More Flop than Flip?

By Athlete's Care on June 06, 2012

The Perils of Summer Footwear and How you may be Contributing to your own Foot Pain.
Article By: Dr. Kate Hood, Chiropractor at Athlete’s Care Yorkvillle

Longer days, the recent arrival of sunshine and warmer temperatures can only mean one thing, that the summer is finally on its way. As the mercury rises we tend to shed our winter layers opting for lighter clothing, allowing for maximal comfort and enjoyment of this all too brief season. This transition even carries over to the choice of what we don on our feet, often eschewing the closed toe, heavier material selections of colder weather. Ladies prefer cute ballet flats while men wear leather slides or sandals and everyone’s favorite, the gender neutral flip flop. As we remove these protective (and warmer) coverings, there is an increased likelihood that afflictions of our heels, ankles, shins and even knees will no longer remain dormant.

Over the years most of us have known or at least suspected that these flimsily constructed pieces are merely just barriers between the ground and our tootsies. However, the recent advent of newly marketed “upgrades” boasting toning abilities and fashionable styles may render us more likely to shed our apprehensions (as well as a few extra bucks) and once again embrace the “foot thong”. But have you ever stopped to ponder what cost to your foot health accompanies this decision?

• Plantar Fasciitis is characterized by pain felt along the medial or inside of the foot, beginning at the heel, often extending along the arch. Patients usually describe a “searing” sensation usually most noticeable during the first steps of the morning.

• The Tibialis Posterior muscle works to invert or turn the foot in such a way that the arch faces inward. It also helps to stabilize our foot’s arch during the walking cycle. Passing behind the medial malleolus or bony prominence on the inside of the ankle, it too is vulnerable to overuse and eventual injury.

• Turning our attention to the back or posterior side of the ankle/foot complex, the key structure is the Achilles tendon. Both the thickest and strongest tendon in our body, it represents the connection between the gastrocnemius and soleus (collectively the calf) muscles and the calcaneus or heel bone. When the calcaneus is not stabilized and allowed to move during the gait cycle it can result in the application of a load greater than the tendon can withstand.

Clinically, all three are vulnerable to repetitive stress leading to overuse conditions. Contributing factors may include, structural issues of the foot, tightness in the calves, hamstring and gluteal muscles, insufficient recovery time between workouts, activities requiring repetitive motion of the ankle (in provocative ranges) as well as, yep you guessed it, “excessive walking/running in inappropriate or non-supportive footwear”. (1)

The last time any of us should have worn flip flops we may have also been young enough to be singing “the leg bone’s connected to the foot bone”. Considering this anatomical relationship it should then come as no surprise that any of the aforementioned conditions if left untreated can progressively lead to the development of knee, hip and/or back pain. If the structure that is meant to support the foot becomes unable to adequately stabilize the arch during gait, the subsequent overload on each link in the chain will eventually result in pain and injury.

Once you suspect you may be dealing with more than you can manage, there are a few things you can do:

  1. Take the time to evaluate your footwear both in and out of the gym. Is it really worth spending all that time and money to get the perfect running shoe and then walking out of the gym in your flip flops?
  2. Stretching your calves by keeping your foot flat on the ground bend your knee and lean forward towards the wall. Repeat the same pattern, only this time move the foot farther back and keep the knee straight. Using a “stick” or foam roller are also effective methods to address any areas of tightness in the calves. If you’re unsure of how best to do this enlist the help of one of the qualified TYC trainers to show you how.
  3. Use a frozen water bottle to roll under the arch of the foot multiple times throughout the day.
  4. A golf ball can be rolled at the base of the heel on the fleshy part where the arch begins to work through current symptoms and keep new ones at bay.
  5. Often over the counter options are sufficient but sometimes they are not. Being properly evaluated for a corrective insole or custom orthotic may be necessary.
  6. If you absolutely must make flip flops your footwear of choice, consider one designed on an orthotic base which will offer more support than a traditional model as well as better cushioning. Sites such as www.thetrainersroom.ca and clinics like Athlete’s Care will carry a good selection.

Remember above all, self –management options can only get you so far and there is no substitute for a proper exam and accurate diagnosis. Don’t let things get out of hand and ruin your summer, If you suspect that you may be experiencing some of these symptoms schedule an appointment with your therapist of choice. The chiropractors, physiotherapists and sports medicine physicians at Athlete’s Care are all skilled at identifying and treating this problem.

Dr. Kate Hood is a chiropractor with a focus on sports injuries. She is in private practice with Athlete’s Care Sports Medicine Centers working at both their Yorkville and King St. locations. Having gone to school in California, she is a now reformed flip flop addict.