The heat of the summer is rapidly approaching, and people are happily stepping out in flip-flops, the footwear of choice for the summer for walking on the beach, relaxing around the house, running errands and most day-to-day casual activities. However, wearing the wrong pair of this carefree footwear can lead to blisters, tendinitis, pain and other foot problems. Most people don't want to hear that their favorite pair of flip-flops can be bad for their health, at least their foot health.

A survey by the American Podiatric Medical Association (APMA) found that 50 percent of Americans have experienced foot pain or discomfort at some point. Improper footwear is often the chief cause of pain, and many types of flip-flops can directly cause foot problems due to their lack of support. Flip-flops make the wearer susceptible to sprained ankles and ligament injuries. These occur easily when stepping off a curb or stepping on an object while walking.

Wearing flip-flops for extended periods of time can result in foot injuries. Continuous walking in flat-soled footwear, such as flip-flops, may also result in straining the Achilles tendon and after a while can aggravate plantar fasciitis or heel pain symptoms. Due to the usual flimsy, open-toed construction of most flip-flops, they provide little protection to the wearer.

Common injuries include stubbing of toes, scrapes and cuts on the feet. There is also more vulnerability to insect bites on the exposed skin and if the wearer drops an object on the foot, there is more of a chance of injury than when wearing a shoe or a boot. The thong between the toes can cause friction, which can result in blisters or ulcers (wounds) that may become infected. This is the reason why people with diabetes should avoid this type of sandal.

For children who frequently wear flip-flops, flat feet may develop due to the unsupported foot's tendency to pronate excessively (roll inward) while walking. The tops of the feet are continuously exposed to the sun, which puts them at risk for sunburn or even skin cancer. Therefore, it's important for flip-flop wearers to use sunscreen on their feet.

During the summer months, podiatrists treat a greater number of foot problems that can be traced back to wearing flip-flops, however, people don't have to give up wearing this type of footwear altogether. As a general rule, most flip-flops should not be worn excessively or for long periods, moderation is the key. It is best to wear flip-flops for short periods and to avoid long walks or sporting activities while wearing them.

If worn properly, flip-flops can live up to all your expectations of being fun, carefree, sporty and safe. The following are simple tips for wearing flip-flops safely and preventing injury and foot pain this summer:

o When purchasing a pair of flip-flops, gently bend them from end to end to see where they bend. The best choice would be a shoe that bends at the ball of the foot. The poor choice is a flip-flop that folds in half, at the middle of the shoe, because it offers no support or stability in the arch.

o If you choose to wear a flip-flop, wear one that has more structure, arch support and is made from natural materials, such as leather, rather than rubber. Choosing a sandal with straps may secure the shoe to your feet better and decrease your chance of injury while still allowing your feet to be cool and stylish.

o Don't re-wear the same flip-flops year after year. Inspect older pairs for wear and tear. If severe signs of wear are found, discard them and buy new ones.

o Don't wear flip-flops if you have diabetes. They leave the feet susceptible to blisters, cuts and scrapes that may lead to ulcers and serious infections made even worse if peripheral neuropathy is present. Instead, opt for lightweight footwear that covers and protects the toes and feet.

o For more information email foothealth242@gmail.com or visit www.foothealth.org, apma.org or orthoinfo.aaos.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates on Albury Lane telephone 394-5820.

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