Dear Sports Doc,

Can wearing flip-flops or other shoes without backs cause plantar fasciitis or other running injuries?

Thanks,

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Anna

Dear Anna,

Flip-flops and shoes without backs will cause running injuries if you run in them and run improperly for the shoe style. Native tribes in Mexico ran in heelless flats strapped to their feet and apparently ran long distances daily without injury.

Most likely you were asking about running injury as an outcome from utilizing flip-flops for daily wear. There is not any data to suggest that wearing flip-flops is a problem, and from my observational experience the medical system would be overrun with foot problems if flip-flops were a cause of injury. It is often suggested, however, that people avoid flip-flops and shoes without heel counters when experiencing problems with plantar fasciitis. I do not think this is an evidence based statement.

Flip-flops seem to change the gait a bit and reading the literature it seems to change it toward a more barefoot style of walking. That will be good for some people and bad for others. When I have asked patients why the wear flip-flops, they usually respond with “comfort.” I am going to venture that most people who find them comfortable are not getting injured. Those who are getting injured from wearing flip-flops will likely move away from that type of footwear.

So if you get plantar fasciitis, should you wear flip-flops? I think if you do not get worse, it is fine to continue in flop-flops. If you have more pain in flip-flops, you should opt for footwear with more foot and arch support. You may even require a temporary arch support to splint the foot and take some of the pressure off the plantar fascia, which is the tension tissue in the compression tension structure that forms the longitudinal arch of the foot.

Flip-flops may not be evil and may be similar to walking barefoot with added protection for the plantar surface of the foot. It is best to replace them before they are worn out. Another of my “office” observations is that people tend wear them beyond the expected life cycle of the product.

I hope this helps.

Cheers,

Bill

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