May 25, 2007
After Dr. Tressler gave me such a great report on the success of the surgery and the chances
of regaining most of my ankle movement, he described a simple exercises I will do to help
stretch out the gastrocnemius muscle.  He had "warned" me before the surgery that I would
be wearing some sort of fixture at night.  As he left the examination room, he said that Danny,
one of the orthopedic technicians, would be in to fit me with a "night splint" that I was to wear
every night for the next six weeks.  When Danny brought the night splint into the examination
room, I could tell from his whole demeanor that this wasn't going to be pleasant.  As you can 
see in the image above, a sturdy padded plastic shell supports the foot and continues up the 
back of the calf.  This shell is slightly flexible at the heel.  Danny's instructions for using the
 night splint were as follows: "Loosen the two diagonal straps, place your foot in the footbed
with the heel seated firmly at the back, and fasten the three padded Velcro straps securely. 
Once the foot is well strapped-in, grab the loose ends of the two diagonal straps
and pull, drawing the foot upwards.  Keep pulling until it hurts, fasten the 
straps, and go to bed.  Do this every night for six weeks." 

As I understand it, when we sleep our muscles relax completely, and the tow of the foot
drops down, allowing the gastrocnemius muscle to contract.  In walking and in doing the
prescribed exercises during the day, I will be stretching out the muscle beyond the "ankle-
neutral" position where it has been limited for over two years.  Without the night
splint, all gains would be lost at night.  

So it really does seem necessary and worthwhile, but the first attempt to sleep with the 
night splint was completely unsuccessful.  With the help of Ambien I slept fine the 
second and third nights.  I hate taking any kind of pharmaceuticals, but they have their 
place, and in this case it really helped.   After two nights, I feel I am already starting to get 
used to the night splint.  I am about  to leave for my summer trip west, and it will be a little 
strange wearing the night splint in my sleeping bag out in the desert.  But this too shall 
pass.  I am just so pleased that I can bend my ankle farther.  It already simplifies walking 
uphill.  I look forward to doing some serious hiking once I regain 
the strength in the gastrocnemius muscle. 

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