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What's the Best Night Splint for an Achilles Tendon?

People who suffer from a painful Achilles tendon often complain of stiffness in the tendon after a night's sleep.

Tendinopathy is the term used by many doctors to describe a tendon injury. Such injuries are usually as a result of overuse, and are common in athletes, particularly older athletes. The term covers both tendonitis (inflammation of the tendon) and tendonosis (tiny tears to the tendon fibers.) Usually tendonosis is the cause of pain. Sometimes the tears can be more severe, or even ruptured. Such injuries can take a long time to heal, and require weeks or months of rest.

During the day a walking boot or cast can be worn, but these are bulky and unsuitable to wear at night.

There are two main options to prevent the Achilles tendon stiffening up overnight and causing increased pain when trying to walk. One is the Strassburg Sock: This covers the foot and lower leg. An adjustable strap runs from the toe end of the sock and fastens at the calf, keeping the foot flexed upwards and slightly stretching the tendon during the night.
Strassburg Sock with adjustable strap

The other option is a brace, or night splint. These have a rigid shell with a padded interior. The shell can be behind the calf and under the foot, or over the top of the foot, ankle, and lower shin. They have adjustable straps with hook and loop fastenings. Night splints hold the foot in a neutral position, rather than slightly stretched, which many users claim is more comfortable than the Strassburg Sock. They can also be more effective as the sock is designed primarily to dorsiflex the toes in order to ease symptoms of plantar fasciitis rather than Achilles tendon pain.

It can take some time to get used to wearing a splint overnight, but if you start by untucking all the bedclothes and allow your foot to hang over the end of bed you might find it easier. You can also remove the splint during the night if you find it too much. You will eventually get used to it and be able to sleep comfortably. Ideally you should wear it for a minimum of three hours.

Dorsal splints are regarded as the most comfortable, although they don't have the ability to adjust the amount of ankle flexion. Air form night splints are considered extremely comfortable and lightweight.

The Ossur Exoform Dorsal Night Splint is very popular. It holds the foot at an optimum 85-90 degree angle. Straps ensure that the brace doesn't slip out of position. Overmolding eliminates any pressure points and the non-slip plantar pad stops the foot sliding forward.

The Ossur Airform night splint is smaller and lighter. It is designed to be positioned on the front of ankle, unlike the dorsal style. It has padded molding and an air-filled pad lines the splint. The fact that it is open at the heel and doesn't weigh much makes it more comfortable and cooler to wear.

Other splints that wearers recommend are the Pro-Tec Night Splint, and the Swede-O Deluxe.

Although it may take a long time for your Achilles tendon to heal, wearing a night splint will speed and ease the process.

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