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 yips that are caused by a focal dystonia, which is a neurological dysfunction affecting specific muscles.

Some people have found relief from the yips by changing the way they perform the affected task. For example, a right-handed golfer might try putting left-handed.

The involuntary movements associated with the yips may:

• Occur at the beginning or middle of your stroke
• Come and go
• Worsen during high-pressure situations

The yips may be caused by neurological or psychological factors.

Neurological
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.

Psychological
In a pressure situation, some athletes become so anxious and self-focused — over-thinking to the point of distraction — that their ability to execute a skill, like putting, is impaired. Choking is an extreme form of performance anxiety that may compromise a golfer's game, and for some, it can trigger the yips.

Neurological yips are associated with:

• Older age
• More experience playing golf
• Lower handicap

Psychological yips, or choking, can be acquired at any age and experience level. When you start to have episodes of the yips, you lose confidence, worry about recurrence and feel anxious whenever you have to putt. These reactions can perpetuate the cycle — your increased yips-related anxiety makes your yips symptoms worse.

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

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 your symptoms on command.

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Cross-handed grip

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. However, if you have the type of yips related to performance anxiety, changing your grip likely won't make much difference.
• 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.