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Plantar fasciatis and night splints

Posted by Christine on 6/09/05 at 20:27 (176422)

I have heel spurs on both feet and have had terrible foot pain due to plantar fasciatis for the last couple of years. I tried over-the-counter orthodics, supportive shoes, and exercises to no avail. I'm currently using custom orthodics, anti-inflammatory medication daily (I tried the cortisone shots but they only gave me relief for one day!), never walk barefoot, do stretching exercises when I get out of bed every morning, and use leg/foot massage for relief -- and I still have daily pain. It's lessened a bit in the morning but is still there. After teaching and standing on my feet for 6-8 hrs straight, when I sit down for any period of time and then get back up -- I'm limping from the sharp pain in my heel and outside of my foot.
So, I thought I'd try a night splint but don't know which kind is best. I've seen the 'sock' kind that slips over your foot and has a stretchy band leading from the toes to the ankle and also 2 kinds of 'L' shaped plastic splints that you strap your foot into -- one with the 'L' behind your calf and supporting the underside of your foot/heel and the other with the 'L' shaped support in front of your calf, laying on top of your foot. Which kind gets the best results??? I'm trying to spend wisely since this is costing a fortune to figure out! My insurance doesn't cover anything. And I want to use something that won't disturb my sleep. Thank you for any advice you can offer on this!
P.S. In case you're wondering, yes, I have seen a podiatrist but he can't seem to answer my questions. Just goes from one thing to the next (exercises/medicine to orthodic to cortisone shot to recommending night splint now). I understand it's a process to figure this out but he offers no advice on the specifics of this night splint. He only sells one kind through his office and it's over-priced and looks very uncomfortable compared to the ones I've found on-line.

Re: Plantar fasciatis and night splints

Ron on 6/09/05 at 20:43 (176423)

Night splints can disturb your sleep. Some people on this message board have mentioned numbness in the toes. Some never got used to it while others say eventually they get used to it. There have been no long term problems I am aware of while using the Night Splint, if that makes you feel any better.

There have been studies that show that night splints increase dorsiflexion in the ankles, which can reduce pressure on the plantar fascia.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9462907&dopt=Citation

Theoretically, stretching will do the same thing. IMVHO, the reason why stretching doesn't work in many cases is because of outmoded stretching techniques. Weight bearing stretches are contraindicated.

Re: Plantar fasciatis and night splints

Tina H on 6/09/05 at 20:57 (176424)

Christine- We all feel your pain. It is possible to get rid of heel pain even after having it for a few years. Loss of flexibility is the main problem in many people with pf. Have you ever gone to a good physical therapist, one who has success in treating pf? If you find a good one they will thoroughly evalutate your situation and determine the cause. They will show you a few simple stretches to do 3 times/day, they may also manually stretch your calf and hamstring muscles, and do other stretches to strength the ankle and foot. Ultrasound may be used to increase blood flow to the area. They may also use some deep tissue massage. If there is some structural problem they can point that out. Stretching once a day is not enough. If you've never tried a good physical therapist now might be time to find one.
Night splints are helpful because they do the same thing, keep your muscles from tightening during the night. I had luck with the A force night splint. I didn't like the Strassburg sock because it pulled on my toes making them sore in the morning. Good luck! Tina

Re: Plantar fasciatis and night splints

Rebecca on 6/10/05 at 07:12 (176435)

I've used one similar to the HealWell splint for about two years now. I get a little relief but midway through the night I usually wake up with numbness in my toes. I personally find them cumbersome and awkward during the night. Stretching provides quite the same result. Of course no one can understand the position you are in and the decision is ultimately your's.

Re: Plantar fasciatis and night splints

Christine on 6/10/05 at 16:49 (176476)

Rebecca --
Thank you for your reply. Where can I find info about your 'A force' night splint? It's not on the list I've printed out so far. (I appreciate your point about the sock...that was my concern too...so I'll avoid that kind.)
Christine

Re: Plantar fasciatis and night splints

Christine on 6/10/05 at 16:51 (176477)

Ron,
Thank you for responding. Can you elaborate on 'outdated' stretching techniques. I don't know if mine are or not! Plus, any advice you may have on the proper stretches to use would be welcome. Also, any recommendation on which type of night splint is better -- 'L' shape over the foot or under it???
Christine

