This article is a transcribed edited summary of a video Bob and Brad recorded in January of 2020. For the original video go to https://www.youtube.com/watch?v=EnLPbVBNVjg
Bob: This video is a part of a series of videos on plantar fasciitis. So this one is called, will a night splint help my plantar fasciitis? Now, the purpose of a night splint is it's going to apply a stretch all night long so that the plantar fascia gets healed in a lengthened position.
Brad: Which is the same as when you're up and standing.
Bob: Which is the same as when you're up and standing. And quite often what you'll find out with plantar fasciitis is that it feels good when you wake up in the morning. Then you take a couple of steps and it retears. And all of a sudden you have that really sharp pain. So what we're trying to do is prevent that by stretching all night long. This worked really well for my wife. This is what put her over the edge, but I would recommend that you first try our first four or five videos and see if that helps you. Maybe you aren't going to need a splint.
Brad: Right. Yeah, it's an option.
Bob: It's an option. So, you're going to try the stretches and massage first. The problem with splints is they can be bulky. They can have a poor fit. They can be uncomfortable, and it can take a while to get accustomed to them. It could get to the point where it may even affect the way you sleep, and believe me you need your sleep in order to heal.
Brad: Right.
Bob: So, that's the negative part of it. So again, if you're making the improvement, hold off. Some people, with, when they have a stretch on their foot all night long, it actually, the foot gets numb, so that's not good either.
Brad: Right. They may have it adjusted too tight possibly. Too much stretch. Are we going to get into that, Bob?
Bob: Yeah, we'll talk about that, but we're going to talk about four different options basically I have here. The first one is an anterior night splint. That means a splint that fits on the top of the foot more.
Brad: Yeah. Maybe should we say more clearly what the splint is doing. So that we clarify the stretch. So, if I'm laying in bed all night long and my foot is like this, which everyone sleeps with their foot we call plantar flexed, that plantar fascia is going to start to heal in a shortened position, and when you stand up and put weight on it, stretch and it tears like Bob was talking about. If we maintain the foot in this position all night long, it will heal in the same position as when we stand on it, eliminating that painful tear.
Bob: And it even goes up into the big toes. That's why you'll see some of these, we like it when they actually stretch the toe a little bit too. But again, it's got to be tolerable. You can't put up with it if it hurts all night long. You won't be able to sleep, and you won't, you'll be throwing this thing away.
Brad: Right.
Bob: So, very good that we took time to do that. These anterior splints, what I found out with them is they do well in holding the arch up, but they don't really pull on the toe at all. But they did research, and they found out that these kinds beat out the posterior ones to some extent. I have one here by Vatery. I'm absolutely not recommending it, not by any means. This is only part of it. It fell apart on me. The little buckle fell off. It's hard to put on. It's just, it was awful.
Brad: So, anterior means the front of the foot. The splint is on the front of the foot, and there is nothing on the back or the side of the foot in regards to an actual splint. And you'll see the difference when we show the posterior.
Bob: The nice thing about the anterior one is they usually tend to be a little bit less bulky. My wife had one that was just really a nice one. I would have recommended it all day long, and they no longer sell it. I mean, it was not bulky. It worked well.
Brad: And the other thing is when you get up at night if you have to go to the restroom or something? Your foot, you can walk on it. Where with the posterior brace, if you're half awake, and all of a sudden you forget you had it on, it could pose a risk of a fall.
Bob: I mean it's made so you can walk on these, but they're a little Herman Munster. So, this is a posterior splint, and like Brad is saying, you know, the problem with it, it's bulky. You know, imagine this in bed with you under the sheets. Again, it does work. I like the fact that you can really adjust how much tension you have.
Brad: So I can push the toes down more or, as it gets better, you continually pull it up a little bit at a time. Now, past neutral would be too much. I feel an aggressive stretch, but I'm just demonstrating the adjustability.
Bob: Now, a lot of them come with a little wedge so you get a little stretch on the toe. So, positionally, I like the posterior brace so much better. But comfort-wise, they're not as good. The problem is, I know I look at the reviews. They all have kind of poor reviews. I haven't found any anterior or posterior splint that has decent reviews. So, it's kind of a bugger.
Brad: I've got a patient right now who's had it for a long time, and he says, yeah they help, but he doesn't wear it every day. He says maybe three nights a week, and it does help when he takes it off, but it's a little awkward in bed with sleeping. And so again, it's something that you really should use consistently day after day after day. And then if you go one or two weeks, and you're not getting good results, then you can assume it's not going to help.
Bob: The other thing you can try is a plantar fascia night sock. Now, the problem with these is people have been having trouble with the fit. But they sound like the perfect thing, don't they, Brad? It's a sock, and it has a little strap that pulls up and attaches to usually a little bit of a collar on the ankle or calf. The problem is people really have trouble with the fit on those, but if you can get the fit right, I would probably lean toward those.
Brad: So, that's just a regular sock.
Bob: Yep, and it's got a strap attached to the sock and it pulls up to a strap that goes up to the ankle, and they attach it.
Brad: What's it called again?
Bob: Plantar fasciitis night sock. So, the final thing which Brad and I aren't so sure about, ideally what it's doing, is a compression sock. Brad has one on. So, they have plantar fasciitis compression socks. They have great reviews, they have thousands of reviews, and they're in the 4.5 range. So, you might want to check them out. They do definitely feel like they hold your arch a bit, right, Brad?
Brad: Yeah, I mean they're tight to get on. You don't just slip them on. You have to work at it a little bit, but it feels good. If you have any swelling problems, it's going to at least help that, and it's supporting the plantar fascia for sure. But, it's got good reviews. We have not had patients that have worn it, and said, yeah they really help.
Bob: Right, we haven't had anyone.
Brad: But that's not to say we're behind the times. I don't know why.
Bob: Yeah, we'll find out. Maybe you guys can let us know in the comments below whether it helps you. Thanks, everybody. Again, check out the full series at bobandbrad.com.
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