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What is an Ankle Reflex?

By Daphne Mallory
Updated: Mar 03, 2024

An ankle reflex is also referred to as an Achilles reflex. Medical professionals tap the Achilles tendon when the foot is pointed toward the legs so that the toes are pointed toward the shin. The position is referred to as the dorsi-flexed position. The normal response should be that the foot jerks downward because of the response from the gastrocnemius and soleus muscles. When there is an absence of an ankle reflex, the medical professional can often work on a diagnosis.

Patients are normally asked to take off their shoes and socks and to relax. They then must sit in an upright position with feet dangling. The right foot is held by the medical professional, who moves it in a dorsi-flexed position. Using a small medical hammer that’s soft and doesn’t inflict pain, the medical professional will strike the tendon. When the Achilles tendon is struck and the ankle does not respond by propelling the foot downward in what’s called a plantarflexion, the medical professional will begin to make a diagnosis.

When an ankle reflex is absent, there are more than 47 different possible diagnoses. It could be the result of a prescription drug toxicity or alcoholic poisoning. Family genetic disorders also play a role in the absence of an ankle reflex. Spina bifida and vitamin E deficiency are two common diagnoses if the patient lacks an Achilles reflex. A trauma, such as a concussion, is also a contributing cause.

Instead of a lack of reflex, there may be an exaggerated Achilles jerk. A possible diagnosis for the exaggeration includes a spinal cord compression. Sugar diabetes and similar diseases can often cause the motor tract to malfunction, which can lead to an exaggerated ankle reflex. The task of the medical professional is to determine what the underlying causes are, and that often requires additional testing on the patient.

Checking the Achilles reflex is often an important part of a routine physical examination, but it’s also used when patients report to the doctor’s office or hospital because they are experiencing various symptoms. It’s an inexpensive method of indicating to the medical professional that the nervous system is working properly or is malfunctioning. There is often no pain associated with the test and it is noninvasive. Other tests for nervous damage and related diseases are invasive, and many medical professionals prefer to delay those if the ankle reflex tests, as well as other symptoms, do not show a problem.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Discussion Comments
By anon330474 — On Apr 16, 2013

I had my ankle reflex tested today in anatomy class when we were going over reflexes and mine was not present. I feel fine and the professor didn't seem worried so I'm not sure it's even worth looking into.

By BabaB — On Jun 28, 2011

After a trip to the doctor to be tested for an Achilles reflex, and finding out that your nervous system is out of whack, you get to look forward to 47 possible diagnosis to be tested for. Who knows how many tests you would have to have to find out the cause.

Actually, I don't remember ever having my ankle reflex tested. Does anyone remember having this test? I remember the knee reflex test, though.

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