One of the great harbingers of summer is a shiny pedicure and strappy sandals. While both can make the feet look beautiful, they can also pose hidden health risks.

According to the American Podiatric Medical Association, approximately 1 million people leave the nail salon with a bacterial, viral or fungal infection from improperly sanitized pedicure tools. Whirlpool foot baths can be a breeding ground for a variety of problems, from warts to MRSA. Look for a salon that has pedicure bowls without whirlpool jets or one that has pipeless whirlpool tubs, and make sure the tub is sanitized between clients.

Most Americans have walked 75,000 miles by age 50, and shoes can have a tremendous impact on the quality of life. While high heels and strappy sandals may look great, they exact a price. Ultra-high heels force the feet into unnatural positions, putting stress on the balls of the feet, which can cause hairline fractures, hammertoes and other deformities. Even mid-high heels can cause what is known as “pump bump”, a bony deformity on the back of the heel. High heels can lead to sprained ankles and even torn ligaments.

The lower the heel, the more natural the foot position, helping avoid problems with metatarsal bones. Chunky heels distribute weight more evenly, making the feet more stable. However, having no heel can be an issue as well—flats with no arch support can lead to knee, hip and back problems, as well as plantar fasciitis. An over-the-counter or custom orthotic can provide the needed arch support.

Flip-flops and sandals, once limited to the beach or swimming pool, are now a summer wardrobe staple. If not strapped to the foot and ankle, they can cause the gait to be compromised and lead to injuries. Look for summer shoes with straps that cross the foot to evenly distribute pressure.

Dr. Mitchell Waskin, DPM, is board-certified by the American Board of Foot & Ankle Surgery and affiliated with The Foot & Ankle Center at Johnston-Willis Hospital. For more information, call 804-320-FOOT (3668) or visit 320-Foot.com.