Widespread 'yips' problem in golf may have physical, psychological causes

December 27, 2000

ROCHESTER, MINN. -- A phenomenon in golf known as the "yips" -- an acquired problem of sudden tremors, jerking or freezing while putting -- may have both physical and psychological causes, according to a summary of current Mayo Clinic research published this week in Sports Medicine. Aynsley Smith, Ph.D., Director of Sport Psychology and Sports Medicine Research at Mayo Clinic, says preliminary research indicates that more than 25 percent of avid golfers develop the yips, which adds an estimated 4.7 strokes to the average 18-hole score of an affected player.

A problem called dystonia, which is very similar to some cases of the "yips," also affects musicians, stenographers, dentists and others who frequently are forced to repeatedly assume a prolonged, abnormal posture.

The first phase of the Mayo Clinic study consisted of a questionnaire completed by 1,031 under 12 handicap tournament players registered with the Minnesota Golf Association. The 453 yips-affected players retained in the study who had an average handicap of 4.5 said they had experienced the problem for six years, although they had been participating in the sport for an average of 30 years. Fast, downhill and left-to-right breaking putts of two to five feet were most likely to produce symptoms, although long putts caused problems for some golfers. Playing in or leading a tournament, tricky putts and playing against specific competitors were also associated with yips episodes.

"While pressure situations make the problem worse, it is difficult to imagine why good golfers would suddenly begin having the yips after years of successful performance if it was only a matter of anxiety or 'choking,'" says Dr. Smith. "Although performance anxiety may cause the yips in many golfers, muscle and nervous system deterioration caused by prolonged overuse may be at the root of the problem for other players. This may explain why some get relief and play successfully by changing their grip or by switching to a longer putter."

In the second phase of the Mayo research, investigators measured the heart rate, arm muscle activity and grip force while putting of four yips-affected golfers and three non-affected counterparts. Those with the yips had higher average heart rates and demonstrated increased muscle activity, particularly in the wrists. In addition, while non-affected golfers were able to make an average of nine out of 10 consecutive five-foot putts, the yips-affected golfers only made half of theirs.

Mayo Clinic researchers from Rochester (Minn.), Jacksonville (Fla.) and Scottsdale (Ariz.) hope to collaborate with Arizona State University Golf Researcher Debbie Crews, Ph.D., in a study next August that would examine a much larger sample in tournament conditions designed to heighten anxiety. The study will test psychological variables, brain waves, stress hormones, heart rate, muscle activity, grip force and putting performance in both "yips" affected and non-affected golfers under baseline, placebo and beta blocker conditions. The study will also test whether beta blockers are beneficial not only in treating the problem but also in improving putting performance. The Ladies Professional Golf Association (LPGA) is the first organization to pledge financial backing for the new study. Information on Phase III is available on the web at http://www.mayo.edu/research/yips/.

Dr. Smith says the yips problem is significant to health professionals. "Regular physical activity is important to long-term health. Golf is an international sport that is now enjoyed by over 26 million Americans. It would be unfortunate if frustration caused by the yips leads competent golfers to abandon the game and thereby lose their preferred activity outlet."
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Mayo Clinic

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