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Night splint for plantar fascitis

Discussion in 'Biomechanics, Sports and Foot orthoses' started by suresh, Apr 9, 2008.

  1. suresh

    suresh Active Member


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    hi,
    any opinion about using night splint for plantar fascitis.
    we are treating with initial physiotherapy, like plantar fascia
    stretching. SWD, foot intrinsic muscle strengthening exercise,
    followed by hydrocortisone injections.
    still few patient has short term relief
    and have been tried with night splint .
    i don't know how its works.
    any defined protocol for treating this problem

    suresh

    :bang:
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. drsarbes

    drsarbes Well-Known Member

    Hi Suresh:

    I've given up on night splints, unless I have a really motivated patient or they happen to get results quickly, most find them very uncomfortable and hard to comply. Many of the PT and general Pods I know that use the night splints do it mostly for the high reimbursement rates! Not a good enough reason.

    I get very good results with simple achilles stretching.

    Steve
     
  4. lgs

    lgs Active Member

    Hi Suresh

    my experience with them is the same as Steve's really, on the whole patients find them uncomfortable & compliance is an issue (they tend to get fed up with them)
     
  5. Best contraceptive I know of.
     
  6. drsarbes

    drsarbes Well-Known Member

    THAT is funny!
    I have an image of a woman lying there...................................................

    Steve
     
  7. Peter

    Peter Well-Known Member


    Simon, wished you'd enlightened me earlier :rolleyes:
     

  8. Steve and Colleagues:

    After feeling the same as you, that most patients found night splints to be cumbersome and difficult to wear, I now have found a night splint that most patients seem to tolerate well and will wear on a regular basis. I purchase it from Universal Footcare Products . I tell patients to wear it at night while sleeping as much as possible and to also wear it when they are sitting down at night while on the computer or watching television. Overall, my compliance is now about 80% with this splint versus less than 50% I had with the four other night splint designs I had tried for my patients. My guess is that the "soft padded" design is probably the reason for the better compliance with this night splint. In some patients it is a miracle cure and in others it does little. But it certainly is worth a try prior to proposing plantar fasciotomy since some patients make remarkable progress by using it regularly.
     
  9. drsarbes

    drsarbes Well-Known Member

    Now Kevin:
    You didn't say whether you are using them for Soft tissue stretching or contraception.
    Steve
     
  10. May be used for mechanically induced soft tissue stretching or for preventing parasympathetic mediated soft tissue stretching.:rolleyes:
     
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  12. LER

    LER Active Member

  13. Lottie May

    Lottie May Welcome New Poster

    i have had great results with the dorsal plantar fasciitis resting splint from Trulife not as bulky as some of the other resting splints you get, used in combination with a good stretching regime and foot orthosis if the patient has foot pathology
     
  14. NewsBot

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    Articles:
    1
    A comparison of two night ankle-foot orthoses used in the treatment of inferior heel pain: A preliminary investigation
    J. Attard, D. Singh
    Foot and Ankle Surgery Volume 18, Issue 2, June 2012, Pages 108–110
     
  15. NewsBot

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    Articles:
    1
    A comparison of two night ankle-foot orthoses used in the treatment of inferior heel pain: a preliminary investigation.
    Attard J, Singh D.
    Foot Ankle Surg. 2012 Jun;18(2):108-10.
     
  16. NewsBot

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    Articles:
    1
    Effectiveness of adjustable dorsiflexion night splint in combination with accommodative foot orthosis on plantar fasciitis
    Winson C. C. Lee et al
    JRRD; Volume 49, Number 10, 2012 ; Pages 1557–1564
     
  17. thekwie

    thekwie Active Member

    I had a patient come in with a sock style device: a strap sewn to the end of the toe area of the sock looped back around the leg just below the knee, velcro adhered to pull the foot into the desired degree of dorsiflexion. He hated it; felt it was cutting his circulation.
    Thoughts?
     
  18. Zac

    Zac Active Member

    Strasbourg Sock? Helped my Achilles' tendon tightness/pain. Uncomfortable to sleep with as it dorsiflexes the hallux & (in my case) really irritated the distal aspect of my hallux. Even loosening it, it was not comfortable. BUT, I did have less tightness/stiffness arising in mornings.
     
  19. thekwie

    thekwie Active Member

    Yep that's the one. I have to say, I completely understand patients being non-compliant with any kind of night splint, all of them seem vastly uncomfortable to sleep in.
     
