The Yips: Methods to Identify Golfers with a Dystonic Etiology/Golfer’s Cramp

Purpose To determine whether quantitative methods could separate golfers with a possible dystonic cause of the “yips” from those that appear to be nondystonic. Methods Twenty-seven golfers completed 10 two-handed and 10 right hand–only putts. Surface EMG assessed forearm muscle co-contraction and motion detectors monitored wrist and putter movements. Based on a videotape review, golfers were grouped into those with yips of dystonic etiology, those with the yips nondystonic, and those with no yips. Results On video review of two-handed putting, five golfers had yips that appeared to be dystonic, nine had yips that did not appear to be dystonic, and 13 had no yips. During two-handed putting co-occurrence of a yipped putt and wrist flexor/extensor and/or pronator/supinator co-contraction was significantly more frequent in those with dystonic yips. The dystonic group had no increase in the number of yipped putts or yips with co-contraction when putting right hand only, whereas the nondystonic group had significantly more yipped putts and more yipped putts with co-contraction with right hand only. Conclusions Quantitative methods were identified that appear to identify golfers with a dystonic etiology for the yips. It is not just the frequency of yips nor just specific motion patterns alone, rather it is also a combination of yips with co-occurring co-contraction when putting with two hands, and then right hand only, that distinguished this possible etiology. Despite being a small study, identifying a dystonic pattern, even in a nonpressure indoor setting, may aid in assessment and possible monitoring of treatment.

[1]  J. Rothwell,et al.  A unifying motor control framework for task-specific dystonia , 2018, Nature Reviews Neurology.

[2]  I. Parees,et al.  Task-specific dystonia: pathophysiology and management , 2016, Journal of Neurology, Neurosurgery & Psychiatry.

[3]  M. Hallett,et al.  A multifactorial conceptual model of peripheral neuromusculoskeletal predisposing factors in task-specific focal hand dystonia in musicians: etiologic and therapeutic implications , 2014, Biological Cybernetics.

[4]  M. Raab,et al.  Reinvestment – the Cause of the Yips? , 2013, PloS one.

[5]  M. Hallett,et al.  Phenomenology and classification of dystonia: A consensus update , 2013, Movement disorders : official journal of the Movement Disorder Society.

[6]  M. Santello,et al.  Are the yips a task‐specific dystonia or “golfer's cramp”? , 2011, Movement disorders : official journal of the Movement Disorder Society.

[7]  S. Frucht Focal task-specific dystonia of the musicians' hand--a practical approach for the clinician. , 2009, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[8]  M. Vidailhet,et al.  Case-control study of writer's cramp. , 2009, Brain : a journal of neurology.

[9]  J. Rothwell,et al.  Task-specific hand dystonia: can too much plasticity be bad for you? , 2006, Trends in Neurosciences.

[10]  A. M. Smith,et al.  Abnormal co-contraction in yips-affected but not unaffected golfers: Evidence for focal dystonia , 2005, Neurology.

[11]  M. Bawden,et al.  Towards an understanding of the personal experience of the 'yips' in cricketers , 2001, Journal of sports sciences.

[12]  M. Hallett,et al.  The pathophysiology of primary dystonia. , 1998, Brain : a journal of neurology.

[13]  A. Duggan Putting on the agony , 1992, Nature.

[14]  M Hallett,et al.  Hand cramps , 1988, Neurology.

[15]  Terence D. Sanger,et al.  Does dystonia always include co-contraction? A study of unconstrained reaching in children with primary and secondary dystonia , 2006, Experimental Brain Research.

[16]  O. Orlova [Focal dystonias]. , 1997, Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova.

[17]  C. Ghez,et al.  Trajectory control in dystonia. , 1988, Advances in neurology.