Mandal with Care

New York Post—June 26, 2007

According to market researchers NDP Group, 20 percent more men bought sandals in 2006, compared to 2005.

Today's "mandals" have a broad, hip appeal. And as women know, where fashion goes, pain often follows.

Doctors in the American College of Foot and Ankle Surgeons reported this week that "along with the growing popularity of men's sandals come more aches and pains for male feet."

According to Rock Positano, DPM, M.Sc., MPH, director of the NonSurgical Foot and Ankle Service at Hospital for Special Surgery, complications include heel pain, most often a result of plantar fasciitis. The plantar fascia is the thick band of tissue that extends from heel to toe on the underside of the foot. When it gets inflamed—which often happens when people wear non supportive footwear (like sandals) on hard flat surfaces (like sidewalks)—it's called plantar fasciitis and is extremely painful.

Doctors are also seeing more Achilles tendonitis, wherein the tendon along the back of your ankle does not stretch properly and gets inflamed. Again, the condition can be caused by wearing flat sandals that put excess stress on the tendon. Again, super-painful.

Big-toe trouble is also a looming sandal problem. Stress fractures and breaks in the skin and bones are serious complications for anyone, and stub injuries are common where the tip of the big toe is traumatized, sometimes leading to fractures and toenail trauma.

Open-toe shoes in general make a person more susceptible to these types of injuries, which are extremely painful.

How to minimize risk? First, and foremost, be aware that foot pain is never normal and acceptable in a sandal (or any shoe) for the first wearing or the hundredth. If there's pain, there's a problem, and no amount of "breaking in" should be tolerated. Take the sandal back. If you don't, it will be very expensive in the long term . . . and terribly painful.

Next, buy the right fitting sandal. The surgeon's group recommends looking for a sturdy, cushioned, supportive sole fashioned with padded straps.

Ask your foot and ankle surgeon for advice. Sandal-type shoes may not be a good fit for individuals who have predisposing musculoskeletal foot issues such as heel and ankle pain and a flat or high-arch foot.

Dr. Rock Positano is the director of the NonSurgical Foot and Ankle Service at Hospital for Special Surgery in New York. His column appears every Tuesday in the New York Post.