Slippers and Singaporeans: A Match Made in Heaven?

ECP ​​ ​ Thursday, 17 March 2022

It isn’t a long stretch to say that Singaporeans practically live in their slippers. After all, what other form of shoe would allow for the same comfort and ease of wear? The feet have over a quarter of a million sweat glands, all of which are especially overactive in our sweltering weather. Featuring a cover-less design, slippers provide sufficient breathability for heat to escape, ensuring your feet stay cool and dry even on the hottest of days. As such, it’s no wonder slippers are the preferred footwear of choice in Singapore.

Risk Factors of Wearing Slippers

Lack of support

In most basic slipper designs, the thin rubber sole provides insufficient arch support and shock absorption. This can subject the foot to extreme ground forces during motion, causing increased forefoot or heel strike impact, pain, and repetitive stress injuries in the lower limbs.

Tripping hazard

Basic slipper design specifications like thongs or straps frequently fail to ensure an adequate amount of grip on the slipper, making them tricky to walk in, especially in wet weather. These styles of flip flops also increase your chances of tripping and falling if they get caught on something, and such awkward landings can result in sprains or fractures.

Lack of protection

Slippers also offer almost zero protection from external factors. The feet are at a greater risk of nail trauma, puncture wounds from sharp objects, or serious damage if something heavy is dropped on the toes.

Not only can injuries come about from acute trauma, but exposed skin can also be at risk for skin cancer. Spots that form due to cancer are relatively hard to catch if they occur on the feet, especially in the areas between the toes.

Slipper Use and Commonly Injured Areas

1. Toes

Toes usually form a clawed motion to ensure that the lightweight sole keeps attached to the feet during movement. This can cause a condition called hammertoes where the toes are permanently bent, painful, and stiff.

Furthermore, excessive gripping on the sole can cause increased pain and the formation or deterioration of bunions.

2. Skin

Given that slippers are open shoes, there is a greater risk of surface wounds from cuts and puncture wounds. The bit of material in between your toes that affix your foot to the slipper can irritate the skin as well, causing tenderness and blisters.

These open wounds leave an individual more vulnerable to fungal, viral, and bacterial infections, all of which are particularly dangerous for those with already weakened immune systems or chronic conditions such as diabetes.

3. Arches

Although they may offer some basic surface protection for the bottom of your foot, slippers typically offer zero or minimal arch support as the calcaneus is not cupped. This causes wearers to suffer fatigue and foot pain during extensive periods of walking.

Furthermore, this form of footwear requires the toes to work harder and grip at the surface to keep the slipper on. This can cause repetitive stress on the plantar fascia, the supportive tissue that stretches from the arch to the heel, resulting in a painful condition known as plantar fasciitis.

4. Heels

The thin rubber material offers little to no shock absorption, causing heels to experience more ground impact. Repeated stress to the heels can lead to tears in the muscles or tissues and cause painful conditions such as plantar fasciitis or Achilles tendonitis.

5. Gait issues

As the foundation of your body, feet suffer great impact during motion and unsupportive slippers can cause the entire body to readjust, altering the way an individual walks. This can affect overall pronation and posture, which not only increases the amount of stress on the joints, but also affects areas higher up in the body such as the knees, hips, and back.

6. Ankles

A slackened grip on the unstable thin sole makes it easy to twist the foot or ankle sideways, especially if the slipper is caught on something. The sole also offers little traction, leaving the individual vulnerable to tripping and spraining their ankle on wet or unstable surfaces.

What can I do for slipper-related injuries or discomfort at home?

To relieve slipper discomfort, start by wearing more supportive footwear.

Here are some home remedies for foot care and management in Singapore.

  • RICE (rest, ice, compression, elevation) for minor injuries
  • Anti-inflammatory medication to reduce swelling and soreness
  • Stretches and exercises
  • Rolling a massage ball or frozen bottle of water under your feet to stretch the tissues and ligaments

If little improvement is noticed, an appointment with a podiatrist is recommended.

How can a podiatrist address slipper-related injuries?

Podiatrists are foot and leg specialists in Singapore that are professionally trained to manage lower limb conditions. They do so in ways such as:

  • Using non-invasive and specialised technologies such as shockwave therapy to provide pain relief and promote tissue healing.
  • Offering advice on switching to more supportive brands of slippers in relation to your foot type and biomechanics.
  • Provide additional support for foot problems with the addition of custom orthotics to suitable footwear.

Individuals That Should Avoid Wearing Slippers

1. Elderly

As individuals age, the onset of osteoporosis (deterioration of bone tissue) leads to weakened and brittle bones. Coupled with weakened muscles and reduced reaction time, walking gait and balance can become impaired. Even a simple fall can lead to a serious bone fracture or head injury, causing the individual to become immobilised for a prolonged period. This thereby reduces their quality of life and increases their morbidity and mortality rate.

2. Children

The growth plates in a child’s feet do not close until the teenage years, and continuous slipper wearing before this age can cause the feet to become deformed before they have finished developing due to the lack of proper support and pressures exerted by the design of the slipper. Examples of such deformities include musculoskeletal abnormalities and a drastic change in gait.

Sports shoes are the ideal type of footwear for children. These shoes help lessen the shock from ground impact and reduce biomechanical stress during motion, which are optimal for promoting healthy growth and development.

3. Diabetic individuals

Diabetic individuals with neuropathy face a higher risk of injury due to their lack of sensation and impaired balance. Any open wound injuries can be life-threatening if infection sets in and leads to extensive tissue death (gangrene) or sepsis.

4. Obese individuals

Individuals that weigh more than the average adult will face increased pressure on their arches, ankles, and lower back. This added weight can also be a risk factor for arch collapse due to the lack of support provided by slippers.

How to choose the ideal slipper?

1. Size

The perfect slipper shouldn’t be too small that the toes are hanging over the edge, nor too big that it’s easy for the edges to be caught on things and cause the wearer to trip.

2. Support

The sole of the slipper should be firm but not rock hard. The middle where the foot folds when lifting off from the ground should be firm to reduce over/under pronation, ankle instability, and sprains.

Make sure to choose flip flops with thicker soles that will cushion your feet and protect you from sharp objects when walking. These designs are also less likely to get caught on something and cause a sudden fall.

Take note to replace your slippers when they wear out over time.

3. Heel

The heel cup should be deep and firm, so the foot is secured in place, preventing overpronation of the arch or the ankle from being too unstable during movement.

4. Fastenings

Slippers with fastenings such as ankle straps are highly recommended as they help secure the foot to the slipper/sandal. This ensures that the toes don’t have to claw at the sole of the slipper during movement, which can cause permanent deformity.

Although it is highly tempting to use slippers for daily wear in our tropical climate, they should only be worn when necessary or over short periods.

Slippers are useful for preventing the contraction of foot fungus or warts in public places like pools, spas, public showers. They can also be worn when running short errands for ease of comfort but should be avoided when walking for extensive periods or long distances.

Speak to a podiatrist for more information about proper slipper usage or how you can manage your slipper-related injuries.