Summer is almost upon us, and we can finally kick off our shoes and slip on our beloved flip flops. As a chiropractor, I also love to wear flip flops and find myself subject to their pitfalls if I’m not wearing the right brand.

As the summer goes on, we find many patients coming into the office with several varieties of foot pain that are all due to wearing the wrong type of flip flops. Traditional, cheap flip flops can be treacherous for the foot because they have no arch support and are lacking a strap on the back of the heel.  This combination causes a collapse of the medial arch of the foot and puts pressure of the soft tissues of the foot and ankle.

The following conditions are associated with wearing flip flops that lack arch support.

Plantar Fasciitis
This usually presents as heel or arch pain. This pain is worse when walking first thing in the morning or after sitting for several minutes. Lack of arch support from flip flops causes the plantar fascia in your arch to pull and tear. This is most common in people that have a rigid foot and arch and with those who have flat feet.

Flexor Hallicus Tendonitis
This is a tendon on the medial side of your ankle that hugs the medial malleolus. This tendon is designed to stabilize your ankle as well as help you push off after your heel leaves the ground. Wearing flip flops creates instability and places excess demand on the tendon which inevitably leads to tendonitis. The flip flop also causes the toes to scrunch in order to keep the flip flop on the foot. This puts extra tension on the tendon and stretches the tendon as you walk.

This is pain on the ball (bottom behind your toes) of your foot. Wearing flat shoes or flip flops causes excessive pounding and pressure on the joints that connect your toes to the long bones of your foot. The most common place to feel pain is just behind your 2nd toe. I frequently see this condition worse with flip flops that are very flat or have a very flexible sole. People who like to garden in their flip flops are also more prone due to the crouching position placing excessive pressure on the metatarsal joint.

Achilles’ Tendonitis
The Achilles’ tendon is especially prone to stress and damage by wearing the wrong type of flip flops. A very flat flip flop places stretch on the Achilles’ tendon near or at its insertion on the calcaneus. A flip flop with a slightly elevated heel can help to alleviate this condition.

Back Pain
I cannot leave out the effect that flip flops have on the low back.  Not only can a flat flip flop place stress on the foot but it can also cause a transfer of stress load up the calf into the hamstrings and on to the low back. A poor flip flop can create a major pelvic distortion causing the back to lose its normal curvature and create pain. Again, a flip flop with an elevated heel may help to take pressure off of the low back and reduce the back pain.

Foot pain can be successfully treated by oneself by first eliminating the wrong flip flops. After that, try improving mobility at the ankle, arch, and metatarsal joints. With two hands twist the foot back and forth down the arch, at the ankle, and at the metatarsal joints. This is a motion similar to wringing out a wet towel. For best results perform this twice daily for 1-3 minutes each time.

Stretching is not indicated with these conditions, contrary to most practitioners’ advice. Being that most of the conditions above are created by a mechanism of injury that involves overstretching any additional stretch to try to treat the condition is not very effective. Additional stretching of the foot will only cause more problems. Try foam-rolling the calf and hamstring to the lengthen the leg muscles without placing unneeded additional stretch on the foot.

Ice may be one of the most effective self treatment techniques. If you can handle an ice bath for the foot pain, try it. It by far is the most effective treatment, although it can be too intense for some. A frozen water bottle or zip lock bag of ice cubes can be a distant second in providing symptomatic relief but I would not advise using a freezer pack or frozen vegetables.

Professional Treatment
If you seek advice from a professional for your flip flop-induced pain, there a few modalities that have been proven to be helpful. Acupuncture has been shown to greatly reduce foot pain due to overuse injuries. Acupuncture has been around for centuries for a reason, it works.

Another much newer treatment for these conditions is Active Release Technique (ART®). ART® Is the only patented soft-tissue technique that has been proven to reduce scar tissue from soft tissue injuries. This highly effective treatment is only performed by certified practitioners and works well on acute and chronic conditions.

Chiropractic care is also an effective treatment for many foot conditions. Not only do chiropractors improve posture that lessen the pressure on the feet, they can also adjust the feet. Foot manipulation helps to improve rigidity in the arch, ankle, or forefoot for those who need it.

The Right Flip Flops
According to Andrew Holbrook at Fleet Feet Sports Roanoke, the right flip flops to reduce and prevent foot pain “should contain a  3-dimensional contoured footbed that better matches the foot’s natural shape and motion than standard “flip flops” found at most retailers. Some brands that offer the support your feet need include Superfeet, Oofos, OluKai, and Ecco.”

These brands may cost a little more than cheap flip flops you’ll find elsewhere, but they don’t cost as much as having some of these ailments! It’s never a bad idea to invest in yourself, from regular chiropractic care to the right sandals needed to maintain your summer fun! To help you invest in your footwear, Fleet Feet Sports Roanoke has graciously offered the coupon below to [CORE] patients. Take this coupon into the store and see what a difference the right flip flops can make!



Daryl C. Rich, D.C., C.S.C.S.