An independent research study using the Strassburg SockTM as the exclusive night splint was published in the July/August 2002 issue of the Journal of Foot and Ankle Surgery. The hypothesis of the study was this. When other injuries occur, standard medical practice is to place and maintain the damaged tissue in an anatomically correct position for the duration of the healing period. If the proper position is not maintained, then swelling, muscular contracture, pain, and delayed healing are seen. The same concept can be extrapolated to plantar fasciitis. Treatments for plantar fasciitis should be focused toward addressing the abnormal pronation and placing the damaged ligament at anatomic length, without uncontrolled stretching.
This study, the second largest ever to evaluate the effectiveness of a night splint consisted of 160 patients. 89 patients used the Strassburg SockTM and 71 were prescribed a gastrocnemius-soleus stretching regimen. Patients using the Strassburg SockTM were told not to stretch during this treatment period, but were instructed to wear the sock for at least 6 hours at night. The results of the study were as follows:
- the mean recovery time for patients using the Strassburg SockTM was 18.5 days
- 97.8% recovered within 8 weeks
- all 89 patients were able to wear the Strassburg SockTM as prescribed (We believe this to be an important fact because in several other studies a significant number of patients did not complete the treatment due to the night splint being uncomfortable)
- All patients in the study were at least a 7 on a 10 visual analogue scale for painful plantar fasciitis.
How is it different from the rigid night splint?
Traditional hard plastic night splints concentrate on ankle-dorsiflexion by holding the ankle in a neutral or -5 to -10 degree position. The theory being that by resisting noctournal contracture of the gastrocnemius-soleus complex you will limit plantar-flexion of the ankle and improve symptoms. The Strassburg SockTM, by dorsiflexing the toes engages the Windlass Mechanism and provides a more complete tissue-specific stretch to the plantar fasciia. In the morning, when the Strassburg SockTM is removed, the fasciia is already in its maximally stretched position where it has been comfortably held all night.
The Strassburg SockTM comes in two sizes, the regular fits a calf size to 16” around and the large fits calf sizes 16” to 21” around. You put it on as you would a normal sock putting the “D” ring just below the knee. For those with a shorter calf, pull it up to the knee and slightly tuck the extra material under prior to attaching the base strap.
After attaching the base strap around the upper portion of the calf, set the ankle in a 90 degree position and pass the toe (tension) strap through the “D” ring. Raise the toes about 1” off of the ground and attach the Velcro strap. If you feel discomfort in the foot or toes you have it on to tight and you should release some of the tension. The Strassburg SockTM should not be uncomfortable.
Some doctors suggest that their patients wear the Strassburg SockTM in the evening after dinner while they read the paper or watch TV. This way they get 3-4 hours stretch combined with 6-8 hours while sleeping. Now you’re looking at almost a half of the day were the plantar fascia is healing in its maximally stretched position. Many patients tell us they feel some relief after the first couple of nights use.
Read the fine print
There have been 8 studies published on the use of night splints for plantar fasciitis. Of these 8 studies, only three other products besides the Strassburg SockTM are commercially available. The other four splints were produced in the podiatrist’s office with available materials. This is very important because the majority of night splints available do not have independent research studies that prove the clinical effectiveness and comfort of their product specifically. Instead they rely on the studies of others with wording such as “studies have shown” but do not cite specific information on their product.