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Night Splint Usage - sometimes ouch!

Posted by John E on 8/26/01 at 08:23 (058003)

As one of the recent recipients of a night splint return, I am quite happy with my experience so far. I am in a resting period of about one month prior to seeing a new podiatrist.

When I wear it loosely I am completely comfortable and I wake up in the morning and my foot feels stretched all day and all night. Very good, I plan to incoporate it with a number of other tools when I start my full scale assault on pf in a couple days (under pod's supervision).

But, if I notch the side straps say 1/2' shorter (or less), I wake up in the night with a sharp pain at the end of my foot in my toes and also tingling. Have to rip it off and keep it off for the rest of the night. The splint still seems relatively lose when I go to sleep. Really painful.

Does anyone have some experience or advice with this. To me it is bizarre, and of course it clearly shows not to tighten it to the pain point.

Thanks,

John E.

Re: Night Splint Usage - sometimes ouch!

john h on 8/26/01 at 10:19 (058015)

john e: i also have used the same night splint for over a year. very good. if you ice your foot you need to look at the new one jeff has for sale. it is the best i have used and makes it easy and comfortable to get the ice to the right area and keep it there.

Re: Night Splint Usage - sometimes ouch!

Ray W on 8/26/01 at 14:35 (058039)

I've used night splints that were specially made for me. Not adjustable. I found the same pins and needles but with time it has disappeared. My right one has disintegrated but I still use the left .

Re: Night Splint Usage - sometimes ouch!

Linda C on 8/27/01 at 07:27 (058079)

I know what you mean... I sometimes wake up and the skin on the ball of my foot would hurt so much I had to take off the splint to get some blood back to that area. Some times I have numb toes. Some nights I rip off my night splint without even waking up.

I wonder if our achilles just naturally want to contract...especially when we sleep. Is the phenomenon of achilles contraction while at rest particular to PF patients? Do non PF patients also experience achilles contraction at rest? Can any Pods answer this?

Re: Night Splint Usage - sometimes ouch!

Michael K on 8/27/01 at 10:57 (058090)

I borrowed my friend's nightsplints , and found pain over the first 2 nights. Then I thought about what these are really trying to do, and their primary function is to keep your foot at 90 degrees to your leg, so that the fascia muscles do not contract. On the 3rd night and following, i strapped the velcro very loosely, which still kept my foot in a 90 degree position to the leg, and it seems to do the trick, and i don't wake up in the middle of the night with pain on one side of the foot.

Re: please clarify

John E on 8/27/01 at 13:00 (058105)

which of the straps are you referring to, the ones that hold the flaps of fabric together, or the ones that run at a 45 degree angle from bottom of calfs to end of toe (more or less) and adjust the angle of foot versus leg. Also any comments on tightness of midfoot straps?

I found with the splint on very loosely (the 45 degree angle straps loose) it was more comfortable but also I didn't think it was doing too much.

I also found the point where pressure is applied to foot was entirely at the point where pain was experienced at ball of foot. Is pressure supposed to be exerted across more area and I am not adjusting properly? 9Seems like blood might be getting cut off somewhere?)

All input appreciated as I am still confused.

Re: please clarify

Glenn X on 8/27/01 at 17:29 (058142)

John E: I'm fairly new with the N'ice Stretch night splints too, so take this with a grain.

I think the trick is to get them snug enough to softly tension your foot and achilles, but not so tight they wake you up at night. While it's tempting to mimic more traditional stretching regimens, I don't believe this stretch should be an 'active' stretch. Rather, it should place your foot in a position that gets a subtle message to your achilles tendon that says, 'hey, something's changed in my environment and I need to start getting longer.'

Couple of other thoughts. May not be necessary, but I have 3/4 Spenco OTC orthotics in mine. I also use the 3/4' strap around the bottom to velcro over the flap on the top of the foot to keep it a little snug.

I'd sure be interested in other input to wearing these too.

Re: Night Splint Usage - sometimes ouch!

Ed Davis, DPM on 8/27/01 at 22:22 (058178)

There are two things to be accomplished with a night splint:

Short term: pre-stretch the plantar fascia in order to prevent post-statisc dyskinesia (pain encountered after rest or in the morning)

long term: elongate the gastrosoleus-achilles complex in order to gain additional ankle dorsiflexion (upwards) range of motion Keep in mind that a tight gastrosoeus achilles complex is a prime instigator in plantar fasciitis.

The key to successful stretching is a long duration of stretch with a low intensity. The discomfort you are experiencing comes from pulling the splint too tight, that is, the part that pulls your foot toward your leg.
The goal is to bring the foot backward on the leg but without sufficient tension to cause the calf muscle to fire. The calf muscle fires involuntarily via a spinal reflex arc. If the calf muscle is activated, no productive long term lengthening of the achilles is occurring.
Ed

Re: Night Splint Usage - sometimes ouch!

john h on 8/28/01 at 10:13 (058210)

your comments about the night splint and the calf muscle 'firing' was most informative. also, the long slow stretch is very good info. i have read that a stretch of about 18 seconds might be appropriate. what is a long stretch in terms of time to you concerning the runners stretch?

