Sizing up summer footwear: Be wary of flip flops

The shift from cold winter days to warm, sunny weather is accompanied by a welcome change of footwear.

Many of my patients are more than ready to shed their heavy boots and shoes and head outside for more exercise or to show off their pedicures. I remind them that comfort and proper alignment of the feet affects all of a person’s joints, especially the knees, hips and spine. Poorly fitting shoes can lead to foot and toe issues that may not show up for years down the road, so smart choices now will help avoid fatigue, pain and foot deformities later.

Sandals? Protect the toes: If you choose to wear sandals, consider a pair that keeps your toes under cover to protect them from injury. Wearing sandals with straps is also a good idea so your toes don’t have to work as hard to keep the shoe in place. People with diabetes should avoid wearing flip-flops because simple foot cuts and scrapes can lead to serious complications like wounds and infections.

Choose shoes with proper arch support: Well-designed shoes may decrease the likelihood of plantar fasciitis, a painful inflammation of the band of tissue that runs along the bottom of the foot. Walking barefoot, or in flimsy shoes without sufficient support, can overstretch, tear or inflame this plantar fascia and cause intense heel pain.

Find the proper fit: Have your feet measured by a professional at the end of the day when your feet are naturally more swollen. Try on both shoes because your feet may be slightly different sizes, and allow for 3/8-inch to 1/2-inch of space between the end of your longest toe and the tip of your shoe when you are standing up. Calluses, blisters, bunions and corns are all the result of improperly fitting shoes. Your shoe size and shape continues to change over your adult years. There are statistics that show nine out of 10 women are wearing shoes that are too small!

Invest in running shoes: Choose athletic shoes designed for your style of exercise. If you strive to complete your first 5K, buy a pair of running shoes instead of using whatever pair you have in your closet. Make smart sock choices, too. The best running socks are ones that are made from synthetic materials such as polyester, acrylic and other tech fabrics because they'll wick away moisture. Stay away from pure cotton socks because once cotton gets wet, it stays wet and can cause blisters.

Need heels? Wear high heels for only short periods of time, if at all. If you really want to wear heels, chunky heels less than two inches high are your best bet. Ultra high heels (those over two inches) force feet into an unnatural position that puts stress on the ball of the foot. Wearing shoes that are too narrow can cause inflammation around the toe joints from overload, irritate nerves that surround them, and even cause toe deformities including bunions and hammertoes. Avoid spikey heels because their instability is an invitation for ankle sprains.

No pointed toes, please: It’s best to avoid pointed-toe shoes altogether. If you must, find shoes that slope to a point beyond the end of your toes. Shoes with a wider toe box are best because pointed shoes can squeeze the entire front of your foot together, leading to nerve pain, bunions, overlapping toes and toenail bruises. Shoes should not pinch the sides or tops of your toes.

Flip flops should be worn sparingly: People who wear them to protect their feet on the beach or in the shower room are better off than going barefoot. When worn for an entire day’s activities, flip flops provide very little protection or arch support and can aggravate plantar fasciitis and cause arch pain.

I advise my patients to wear flip flops for a specific purpose, then switch to better-structured sandals. Higher quality slip-on sandals that resemble flip flops are a good alternative because the thick sole raises the foot above debris on the ground, provides some shock absorption, and is often designed with good arch support. There are even some

brands of sandals that have room for a custom orthotic, a shoe insert that supports, cushions and/or corrects abnormal motion of the foot.

Be wary of barefoot shoes: These shoes resemble a “glove” for your feet have been promoted in the media as a return to nature over today’s high tech running and walking shoes. These shoes offer very little support for your heel or arch and no shock absorption. The "fingers" also separate the toes and this interferes with a person’s natural walking movement.

Ballet flats have a limited role. Many of the cute, inexpensive brands provide little to no shock absorption or arch support. Look for well-designed flats structured with arch support and cushion, and wear new shoes around the house to break them in instead of wearing them all day right away..

Be sure to get out there and exercise and look your best. But if you put on shoes that are not comfortable, wear them for a couple of hours and then switch to well-structured and supportive shoes. Do all good things in moderation, but soak up as much of our Wisconsin summer as you can.

Dr. Kristen Sandoe is a foot and ankle surgeon with ThedaCare Orthopedics.