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Minerva

Tapping tendons . . . and other stories

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k868 (Published 01 March 2018) Cite this as: BMJ 2018;360:k868

Ankle jerks

Techniques of physical examination are under researched, but a few studies have shown that the most reliable way to elicit an ankle jerk is for the examiner to place a hand on the plantar surface of the patient’s foot and then strike that hand with the tendon hammer. Why, asks an article in Practical Neurology (doi:10.1136/practneurol-2017-001688), are medical students still taught to tap the Achilles tendon directly? There’s no evidence about which technique patients prefer but, because the direct tap method requires them to adopt an undignified position by flexing the knee and abducting and externally rotating the hip, Minerva reckons they’d opt …

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