Some athletes have faced the sad situation where, for no apparent reason, they suddenly lose the ability to perform a basic skill that was previously effortless. Although most commonly seen in golf and baseball, it also has been known to occur in place-kickers and musicians who have reached the highest levels in their fields.
Commonly known as the “yips,” the cause and treatment continue to elude physicians, psychologists and other sports medicine specialists. There is no consensus regarding a physical or psychological origin of this problem. In baseball, the yips have detoured the careers of Rick Ankiel, Steve Sax and Chuck Knoblauch to name a few.
Many specialists believe the yips are the result of a movement disorder best classified as a focal dystonia. The most common example of a focal dystonia is writer’s cramp.
Movement disorders are neurologic disorders that affect the brain’s ability to execute smooth, coordinated movements. The brain consists of a variety of regions that contribute to movement. These include the cortex, basal ganglia and brain stem. Communication among these areas is accomplished through neurochemicals. Any imbalance in these substances will result in an abnormality.
One part of this chain of activity that is believed to play a crucial role in the yips is proprioception. This is the ability for the brain to recognize the position of an extremity in space. A change in the usual position of the arm when throwing may be the initial disruption of the chain of events.
“Sensorimotor retraining exercises, oral medications and Botox injections can help with the dystonia,” reports Dr. Bernardo Rodrigues, a neurologist specializing in the treatment of movement disorders at UConn. “In some cases, Deep Brain Stimulation (DBS) surgery can also be offered to aggressively treat this condition.”
The yips may be more than a psychological condition and treatment with appropriate medications can possibly revive a failing career.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at firstname.lastname@example.org