Cold-weather warfare
Trench foot is a medical condition caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions at temperatures as warm as for as few as 13 hours. Exposure to these environmental conditions causes deterioration and destruction of the capillaries and leads to morbidity of the surrounding flesh. Affected feet may become numb, affected by erythema (turning red) or cyanosis (turning blue) as a result of poor blood supply, and may begin emanating a decaying odour if the early stages of necrosis (tissue death) set in. As the condition worsens, feet may also begin to swell. Advanced trench foot often involves blisters and open sores, which lead to fungal infections. If left untreated, trench foot usually results in gangrene, which may require amputation. If trench foot is treated properly, complete recovery is normal, though it is marked by severe short-term pain when feeling returns. Trench foot affected tens of thousands of soldiers engaged in trench warfare in World War I. Keeping feet warm and dry, or at least changing into warm and dry replacement footgear, is the best way to avoid trench foot.
Shin splints
Treatments include rest, ice and gradually returning to activity. Rest and ice work to allow the tibia to recover from sudden, high levels of stress and reduce inflammation and pain levels. It is important to significantly reduce any pain or swelling before returning to activity. Strengthening exercises should be performed after pain has subsided, on calves, quadriceps and gluteals. Cross training is recommended in order to maintain aerobic fitness e.g. cycling, swimming, boxing etc. Individuals should gradually return to activity, beginning with a short and low intensity level. Over multiple weeks, they can slowly work up to normal activity level. It is important to decrease activity level if any pain returns. Individuals should consider running on other surfaces besides asphalt, such as grass, to decrease the amount of force the lower leg must absorb. Orthoses and insoles help to offset biomechanical irregularities, like pronation, and help to support the arch of the foot. Other conservative interventions include footwear refitting, orthotics, manual therapy, balance training (e.g. using a balance board), cortisone injections, and calcium and vitamin D supplementation.
Less common forms of treatment for more severe cases of shin splints include extracorporeal shockwave therapy (ESWT) and surgery. Surgery is only performed in extreme cases where more conservative options have been tried for at least a year. However, surgery does not guarantee 100% recovery.