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Understanding the Reflex Test

Understanding the Reflex Test

When people go for check-ups, doctors usually use a tool to see how patients’ reflexes respond to that tool. This is called the reflex test.

What is a Reflex?

A reflex is an automatic body reaction. It means that your body involuntarily reacts to a certain impulse. This specific impulse lets the senses send signals to the spine in which the brain and the nerves will allow the muscles in your body to react. For example, you’re a parent with a 6-month old son who is hyperactive and crawls a lot. You’re doing household chores while he plays in the crib in his room. Moments later you come back to his room to check on him and see him hanging from the rail guard of his crib about to fall off. You almost teleport to his position just in time to catch him—that is reflex.

reflex test

Reflex Tests

Reflex tests measure the strength and appearance of a number of reflexes. These tests are actually part of a neurological exam done for spinal cord injuries or neuromuscular conditions—to check whether or not the nerves in the spine are still functioning. A so-called “deep tendon reflex” is included in the examination; it mainly measures the reliability of the body’s motor system—muscular reactions to activities such as walking, running, dancing, etc.

There are six major locations for testing the reflex to ascertain the health of the spinal cord. These are the ankle, knee, abdomen, forearm, biceps and triceps. The ankle  is connected to the nerves of the first and second backbones. The knee is connected to the nerves of the second through the fourth backbones. The abdomen is connected to the nerves of the eighth through the twelfth backbones. And finally, the forearm, biceps and triceps are connected to the nerves of the fifth, sixth and seventh backbones. In order to see if the nerves are fully functional, these major locations are lightly tapped using a rubber hammer to see if there is a reflex to each part. For example, a “knee-jerk” suggests that the nerves in the lower part of the spine are functioning well.

Another reflex test is called the Babinski Test, which we shall discuss in my next article.

The Reflex Hammer

The tool being used for these reflex tests is called a reflex hammer. It is a medical tool that physically checks the overall condition of the nervous system.

The hammer was invented in 1800 by a Scottish physician named Sir David Barry, and was mainly used for pounding. In 1870, two physicians named Wilhelm Heinrich Erb and Carl Friedrich Otto Westphal discovered the “deep-tendon reflex” and decided to use the hammer to test the knee reflex. In 1888, a Philadelphia neurologist John Madison Taylor invented the first certified reflex hammer. Since then, it has been medically used for various reflex tests all over the world. Basically, neurologists or physicians are permitted to use this tool.

But don’t worry—it’s not going to hurt since it’s just a small hammer with a rubber head and a metal handle. In fact, you can check yours or your family members’ reflexes at home. All you need is the reflex hammer.

How the doctor conducts the reflex test

The (adult) patient is seated straight at the edge of a checkup bed, arms and legs are relaxed with one hand on top of the other. The patient should be calm and relaxed.

1. Biceps. On one arm, doctor places thumb on the biceps and then the thumb is struck with the reflex hammer. The same thing is done on the other arm. If both arms jerk similarly that means the nerves connected to the biceps are completely normal and functioning well.

2. Forearm. The patient relaxes both arms. Doctor then strikes the forearm tendon on one arm three inches from the wrist, will then do the same on the other arm. If both reflexes respond similarly, it means that the nerves connected to the forearms are normal and functioning well.

3. Triceps. The doctor will hold the patient’s arm with one hand and strike the tendon directly with the reflex hammer. The same thing is done on the other arm. If both arms respond similarly, then the nerves connected to the triceps are normal and functioning well.

4. Knee. This is where the “knee-jerk” comes in. Patient hangs the lower leg freely from the edge of the checkup bed. Doctor strikes the large tendon located just above the kneecap (quadriceps tendon) with the reflex hammer. The same thing is done with the other knee. If the reactions are the same, then the nerves connected to the knees are normal and functioning well.

5. Ankle. Doctor holds the relaxed foot with one hand and strikes the Achilles’ heel with the reflex hammer. he same thing is done with the other foot. If the reactions are the same, then the nerves connected to the ankles are completely normal and functioning well.

Why it is important to have reflex tests

Reflex tests help doctors recognize brain damages, spinal injuries and neuromuscular conditions. Doctors are then able to recommend that patients see neurologists or specialists who can further assist them with their illnesses.

And as always, the best way to achieve a healthy life is to have do daily exercises, eat nutritious food, and take vitamins that are good for the brain, spine, nerves and muscles.


