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Trying to break in nightsplint: Is it normal for it to hurt?

Posted by Beverly on 12/06/00 at 21:25 (034364)

Well, it took me nine months, and God knows, I should have tried them sooner, but I am finally in those instruments of torture, the nightsplints.
I'm wearing one on each foot. It is very soft-sided. A gentle setting 2 degrees below neutral.

The thing is agreeing with my left foot just fine. But my right foot feels pulled so tight in the arch that I got a cramp. Left an achey feeling. I took it off a while and massaged my foot and put it back on. I lasted another 30 minutes. I've not yet tried sleeping in it. Just wearing it on the recliner with TV. I wore it for 90 minutes. Not much, but a start.

As Barbara reported, I also feel an ache in my ankle when wearing it (the top part when it joins the foot).

So, is this just part of getting used to it? Is it worse before it gets better? I have no idea why it feels fine on my left foot and miserable on my right foot.

But I am persevering on... trying to get used to this thing a little bit at a time.
Thanks,
Beverly

Re: Trying to break in nightsplint: Is it normal for it to hurt?

Bob G. on 12/07/00 at 00:54 (034374)

You are doing fine, Beverly, good for you to get started. And you are doing both feet? That's twice what I ever did.

I wore my nightsplint last night because I was sensing something coming on, and I took it off an hour before I got up (it was just keeping me awake) but I left my Strassberg Sock on so that I did not waste a night of nightsplint.

Back when I needed to wear it every night I had a difficult time for a while (weeks). I could not sleep with it on, but I finally did after much determination. I learned that if it is bugging you, to just take it off - and try again later. You may lose a battle, but you are going to win the war.

FLASH FORWARD Today I jogged on the beach (gently) for five miles, first time in 17 months! The nightsplint is my friend!!! I may wear it tonight just to celebrate and for the fun of it, hehehe...

Best of luck to you, Beverly, don't give up! BG

Re: Trying to break in nightsplint: Is it normal for it to hurt?

Bob G. on 12/07/00 at 01:01 (034375)

Oh, and be sure to arrange loose bed covers so that you can move about in your sleep without having to fully wake up.

Other comfort tips are: try wearing the S/Sock to lessen bottom-foot/nightsplint pressures, and arch supports to make walking around in the middle of the night more comfortable.

If your nightsplint is too much, take it off and try again the next night.

Re: no hurt with nightsplint

alan k on 12/07/00 at 06:56 (034381)

It is wise that you are 'breaking them in' first before having them work while you are unconscious for an indefinite period of time. If you are experiencing pain in one of them after only an hour or so, it probably isn't a good idea to wear it all night on that foot. You might try the other one though.

Here's what to do with the troublesome foot: I assume your splint is not adjustable, so you just make it so. Take a sock and fold it over at about the one third point, and take the doubled-over side and place it in the heel cup with the rest extending toward the tip. Place your foot inside and adjust the single-sided end of the sock to conform to your arch. By placing a 'heel lift' in the night splint you are decreasing the degree of dorsiflexion, plus also creating support for your arch.

Experiment with this for hour long sessions like you are doing now. Perhaps you want more lift in the heel, or perhaps more in the arch, or perhaps nothing on the arch. Scrunch and shift the sock around until you find the position that is right for you. Maybe even add a sock.

Nightsplints should not hurt. In fact, our rule is that nothing at all that you do at home, unsupervised, should ever hurt. True, sometimes physical rehab is painful, but that is under a therapists supervision. Home, self-applied therapy should NEVER involve pain unless specifically directed by a physician.

Nightsplint philosophy should be patience and caution. They do their work slowly, and apply a mild passive stretch. The main benefit of a nightsplint is in its prevention of contraction, not really the stretching part, though that does happen. What you want with your troublesome foot is just to keep it from contracting while you sleep. The stretching will all come in good time. So the splint should prevent that degree of contraction that is perfectly comfortable. Surprisingly, with this conservative approach the results are rapid in most cases-- it doesn't seem intuitively correct, but go figure.

