Yips, causing athletes to fail

Stephen Hendry, deemed one of the most successful snooker players of all time, began developing a condition called the ‘yips’ as his career progressed. The condition began causing the loss of his fine motor skills.

Explaining the symptom of the disease, Dr I. Bharat Kumar Reddy, senior consultant, Psychiatry, at Apollo Hospitals, says, “Yips cause a sudden loss of skills. There’s no clear explanation why it happens, and it’s mostly seen in experienced players. The malady doesn’t have a treatment and some sportspersons have had to either give up their sports or change their action.”

The term ‘yips’ was coined around the middle of the last century by the Scottish golfer Tommy Armour, a sufferer. He defined it as “a brain spasm that impairs the short game.” Some medical websites define yips as “involuntary wrist spasms that occur most commonly when golfers are trying to putt.”

Then again, golfers aren’t the only athletes that yips afflicts — cricket bowlers suffer a similar disability, which is also called the yips. In darts, the problem is called “dartitis”, in snooker, it’s “cueitis”, in archery, “target panic”, in gun shooting, “flinching” and in baseball it’s called “pitching”.

Who else can yips affect?
Incidentally, the condition can also affect those outside sports. Dr Nitin Kumar B., senior arthroscopy surgeon and sports medicine specialist at Yashoda Hospitals, talks about how it can affect professionals such as dentists, craftsmen, musicians and surgeons. “The affected individuals suffer from involuntary muscle contractions while performing specific repetitive tasks, developing tremors, spasm, cramps, or sudden freezing without any warning,” elaborates Dr Kumar.

Dr Reddy from Apollo Hospitals adds that yips are unexplained loss of skills always associated with performance anxiety. He adds that there is some mention of yips-like phenomenon way back in fifteenth-century literatures although it’s more often described since 1963. “Now, people have begun attributing the ailment to a neurological condition such as focal dystonia, in which small muscles go into spasms. And till date, it’s one of the conditions sports medicine has no clear answers for,” explains Dr Reddy.

Functional changes accompanying yips
Dr Deepika Sirineni, senior consultant and neuro physician at Apollo Hospitals, believed ‘yips’ are an acquired deterioration in the function of motor pathways, which aggravate when thresholds of high stress and physiologic arousal are exceeded. “Golfers afflicted with yips have more forearm electromyogram activity and higher competitive anxiety than unaffected golfers in both high and low anxiety conditions,” she explains. Electromyogram, by the way, is the record of the electrical activity produced by skeletal muscles.

Dr Sirineni goes on to add that yips appear particularly relevant for women, resulting in significantly greater increases in cortisol and systolic blood pressure (SBP) for women than in men.

Talking about the remedies
A question that remains is if yips and other sports-related movement problems are solely anxiety-related, why do they affect only certain motions? Can a change of target, technique or equipment help them go away?

One possibility is the biochemical changes in the brain accompanying ageing. Excessive use of the involved muscles and intense demands of coordination and concentration may increase the problem.

“Sometimes, simple measures like changing the grip, mild changes in action, altering the equipment can also help,” says Dr Kumar. He then goes on to add that scientists have developed a wrist band that shows increased stress levels and how it affects the fine motor skills during stressful times.

Symptoms:
The person can have spasms, jerky movement, tremors and, at times, even freezing of action.

Diagnosis:
The problem is diagnosed clinically based on symptoms and presentation. In some cases, electroneuromyography (ENMG) test is done.

Treatment:
Two-pronged strategy is adopted for treating the ailment:
Sports medicine specialists help in reducing overworked muscles. For this, they may suggest a change in grip or action.
Counselling sessions can be useful. Psychologists can help in mental-skills training to reduce anxiety, which worsens this condition. For this, relaxation and anxiety management techniques will help.
Taking a short break from the game as well as stress relieving measures including meditation and yoga sessions can be useful.
Botox injections are used in specific muscles to reduce spasms. However, these injections may need to be repeated every six months as the effects of the Botox injections can be short-lived.