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Achilles (Heel) Deep Tendon Reflex Assessment

As a nurse and nursing student,  you will learn how to assess the deep tendon reflexes. In this article, I will discuss how to assess the achilles tendon reflex along with a video demonstration.

The deep tendon reflex examination is part of the neuro assessment for the nursing head to toe assessment. This assessment is usually conducted during the head-to-toe nursing assessment. Nurses do not routinely assess the deep tendon reflexes unless they work in settings such as labor and delivery or neurology or a patient’s condition warrants it (electrolyte imbalances etc.).

Why do nurses assess the deep tendon reflexes?

It helps evaluate the lower motor neurons/fibers at certain levels of the body. For example, the triceps reflex evaluates C7 to C8, and the brachioradialis reflex evaluate C5 to C6.

Grading Scale for Deep Tendon Reflexes

4+ Hyperactive (clonus)

3+ Brisker than normal (hyperreflexive)

2+ NORMAL

1+ Diminished (hyporeflexive)

0 Absent

Demonstration on How to Assess Achilles Deep Tendon Reflex

How to Assess the Achilles Deep Tendon Reflex

  1. achilles-reflex-testFind the achilles tendon.
  2. Locate the heel of the foot and dorsiflex the foot. The achilles is found right above the heel.
  3. Now  have the patient dangle the foot while you dorsiflex it.
  4. While the foot is dorsiflex, tap with the reflex hammer briskly on the achilles tendon.

Expected Response of the Achilles Deep Tendon Reflex

You will see the foot plantarflex.

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