If I were a betting woman, I would put a huge wager on the odds that everyone in Jamaica over the age of 10 owns a pair. They come in various colours and styles and can be very affordable.

The best purpose of flip-flops is to offer some form of basic protection to the feet while on the beach, walking around a poolside, or on a hot surface. They can help in protecting you from catching fungal infections and plantar warts (verrucae) in public showers and gyms. They keep your feet cool and, conveniently, are easy to slip on.

Hidden dangers

Most people find them very comfortable, but are unaware of the hidden dangers they might pose.

One study in the United States in 2014 found that of the 198,437 emergency room visits due to shoe-related injuries, 25,300 were associated with flip-flops. Here are a few reasons to avoid wearing them too often:

1. They offer no support. Flip-flops offer no support to your toes, arch, heel, or ankle. Long-term use can cause arch and heel pain and lead to bone spurs and plantar fasciopathy. Our toes have to work overtime to hold the shoe in place. Long-term use can lead to hammer and mallet toes. Ultimately, some people will end up with knee, hip and back pain.

2. They are bad for your heels. Your heel hits the ground with a high force. When you just have a few straps holding the shoe to your foot and a thin strip of foam for shock absorption, this can cause chronic pain — especially if you stand for long periods of time.

3. Flip-flops can slow you down. Studies show that people take smaller steps in this type of shoe as opposed to a more supportive form of footwear.

4. Flip-flops may be made of toxic materials. Cheap ones may be made of plastics that contain BPA (a toxin that can cause cancer). Leather or cloth materials are often a better option.

5. They can cause postural problems. Any shoe that is very flat and does not bend like your foot when you walk barefoot, can alter your posture and biomechanics, leading to back pain.

6. They can aggravate bunions. This is due to the hard work your feet are doing to keep the shoe in place.

7. They can cause blisters. When a thin strap is all that is holding your shoe onto your foot, friction will occur between it and your skin. This friction can lead to blistering.

8. They can expose your feet to infection. If your feet are exposed, they will come into contact with bacteria, parasites, fungus, and viruses. These are all opportunistic and may cause infection if there is a break in your skin.

On a wet day, stepping in dirty puddles should be avoided. Staphylococcus bacteria, hookworms and multiple other infections may be lurking to infect a wound or a micro-wound that you can’t even see. I have seen cases where patients have had a micro-wound from a pedicure that has led to something quite nasty.

Minimising the risks

So, how can you wear flip-flops without them ruining your feet?

1. Don’t let flip-flops be your primary footwear, even in your home. Wear them in moderation.

2. Replace your flip-flops regularly.

3. Wear leather or cloth flip-flops, if possible.

4. Look where you are walking. It is very easy to trip wearing flip-flops and they provide very little protection, so be aware of your surroundings.

5. Don’t drive while wearing them. It is easy for one to get caught up under a pedal and lead to an accident.

6. Invest in a reputable brand. They are likely to be made with safer materials and manufactured at a higher standard.

7. Alternatively, buy sandals that are held onto your feet securely around the ankle. They may take a few more seconds to put on, but they are a much healthier option.

If you have swollen feet and ankles and find it easier to wear flip-flops, invest in a pair of sandals that have adjustable straps and can be loosened as your feet expand. Always purchase your footwear in the afternoon when your feet are usually at their worst.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293-7119), Mandeville (962-2100), Ocho Rios (974-6339), Kingston (978-8392), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.