Night Splints

Night splints or braces are devices that you wear at night when sleeping to help stretch the calf muscles and plantar fascia. They are most commonly recommended for conditions such as plantar fasciitis and Achilles tendon problems that can get some clinical benefit from the stretching.

How do Night Splints Work
The evidence is really clear on tight calf muscles being an important risk factor for plantar fasciitis, so daily stretching is an important part of the treatment. The night splints hold the foot in a dorsiflexed position (with the toes pointing upward) to maintain a gentle stretch of the plantar fascia and calf muscles while you sleep. Those people who have really severe first step pain in the morning (a common symptom of plantar fasciitis called post-static dyskinesia), the night splints can be particularly helpful for reducing that ‘hobbling’ for the first few steps in the morning.

Types of Night Splints
Night splints are generally of three types:
Dorsal Night Splints (pictured above): These are worn on the front (dorsal side) of the foot and leg. They tend to be much bulky and usually more comfortable than other types. However, some versions might not give as aggressive a stretch as is needed.
Boot-Style Splints (‘Moon” boots): These are much bulkier, resembling a boot that is often prescribed after foot and ankle trauma. They are worn on the back of the leg and foot. They do tend to provide more support and can provide a stronger stretch. However, they can be less comfortable.
Sock Night Splints (eg Strassburg sock): These are a stretchy, sock-like devices which pull the toes upward. They tend to give more of a stretch to the plantar fascia and not as much to the Achilles tendon. They are, however, less obtrusive but may not work as effectively for those who need significant calf muscle stretching.

Benefits of Using Night Splints
Reduces Morning First Step Pain – keeping the plantar fascia stretched overnight, there can be less pain when they take their first steps in the morning. The night splints can help improve flexibility in the plantar fascia and Achilles tendon. They are a non-invasive option that can be used alongside other interventions like physical therapy, orthotics, and stretching exercises.

There can be problems with night splints
Some people find them somewhat uncomfortable and may find it difficult to sleep with a splint due to its bulkiness or restrictive nature. It may take a few or more nights to get used to wearing a splint. Night splints are most effective when combined with other treatments rather than a standalone treatment.

Advice
Start wearing the splint gradually – only wear it for short periods at first and gradually increase the duration as you get used to it. Most splints allow you to change the angle of the stretch. Start with a mild stretch and increase it as tolerated. Always combine it with other treatments such as calf stretches, massage, foot supports and hot packs. Always ensure that the splint fits well and be on the look out for any pressure points or discomfort.

Evidence for Night Splints
A 2018 systematic review in The Journal of Foot and Ankle Research found that night splints were effective when used as part of a broader treatment plan. One RCT published in The Foot (2012) concluded that dorsal night splints significantly improved pain and function after 8 weeks of use compared to stretching exercises alone.

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