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PLANTAR FASCIITIS AND THE BENEFITS OF SPLINTING

Posted on October 17 2018

 What is Plantar Fasciitis?

Plantar fasciitis is a common and often persistent kind of repetitive strain injury afflicting runners, walkers and hikers, and nearly anyone who stands for a living — cashiers, for instance — especially on hard surfaces. Working on concrete and running on pavement are probably risk factors.

  • It causes mainly foot arch pain and/or heel pain
  • Morning foot pain is a signature symptom.
  • Plantar fasciitis is not the same thing as heel spurs and flat feet, but they are related and often confused.

Most people recover from plantar fasciitis with a little rest, arch support (regular shoe inserts or just comfy shoes), and stretching, but not everyone: plantar fasciitis can be more stubborn than a cat that wants out. Severe chronic cases can stop you in your tracks, undermine your fitness and general health, and drag on for years.

 Many people are afraid of running because between 30 to 70 percent of runners get injured every year.

 So why does it happen?

Plantar fasciitis is caused by tissue fatigue in the arch of the foot due to excessive strain, plus probably vulnerability due to biological factors. Not everyone who asks a lot of their feet gets plantar fasciitis!

If the arch of your foot is like a bow, think of the plantar fascia as the bow’s string. The plantar fascia, along with several muscles both in the foot and in the leg, supports the arch and makes it springy.Too springy, and the foot flattens out, overstretching the plantar fascia. Not springy enough, and the plantar fascia absorbs too much weight too suddenly.

With plantar fasciitis, the tissue on the bottom of your foot gets inflamed and makes the bottom of your heel or the bottom of your foot hurt. It happens a lot with runners and people who have flat feet, high arches, are overweight, or who are on their feet a lot.

It can take 6-12 months for your foot to get back to normal. You can do these things at home to ease the pain and help your foot heal faster:

Rest: It's important to keep weight off your foot until the inflammation goes down.

Ice: This is an easy way to treat inflammation, and there are a few ways you can use it.

To make an ice pack, wrap a towel around a plastic bag filled with crushed ice or around a package of frozen corn or peas. Put it on your heel 3 to 4 times a day for 15 to 20 minutes at a time.

Or you can fill a shallow pan with water and ice and soak your heel in it for 10 to 15 minutes a few times a day. Be sure to keep your toes out of the water.

Another option is to fill a small paper or foam cup with water and freeze it. Then rub it over your heel for 5 to 10 minutes. Never put ice directly on your heel.

Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) can make your foot feel better and help with inflammation.

Stretching and exercise: Stretch your calves, Achilles tendon, and the bottom of your foot. Do exercises that make your lower leg and foot muscles stronger. This can help stabilize your ankle, ease pain, and keep plantar fasciitis from coming back.

Athletic tape: Tape can support your foot and keep you from moving it in a way that makes plantar fasciitis worse.

Shoe inserts. Also called insoles, arch supports, or orthotics, they can give you extra cushion and added support. You can get them over-the-counter (OTC) or have them custom made. Typically, your results will be just as good, and cheaper, with OTC inserts. When you choose one, firmer is better -- and make sure it has good arch support.

Night splints. Most of us sleep with our feet pointed down, which shortens the plantar fascia and Achilles tendon. Night splints, which you wear while you sleep, keep your feet at a 90-degree angle. So instead of shortening your plantar fascia, you get a good, constant stretch while you sleep. 

They can be bulky, but they tend to work really well. And once the pain is gone, you can stop wearing them.

Benefits of Splinting And Stretching For Plantar Fasciitis

The therapeutic benefit of night splints is based on maintaining the length of the plantar fascia while the patient sleeps. Normally, muscle tone within the triceps surae causes the ankle joint to assume a plantarflexed position while at rest. With the foot in the plantarflexion position, the plantar fascia and intrinsic plantar musculature shorten, relax and adapt overnight to a nonfunctional state.

The posterior night splint retains the tension within the plantar fascia and intrinsic musculature, maintaining their functional lengths and decreasing the sudden stress that ambulation places on the plantar aspect of the foot after periods of rest. One can position splints with the foot dorsiflexed at 5 to 15 degrees to the leg. In addition, podiatrists may add a pad to the anterior aspect of the night splints to maximize the stretching of the plantar fascia and intrinsic musculature.

Night splints provide constant, consistent strain. This not only maintains functional length but eventually provides a net reduction of stress within the plantar fascia and intrinsic muscles.

 How do night splints work?

Night Splints work by stretching the calf and plantar fascia of the foot as you sleep. This helps to minimize stress on the areas of the foot that are inflamed. Many users find that the morning pain they experience in their feet are reduced drastically. Night splints also help provided the supportive stretching the user may need throughout the day while they are on their feet. The support can potentially aid work, exercise and many other everyday routines.

The most exciting thing about night splints is that they gently stretch the fascia! The user doesn’t feel overwhelming discomfort while wearing them. Once stretched out, the plantar fascia will be less tense. This means the user will experience less pain! For some people wearing the splints overnight works best. However, many other users report feeling more benefits after wearing the splints for a longer period of time. When first starting to use night splints you should try to only wear them for about one hour. You should gradually extend the amount of time you spend in the splints each night.

 In Conclusion

Night splints offer podiatrists an effective treatment modality for the treatment of plantar fasciitis. There is a broad difference of opinion on how and when the devices are indicated. However, studies determine that splints can be therapeutically effective as part of a comprehensive plan of care including one of more of the following: icing; shoe recommendations; corticosteroid injections; prefabricated inserts; custom orthotics; stretching exercises; and prefabricated walking casts.

References:

https://www.painscience.com/tutorials/plantar-fasciitis.php

https://www.podiatrytoday.com/secrets-to-patient-adherence-with-night-splints

https://www.webmd.com/fitness-exercise/qa/how-can-night-splints-help-with-plantar-fasciitis

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