Re: Plantar fasciatis and night splints

Christine on 6/10/05 at 16:53 (176478)

Tina,
Thank you so much for your message. I am looking into working with a physical therapist friend of mine and already am using some deep tissue massage to help loosen my calf muscles and tightness in my achilles tendon area. Just realized I posted my question on where to find the 'A force' night splint to the wrong person! (Sorry, please bear with me.) Can you tell me where to find info on it? And thanks for steering me away from the sock type...I thought that might pose a problem.
Christine

Re: Plantar fasciatis and night splints

Christine on 6/10/05 at 16:55 (176479)

Rebecca,
Sorry I messed up before on who I directed my message to. Thanks for your reply. Can you tell me what kind of splint you use and where you found it? And what stretches have been most successful for you? I really appreciate the help in sorting this all out!
Christine

Re: Plantar fasciatis and night splints

janice on 6/10/05 at 17:11 (176481)

Just wanted to add from my experience. I have been using a night splint for about six months and it has really helped my pf. I wish I would have used it from the beginning, but as we all know about the high cost of trying this and that gadget in pursuit of pain relief, I did not gravitate towards this one until I had suffered for three years and thought 'what the heck, I have tried about everything else!' I purchased mine at footsmart.com. It is L shaped under the foot and does a nice job of keeping the foot flexed through the night. It took some getting used to, but it was not uncomfortable, just felt strange. Good luck, hope you have as much success as I did.

Re: Plantar fasciatis and night splints

Ron on 6/10/05 at 18:35 (176491)

'Outdated' isn't exactly accurate. 'Wrong' would have been more accurate. There's mounting evidence that tradional weight bearing stretches may be counter productive for PF. Even though this is how most professionals recommend to stretch.

There have been some people who've actually cured their PF by simply hyperextending their toes towards their ankles. This must stretch the calf and achillies tendon enough to relax the pressure on the plantar fascia.

As for me, I'm an Active Isolated Stretching fan, but this technique is nowhere near definitive. Julie has some recommendations on her yoga stretching bbt.cgi?n=152097 .

Re: Plantar fasciatis and night splints

Christine on 6/10/05 at 18:53 (176494)

Janice -- Thanks for taking the time to chime in! That's the night splint I was gravitating towards (blue, padded, FootSmart Passive Night Splint -- right?) so it's good to hear a recommendation for it. Since using it, have you had to continue with other methods of treatment? For example, orthodics, meds, stretching, or anything else? One thing I especially hate is not being able to wear any shoes the orthodics won't fit in (ie. sandals or dress shoes) without having pain. Just wondering if there's light at the end of the tunnel!?!?!
Christine

Re: Plantar fasciatis and night splints

Christine on 6/10/05 at 18:56 (176495)

Ron - Yes, the podiatrist had me doing weight bearing exercises. Roll foot on a can, lean against the wall with legs straight and feet flat, put foot on chair and lean into it, etc. I will definitely try the yoga stretching you recommended instead and see if there's a difference. Thank you so much!!!
Christine

Re: Plantar fasciatis and night splints

Ron on 6/10/05 at 20:58 (176507)

The rolling of the foot on a can (or ball) isn't exactly weight bearing. This is a safe way to loosen up your plantar fascia.

I can't tell you how uncomfortable I am with over-riding your doctor's recommendations. Use the technique that improves flexibility, either Julie's way or another way. There are many stretch books on the market, but rarely do they deal with PF precisely.

Tell this group what worked for you, OK?

Good luck!

Re: Plantar fasciatis and night splints

Christine on 6/10/05 at 22:00 (176514)

Ron -- Please don't feel uncomfortable. I'm responsible for what I choose to do and I can feel that what I'm presently doing isn't working. I'll try the other and definitely report back. Thanks again for being willing to offer your opinion and share your recommendations. If it doesn't work for me...I won't fault you for it! I'm just happy to have a forum in which to discuss this with other people who are 'in the know'...thanks to everyone who is responding!
Christine

Re: For Ron

Julie on 6/11/05 at 02:23 (176515)

Ron, I see that you've told a couple of people about the yoga foot exercises. I'm very glad: they have been helpful to a number of people over the past several years, and although I haven't the time to contribute to these boards any more, I'd be sorry to see them disappear. So if you feel you want to direct people to them you might like to know for future referebce that Scott provided a direct link to them a year or so ago, and the key words that activate it are: foot yoga. Clicking on foot yoga takes you to the post, which also includes the plantar fascia stretch that Dr Z recommends.

