Overview

The yips are involuntary wrist spasms that occur most commonly when golfers are trying to putt. However, the yips can also affect people who play other sports — such as cricket, darts and baseball.

It was once thought that the yips were always associated with performance anxiety. However, it now appears that some people have the yips due to a neurological condition affecting specific muscles (focal dystonia).

Changing the way you perform the affected task might help you find relief from the yips. For example, a right-handed golfer might try putting left-handed.

Symptoms

The most common symptom associated with the yips is an involuntary muscle jerk, although some people experience tremors, twitches, spasms or freezing.

Causes

In some people, the yips are a type of focal dystonia, a condition that causes involuntary muscle contractions during a specific task. It's most likely related to overuse of a certain set of muscles, similar to writer's cramp. Anxiety worsens the effect.

Some athletes become so anxious and self-focused — overthinking to the point of distraction — that their ability to execute a skill, such as putting, is impaired. "Choking" is an extreme form of performance anxiety that may compromise a golfer's or any athlete's game.

Risk factors

The yips tend to be associated with:

• Older age
• More experience playing golf
• Tournament play

Treatment

Because the yips may be related to overuse of specific muscles, a change of technique or equipment may help. Possible strategies include:

• Change your grip. This technique works for many golfers, because it changes the muscles you use to make your putting stroke.
• Use a different putter. A longer putter allows you to use more of your arms and shoulders and less of your hands and wrists while putting. Other putters are designed with a special grip to help stabilize the hands and wrists.
• Mental skills training. Techniques such as relaxation, visualization or positive thinking can help reduce anxiety, increase concentration and ease fear of the yips.
• Botox injection. A careful injection of onabotulinumtoxinA (Botox) into the muscles that are overacting can help to limit muscle contractions and calm the yips.

Preparing for an appointment

While you may initially consult your family physician, he or she may refer you to a doctor who specializes in sports medicine.

What you can do

You may want to write a list that includes:

• Detailed descriptions of your symptoms
• Information about medical problems you've had
• Information about the medical problems of your parents or siblings
• All the medications and dietary supplements you take
• Questions you want to ask the doctor

For yips, some questions to ask your doctor may include:

• What might be causing my symptoms?
• Is there any treatment for my symptoms?
• Will I always be affected by the yips?
• Do you have any brochures or printed material I can take with me? What websites do you recommend for information?

What to expect from your doctor

Your doctor may ask detailed questions about how and when your symptoms occur. He or she may also want to observe your putting stroke. But because the yips occur most often under tournament conditions, it may be impossible to demonstrate the yips on command.

Questions your doctor has for you might include:

• When do your symptoms usually occur?
• How long have you been experiencing symptoms?
• Do your symptoms occur with any other activities?
• What, if anything, seems to make your symptoms better?
• Does anything seem to make your symptoms worse?