Luckily, you have been on the board long enough to understand all this and so took cautious steps with the nightsplint from the start.

hope this helps,

alan k

Re: Trying to break in nightsplint: Is it normal for it to hurt?

Susan S on 12/07/00 at 07:26 (034382)

And please let me suggest a little Tylenol PM. Worked for me!

Re: Thanks all. Question for Alan and Bob

Beverly on 12/07/00 at 12:07 (034414)

Thanks to everyone on your nightsplint tips.
Alan, I like your sock idea. My splint is adjustable. I'm taking it to the orthodist to have it changed from negative 2 (2 degrees below neutral) to negative 5. Do you think I should still use the sock? I know this is an extremely gentle setting. The orthodist says my resting postion is about 10 degrees below neutral. Therefore, negative 5 will still be more 'flexed' than my usual resting position. Between that and the sock, I hope this helps.

Do you have any idea why my foot cramped up to the point that my big toe went stiff? It was like my foot was 'stuck.' I had to massage it to get it to uncramp. Even today, I'm still sore. I also ache around the top and outside part of my ankle from wearing the splint.

Yet, the left foot splint feels just fine. It's just the right foot I'm having trouble breaking in. This is also the leg with the hamstring strain and that hurts more today.
My PT says I also have very tight gastrocs. He thinks the splint will help loosen them up.
Thanks,
Beverly

Re: Trying to break in nightsplint: Is it normal for it to hurt?

Jan on 12/07/00 at 15:45 (034425)

I've been in mine for 2 months. I noticed an increase in pain in the achilles and inside anckles on both feet too. I mentioned this to my PT and he said it was normal. This tissue is very tight and it being stretched for the first time in ages. Also, as you are able to start walking again, you'll notice your calves may tighten up very quickly (and will cause ankly, achilles, or PF pain)...this is because the calves are not used to being used. They're out of shape and will be sore becuase they're firing quickly now from being used.....
Mine said, give the splints a night off to see if that decreases the new pain and ease into a regimine that can be tollerated....and to decrease dorsiflexion if possible by adjusting the splint.

Re: Got my splint lowered to 5 degrees plantar flex.

Beverly on 12/07/00 at 20:16 (034443)

It is good for me to read your comments about how hard this thing is to get used to. My right foot sure does hurt from the splint causing it to 'freeze up' into the cramp to end all cramps. I'm giving it a few nights off before I try this again.

I went to orthodics place today and got the splint adjusted. I discovered that one was set as I requested at 2 degrees below neutral, but the other was at neutral. I am hoping the one that was set wrong is the splint I put on my right foot. Because I had both reset to 5 degrees plantar flex/5 degrees under neutral... a much easier setting. Perhaps too light but I've got to start somewhere.

I know Judy said the splint made her feet get cramps. Has anyone else gotten cramps or feeling their foot 'freeze' into a locked and painful position from the splint? I massaged it loose but it still hurts.
Thanks,
Beverly

Re: Thanks all. Question for Alan and Bob

alan k on 12/07/00 at 20:41 (034446)

Those are all great questions.

The sock: the thing with the sock is that it is infinitely adjustable. If after adjusting the splint it still seems not quite right, the sock is always there for you. Some people might feel it gives a more humane shape to the splint, supporting the arch, but for others arch support might be uncomfortable. It really depends, but you can fiddle with it a hundred different ways.

The cramp may be due to imbalances in muscle tension, elasticity, and strength which show up once the foot is 'frozen' in place, and those imbalances send incorrect signals in an unbroken loop through your musculature ('unbroken' because of the imobilization). At least that shows that your PT is right that muscle problems are indeed at work in your condition. That's good news, since of all the things down there the muscles are the easiest to work with. They heal and are trainable far faster than the plantar fascia itself or tendons.

I still think that if you are experiencing adverse effects from the splint, adjustments are in order until you are comfortable. It may not take more than a few nights, once you find a comfortable position, for the feet and legs to adjust, and then more degrees of dorsiflexion added. Be patient and cautious. I bet that if you slowly sneak up on this by maintaining comfort and not causing strain, these thingies are going to help you considerably.

alan k

Re: Got my splint lowered to 5 degrees plantar flex.