I wish you continued progress with AIS towards a pain-free life.

Best wishes,

Julie
*

Re: For Ron

Ron on 6/11/05 at 11:01 (176527)

I won't be around much longer either, Julie. But it's simply neither your fault nor my own that people don't know how to use a search engine. I think every answer for PF is on this site.

AIS has benefited me greatly but there's always room for a better or complimentary routine.

Re: To Christin A Force splint

Tina H on 6/11/05 at 21:41 (176566)

http://supports4less.com/activeankle/nightsplints/aforce-nightsplint.htm
Here is a link showing the picture of the splint I got from my doctor. She just gave it to me and I was never charged for it so I didn't realize that they were quite this expensive. If you search you might find a better price somewhere else. The inner lining of mine is removable so it can be washed. Good luck, keep stretching, it's the key to a cure! Tina

Re: To Christin A Force splint

Christine on 6/12/05 at 08:13 (176574)

Thanks, Tina! I found that night splint for a little less at FootSmart.com. (I sure wish I had YOUR doctor -- sounds like she really takes good care of you. Any chance she's in the Tampa Bay area of Florida?) I'm trying the Yoga stretches and like them much better. I'm also trying to remember to stretch throughout the day. Thank you so much for your advice and support. This message board has been a great find for me! Christine

Re: Plantar fasciatis and night splints

Christine on 6/12/05 at 21:51 (176636)

I just have one last question (hopefully) regarding the night splints. Should I start wearing it through the night right away? Or should I ease into it (like with orthodics) a few hours at a time? I just ordered one to try and I want to make sure I don't aggravate anything by trying to wear it an entire night right away. Any guidance on this would be most welcome!
Christine

Re: One Last Question about Nightsplint

Christine on 6/12/05 at 21:55 (176637)

I just have one last question (hopefully) regarding the night splints. Should I start wearing it through the night right away? Or should I ease into it (like with orthodics) a few hours at a time? I just ordered one to try and I want to make sure I don't aggravate anything by trying to wear it an entire night right away. Also, most of my pain is in my right foot. Should I just try the nightsplint on that foot for a few weeks (4-6 weeks, I'm guessing?) to see if I get any relief? Or should I alternate between both feet (I do also have pain in the left but not as bad)? Any guidance on this would be most welcome!
Christine

Re: Plantar fasciatis and night splints

Rebecca on 6/13/05 at 06:35 (176643)

I was sent to a sports medicine doctor to be fit for my night splints. I also find lunges and toe stretches to work the best. It feel so good to move my toes around. My doctor suggested picking marbles and other small objects off the floor with my toes. It seems to work well. I never thought I'd feel so good after moving my toes around.

Re: One Last Question about Nightsplint

janice on 6/13/05 at 16:33 (176699)

In response to your previous question to me about whether I still do all of the other things for treatment - yes. I still ice, take advil or celebrex, STRETCH RELIGIOUSLY, and wear my orthotics. I started wearing the night splint all night right away and it helped me almost immediately. The pain in the morning from those first few steps was almost entirely alleviated by keeping the foot stretched all night in the splint. It felt weird at first and I think I unconsciously removed it a few times but after a month or so I could sleep through the night with it on no problem. I have been trying to wean myself off of it because it is cumbersome and to be honest, not real sexy in bed! However, if my foot acts up again I go back to it and see a difference overnight! If you are feeling something up in the other foot, by all means address it early. Maybe try alternating using the splint on each foot every other night and see what that does. I am pretty certain you at least can't do any harm and maybe this is all you need to head off pf in the foot that is borderline right now. I wish I had not waited three years to invest in one! Good luck, there is light at the end of the tunnel, however when the pf is flared up that light seems like the oncoming train!!!

Re: One Last Question about Nightsplint

Christine on 6/13/05 at 21:56 (176728)

Thank you so much for responding! Your input has really helped me feel hopeful that these things I'm trying will help. Plus, it's reassuring to talk with someone who's 'been there' and gotten better. I will try to follow in your 'footsteps' (ha-ha) and, hopefully, report back soon that I'm feeling relief!