Healthy Outlook

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Since I live and work in sunny California, many of my patients come to their appointments wearing flip-flops. Not surprisingly, a good number of those patients complain to me about foot pain.

It's not surprising because flip-flops are terrible for your feet. With flip-flops, your toes need to grip the strip of fabric at the top to keep the shoe in place. This causes the muscles in the feet to contract instead of stretching out. Over time, this repetitive stress can increase a person's risk for tendonitis, Achilles problems and a painful condition called plantar fasciitis.

Of course, flip-flops can't be blamed as the cause of all my patients' foot pain. There are other factors like excessive weight and inactivity. But bad footwear like flip-flops can compound the problems created by these other factors.

The advice I give to my patients—and to all of you reading this—is to toss aside those flip-flops and invest $30-$40 in some comfortable running shoes without thick heels. Seriously, get ones with the flattest soles you can find.

It might surprise you that I'm not pushing people to get those gel-cushioned running shoes that manufacturers say provide needed extra support. I subscribe to the ideas put forth in the bestselling book, Born to Run: Fancy running shoes with all the cushioning are harmful to our feet; our feet are happiest when shoes allow us to experience the ground below.

Let me explain. Modern running shoes encourage bad mechanics like landing on our heels, the part of the shoes with the most cushioning, instead of the front of our feet. Landing on our heels transfers stress to our lower backs and spines. Also, the more cushioning a shoe has, the less your feet muscles are getting exercised. This can cause stiffness in the ankles and knee problems.

It may seem counterintuitive that less cushioning is better for your feet. But consider that some cultures have a long tradition of running without the benefit of high-tech sneakers. For hundreds of years, the Tarahumara Indians in Mexico, the legendary distance runners featured in Born to Run, have run in their bare feet or wearing thin sandals without suffering the kinds of injuries so common among today's modern runners in their fancy shoes.

Low-profile or flat shoes (not flip-flips, though!) are good because they let our feet stretch and encourage them to naturally adjust to the surfaces underneath them. I've been a runner all my life and I can tell you that switching to the low-profile running shoes has made a world of difference. I've noticed that I start my strides on my forefoot instead of the heel and I feel a lot better.

I also encourage my patients, and all of you, to walk around barefoot as much as you can. Even if it's just around the house, that's better than nothing. Going shoeless will stimulate your feet and let them feel the ground below them. And that's a good thing. Trust me, your feet will thank you for it.

Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at theairdoctor@gmail.com. For more health information, go to www.cchealth.org.