Rule of thumb for increasing splint force: what should be increased first?

• A. total end range time
• B. duration of wear
• C. amount of padding
• D. frequency of adjustments

Answer: (A)

The key idea is that tissues lengthen mainly through sustained, low-load stretch over time. If you want to increase the force from a splint, first extend how long the end range is held. Holding the end range longer allows collagen fibers to creep and remodel gradually, giving you gains in soft tissue length with less risk of pain or tissue damage. Once the patient tolerates longer end-range holds, you can safely increase the force magnitude. Other adjustments—like simply wearing it longer, changing padding, or adjusting how often you tweak the splint—don’t promote the same safe, progressive elongation as increasing end-range time.