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Night splints have become increasingly popular for the treatment of plantar fasciitis. One of the most distinctive features of plantar fasciitis is morning arch and heel pain.
This painful phenomenon is the why the concept of night splints seems like a good idea. However, mechanically this doesn't make sense.
I began assessing night splints as an application for treatment several years ago. My conclusion was that night splints may decrease pain in the short term, but this application does not have a significant effect on prevention or recurrences long term.
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.
Because plantar fasciitis/fasciosis is more closely related to a tendinopathy and less of an inflammatory disorder, the most effective treatments involve active or dynamic stretching vs. static or prolonged stretching.
I'll explain the best type of treatment to correct plantar fasciitis, but first let's answer some of the other questions you may have about night splints.
Dr. Angela Walk
The Plantar Fasciitis Doc
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 plantar fasciitis, 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.
Let's take a look at the best way to increase flexibility in your plantar fascia, calf muscle group and Achilles tendon.
What Is The Best Way To Stretch For Plantar Fasciitis?
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.
There are two types of stretching, static and active stretching.
Static stretching is when the body segments are not moving, while in active stretching, there is motion. Active or dynamic stretching is the most effective type of stretching for plantar fasciitis
recovery.
Recent studies have shown that plantar fasciitis is as a result of degeneration, or a breakdown of the collagen fibers within the fascia and not an inflammatory condition.
Therefore, this type of injury responds to treatment measures resembling a tendinopathy. Thus, targeted strengthening exercises, dynamic/active stretching, and progressive loading is the most effective protocols.
Active Isolated Stretching vs. Static Stretching For Plantar Fasciitis
One mistake many make when stretching is doing the wrong type of stretch. There are multiple styles of stretching that target different goals.
When most people hear the word “stretch,” they think about holding a stretching position for a prolonged period of time, most often recommended is 20-30 seconds. This is called static stretching.
The problem with static stretching is that if a muscle is stretched too far, too fast, or for too long, it elicits a protective action known as the myotatic reflex, causing it to automatically recoil in an attempt to prevent the muscle from tearing.
This occurs about three seconds into a stretch. Therefore, I recommend stretching to your natural range of motion (hold for 2 seconds), before the negative stretch reflex kicks in, then return to the start position and repeat 10 times.
This type of stretching is called Active Isolated Stretching (AIS) and is a type of dynamic stretch. The stretch feels more like repetitions than stretching, and it is the most effective type for for plantar fasciitis recovery. Read more about AIS here.
Active Isolated Stretching For Plantar Fasciitis
Active Isolated Stretching (AIS) is one of the methods of stretching most used by today's athletes, chiropractors, physical therapists and personal/athletic trainers.
Active Isolated Stretching technique involves the method of holding each stretch for only two seconds.
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)
Active Isolated Stretching Guide
1. Isolate the Muscle to Stretch
If you didn’t already know, muscles often work in opposition. If you want to isolate a muscle, you need to do the opposite for the other muscle.
For example, when you flex your quadricep (thigh muscle), you stretch your hamstring and vice versa. So you need to flex one muscle in order to stretch another.
Then, the brain sends a signal to the hamstrings to relax. This provides a perfect environment for the hamstring to stretch.
2. Only Hold the Stretch for Two Seconds
Flex the opposing muscle to stretch the muscle you are isolating. But don’t hold it for a minute like static stretching! Instead, only hold the position for two seconds.
Each stretch is held for a maximum of two seconds in order to avoid the activation of the stretch reflex. The stretch reflex (also called the myotatic reflex) prevents a muscle or tendon from overstretching too far or too fast.
This is our body's natural protection against strains, sprains, and tears. By holding short-term stretches, we increase our range of motion with each repetition and eliminate any fear of pain.
3. Perform 10 Repetitions
Simply repeat this process until you have done about 10 reps. Breathing is also important, so exhale during the stretching portion of each rep. This allows oxygen to pump through the body and increase circulation.
Repeat each stretch 10 times in order to increase the circulation of blood, oxygen, and nutrients to the muscles being stretched.
What Stretches Should I Do For Plantar Fasciitis?
The most effective way to increase flexibility in your plantar fascia and calf muscle group is with Active Isolated Stretching with a foot rocker or stair step.
Active Isolated Stretching With A Foot Rocker
1. Using a or stair step or foot rocker, carefully lower your heel without bending your knees, letting your toes rise naturally.
This will create a stretch in your hamstring, calf muscle, and plantar fascia.
I recommend a foot rocker as it offers a special angled platform made specially to elongate the calf muscles. It's the best $20 you will ever spend.
Steady yourself by holding onto a chair or the wall.
If you are using a stair step, stand toward the end of the surface with firm toes and a slightly elevated heel
Now, lower you heel and begin to stretch. Hold this stretched position for 2 seconds then come back to the neutral position.
Perform 10 repetitions of this exercise on each side, 3 times per day.
Can I Treat Plantar Fasciitis At Home?
If you have this debilitating condition, here are my top 3 recommendations to get you started on your home rehabilitation.
1. Download my free guide. This is the first step on your PF recovery journey. I show you the exact steps to resolve plantar fasciitis at home.
2. Follow my social media pages. I offer daily tips, exercises, and the latest insights on PF. You can also connect and learn from others with the same struggles. Join us: Facebook page & Instagram
3. Take a look at my approved footwear guide. Dr. Angela's Recommended Shoe List and make sure you are not sabotaging your recovery by wearing the wrong shoes.
Because there is so much misinformation out there about plantar fasciitis, I spend most of my time educating people on what NOT to do.
Most rehabilitation efforts fail because they are relying on cortisone shots, night splints, orthotics, ineffective stretching, thick, cushiony shoes, and rolling on a frozen water bottle.
These methods are either ineffective or just short-term band-aids, and do not provide long-term correction.
In my (6) step free guide, I offer solutions through addressing multiple factors. Improving footwear, identifying areas of weakness in the foot and ankle, and restoring proper foot function.
Summary
I hope this article has provided you with an alternative perspective to most of the content out there about night splints and foot health.
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.
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 25 years as a sports chiropractor and foot health coach. 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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