By Erika Kruger Photographs; Martin Van Niekerk, Shufti Pics Summer is here and so are patients arriving at the massage practice wearing flip-flops or in local parlance, the all-time popular plakkies. People’s views on this form of footwear flip-flops between near veneration by wearers  (‘It is so comfortable and easy to wear – absolute freedom!’) and health professionals blaming overuse of the plakkies for a host of podiatric problems and postural imbalances. Personal observation has led me to conclude that patients’ complain of pain in the feet and in the lower legs more often in the summer months than during winter. Questions about their preferred footwear, usually indicate extensive use of plakkies. Despite claims that it feels just like walking barefoot, flip-flops might not be a healthy choice after all. A study conducted by a doctoral student in biomechanics at the University of Auburn, Alabama, confirms this. 1) Justin Shroyer started his investigations into a possible link between wearing flip-flops and lower leg and foot pain, by observing 39 college-age female and male volunteers wearing thong-style, flat-soled flip-flops and then regular athletic shoes while walking on a platform that measured the force they exerted when their feet struck the ground. He also filmed them as they walked to study differences in the movements of their hips, legs, knees, ankles, feet and toes. The visual and other data was then digitised and analysed. Shroyer’s conclusions confirmed that despite the freedom and comfort wearers profess, plakkies first of all do not provide enough stability for the foot and secondly can lead to postural imbalances resulting in back ache. 2) SHOCK ABSORPTION Flip-flops provide little support and shock absorption, and as a result, they provide little comfort and protection against the impact from walking. Without suitable cushioning on the feet, over time the impact will cause pain in sensitive areas of the back and spine, particularly in the discs, joints and ligaments. 3) STABILITY Physiatrist Dr Chritina Lasich explains that a shoe has everything to do with how ones back feels. 4) She compares shoes to tires – both “provide for your comfort (ride quality), your stability (support), and your posture (alignment). Shoes form the foundation of the body.” According to the American Podiatric Medical Association (APMA) flip-flops do not fit any of these requirements – it doesn’t provide any arch support, heel protection or shock absorption and causes problems like tendonitis, arch-pain and sprained ankles. 5) The problem is that flip-flops “don’t really hold on the foot like most shoes do, so we use the tendons and muscles to hold them on,” says Dr. Greg Cohen, a podiatrist at Long Island College Hospital in Brooklyn, N.Y. 6) Unlike a good shoe...