Barefoot Running: Interview with Dr. Andrew P. Gerken

Barefoot running is a fitness trend of concern to many of our readers. Runners would like to know if there are benefits to barefoot running shoes, and if there are, who should use them? With the "barefoot" question in mind we requested an interview with Dr. Andrew P. Gerken of the Newport Orthopedic Institute. Dr. Gerken has special expertise in ankle arthroscopy and fixing chronic ankle problems that have not responded successfully to treatment. He also has a wealth of personal experience as a college cross country and marathon runner who continues to run today. We thank Dr. Gerken for answering our questions and offering his personal story and observations as well.

HOI: Are barefoot running shoes better for your feet?

Dr. Gerken: That probably depends on what type of runner you are: old and slow vs. young and fast; running long or short; overweight or slender. If one has run for years in a consistent pattern and has been injury free, then I would not recommend changing shoes. I do not think there is evidence the barefoot running shoes are better for the feet as far as reported injuries go. They may be better further up, i.e. knees, hips and back.

HOI: Some of the websites selling barefoot running shoes claim that these shoes relieve and/or prevent orthopedic injuries. What is your view with regard to this claim?

Dr. Gerken: In some individuals, barefoot running shoes may be a better alternative. Remember, many people have had injury free running careers, and so for these people, “regular” running shoes should be continued and they will do just fine. "If it isn’t broke, don’t fix it." I have seen more injuries recently in runners who have changed to barefoot shoes. I do not think there is enough data to suggest that all people are better off with barefoot running shoes, or how to decide what shoe a particular runner should wear.

HOI: Can you talk about Olympian Zola Budd who has gained quite a lot of attention running barefoot? Is she doing damage to herself, or would her barefoot running practice help her feet?

Dr. Gerken: I was at the coliseum in 1984 and saw her race Mary Decker in the Olympics. Although she was phenomenal, she was the only one in the race barefoot. Many others had shoes and were contenders. I do not think Zola was doing damage to herself, and quite well may have been helping her feet with her style of running.

HOI: What is your viewpoint on allowing children to run and play on grass or other safe outdoor surfaces barefoot? Are they strengthening their feet and ankles or do young feet need the support of shoes?

Dr. Gerken: I do not believe that children should run barefoot... glass and punctures can be very dangerous and can lead to infections. A minimally supportive, but protective layer under the sole of the foot would be a minimum.

HOI: What should runners look for when purchasing running shoes?

Dr. Gerken: Since it is so important, you want to get the right reps who can help analyze the runner and suggest a few models of shoes the runner may consider. Then the runner should test and compare the different shoes and pick the one that feels best. After a certain shoe has been used and works, the runner can easily repurchase that type of shoe in the future. Since so much time will be spent in them, a runner should plan to spend an hour at the store buying a pair of shoes. Some running shoe stores such as Snail’s Pace, Road Runner Sports, etc. have very good sales.

HOI: What is the best surface to run on, and is it damaging to run on pavement no matter what kind of shoes you wear?

Dr. Gerken: Softer surface is better to run on… grass, and then dirt, followed by asphalt and then pavement. However, some people have weak ankles and are susceptible to sprains, and then grass is too risky to run on.

HOI: Would you be willing to share some of your personal running experience with our readers?

Dr. Gerken: Of course I'd be glad to. I graduated in the same year (1985) as Christopher McDougall, the author who wrote “Born to Run.” We were classmates at Harvard, but I did not know him. A year prior, 1983 (Fall), I ran what was then 3 seconds off the school record for cross country. Later, after I graduated, I trained with my coach, Ed Sheehan (sub 29 for 10K), to run a marathon, taking a year off before starting medical school. I was sponsored by Reebok, and although I could get any shoe free, I chose the cheapest model they had. The expensive $125 shoe was terrible… too much shoe. Why? Because I had trained myself to run up on my toes. It was very unnatural at first, but it got me to my goal… sub 30 for 10K. I had been struggling, and I noticed that at 6AM in the morning, dead tired, Ed Sheehan would be running on his toes from the start. So I thought I would try this, as I kept missing my goal of getting under 30 minutes for 10K. The point is that it was not totally the shoe that was a factor in how I ran. I had to train myself to run up on my toes. Having a non-intrusive shoe made it possible.

However, now as an older person trying to run, my calves are my weak point and running on my toes is not possible unless I am getting in very good running shape. So I run now in my Brooks Endurance running shoes. I notice that in many people getting into their 30’s and 40’s, the calves and achilles become a weak point, and heel striking may become necessary again.

Kate Wiley, M.D., still has the Ivy record for Cross-Country and is a sports medicine doctor. She struggles with her calves now as a runner. So my concern is that barefoot running will overstress the calves in some runners, giving them problems. For younger, competitive runners, it may be better to have less shoe (but not necessarily barefoot). I do not think one needs to be barefoot and risk injuring the skin. I think the important feature is to run up on the ball of the foot. I certainly do not recommend to all people that they should switch to barefoot shoes. If someone were going to try it, either because of prior injuries or performance goals, I would recommend a gradual transition.

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Dr. Andrew P. Gerken is an orthopedic surgeon specializing in foot and ankle surgery. His office is at the Newport Orthopedic Institute (NOI), which is the largest orthopedic and musculoskeletal group in coastal Orange County. Among Dr. Gerken's achievements is a new approach he developed for treating calcaneous fractures. His special expertise is in ankle arthroscopy and fixing chronic ankle problems that have not responded successfully to treatment.