Multiple Sclerosis Community
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233622 tn?1279338505

heel to shin test

is this test suppose to be done while sitting or standing. Also, what does it mean when a person can get pull one foot onto of the knee on one side but not the other?

I can get my left foot on top of my right knee but have to pull my right knee ontop of my left knee.

Also, I can lift my right heel and run it along my left shin, with a lot of effort while I am sitting.

While standing I can NOT run my right heel along my left shin.
But  while standing I can run my left heel along my right shin ...it that clear as mud?!

I know, I have been doing too much reading! Two weeks to go until I see the MS specialist and I am wondering if she will even do any of these types of tests.

I am also wondering if I should take any notes from my previous, tunnel vision type, neurologist who refuses to think out side of the box. Or just take the test results and films so I do not infect my new doctors thoughts with my old doctors short sidedness.  

22 Responses
Avatar universal
I believe this is for motor coordination (Ataxia) check and balance.  When I did it I was standing up.
Avatar universal
"I am also wondering if I should take any notes from my previous, tunnel vision type, neurologist who refuses to think out side of the box. Or just take the test results and films so I do not infect my new doctors thoughts with my old doctors short sidedness." This is a great question!!

I am wondering the same thing as I am about to see my third Neuro.

Avatar universal
I'm taking only the copies of reports, they are objective findings.  The doctor's notes are subjective and if they reflected the doc's belief in your symptoms then you wouldn't need to find another doc.
220917 tn?1309788081
I have always done this sitting.  Now granted, I was not able to stand well at the time. And I pretty much failed it in that I was supposed to smoothly slide my right heel down the length of my left shin, and vice versa.  Was not happening.  I could fairly smoothly run my left heel down my right shin, but not the other way around.  I could hard LIFT my right heel to get it up to my left knee, and when I tried to do anything remotely smoothly, it tremored fiercely.    I think it gave them a good idea about left/right side comparison and also perhaps strength.  Not sure.

Hope it helps!

233622 tn?1279338505
thank you for your responces. I was sitting when this was done. Actually sitting on the exam table with my feet dangling. I struggled with my right foot but the doctor didn't say anything. I guess she was looking for really strong clues. Mine aren't so clear. She didn't take the time to really listen...oh well. That is why I am not going back to her and am off to see an MS specialist!

Ok, so it is best to only take the tests and not her notes. I am taking a letter from my PCP. He was not happy with the neuro I saw. I can get all of my records from him because I had the nueros office send everything to my PCP.

Right now I am just trying to keep up my hope that this new neuro will listen to me. At least show some interest that I am having a difficult time. Something is causing my problems....but what.  

147426 tn?1317269232
huh...I was taught to do the heel down shin while the patient was lying down.  This requires less muscle strength and would more accurately measure the proper thing which is the ability to "know and move in a straight line."  Standing I can't lift my right leg that high and if I wobbled it would be because of muscle weakness.

220917 tn?1309788081
That is so weird.  My Attentive neuro was haunched over staring at my legs like he SO wanted a straight line, but was expecting not.  Then seemed surprised at all the shaking.  I wonder why all the differing takes?  (Mine could be because I came straight from work in a dress that day?)

And I'll tell you what else--my internist tried to repeat the babinski in his office the other day with a very prickly device.  Couldn't do it.  Couldn't produce ANY hyper reflexes.  I know my neuro twisted his hammer a bit, like he was adjusting it.  But I was kicking like mad.  It's got to be skill developed over time, wouldn't you all agree?

Wondering in Detroit,

147426 tn?1317269232
As someone who had to work hard to develop the skill, I agree.  Also, Zilla, you said you were feeling better and a little stronger.  Your exam might be changing, too.  Is that true?  Are your legs a little stronger?  That would speak to one of the Relapsing Remitting processes like MS or CIDP, rather than some of the other,not-so-good upper/lower motor neuron diseases.

BTW - How are you feeling?  You are less around these days.  I hope it because you're better and actually getting things done.

220917 tn?1309788081
I still peek in on you all.  I am on half days at work, so I am trying to find a way to prioritize, I suppose, is the best way to say it!  Mornings are good, but as the day goes on (10 a.m.)I get exhausted, so I nap when I need to, but I am getting really strong.  My toes are really back to normal.  My legs are much better, as well.  Weird.  I don't want to jinx myself.  I don't know what that means at all.  But I'm really eager to find out!  Thanks for asking.

You know I'm glad you're back!

233622 tn?1279338505
OH so confusing! Well, what I do know for sure is the doctor I saw didn't do anything close to the way it seems things are suppose to be done.

220917 tn?1309788081
I think this is just a small piece of the puzzle.  What was the rest of your exam like -- I forget?
233622 tn?1279338505
Well, She looked at my eyes, I have ON. Had me touch her fingers. Had me walk away from her and back to her about 6 steps. We were in a very small room. She tried to do the Babinski test through my sock with the end of her reflex hammer, but go no response. Checked my leg reflexes and had me resist her as she tried to push my leg down. My left leg is fine. My right leg is weak. I had quick reflex in my right leg and it was uncomfortable. My right ankle really did not respond to the reflex test. It didn't take much for her to push my right leg down because I could hardly raise it to start with.
So, I don't know. Is that a through nuero exam? We were in her office about 30 minutes total. That included the exam, checkout, and setting up a few tests.
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