Golfers' cramp: Clinical characteristics and evidence against it being an anxiety disorder

Abstract

The clinical characteristics of 20 golfers suffering from golfers' cramp or the "yips" are described. The typical description is that of a middle-aged golfer who has played competitive golf since his teens and develops the problem during a tournament in the form of a jerk, spasm, or freezing of movement while putting or chipping, with the rest of the game being relatively unaffected. The problem generally takes a chronic fluctuating course, and a number of 'trick' strategies are partially or fully successful. In this study, the subjects were compared with a matched group of 20 unaffected golfers on a number of indices of psychopathology; no significant differences emerged. The more severely affected golfers also did not differ significantly from the mildly affected ones, except on the subjective report of anxiety. These data support the argument that golfers' cramp is not an anxiety disorder or a neurosis. The important role of anxiety and arousal in its manifestation is, nevertheless, recognized and its pathophysiology speculated upon.

Self-report vs. kinematic screening test: prevalence, demographics, and sports biography of yips-affected golfers

“…The results show that high-handicap golfers with relatively little experience also report being affected by the yips. This seems to contradict the postulation that all forms of the yips are a task-specific focal dystonia (McDaniel et al, 1989;Sachdev, 1992). In this study, the prevalence of the yips across the entire skill range is estimated at around 22.4%.…”

“…Neurophysiological reasons for the yips have been postulated based on its physical manifestation and observed cocontractions, which are similar to those of task-specific focal dystonias (Adler, Crews, Hentz, Smith, & Caviness, 2005;Adler et al, 2011;McDaniel et al, 1989;Sachdev, 1992) such as writer's cramp (Hermsdörfer, Marquardt, Schneider, Fürholzer, & Baur, 2011) or musician's cramp (Altenmueller & Jabusch, 2009). Psychological reasons have been suggested based on the symptoms worsening under stress (Masters & Maxwell, 2008), and the yips has been discussed as a chronic and severe form of choking under pressure (Bawden & Maynard, 2001;Klämpfl, Lobinger, & Raab, 2013a, 2013b) -a drop in performance caused by a perceived mismatch of situational demands and the athlete's own resources to master the situation (Hill, Hanton, Matthews, & Fleming, 2010).…”

“…There is a growing demand for a standardised screening test (Klämpfl et al, 2013a;Philippen, 2012). Different methods have been applied to analyse the yips, including psychometric measures (McDaniel et al, 1989;Roberts, Rotheram, Maynard, Thomas, & Woodman, 2013;Sachdev, 1992), electromyographic measures (Smith et al, 2000), performance measures (Smith et al, 2000;Stinear et al, 2006), kinematic measures (Marquardt, 2009), and behavioural measures (Stinear et al, 2006). The application of a kinematic measurement of the putter head during the execution of a one-handed putt was estimated to be the most sensitive yips-detection method of an extensive test battery that included the aforementioned measurements (Klämpfl et al, 2013a).…”

Runner's dystonia

“…In patients with adult-onset dystonia, focal or segmental dystonia manifested by a variable combination of blepharospasm, oromandibular dystonia, and torticollis (cranial-cervical dystonia), is most common [3]. With the possible exception of "golfer's yip" which has been receiving increasing attention [4,5], adultonset, focal dystonia in lower limbs in athletes has rarely been reported. Specifically, dystonia in long-distance runners has never been described in the literature.…”

Decreasing Putting Yips in Accomplished Golfers via Solution-Focused Guided Imagery: A Single-Subject Research Design

“…An estimated 30% of experienced golfers have had the yips (Smith et al, 2000) and although the yips can emerge in any golf stroke (Achenbach, 2004;Haney, 2004), they are typically present during short putts (Smith et al, 2003). Those afflicted with the yips are often accomplished golfers with considerable playing experience (McDaniel, Cummings, & Shain, 1989;Sachdev, 1992;Smith et al, 2000). For example, Harry Vardon, Bobby Jones, Bernhard Langer, and Sam Torrance have each experienced this affliction at some point in their career (Achenbach, 2004;Palmer & Dobereiner, 1986).…”