The sciatic nerve acts as both the afferent and the efferent pathway, and the spinal root is L5-S1.
The mobile patient
- The patient should kneel on a chair with their feet hanging over the edge.
- Using one hand, push the foot or feet until they are in slight dorsal flexion.
- Strike the Achilles tendon directly [Figure 90].
- Note any foot movement and contraction of the calf muscle.
Figure 90
The supine patient (a)
- The patient should cross their legs.
- Take hold of the foot of the top leg and loosely move the ankle, flexing and extending it until you feel the calf muscle is relaxed.
- Place the foot in slight dorsal flexion.
- Strike the Achilles tendon directly with the reflex hammer [Figure 91].
Figure 91
The supine patient (b)
- Take hold of the patient’s forefoot.
- Bend the patient’s leg at the hip and knee.
- The patient allows their leg to lean against your body in either exororation or endorotation at the hip.
- Instruct the patient to let the entire weight of their leg rest in your hand.
- Strike the Achilles tendon once you feel that the patient’s leg is properly relaxed.