Shin splints are most common in those with moderate to severe foot overpronation. From an engineering point of view, those whose calcaneus falls to the lateral side and the foot flares out have tendons that follow a more indirect path (inefficient) than those who have the arch lifted which changes the angle of pull for the tibialis anterior and posterior as well as the peroneii.
The condition is best treated with myofascial release, since it is the tightening of the outerfascia that causes the mechanical firing patterns of these muscles to work poorly, and as the tissue surrounding the muscle allows for less function and shock absorbtion, we get the classic shin pain although, many feel it as knee pain since these muscle insert high into the shin just below the knee.
Orthotics work as a preventative measure, however, exercises and work hardening are also important especially for the beginning runner. Those with better natural body mechanics rarely have the problem. In its worst cases, we see osgood schlatter malformation at the shin which I believe can be handled more effectively with the measures mentioned above instead of watching and waiting and tolerating during ones growing years.
Regarding barefoot walking or running, I am not sure that would make much of a difference except for perhaps where on the shin the pain may occur since the mechanics behind the problem are the same with more of a mid foot strike.
Another part of the mechanism rarely talked about is the fact that we absorb shock through the ankle and hip and pelvis, and as one of the doc's mentioned on the panel, he believes walking and running requires a spring mechanism. In my opinion, if we have symmetry, this works weather shod or barefoot, since if the ankle locks up, it also locks up the hip, causes recruitment into the pelvis and we absorb less shock through the pelvis and the body. Shin splints can also be seen as a failure of this mechanism to work properly, because when our core distorts, our stride shortens and our impact to the ground increases markedly, causing a pounding or hard gait. This can lead to injuries because of the very nature of abnormal impact, and damage to tissues as they repeatedly are insulted by the harder than desirable impact and little shock absorbtion through the kinetic chain (series of joints from the foot to the knee to the hip and then into the upper body).
You can understand this better if you read my book Cheating Mother Nature, what you need to know to beat chronic pain which is available on Amazon.com.
