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The ‘right’ way or the best way to do the ankle jerk?
  1. Chris Allen
  1. Department of Neurology, Addenbrooke's Hospital, Cambridge, UK
  1. Correspondence to Dr Chris Allen, Honorary Consultant Neurologist Addenbrooke's Hospital Cambridge, 232 Hills Road Cambridge CB2 8QE; cmca100{at}cam.ac.uk

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Much of the neurological examination of the motor system of the limbs tests their physiological state to determine the anatomy of a patient's pathology. However, physicians were bashing tendons long before they understood the physiology behind the jerks.1 2 This empirical evolution of our clinical methods perhaps explains the myths concerning the ‘right’ way to do things, passing through the mouths of successive clinical teachers to their students without going through the minds of either. This matters when the ‘right’ way is not the best or easiest way, needlessly adding to the difficulty of something already seen as an intimidatingly complex set of skills called the ‘neuroexam’.

For a start, tendon reflexes are not tendon reflexes.2 When ‘doing the tendon reflexes’, we examine the muscle …

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