A recent study by Bill Vicenzino and his colleagues looked into the difference between contour sandals (commonly known as Birkenstocks), flat thongs and shoes with an orthotic insert. The participants in the study all had plantar heel pain commonly known as plantar fasciitis. The results were interesting and definitely worth thinking about during these hot Summer months when we all go back to wearing thongs.
In this study the participants (50 in each group) were asked to wear their allocated footwear (thongs, contour sandals, or shoes with orthosis) for a 12-week period. After this 12-week period they were re-assessed based on pain outcome measures taken prior to the study. It was found that both the contour sandal and the shoe with the orthotic outperformed the thongs. Pain improvements across these two groups were at least 61% better than the thongs group.
So what can we take from this study?
Wearing contour sandals instead of thongs will mean that for every 4 patients with plantar heel pain, 1 of those patients will be quite a bit better, a great deal better, or a very great deal better than if they wore thongs.
During the study only 2 out of 150 patients had to pull out due to an increase in their pain. One of those patients wore the shoe with an orthotic and the other was wearing thongs. So we could happily assume that wearing a contour sandal is not going to make the heel pain worse, or do harm.
The study showed that there was no difference in resting foot posture before and after the study. What this means is that wearing any of the above mentioned footwear will not change your foot type eg: pronated foot type, supinated foot type and so on will not change.
Based on the above information my take home message would be that trying a contour sandal instead of your thongs would be a good alternative if you are suffering from plantar heel pain. It is also important however that appropriate foot strength and loading exercises are also completed to help further improve pain outcomes. These exercises can be given by your physiotherapist or podiatrist. It is also important to note that this study only looked at thongs with respect to plantar heel pain. It does not mean that thongs are the devil and you should throw them out. Generally, most people who present with foot pain from wearing thongs are those who have substantially increased their time in thongs over a short period of time. A classic example of this would be an office worker who goes on holidays to Lorne for 2 weeks and spends majority if their time in thongs while away. Key message: be SUNSMART and THONGSMART