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Night splints are becoming increasingly popular as a treatment for plantar fasciitis. This prompted me to begin evaluating the effectiveness of wearing a night splint with my plantar fasciitis patients.
Many of my patients have questioned, can night splints make plantar fasciitis worse?
Over several years of the assessing night splints as an application for treatment, my conclusion is that although It is true that night splints have been shown to decrease pain in the short term; this application does not have a significant effect on prevention or recurrences long term.
Biomechanically, it just doesn't make sense. With a plantar fascia injury, you have already elongated your plantar fascia and created trauma and microtears. You don't want to stretch it for an extended amount of time and further injure the area with a night splint. I will explain more about this later.
Now that you know that nights splints aren't the best remedy to resolve plantar fasciitis, let's answer some of the other questions you may have about night splints and other remedies that DO work.
Dr. Angela Walk
Chiropractic Physician
Foot Health Coach
What Is A Night Splint?
A night splint is a device that is worn while a person sleeps to keep their foot held up in a position like you were walking on your heels. This position is called dorsiflexion and it stretches the calf and Achilles tendon at night.
Night splints prevent the overnight shortening of the calf muscles and plantar fascia while we sleep. During sleep, your feet naturally fall into a plantar-flexed position. This means the feet are pointing downwards.
This causes the calf muscles which are attached to the Achilles tendon to shorten and increases tension on the Achilles tendon which results in tightening of the plantar fascia overnight.
Many night splint wearers tend to have a love-hate relationship with their device. On one hand, you notice less pain with your first step in the morning, and on the other hand, it is quite difficult to get comfortable while sleeping.
Now that you know what a night splint is, you may be wondering, is it worth the sleepless nights and do night splints really work for plantar fasciitis?
Do Night Splints Really Work For Plantar Fasciitis?
Night splints have been shown to be helpful for some plantar fasciitis sufferers, yet, there are a couple of problems with stretching the plantar fascia for such an extended length of time while wearing a night splint.
The main reason is that prolonged or extended stretching (static stretching) has been shown to be virtually ineffective and initiates our stretch reflex that is designed to prevent injuries of our muscle, tendons, and ligaments.
The night splint holds your calf muscles, soleus, Achilles tendon, and plantar fascia in a static stretch for hours. You may feel relief in the morning, but long-term it is not healing your plantar fasciitis.
Arch and heel pain is often worse first thing in the morning and this is a telltale sign of PF, so it makes sense that you would want to find a solution to avoid that morning pain with an overnight treatment such as a night splint.
However, there are more effective ways to rehabilitate you plantar fascia and eliminate the pain with your first step out of bed in the morning. Why is your pain worse in the morning , you may ask?
Why Do My Feet Hurt Worse In The Morning?
Morning foot and heel pain is a distinctive feature of the presence of plantar fasciitis. Many sufferers wonder, why does plantar fasciitis hurt worse in the morning?
The reason is because while we are sleeping, our feet and ankles naturally shift into a plantar flexed position (toes pointed downward) and this shortens the calf, Achilles tendon, and plantar fascia overnight.
This happens due to the long period of inactivity while you sleep and causes the plantar fascia ligament to tighten up and contract.
So, when you awake in the morning and put your feet down to the ground to take your first step, it's a sudden deep stretch of the calf, Achilles tendon and plantar fascia in order for you to get your heel to make contact with the ground.
This rapid change in tendon and fascia length causes an immediate sharp, unrelenting pain response with the symptoms lessening as walking continues
The best way to prevent this debilitating morning event is to begin elongating and stretching the plantar fascia before you take that first step. Find the best morning stretches here.
This painful phenomenon is the why the concept of night splints seems like a good idea. However, mechanically this doesn't make sense.
Many people who use night splints are attempting to release the tightness they feel in the fascia and also the calf muscles. Elongating the calf muscles is a critical step in actually heal from PF.
Do Tight Calves Cause Plantar Fasciitis?
One of the more common causes of plantar fasciitis is tight calf muscles. If there is not enough motion in the ankle joint due to a lack of flexibility then there will be extra strain on the fascia which may lead to this injury.
Calf tightness alters walking and running gaits, leading to a tremendous amount of knee, ankle, and foot injuries.
When the ankle is limited in its ability to dorsiflex, it causes excessive stretching of the plantar fascia.
That means with every step up the stairs and every squat, limited ankle mobility and tightness of your calves could be putting excess tension on the plantar fascia.
