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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 …
Acknowledgements I am grateful to Dr Mark Baker of the University of Newcastle-upon-Tyne for helpful comments on the physiology of muscle spindle reflex function.
Contributors None declared.
Competing interests None declared.
Patient consent None.
Provenance and peer review Commissioned; externally peer reviewed. This paper was reviewed by Michael Lunn, London, UK and Lionel Ginsberg, London, UK.