Bob G. on 12/08/00 at 01:03 (034466)

Beverly, if there is discomfort, I would suggest backing it off to neutral, or even less. At least it will keep your foot from going into the toes-pointed position.

If you experience pain or cramps, back off and try again at a later date.

The nightsplint can be a godsend. It just takes getting used to. BG

Re: Trying to break in nightsplint: Is it normal for it to hurt?

Bob G. on 12/07/00 at 00:54 (034374)

You are doing fine, Beverly, good for you to get started. And you are doing both feet? That's twice what I ever did.

I wore my nightsplint last night because I was sensing something coming on, and I took it off an hour before I got up (it was just keeping me awake) but I left my Strassberg Sock on so that I did not waste a night of nightsplint.

Back when I needed to wear it every night I had a difficult time for a while (weeks). I could not sleep with it on, but I finally did after much determination. I learned that if it is bugging you, to just take it off - and try again later. You may lose a battle, but you are going to win the war.

FLASH FORWARD Today I jogged on the beach (gently) for five miles, first time in 17 months! The nightsplint is my friend!!! I may wear it tonight just to celebrate and for the fun of it, hehehe...

Best of luck to you, Beverly, don't give up! BG

Re: Trying to break in nightsplint: Is it normal for it to hurt?

Bob G. on 12/07/00 at 01:01 (034375)

Oh, and be sure to arrange loose bed covers so that you can move about in your sleep without having to fully wake up.

Other comfort tips are: try wearing the S/Sock to lessen bottom-foot/nightsplint pressures, and arch supports to make walking around in the middle of the night more comfortable.

If your nightsplint is too much, take it off and try again the next night.

Re: no hurt with nightsplint

alan k on 12/07/00 at 06:56 (034381)

It is wise that you are 'breaking them in' first before having them work while you are unconscious for an indefinite period of time. If you are experiencing pain in one of them after only an hour or so, it probably isn't a good idea to wear it all night on that foot. You might try the other one though.

Here's what to do with the troublesome foot: I assume your splint is not adjustable, so you just make it so. Take a sock and fold it over at about the one third point, and take the doubled-over side and place it in the heel cup with the rest extending toward the tip. Place your foot inside and adjust the single-sided end of the sock to conform to your arch. By placing a 'heel lift' in the night splint you are decreasing the degree of dorsiflexion, plus also creating support for your arch.

Experiment with this for hour long sessions like you are doing now. Perhaps you want more lift in the heel, or perhaps more in the arch, or perhaps nothing on the arch. Scrunch and shift the sock around until you find the position that is right for you. Maybe even add a sock.

Nightsplints should not hurt. In fact, our rule is that nothing at all that you do at home, unsupervised, should ever hurt. True, sometimes physical rehab is painful, but that is under a therapists supervision. Home, self-applied therapy should NEVER involve pain unless specifically directed by a physician.

Nightsplint philosophy should be patience and caution. They do their work slowly, and apply a mild passive stretch. The main benefit of a nightsplint is in its prevention of contraction, not really the stretching part, though that does happen. What you want with your troublesome foot is just to keep it from contracting while you sleep. The stretching will all come in good time. So the splint should prevent that degree of contraction that is perfectly comfortable. Surprisingly, with this conservative approach the results are rapid in most cases-- it doesn't seem intuitively correct, but go figure.

Luckily, you have been on the board long enough to understand all this and so took cautious steps with the nightsplint from the start.

hope this helps,

alan k

Re: Trying to break in nightsplint: Is it normal for it to hurt?

Susan S on 12/07/00 at 07:26 (034382)

And please let me suggest a little Tylenol PM. Worked for me!

