plantar pressures were higher than when they wore athletic sneakers, but lower than wearing no shoes at all.1 As elevated plantar pressure has been linked to an increased risk for pathologic abnormalities, this would seem to indicate that flip-flops could cause an increase in such conditions. However, no other types of sandals or flat-style shoes with similar amounts of support were tested for comparison. Without such comparison, this study does not show that flip-flops are worse than any other type of sandal. Other studies, including one that found changes in kinetic and kinematic values in gait when wearing flip-flop style sandals versus sneakers also lacked comparison to any other styles of sandals.2
This lack of evidence demonstrating flip-flop style sandals to be more common culprits of foot and ankle pain compared to other sandal-type shoes, lead to the new informal study gathering more information about experiences of the general public with flip-flops. For one week (five business days), 300 people who entered the waiting area of the Weil Foot and Ankle Institute, whether they were there for a foot condition or were simply accompanying a patient, were offered an anonymous survey of ten questions about flip-flop sandals to fill out. The 213 (71%) responders to the survey indicated that they wore flip-flops an average of 3.1 days per week and purchased them about 1.8 times per year. Only 11.7% of the survey participants stated that they had injuries due to flip-flops. The most commonly reported injury by 2.8% of survey participants was twisting of the ankle, with plantar fasciitis (1.9%), blisters to the first interspace (1.9%) and stress fractures (0.9%) being other common injuries. Interestingly, 64.3% stated that flip-flops were more, or equally as comfortable as sneakers, with only 12.7% reporting pain while wearing them.
Based on these non-standardized survey results, it would seem that flip-flops are not the "global warming" of podiatry that they have been made out to be. From our survey, it appears that "flip-flops" remain popular due to their appearance and ease of use. Although 12.7% had pain while wearing them, more than half believed "flip-flops" were more comfortable than regular sneakers. Patients who returned the survey were frequent wearers of "flip-flops" at over 3 times per week. However injuries believed to be caused by "flip-flops" were at 11.7%, with the most common injury of spraining an ankle.
Although these results aren't surprising, it does give the appearance that "flip-flops" are not the "global warming" threat some have made them to be. Patients reported relatively low levels of injury and the majority had increased levels of comfort while wearing flip-flops. Whether it is flip-flops or any other shoe, a comfortable fit and a good feeling of stability will often be the most helpful selection criteria to keep feet healthy and avoid injuries. However, we believe this data can alleviate fears that "flip-flops" will ruin feet with impunity. In fact, we believe this data shows "flip-flops" cause no more or equal amount of injuries to the foot as other sandal-type of shoe.
Keep writing in with your thoughts and comments. Better yet, post them in our eTalk forum and start a discussion on the what matters to you and your colleauges.
Best regards,
Wenjay Sung, DPM
Fellow, Foot and Ankle
Weil Foot-Ankle & Orthopedic Institute
1455 E. Golf Rd
Des Plaines, IL 60016
Email: [email protected]
Twitter: @jaysung
FB: facebook.com/wenjaysung
References:
-
Carl, Tanya J., and Stephen L. Barrett. "Computerized Analysis of Plantar Pressure Variation in Flip-Flops, Athletic Shoes, and Bare Feet” Journal of the American Podiatric Medical Association 98 (5): 374
-
Shroyer, J. F., and W. H. Weimar. "Comparative Analysis of Human Gait While Wearing Thong-Style Flip-flops versus Sneakers” Journal of the American Podiatric Medical Association 100 (4): 251
Get a steady stream of all the NEW PRESENT Podiatry
eLearning by becoming our Facebook Fan.
Effective eLearning and a Colleague Network await you. |
 |
|