Re: Night Splint Usage - sometimes ouch!

Ed Davis, DPM on 8/28/01 at 13:26 (058230)

The runners' stretch is basically a warm up to prevent injury. The goal of the night splint is to achieve 6 to 8 hours of stretching per day (or night). That is why it used during sleep.
Ed

Re: Night Splint Usage - sometimes ouch!

john h on 8/30/01 at 11:50 (058463)

should have said the new one Scott has for sale.

Re: Night Splint Usage - sometimes ouch!

john h on 8/26/01 at 10:19 (058015)

john e: i also have used the same night splint for over a year. very good. if you ice your foot you need to look at the new one jeff has for sale. it is the best i have used and makes it easy and comfortable to get the ice to the right area and keep it there.

Re: Night Splint Usage - sometimes ouch!

Ray W on 8/26/01 at 14:35 (058039)

I've used night splints that were specially made for me. Not adjustable. I found the same pins and needles but with time it has disappeared. My right one has disintegrated but I still use the left .

Re: Night Splint Usage - sometimes ouch!

Linda C on 8/27/01 at 07:27 (058079)

I know what you mean... I sometimes wake up and the skin on the ball of my foot would hurt so much I had to take off the splint to get some blood back to that area. Some times I have numb toes. Some nights I rip off my night splint without even waking up.

I wonder if our achilles just naturally want to contract...especially when we sleep. Is the phenomenon of achilles contraction while at rest particular to PF patients? Do non PF patients also experience achilles contraction at rest? Can any Pods answer this?

Re: Night Splint Usage - sometimes ouch!

Michael K on 8/27/01 at 10:57 (058090)

I borrowed my friend's nightsplints , and found pain over the first 2 nights. Then I thought about what these are really trying to do, and their primary function is to keep your foot at 90 degrees to your leg, so that the fascia muscles do not contract. On the 3rd night and following, i strapped the velcro very loosely, which still kept my foot in a 90 degree position to the leg, and it seems to do the trick, and i don't wake up in the middle of the night with pain on one side of the foot.

Re: please clarify

John E on 8/27/01 at 13:00 (058105)

which of the straps are you referring to, the ones that hold the flaps of fabric together, or the ones that run at a 45 degree angle from bottom of calfs to end of toe (more or less) and adjust the angle of foot versus leg. Also any comments on tightness of midfoot straps?

I found with the splint on very loosely (the 45 degree angle straps loose) it was more comfortable but also I didn't think it was doing too much.

I also found the point where pressure is applied to foot was entirely at the point where pain was experienced at ball of foot. Is pressure supposed to be exerted across more area and I am not adjusting properly? 9Seems like blood might be getting cut off somewhere?)

All input appreciated as I am still confused.

Re: please clarify

Glenn X on 8/27/01 at 17:29 (058142)

John E: I'm fairly new with the N'ice Stretch night splints too, so take this with a grain.

I think the trick is to get them snug enough to softly tension your foot and achilles, but not so tight they wake you up at night. While it's tempting to mimic more traditional stretching regimens, I don't believe this stretch should be an 'active' stretch. Rather, it should place your foot in a position that gets a subtle message to your achilles tendon that says, 'hey, something's changed in my environment and I need to start getting longer.'

Couple of other thoughts. May not be necessary, but I have 3/4 Spenco OTC orthotics in mine. I also use the 3/4' strap around the bottom to velcro over the flap on the top of the foot to keep it a little snug.

I'd sure be interested in other input to wearing these too.

Re: Night Splint Usage - sometimes ouch!

Ed Davis, DPM on 8/27/01 at 22:22 (058178)

There are two things to be accomplished with a night splint:

Short term: pre-stretch the plantar fascia in order to prevent post-statisc dyskinesia (pain encountered after rest or in the morning)

long term: elongate the gastrosoleus-achilles complex in order to gain additional ankle dorsiflexion (upwards) range of motion Keep in mind that a tight gastrosoeus achilles complex is a prime instigator in plantar fasciitis.

The key to successful stretching is a long duration of stretch with a low intensity. The discomfort you are experiencing comes from pulling the splint too tight, that is, the part that pulls your foot toward your leg.
The goal is to bring the foot backward on the leg but without sufficient tension to cause the calf muscle to fire. The calf muscle fires involuntarily via a spinal reflex arc. If the calf muscle is activated, no productive long term lengthening of the achilles is occurring.
Ed

Re: Night Splint Usage - sometimes ouch!

john h on 8/28/01 at 10:13 (058210)

your comments about the night splint and the calf muscle 'firing' was most informative. also, the long slow stretch is very good info. i have read that a stretch of about 18 seconds might be appropriate. what is a long stretch in terms of time to you concerning the runners stretch?

Re: Night Splint Usage - sometimes ouch!

Ed Davis, DPM on 8/28/01 at 13:26 (058230)

The runners' stretch is basically a warm up to prevent injury. The goal of the night splint is to achieve 6 to 8 hours of stretching per day (or night). That is why it used during sleep.
Ed

Re: Night Splint Usage - sometimes ouch!

john h on 8/30/01 at 11:50 (058463)

should have said the new one Scott has for sale.