September 2010

Out on a Limb: Flip-flop Flak

Jordana Bieze Foster, Editor

Angelina Jolie and I have so much in common – beauty, fame, fortune. But when it comes to flip-flops, that’s where the similarities end.

Angie sent the fashion blogosphere into a minor frenzy early this month when she was photographed in New Orleans wearing a $48 pair of Tkees flip-flops as part of at least two different casual-chic outfits. I, on the other hand, own one pair of flip-flops that I got for free as a gift with purchase years ago, and which have never been seen in public.

Whether I like it or not, flip-flops are more mainstream than ever, and not just among the Hollywood elite. Sure, Jessica Alba and Vanessa Hudgens love their Tkees too. But this is no exclusive trend, as evidenced by the growing popularity of the Flip Flop Shops franchise, which now has 23 locations in the U.S., Guam, and Canada.

You may also be interested in the following article:

Flip-flops: Fashionable but functionally flawed

That’s right, flip-flops can be purchased all year round in Canada. The flimsy footwear isn’t just for warm-weather climates any more. Of course, anyone who knows a college student already knew that. In fact, the Boston Globe published an editorial on Sept. 12 imploring the thousands of area college students to shelve their flip-flops as the leaves start to change and temperatures drop—a message that will almost certainly go unheeded.

As entertaining as it may be to debate the relative merits of flip-flops as a fashion choice, practitioners are more concerned with what the current flip-flop craze means for lower extremity health. And that, right now, is hard to say.

For years, practitioners have decried flip-flops because they lacked the supportive structure of, say, a motion control running shoe. Now that researchers are beginning to delve into the potential benefits of going barefoot or wearing minimalist shoes, it’s tempting to conclude that that same lack of structure actually gives flip-flops a biomechanical advantage.

And at least some research seems to support that theory. A July study of patients with knee OA found that walking in flip-flops was associated with knee adduction moments that were significantly lower than walking in clogs or stability running shoes, and not significantly different from barefoot walking.

However, research from Auburn University (see “Flip-flops: Fashionable but functionally flawed,”) has found that foot and ankle biomechanics while wearing flip-flops are quite dissimilar from barefoot gait, and that adding structure to a flip-flop design seems to make it function more like a bare foot, not less.

Are these two sets of findings mutually exclusive? Maybe not. The knee adduction moment may be primarily a function of heel height rather than changes at the foot and ankle. Or perhaps flip-flops affect knee OA patients differently than the healthy volunteers used in the Auburn research. Only time will tell.

These issues might not matter much to Mrs. Brad Pitt. But they might make a big difference for your patients, particularly if you practice anywhere near a Flip Flop Shop.

In the meantime, my own flip-flops will remain safely out of paparazzi range. At least for now.

One Response to Out on a Limb: Flip-flop Flak

  1. Kate Kuhl says:

    Your mom (my pal from EWC) forwarded this to me. Love your humor and good sense. And yes, you are beautiful as well as sure-footed.

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