FEET FIRST: SANDLES KEEP FEET COOL, BUT CAUTION HELPS KEEP THEM HEALTHY IN SUMMER

This collection of sandals at Crown Shoes shows that footwear can be stylish as well as functional.

Hippies spurred the first sandal surge in the United States during the 1960s.

Then soldiers returning from Vietnam soldiers used a Vietnamese technique of cutting soles from pieces of tires and tying them to their feet, explained Dr. Zenon M. Duda, D.P.M., P.C.

Today, the original black rubber soles have evolved into name brand flops and all-conditions gear like Birkenstocks and Tevas. They are just as much a summer fashion accessory as RayBan sunglasses and Speedo swimsuits.

"Sandals are more for fashion than anything," said Tammy York, a shift manager at Lady Footlocker. "Most people come in here looking for nothing but Nike and Adidas."

Although the most popular style is the more convenient and cheaper slip-on flops, more rugged individuals seek out the more expensive all conditions gear that features straps, more arch support, an Achilles pad and a hard rubber sole for rougher terrain, she said.

"The all-conditions gear is popular for people that go canoeing and hiking," York said. "It is good support for someone that has to hike to the river before playing in it."

Some of York's sandals feature massage nubs. The surface of small plastic nubs is supposed to increase stimulation and blood circulation, helping to reduce foot fatigue, she said.

This idea stems from reflexology and has theoretical basis in the health benefits found by those who practice acupuncture, Duda said.

"These types of sandals change how you are putting pressure on certain areas of your feet since more areas are being touched by the nubs," he said. Like pins used in acupuncture, the nubs break up the crystalline deposits that build up in different areas and nerve endings in the feet.

Different parts of the body benefit because since different areas of the foot correspond to different parts of the body like the heel to the colon and the pulpy parts of the toes to the sinuses, Duda said.

Whether sandals are worn for summer fashion or convenience, the sockless shoes guarantee one thing -- exposed skin. As a podiatrist, Duda knows open-aired shoes set up prime conditions for foot problems.

During the winter months, feet are concealed and protected from the cold by heavier shoes, he explained. But in the summer, people don't have to worry about the cold, so they opt for sandals or go barefoot in some situations.

"The skin isn't significantly toughened and it's vulnerable to excessive dryness and cracking from exposure to the sun and air," he said. "When the integrity of the skin is broken down, it leads to infections like fungus."

He suggests thoroughly cleaning the feet and using emollient creams with lanolin, urea based creams, Vaseline or udder balm.

More internal foot problems can result from wearing sandals. The most common foot problem Duda sees in his younger patients during the summer months is heel pain from sandals and other thin-soled shoes like Keds and jellies.

"Sandals such as flip-flops don't offer shock absorption," he said. "The flimsy sole doesn't support the foot and it allows for fallen arches and strained arch ligaments."

Duda prefers sandals like Birkenstocks that have cork latex rubber soles or Tevas that have well-molded arches, thick soles and straps that hold the shoe well on the foot.

Another foot problem Duda sees a lot of toward the end of the summer is children with plantar warts on the bottom of their feet. Usually kids pick up the fungus that causes the warts in June and July, but it isn't until August or September that parents bring their children in for treatment after the warts have grown and are beginning to hurt, he said.

All plantar warts require treatment such as being cut out, treated with acid or removed by laser.

Bare and sandalled feet are prime opportunities for foot injuries and ailments. Exposed feet lead to foot fungus, sometimes acquired in pool showers, poison ivy, sunburned feet, stubbed toes and insect bites and bee stings on the bottom of the foot.

Except for sports-related injuries, the number of foot injuries treated in the emergency room at St. Francis Medical Center during the summer months is proportional to those treated during the winter months.

On the average, the emergency room treats approximately six foot-related injuries daily, said Marcia Abernathy, a registered nurse and clinical coordinator at St. Francis. But even though "the numbers stay the same, the mechanisms are different. They are activity-related injuries, rather than weather-related injuries."

Abernathy sees a number of foot lacerations from glass and nails as well as toe amputations from lawn-mowing accidents. Every summer, usually one or two children are injured from playing too close to lawn mowers or falling off lawnmowers and being injured in some way, she said.

Duda and Abernathy both stress wearing shoes while doing yard work so the entire foot is protected. Abernathy also suggests considering tetanus immunizations.