FLORIDA KEYS -- Some call it flip-flop weather everyday in this island chain, but as summer heats up, nearly everyone can be seen wearing the open-toed sandal. With this, podiatrists say they expect many more visitors in their offices.

According to a June 2012 study from the Institute for Preventive Foot Health, about 78 percent of people older than 21 have been treated for some type of foot problem. The blame is being put on flip-flops and sandals.

A Tavernier podiatrist is advising her patients this summer to stay away from $2 flip-flops at drug and grocery stores.

According to Brigette Smith, this footwear lacks stability and leads to ankle and foot problems. But many people in the Keys wear them too often, and convincing her patients to change can be a task.

"About 50 percent of people I can convince the flip-flop is the problem," she said.

Smith said the other half complain about the warm climate and refuse to give up flip-flops cold turkey.

They slowly change by wearing them only at the beach or while doing leisure activities.

Smith said the patients who take her advice are usually motivated by their pain and are willing to try anything.

But once the pain goes away, she said some of her patients fall off the wagon by reverting back to unhealthy habits.

And although overweight people may be more prone to having foot problems, Smith said anyone can be susceptible.

A manager for a Marathon sandals store said his customers over the last two years have been turning to an orthopedic-designed sandal with more support.

"Things have changed," said Mike Klimpl, of Sandal Factory Outlet. "The consumer is more aware of foot health."

Klimpl said northern tourists usually don't invest in a foot-healthy pair of flip-flops or sandals because they are only in the Keys for a week or so before they return to the colder climate.

And though some people might be turning over a new leaf, Klimpl said there are still many whose main concern is fashion not support.

"They still want stylish and fashionable," he said referring to a pair of $200 name-brand flip-flops with little stability at all.

Klimpl said he offers customers a wide range and they can choose the type of support they want.

A couple of Keys musicians have been wearing flip-flops everyday for years, and potential foot problems don't worry them.

Micah Gardner, known in the Upper Keys by his stage name Barstool Sailor Micah, said flip-flops and Keys life go hand in hand.

"It's the philosophy on how we want to live," Gardner joked. "The Keys breed laziness."

Flip-flops, he said, are one step down from Velcro shoes.

"Even when playing for weddings, I have not been asked to wear shoes," he said with a laugh.

Howard Livingston, a musician in Summerland Key, wears sandals just about all the time.

"It's a rare day I wear shoes with fronts and backs," he said.

And he said most of the people who come to watch him play are wearing flip-flops, too.

"Maybe 10 or 15 percent are wearing boat shoes," he said.

Livingston, though, isn't going cheap on his footwear.

"I take my sandals seriously," he said. "That's all I wear."

jgore@keysnews.com