Dorsal Night Splints

Everything you should know about Dorsal Night Splints

Written by: Dr. Dina Elsalamony, MD, MScPH

Night splints are valuable and effective tools in the treatment of plantar fasciitis, Achilles’ tendonitis as they help maintain the ankle in an upright position, providing a gentle stretch to the fascia and the calf muscles. However, the original/posterior night splint could be a little bulky and some people report discomfort during sleep when wearing it. The dorsal night splint was designed to provide a more comfortable experience.

What is A Dorsal Night Splint? 

The dorsal night splint is a device that you wear while sleeping at night or resting, it looks like a boot that you slip your foot into. This splint is also known as the anterior night splint, since it covers only a small part of the bottom of the foot, and relies mostly on pulling the top/anterior of the foot towards the ankle to achieve the 90-degree angle needed to prevent the plantar fascia and intrinsic muscles from shortening overnight, which is the main reason people experience pain when trying to stand or walk first thing in the morning.

The dorsal night splint is usually available in various sizes and is often made from more breathable materials, which makes it lightweight, cool, comfortable to wear and easy to sleep in at night.

Dorsal Night Splints for Plantar Fasciitis

Heel pain first thing in the morning is one of the main characteristics of plantar fasciitis, dorsal night splints are very effective in addressing the causes and risk factors associated with this pain. The dorsal night splint has a comfortable design that focuses on keeping the foot on a neutral position without extra dorsiflexion to the ankle, ensuring a gentle stretch to the fascia while placing it at proper length to prevent further damage and allow it to heal during non-weight-bearing positions. Despite the fact that more dorsiflexion of the ankle can provide further stretch to the fascia and calf muscle, it can also be uncomfortable for some people, which is why the dorsal night splint has a great record when it comes to compliance and ability to use for longer periods, which consequently accelerates the healing process.

To achieve faster and better healing results, it is recommended to use the dorsal night splint as a part of a wider conservative treatment plan, including foot orthosis, stretches and modification to your lifestyle. In a clinical trial, it was found that the use of dorsal night splints in addition to foot orthoses is one of the best choices of treatment for plantar fasciitis, as when used together, they are very effective in treating both short and long-term plantar fasciitis, with an improvement in overall function and foot-related quality of life. (1)

Dorsal Night Splint Vs. Original Night Splint

The dorsal/anterior night splint is a newer product that was designed to improve people’s tolerance for wearing night splints. The dorsal/anterior night splint and the original/posterior night splint are both successful in treating plantar fasciitis pain, but despite having the same primary goal of preventing the fascia from shortening and stiffening overnight, they do vary in the design, material used, and the degree of stretch they each provide.

The original night splint usually comes in a boot form that is made of a relatively rigid material, it fully covers the bottom of the foot, back of the heel and the calf muscles. This type of night splint often comes with adjustable straps that allows the person to change the degree of stretching, it also offers the option of elevation of the toes which provides further stretch to the fascia.

The dorsal night splint, on the other hand, comes in the shape of an open leg brace that is made of more elastic materials, only covering a small part of the bottom of the foot and the calf muscles, and covering a bigger section of the anterior part of the leg, ankle, and foot. This open, small and lightweight design retains less heat than the original night splint, making it more comfortable to sleep in at night. However, the dorsal night splint is not usually adjustable and does not pull the toes back.

When it comes to the main functional difference between the two splints, it is essentially the degree the foot is held to the ankle during rest or sleep. The dorsal night splint holds the foot to the ankle in a plantigrade/neutral position, while the original night splint maintains it in a dorsiflexed position, which in turn offers more stretch to the fascia, Achilles’ tendon and the calf muscle. That being said, it is thought that this extra stretch could be the reason why excess discomfort is experienced by some of those who wear the original night splint, disrupting their sleep and possibly leading them to stop the treatment. (2)

Few studies have compared the 2 splints and reported higher efficacy for the dorsal night splint due to its comfortable and tolerable design that doesn’t disturb sleep at night, hence participants were more likely to wear it for longer periods and complete their treatments. (2,3)

Benefits of Dorsal Night Splint

1. Providing gentle stretch to the fascia.
2. Breathable and cool at night.
3. Comfortable to wear for long periods.
4. Highly effective in reducing early morning pain and speeding up recovery.

How to put on a Dorsal Night Splint

Not sure exactly how to wear your Dorsal Night Splint? Follow along with this video:

References:

1. Roos, E., Engström, M., & Söderberg, B. (2006). Foot orthoses for the treatment of plantar fasciitis. Foot & ankle international, 27(8), 606–611. https://doi.org/10.1177/107110070602700807
2. Attard, J., & Singh, D. (2012). A comparison of two night ankle-foot orthoses used in the treatment of inferior heel pain: a preliminary investigation. Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons, 18(2), 108–110. https://doi.org/10.1016/j.fas.2011.03.011
3. https://lermagazine.com/article/night-splint-treatment-of-plantar-fasciitis-pain