Everything you should know about Passive Night Splints

Written by: Dr. Dina Elsalamony, MD, MScPH

Conservative treatment of plantar fasciitis has been shown to eliminate the symptoms in the majority of cases within 6 to 12 months. Night splints are some of the most effective tools used in conservative treatment plans, particularly for managing early morning pain. Despite the original night splint providing great stretch and pain relief in many cases, it could be bulky and uncomfortable to use for some people, which tends to affect the compliance with the treatment and consequently the prognosis of this condition. The passive night splint utilizes the same mechanism as the original night splint, however, it is designed in a more comfortable and practical manner.

What is A Passive Night Splint?

A passive night splint is a boot-like brace that the person can wear during resting or sleeping at night which keeps the foot in a passively dorsiflexed position, ensuring a gentle yet effective stretch to the plantar fascia. The boot is usually made of a soft, flexible and durable material that is also antibacterial and can be washed. This design makes it convenient to wear for long periods of time and clean regularly when needed.

Passive Night Splints for Plantar Fasciitis

The way that passive night splints treat plantar fasciitis pain is by preventing the plantarflexed position of the feet that most of us tend to have while sleeping or resting, this position aggravates the symptoms of plantar fasciitis as it causes the plantar fascia, the intrinsic muscles around it and the calf muscle to shorten and contracts overnight, which in turn lead to early morning severe pain when you try to take your first few steps while these muscles are stretching again to accommodate the current walking position. Instead, the passive night splint keeps the foot upright and in a slightly dorsiflexed position, usually around 5 degrees, providing a passive and gentle stretch to the plantar fascia and the calf muscles. This reduces heel pain in the morning and assists in the healing process for faster recovery.

Various studies have suggested that to achieve the best results from the night splint, it should be incorporated in a more comprehensive conservative treatment program, in addition to icing, NSAIDs, lifestyle changes, and stretching exercises. (1,2)

Passive night splints are available to purchase online.

Passive Night Splint vs Original Night Splint

Passive night splints have a similar shape and work the same as original night splints, however, the passive night splint is a newer product that was designed to overcome some of the drawbacks of the original night splint while providing a similar degree of effective stretching. Unlike the original night splint which is bulky, made of prefabricated plastic, and is difficult to clean, the passive night splint is slightly less bulky, made of a soft flexible material that hugs the feet and back of the leg comfortably, it is antibacterial while also could be washed when required. 

The passive night splint often comes preset with a 5-degree angle of dorsiflexion while the traditional night splint could be adjusted to various degrees of dorsiflexion, however, the passive night splint usually comes with a toe wedge piece that can be inserted below the toes to lift them up, offering even further stretching to the plantar fascia. The passive night splint is available in various sizes for a well-fitted and personalized experience. Despite being more comfortable than the traditional night splints, passive night splints are still not supposed to be worn while walking as they are not designed for this purpose and could cause falls and serious harm if used for walking.

Benefits of Wearing Passive Night Splints

1. Providing gentle and effective stretch of the plantar fascia and calf muscles.
2. Significantly reducing early morning pain.
3. Accelerating the healing process
4. Soft and comfortable to wear for long periods.
5. Antibacterial and washable material.

References:

1. Ryan, John & Overend, Tom. (2000). Effectiveness of Tension Night Splints in Treating Plantar Fasciitis: A Review. Physical Therapy Reviews. 5. 147-154. 10.1179/108331900786166704.
2. Beyzadeoğlu, T., Gökçe, A., & Bekler, H. (2007). Plantar fasiitis için konservatif tedaviye eklenen dorsifleksiyon gece atelinin etkinliği [The effectiveness of dorsiflexion night splint added to conservative treatment for plantar fasciitis]. Acta orthopaedica et traumatologica turcica, 41(3), 220–224.