  20. Charlotte Darbyshire

    Charlotte Darbyshire Active Member

    Hi everyone

    Although I regularly find the use of night splints a challenge for patient compliance. My colleagues and I tend to refer to them as resting splints now. We tend to advocate using the splint for when the patient is seated with the leg extended. Whether that is watching TV, on the computer or at work. When you show the patient the device you're hoping they will wear for bed. You can normally tell straight away that the compliance rate will be low.
    I guess using it as a 'resting splint' reduces the number of hours the patient is standing for in some instances. Which I guess can only have a positive effect on the soft tissue loading.
    Using as above we tend to get more positive results (sorry I can not give an exact figure).
     
  21. drdebrule

    drdebrule Active Member

    I am not a big fan of night (or resting) posterior or dorsal splints and use them not very much at all. I use them mostly for chronic heel pain when several other options have not worked. I think 4-5 minutes of plantar fascia specific stretching before getting out of bed addresses the problem just as well for most patients. There are quite a few studies out there on night splints, Strassberg sock etc. but I think they all lack placebo controls.

    Also, why not try osteopathic manipulation and the patient may get an instant increase in range of motion without anyone losing sleep or upsetting their television time?

    Recently I have used dynasplint for a handful of patients with good results in terms of increased ankle dorsiflexion and decreased foot pain. See www.dynasplint.com I think is the website. However, I do not feel any comment much further on dynasplint or similar technology.

    Furthermore, what about patients with plantar fasciitis that do not have equinus? Do you give them a night splint device? I don't. Hope that is helpful.
     
  22. Lee

    Lee Active Member

    Hello Charlotte,

    I agree. I tend to use them prior to and following surgery. Compliance prior to surgery is considerably lower than post-op in my experience. Personally, I would rather try a splint than have surgery and I tell my patients this. In the very few patients that end up heading towards the operating table I make them well aware that they are going to be wearing a splint at night in the weeks following surgery and this seems to help with compliance pre-op - a period of 'getting used to it' at least. If this resolves things everyone's happy.

    I also advise patients that I had plantar fasciitis and it responded well to stretches and orthoses (and losing a bit of weight I think). A great motivator for me was avoiding injections in my heel, etc... as I am a big softy so I was a very compliant patient! I still remember Frank McCourt's lectures on it now.

    Hope you're well,
    Lee
     
  23. Sicknote

    Sicknote Active Member

    Again, diet plays a major role whether your tendons are stiff or compliant.

    It's incredible they load energy drinks with sugar. The stuff is known to make people stiff & damage joints.
     
  24. NewsBot

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    Articles:
    1
    Effectiveness of adjustable dorsiflexion night splint in combination with accommodative foot orthosis on plantar fasciitis.
    Lee WC, Wong WY, Kung E, Leung AK.
    J Rehabil Res Dev. 2012 Dec;49(10):1557-64.
     
  25. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effectiveness of adjustable dorsiflexion night splint in combination with accommodative foot orthosis on plantar fasciitis.
    Lee WC, Wong WY, Kung E, Leung AK.
    J Rehabil Res Dev. 2012;49(10):1557-64.
     
  26. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The effectiveness and tolerability of tension night splints for the treatment of patients with chronic plantar fasciitis – A case-series study
    Patrick C. Wheeler
    International Musculoskeletal Medicine
     
  27. NewsBot

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    Articles:
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  28. NewsBot

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    Articles:
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    The effectiveness of combined prescription of ankle–foot orthosis and stretching program for the treatment of recalcitrant plantar fasciitis
    Rehab A.E. Sallam MD , Atif I El Ghaweet
    Year : 2016 | Volume : 43 | Issue : 4 | Page : 172-177
     
  29. NewsBot

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    Articles:
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    The addition of a tension night splint to a structured home rehabilitation programme in patients with chronic plantar fasciitis does not lead to significant additional benefits in either pain, function or flexibility: a single-blinded randomised controlled trial
    Patrick C Wheeler
    BMJ Open Sport & Exercise Medicine 2017;3:e000234. doi: 10.1136/bmjsem-2017-000234
     
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    Articles:
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    Impact of night orthotic managements on gastroc-soleus complex tightness in pediatric with flexible flatfoot: Systematic review
    Sahar Payehdar et al
    Prosthet Orthot Int. 2023 Feb 1;47(1):112-116
     
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