Night Splints

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Night Splint Sock

Anterior Night Splint

Posterior Night Splint

How do Night Splints Work?

Night splints work by holding the ankle in a neutral position which does not allow the calf muscles or the plantar fascia to shorten overnight therefore when you put your feet down to the ground first thing in the morning the calf muscles and plantar fascia only has to stretch a minimal amount, reducing the common symptom of morning pain. Some designs (the sock) available also pull the toes backwards as well as keeping the ankle in a neutral position. This provides added benefit by stretching the plantar fascia as well as the calve muscles. A night splint is designed to be worn whilst you sleep at night. If you're lucky enough to get a magic 8 hours sleep, this means the night splint is doing all the hard work over a long period of time whilst you enjoy your well deserved rest. When it's time to get out of bed in the morning, you simply take off the splint, put your foot down to the ground, and feel sheer relief that you don't feel as if you've just stood on 50 pieces of Lego.

Which is the Best Night Splint?

This is dependent on patient preference. Most people find posterior night splints very bulky, uncomfortable and difficult to wear whilst sleeping. Posterior night splints have been shown to be less effective than anterior night splints and I do not recommend them. Anterior night splints are less bulky and more comfortable than posterior night splints. A limitation of the anterior night splint, however, is that it does not pull the toes back, it only keeps the ankle joint in a neutral position. It has been clinically proven that dorsiflexion (pulling the toes back) of the toes in combination with dorsiflexion of the ankle provides a maximum stretch on the plantar fascia and Achilles  tendon. The most recent night splint design, the sock design is not made from plastic and is the most comfortable of the three designs for most people. The sock design night splint provides dorsiflexion of the toes in a combination of  dorsiflexion of the ankle, providing the most effective stretch whilst sleeping. Due to improved clinical effectiveness and improved comfort the sock design night splint is considered the best option, however some people may prefer the other two types, hence it really is down to patient preference.


My Verdict

There is moderate evidence to support the use of night splints for treating plantar fasciitis. A night splint is an incredibly effective device at eliminating heel pain first thing in the morning which is what almost every patient with plantar fasciitis suffers with. The main challenge with all types of night splints is patient tolerance as for some people they are intolerable to wear whilst trying to sleep regardless of design. Night splints are a safe and very effective adjunctive treatment option which help breaks the morning pain cycle and promotes faster recovery.