  1. “Reflex Tests,” Encyclopedia of Children’s Health; last accessed 2/13/2020
  2. “The Neurological Examination,” UCSD’s Practical Guide to Clinical Medicine; last accessed 2/13/2020
  3. “Reflex Hammers: History, Current Use and How to Buy,” All Heart; last accessed 2/13/2020
  4. “Deep Tendon Reflexes,” The Precise Neurological Exam; last accessed 2/13/2020

Dr. Allamm Morales, M.D.

Dr. Allamm Morales has over 15 years experience in personal injury and a wide range of neurological disorders. He has privilege, and provides patient care in local Baptist hospitals.

He was Chief Resident at the Neurology Residency Program of the University of South Florida, and worked at the Florida Hospital of New Smyrna, and St. Luke Hospital in Ponce, Puerto Rico. He also served many years with the Florida Neurology Institute, Inc.

Dr. Morales is a Diplomate of the American Board of Vascular Neurology, and a Diplomate of the American Board of Psychiatry and Neurology.

Dr. Morales studied in Nova Southeastern University, Davie, FL, had residency at the Caibarien General Hospital, Cuba, and obtained the MD degree at the Superior Institute of Medical Science in Cuba.

Fiaz Jaleel, M.D.
Physical Medicine & Rehab, Pain Management

“Life is short and precious. As a Physiatrist and Pain Physician my goal for my patients is to reduce their pain and suffering, enhance form, improve function and ultimately promote the best quality of life for that individual.”

Dr. Fiaz Jaleel graduated from the University of The West Indies in 1987. He completed a two year internship at Port of Spain General Hospital in Trinidad and Tobago. He completed his internship in Internal Medicine at St. Francis Hospital in Evanston, IL and went on to do a residency in Physical Medicine and Rehabilitation at Barnes Jewish Hospital in St. Louis , MO. In 2007, Dr. Jaleel joined the team at Absolute Injury and Pain Physicians as Medical Director. He is currently Board Certified in Physical Medicine and Rehabilitation as well as Pain Medicine via the American Board of Pain Medicine.

In Trinidad and Tobago, Dr. Jaleel held positions as an Intern, House officer, and District Medical Officer. He has also practiced in Illinois, Missouri, South Dakota and Central and North Florida.

While practicing in Trinidad , Dr. Jaleel also worked in Internal Medicine, General Surgery, Pediatrics, Neonatology, Obstetrics and Gynecology, Ear, Nose and Throat Surgery, Ophthalmology, Radiology, Neurosurgery, Plastic Surgery, Orthopedics, Emergency Medicine and Community Medicine.

Dr. Jaleel has encountered many diseases, disorders and clinical situations related to multiple aspects of trauma including penetrating and non-penetrating injuries, motor vehicular accidents and concomitant injuries including intra-abdominal injuries, closed head injuries, fractures and burns.

When not treating his patients, Dr. Jaleel enjoys travelling, reading and spending time with friends and family.

Dr. Jaleel has the following affiliations:
Diplomate, American Board of Physical Medicine and Rehabilitation
Diplomate, American Board of Pain Medicine
Fellow, American Academy of Physical Medicine and Rehabilitation
Member, American Academy of Pain Medicine
Member, Florida Society of Physical Medicine and Rehabilitation
Member, Florida Academy of Pain Medicine
Member, Florida Medical Association

Deric L. D’Agostino, D.C.
Chiropractic Physician

“The health of a body is in direct proportion to the health of its nervous system. The nervous system controls every cell, tissue and organ in your body, tap into that and “miracles” will most certainly happen!”

Dr. Deric D’Agostino attended the Logan College of Chiropractic and has been helping patients at Absolute Injury and Pain Physicians for the past nine years. Around here we call him “Dr. D.”

Dr. D’Agostino specializes in Koren Specific Technique and in the treatment of injuries resulting from motor vehicle accidents. He is a master of his craft and firmly believes that chiropractic treatment can not only help the body but also the mind. His sense of humor and the personal attention that he provides really puts patients at ease.

Dr. D’Agostino genuinely listens to the patient while working very hard to erase their pain-inducing symptoms. He is always seeking out continuing education and new methodology to add to his care repertoire.

When he is not helping patients find relief, Dr. D’Agostino enjoys training for sprint triathlons, gardening, as well as being an awesome father and husband. You will most likely find him at our Arlington location dawning a huge smile while drinking his homemade juice.