A night splint is an orthopedic brace designed to be worn while resting or sleeping. Its purpose is to hold the foot and ankle in a fixed, neutral position, typically at a ninety-degree angle relative to the leg. This prevents the foot from pointing downward, which allows soft tissues to contract and tighten overnight. By maintaining a gentle, sustained stretch on the plantar fascia and Achilles tendon, the splint reduces the intense pain often experienced during the first steps in the morning. This article details the correct process for applying and adjusting a night splint.
Step-by-Step Application
Sit down in a comfortable position where you can easily reach your foot and the splint. It is recommended to apply the splint while the knee is slightly bent, as this helps keep the calf muscles relaxed during the initial fitting process. Ensure all straps are loosened or unfastened to allow the foot to slide into the device without resistance.
The first step involves placing the foot securely into the splint’s shell, ensuring the heel sits deeply and correctly against the splint’s base or padding. Next, secure the strap located around the calf or ankle, as this provides the foundational anchor for the entire device. This strap should be fastened snugly enough to prevent the splint from shifting up or down the leg, but it must not be so tight that it causes any immediate discomfort or restriction.
Following the initial calf/ankle strap, secure the strap that crosses over the top of the foot or forefoot, which helps hold the foot firmly within the shell. The goal is simply to secure the device to the limb, keeping the foot at the intended neutral angle. Before moving to tensioning, verify that the foot is positioned at this right angle or in slight dorsiflexion, meaning the toes are aimed slightly upward toward the shin.
Proper Adjustment and Tension Setting
Once the main body of the splint is securely fastened to the leg and foot, the focus shifts to adjusting the tension strap, which creates the therapeutic stretch. This strap is often separate from the primary securing straps and connects the foot portion of the splint to the calf portion, allowing for an adjustable degree of dorsiflexion. The objective is to achieve a gentle, persistent pulling sensation, not a sharp or painful stretch.
Begin the adjustment process by tightening the tension strap minimally, just enough to feel a slight pull along the arch of the foot or the back of the calf. Start with the foot at a neutral, ninety-degree angle and gradually increase the stretch over several consecutive nights. This gradual approach allows the soft tissues to adapt to the new, lengthened position.
If the tension causes immediate pain or significant discomfort, the strap should be loosened immediately. The splint should feel secure and supportive without ever restricting blood flow, so check that the toes remain their normal color and temperature after adjustment. Consistent use with a tolerable, light stretch is much more effective than aggressive tension that leads to the user prematurely removing the splint during the night.
Addressing Discomfort and Nighttime Use
When incorporating the night splint into a nightly routine, users may experience common issues related to comfort and compliance. If the splint begins to slip or shift on the leg during sleep, check the tightness of the main calf and ankle straps, ensuring they are firm without being restrictive. Placing a pillow between the legs can sometimes help stabilize the splint and provide additional comfort for side sleepers.
Monitoring the foot and toes for signs of impaired circulation is an important safety measure during nighttime use. If the toes become numb, tingly, cold, or develop a bluish tint, the splint is likely too tight and requires immediate loosening or removal. Even with proper adjustment, some users may find the splint causes pain that wakes them up, in which case the tension should be reduced or the device can be temporarily taken off for the remainder of the night.
Consistency is a main factor in the splint’s effectiveness, and the device should be worn nightly for several weeks to months, depending on the condition’s severity. While wearing it all night is ideal, a minimum of five to six hours can still provide significant therapeutic benefit if a full night is not tolerable. Users should begin with shorter periods, such as two to three hours while relaxing in the evening, and then slowly increase the duration to build tolerance.