Cause of the “Yips”

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The Yips are a sudden twitch or jerk that strikes a golfer as he prepares to take a swing. Now, researches at the Mayo Clinic have looked into the cause of the yips and are closer to figuring out what causes that annoying jerk or twitch in some golfers. Dr. Charles Adler of Mayo Clinic will discuss his research.

Ted Simons: They're notorious among golfers. They can ruin a perfectly good round with one little twitch. They're the yips, and they can really mess up your mind and your golf game. Researchers at the Mayo Clinic have been looking into what causes the yips. Here to talk about the study is Dr. Charles Adler, a Mayo Clinic neurologist and researcher. Thanks for joining us.

Dr. Charles Adler: Thanks for having me.

Ted Simons: Lets defines terms here. What are the yips?

Dr. Charles Adler: Yips are people who putt or chip and get an involuntary movement. Usually they describe it as a twitch, a jerk or sometimes a tremor.

Ted Simons: You said putting and chipping. Some people think they have the yips was a driver, possible?

Dr. Charles Adler: I think possible, but traditionally, people talk about it mainly with putting and chipping.

Ted Simons: Ok. Yips, traditionally, it's another word for choking. Accurate?

Dr. Charles Adler: I think it's accurate in many golfers that performance anxiety and that's one of the cause of yips. Our research is geared at looking at whether everybody is more of a psychological or neurological type of yip. We believe there are a number of golfers who have a golfer's cramp, much like musician's cramp or writer's cramp. It's a neurologic disorder.

Ted Simons: So it's not the kind of thing if you're walking down the street, your hand goes like this. Only when you're holding a putter and -- why then?

Dr. Charles Adler: If you saw someone whose hand shook.

Ted Simons: Yes.

Dr. Charles Adler: Just as they're sitting here then you wouldn't be surprised if their hand shook when golfing.

Ted Simons: Yes.

Dr. Charles Adler: The research we're doing, people, like you said, don't have a movement disorder when they're just walking around and it's just during that task. We call it a task-specific movement dystonia or a task specific movement disorder. Again, musician's cramp, people who play the violin and people who write, and only when they're writing, no other activity, typing, only when writing do they get a twitch or involuntary movement of their hand.

Ted Simons: That suggests overuse. Do you think do you understand the musician with the cramp and the writing so much your hand freezes up? Overuse here in terms of putting.

Dr. Charles Adler: There's a lot of discussion about it being due to overuse. Nobody has proven whether these task specific dystonias are truly due to overuse. It may be a genetic predisposition. And in the setting of overuse, that's when they get it. And then we all write but don't all get writer's cramp. Many people play instruments and yet don't get a musician's cramp. Same with golf.

Ted Simons: Talk to us about the study. What you did and how the research was conducted.

Dr. Charles Adler: We did a study where we took 10 people who complained of the yips and 10 who didn't. We had them in the lab at Mayo clinic and we studied hand movements and forearm movement. This study was done at ASU at the practice green at Carson golf course with my colleagues both in Mayo and in ASU and studied 25 golfers who complained of yips and 25 golfers who did not. And we videotaped them and had surface EMG, which is an electrical recording device to look at movements of the muscles and contraction of the muscles. And then had their wear a glove which measured joint position at the fingers as well at the wrist. It also measure the rotation at the wrist.

Ted Simons: Did you find that they gripped tighter, change throughout the putting stroke? I'm trying to get this neurological situation down here. Because again, some folks think the yips -- I actually read this once, where a putting instructor thought that with the yips - when you're taking the putter back, you're thinking you're aiming too far in one direction and your mind says compensate, compensate, compensate. And by doing that you start poking at it.

Dr. Charles Adler: I have read that as well and can't say it's incorrect. In the research, we've done, we've identified a number of individuals that have an excessive amount of rotation around the wrists. Some have co-contractions, so their wrist flexors and extensors contract at the same time. People who don't complain about yips mainly do not have that. We think there's a percentage of people, 10, 15, 20 percent, maybe higher that have a neurologic cause as opposed to a performance anxiety or choking cause as you described.

Ted Simons: And it seems as though you don't hear about young people having the yips. Always the older guys and complaining and they've got the belly putter because they just can't do it. If it's neurological, why don't we see more young folks out there with this?

Dr. Charles Adler: This was followed in line with all of these other sort of movement disorders. They occur as one ages. Think about tremor, think about Parkinson's disease, think about people who have writer's cramps and musician's cramps. Similar pattern usually occurs in their 40s and 50s and maybe 60 in terms of the onset. So same thing here.

Ted Simons: What kind of treatment are we talking about? I know it's early in the study and this of course is looking at golf. But as for the golf aspect, what do these folks do?

Dr. Charles Adler: The first -- first of all, the study was not a treatment study. We didn't actually look at any treatment modality. That's the point of what I hope will be the next study. The first treatment option as with the other type of cramp, change your grip. Use a longer putter. People say doesn't that prove it's not neurologic? And the answer is no. If you have a writer's cramp patient, we often change the size of their pen and how they grip the pen to get them to compensate. Various oral medications can be tried and depending on the patient, there are a couple of other options. Toxin injections used for writer's and musician's cramp and there's even surgical intervention with deep brain stimulation surgery. I'm not saying that should be used on golfers.

Ted Simons: That's what I was going to say.

Dr. Charles Adler: There's one golfer who has had that. A professional golfer. That's something that would need a lot more study. But that's way down the line.

Ted Simons: Quickly, if someone has the yips, is that a concern, a health concern?

Dr. Charles Adler: I think the answer is no.

Ted Simons: Very good. Well, thank you. This is fascinating.

Dr. Charles Adler: Thanks for having me.

Dr. Charles Adler: Mayo Clinic;

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