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A reflex is an involuntary action produced as a response to a stimulus. Tendon reflexes are tested to provide vital information on the integrity of the central and peripheral nervous system. The reflexes are:

Reflex Spinal Level Tested
Biceps C5, 6
Brachioradialis C5, 6, 7
Extensor Digitorum C6, 7
Triceps C6, 7, 8
Patella Tendon L4
Ankle Jerk S1, 2
Babinski (plantar response) L5, S1, 2

Tendon reflex testing by a specialist MSK therapistAbove: Tendon reflex testing by a specialist MSK therapist

Grading of reflexes shows abnormalities, the grades are:
  • Grade 0 – abnormal
  • Grade 1 – diminished (can be abnormal is asymmetric)
  • Grade 2 - normal
  • Grade 3- brisk (abnormal if asymmetric)
  • Grade 4 – repeating reflex (abnormal)

What causes abnormal reflexes?

If a reflex is graded as abnormal this can show there is:
  • A lesion in the motor pathway
  • A nerve compression
  • Neurological condition
Causes can be complex but with specific tests from a Physiotherapist a clearer picture may be gained.

Specialist musculoskeletal Physiotherapist testing tendon reflexes at the elbowAbove: Specialist musculoskeletal Physiotherapist testing tendon reflexes at the elbow

How can Physiotherapy help?

Physiotherapy can help by assessing and giving possible diagnoses for the abnormal reflexes. Physiotherapists from can help treat the symptoms which can accompany abnormal reflexes such as:
  • Walking difficulties
  • Muscle weakness
  • Altered muscle tone
  • Abnormal sensations (pins and needles)

What type of Physiotherapy Treatments can be expected for abnormal reflexes?

Treatments for the additional symptoms can include: Treatments will be decided upon at the initial assessment. Physiotherapists at can also signpost you to appropriate medical teams if necessary.


Abnormal reflexes can be as a result of many causes and can have an array of accompanying symptoms also. The experienced Physiotherapists at can offer a professional high quality service to clients. Please contact us or call 0330 088 7800 to arrange an appointment.

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