The best way to elongate and increase range of motion of your calf muscles is to use Active Isolated Stretching on a stair step or with a foot rocker. Perform stretches 3 times a day for best results.
What Is The Best Way To Stretch My Plantar Fascia?
There are actually many different ways to stretch. Stretching just feels good, so people often stretch just for relaxation. Then, there are therapeutic stretches which are designed to help rehabilitate an injury. Let's look at he two most common types of stretching.
What Is Static Stretching?
Static stretching (the type of stretching traditionally taught in athletic training, yoga and dance studios, physical therapy and chiropractic clinics), is a stretch holding one position for 20-30 seconds.
This lengthy stretch activates our stretch reflex. The stretch reflex is designed to prevent us from tearing our muscles, tendons, and ligaments. When we stretch too far, our stretch reflex kicks in and contracts our muscles to prevent tearing.
So, with static stretching (holding a stretch for longer than 20 seconds) the voluntary and involuntary parts of our nervous system are battling each other, trying to achieve opposite results.
Our brain is sending the voluntary message to manually stretch our muscles by pulling on them, but despite all our efforts, our stretch reflex is automatically kicking in.
There is a place for static stretching for example: increasing flexibility in general, yoga and however, for therapeutic benefits, such as attempting to heal from PF, there is a better way to stretch.
Active Isolated Stretching For Plantar Fasciitis
I recommend a specific type of stretching called Active Isolated Stretching that allows the muscles and fascia to stretch slowly and more effectively. Active Isolated Stretching technique involves the method of holding each stretch for only two seconds and performing 10 repetitions.
This method of stretching is also known to work with the body's natural physiological makeup to improve circulation and increase the elasticity of muscles, joints, and fascia without triggering the negative reaction of the stretch reflex as in static stretching (holding a stretch for 20-30 seconds).
For more specific details on how to stretch using Active Isolated Stretching For plantar fasciitis, read more here.
Can I Treat Plantar Fasciitis At Home?
As a chiropractor and foot specialist, I often see patients with plantar fasciitis after they’ve tried everything. Cortisone shots, night splints, ineffective stretching, and rolling on a frozen water bottle are a few of their failed remedies.
If you’re wondering how to treat plantar fasciitis at home, I want to share a few insights that have worked for my patients. The solution for most of my patients is through addressing multiple factors.
Improving limited ankle mobility and dorsiflexion
Strengthening weak intrinsic foot muscles
Stretching and strengthening the calf muscles and Achilles tendon
Wearing toes spacers for proper alignment of the toes and feet
Rarely is there a quick fix for PF. Identifying areas of weakness in the foot and ankle and restoring proper foot function is the most important piece of the puzzle.
I have created a step-by-step comprehensive guide on how to resolve Plantar Fasciitis at Home. Take a look at my FREE GUIDE here.
Other Helpful Tips:
In addition to the stretches, strengthening, and fascial recovery protocols mentioned above, these tips can help you pain and stiffness of the plantar fascia:
Transition to minimalist footwear that offers a wide toe box and no elevation of the heel.
Walk barefoot daily. Start with 20 minutes and increase daily
Running or walking on softer surfaces
Stay properly hydrated. It is critical for healing of muscles, joints, and fascia
Summary
It is true that night splints have been shown to decrease pain in the short term; however, this
application does not have a significant effect on prevention or recurrences long term.
So that means that it can be effective at reducing the pain that people feel first thing in the morning, but it doesn’t actually help to heal the problem that is causing the heel pain.
Dealing with the pain of plantar fasciitis can be life changing--but it doesn’t have to be a life sentence.
By arming yourself with knowledge and taking charge of your healing, you can get back to the activities you love and feel like yourself again.
One of the most IMPORTANT things you can do to fix your feet is to educate yourself fully about the condition. Follow Dr. Angela's social media pages for daily tips on footwear, exercises, and prevention on Facebook & Instagram!
If you have additional questions about heel pain and plantar fasciitis, don’t hesitate to reach out. We’re here to help get you back on your feet--literally.
Best of Health,
🦶Dr. Angela
I've written extensively on the topic of Plantar Fasciitis. Take a look at these other related blog posts:
Hi, I'm Dr. Angela Walk...
I have been involved in the health and wellness industry for over 20 years as a health & wellness physician. I have written extensively for health publications and I am keenly aware of trends and new developments in natural health.
I embrace an active lifestyle combining diet, exercise and healthy choices. My goal is to inform my readers of natural options available to them in hopes of improving their health and quality of life.
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