There is a flip side to fashionable flip-flops: Doctors are seeing rash of injuries, from fractures to tendinitis

The Baltimore Sun

"I blew out my flip-flop, stepped on a pop top, cut my heel, had to cruise on back home ..."

-- Jimmy Buffett, "Margaritaville"

When Buffett wrote those lyrics in 1977, the flip-flop was still beach attire, engineered to do no more than shield your feet from a hot boardwalk or a sharp shell. But somewhere along the line, between the advent of casual Friday and the Northwestern University lacrosse team's White House visit, the flip-flop became foot fashion de rigueur.

And "flip-flop foot" became a familiar term in medical circles.

"We haven't counted them officially, but we know anecdotally that there is a rash of flip-flop injuries," reported Dr. Steven Ross of Orange, Calif., president of the American Orthopaedic Foot & Ankle Society.

Ditto from the American Podiatric Medical Association, said its spokesman, podiatrist Dr. John Grady, who practices in Oak Lawn, Ill.

"Not a week goes by that we don't see one in my practice alone," Grady said. "It even happened to one of my office assistants. Short term, wearing flip-flops can cause fractures, sprains, cuts. Long term, the lack of support can lead to tendinitis and even arthritis of the ankle, knee or hip."

Indeed, even the retail stores recognize the danger. Signs placed recently near store escalators at American Girl Place in Chicago warn shoppers wearing flip-flops to use the elevators. Although no one has been seriously hurt, a company spokesman said, a few cases of shoes caught in the grips of escalators, combined with the prevalence of flip-flops, led to the signs.

For Lori Geller, 24, of Chicago, wearing flip-flops led to a broken ankle.

"The ground was wet, so my foot slipped off and turned," Geller explained. Even though the July injury put her in a cast and dampened her subsequent summer vacation, Geller has no intention of giving up her collection of 25 pairs of flip-flops, which range from $20 rubber models to $140 fancy numbers.

"If it's over 50 degrees, I'm wearing them," Geller said. "In the winter, I have them under my desk. This won't affect my [flip-flop] addiction, but I will be more careful around water."

Nor will Melanie Helgeson, 18, of St. Charles, Ill., give up hers, despite enduring five stitches and spending her summer vacation sporting a pair of crutches.

In June, while she was wearing flip-flops to church, a door with a sharp underside swung over her foot, leaving it a bloody mess.

"I'll still wear them because they are so convenient," said Helgeson. Her 30-plus collection, she said, includes "everything from Old Navy plastic ones to a $60 pair I wore with my prom dress."

Tracey Carroll, 43, of Lemont, Ill., on the other hand, is willing to change her flip-flop ways. After a year of pain, she finally went to the doctor in July and was diagnosed with plantar fasciitis, which is heel pain caused by the inflammation of the plantar fascia tissue. The cause, her doctor said, was her constant wearing of flip-flops.

"I may wear them to the beach," Carroll said of her flip-flops. "But to walk the dog or do errands, I'm wearing tennis shoes now. I'm not willing to put up with the pain."

The problem with the flip-flop, Ross explained, is "it doesn't meet the basic criteria of a shoe, which are protection, support and shock absorption. The other most popular shoe, the athletic shoe, does, which is why we recommend wearing it instead."

For those who are willing to consider doctor-approved alternatives, the American Podiatric Medical Association includes a list on its Web site,, highlighting such sturdy brands as Crocs, Chaco, Dansko and Rockports.

Grady said he suggests aqua shoes or sports sandals with ankle straps for the beach or the pool. At least they don't slide off, he said.

But women and girls, especially, are slaves to fashion, and flip-flops are fashionable.

"It's different for boys," Ross said. "They compete in different ways, like physical strength. But for girls, it is all about social status, and fashion is part of that."

Ross said parents have asked him to tell their daughters to stop wearing flip-flops.

"But they don't listen to me any more than they listen to their parents," Ross said. "What teenage girl wants to listen to any authority figure?"

Leslie Mann wrote this article for the Chicago Tribune.

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