Re: Thanks all. Question for Alan and Bob

Beverly on 12/07/00 at 12:07 (034414)

Thanks to everyone on your nightsplint tips.
Alan, I like your sock idea. My splint is adjustable. I'm taking it to the orthodist to have it changed from negative 2 (2 degrees below neutral) to negative 5. Do you think I should still use the sock? I know this is an extremely gentle setting. The orthodist says my resting postion is about 10 degrees below neutral. Therefore, negative 5 will still be more 'flexed' than my usual resting position. Between that and the sock, I hope this helps.

Do you have any idea why my foot cramped up to the point that my big toe went stiff? It was like my foot was 'stuck.' I had to massage it to get it to uncramp. Even today, I'm still sore. I also ache around the top and outside part of my ankle from wearing the splint.

Yet, the left foot splint feels just fine. It's just the right foot I'm having trouble breaking in. This is also the leg with the hamstring strain and that hurts more today.
My PT says I also have very tight gastrocs. He thinks the splint will help loosen them up.
Thanks,
Beverly

Re: Trying to break in nightsplint: Is it normal for it to hurt?

Jan on 12/07/00 at 15:45 (034425)

I've been in mine for 2 months. I noticed an increase in pain in the achilles and inside anckles on both feet too. I mentioned this to my PT and he said it was normal. This tissue is very tight and it being stretched for the first time in ages. Also, as you are able to start walking again, you'll notice your calves may tighten up very quickly (and will cause ankly, achilles, or PF pain)...this is because the calves are not used to being used. They're out of shape and will be sore becuase they're firing quickly now from being used.....
Mine said, give the splints a night off to see if that decreases the new pain and ease into a regimine that can be tollerated....and to decrease dorsiflexion if possible by adjusting the splint.

Re: Got my splint lowered to 5 degrees plantar flex.

Beverly on 12/07/00 at 20:16 (034443)

It is good for me to read your comments about how hard this thing is to get used to. My right foot sure does hurt from the splint causing it to 'freeze up' into the cramp to end all cramps. I'm giving it a few nights off before I try this again.

I went to orthodics place today and got the splint adjusted. I discovered that one was set as I requested at 2 degrees below neutral, but the other was at neutral. I am hoping the one that was set wrong is the splint I put on my right foot. Because I had both reset to 5 degrees plantar flex/5 degrees under neutral... a much easier setting. Perhaps too light but I've got to start somewhere.

I know Judy said the splint made her feet get cramps. Has anyone else gotten cramps or feeling their foot 'freeze' into a locked and painful position from the splint? I massaged it loose but it still hurts.
Thanks,
Beverly

Re: Thanks all. Question for Alan and Bob

alan k on 12/07/00 at 20:41 (034446)

Those are all great questions.

The sock: the thing with the sock is that it is infinitely adjustable. If after adjusting the splint it still seems not quite right, the sock is always there for you. Some people might feel it gives a more humane shape to the splint, supporting the arch, but for others arch support might be uncomfortable. It really depends, but you can fiddle with it a hundred different ways.

The cramp may be due to imbalances in muscle tension, elasticity, and strength which show up once the foot is 'frozen' in place, and those imbalances send incorrect signals in an unbroken loop through your musculature ('unbroken' because of the imobilization). At least that shows that your PT is right that muscle problems are indeed at work in your condition. That's good news, since of all the things down there the muscles are the easiest to work with. They heal and are trainable far faster than the plantar fascia itself or tendons.

I still think that if you are experiencing adverse effects from the splint, adjustments are in order until you are comfortable. It may not take more than a few nights, once you find a comfortable position, for the feet and legs to adjust, and then more degrees of dorsiflexion added. Be patient and cautious. I bet that if you slowly sneak up on this by maintaining comfort and not causing strain, these thingies are going to help you considerably.

alan k

Re: Got my splint lowered to 5 degrees plantar flex.

Bob G. on 12/08/00 at 01:03 (034466)

Beverly, if there is discomfort, I would suggest backing it off to neutral, or even less. At least it will keep your foot from going into the toes-pointed position.

If you experience pain or cramps, back off and try again at a later date.

The nightsplint can be a godsend. It just takes getting used to. BG