Sports Injuries

Yips are involuntary wrist muscle spasms that affect athletes. They are often associated with golf, baseball, and sports that involve swinging and throwing motions, such as bowling, darts, cricket, and others. Can understanding the information and causes help diagnose and find the right therapy or training?

Yips

Yips are involuntary wrist spasms that athletes experience. The term is also used to refer to performance anxiety without physical spasms. Researchers believe they are caused by muscle overuse that leads to dystonia (a condition that causes muscles to contract involuntarily), and combined with psychological factors like performance anxiety and overthinking, can make them worse. (Beacon Health Systems, 2024)

Types

Researchers have identified three types of yips that affect athletes (Clarke P. Sheffield D. and Akehurst S., 2020)

Type I

• Muscle spasms
• Freezing up/choking

Type II

• Performance anxiety
• Psychological symptoms

Type III

• Muscle spasms
• Performance anxiety

A study of over a hundred experienced athletes found that nearly 68% of archers and 40% of golfers experienced yips. (Clarke P., Sheffield D. and Akehurst S. 2020)

Symptoms

The most common symptom is muscle spasms, often in the hands and wrists. That’s why it is the most common among athletes who play sports that require precision hand and wrist movements. Yips affect fine motor skills. (Aoyama, T. et al., 2021) In addition to muscle spasms, symptoms can also include: (Beacon Health Systems, 2024)

• Twitching
• Tremors
• Freezing up
• Psychological distress

Causes

Healthcare providers, trainers, coaches, and researchers know that psychological and physical factors cause yips. Underlying physical causes include overusing wrist muscles, which leads to dystonia or involuntary muscle movements. Also known as task-specific dystonia, it can also affect individuals who engage in repetitive muscle movements, like factory and assembly line workers, store check-out clerks, musicians, etc. (Clarke P., Sheffield D., and Akehurst S. 2020). Performance anxiety and psychological stress can worsen dystonia. (Aoyama, T. et al., 2021) Athletes can become so focused on their movements that they overthink their actions and perform worse. Individuals who have anxiety, self-consciousness, or stress about a game or performance often find that their involuntary wrist spasms are worse. (Clarke P., Sheffield D. and Akehurst S. 2020)

Increased Risk

Yips are most common in athletes who use their hands and wrists for their sport and are likely to impact more experienced, competing, and older athletes. (Beacon Health Systems, 2024) They are more common in athletes focused on smaller movements or shorter distances. For example, golfers commonly experience involuntary wrist spasms when putting, and baseball players are likelier to experience them when throwing less than 20 meters. (Clarke P., Sheffield D. and Akehurst S. 2020)

Diagnosis

There is no official diagnosis for yips. However, a coach, athletic trainer, sports doctors, and others can observe the pattern of symptoms and behavior and provide an informed diagnosis.

Treatment

Identifying triggers is important as yips can be triggered by: (Aoyama, T. et al., 2021)

• Psychological distress - anxiety and/or fear
• Abnormal sensations
• Symptoms of discomfort and pain
• Mechanical movement/motion adjustments or changes 

Once trigger/s are identified, they can be addressed. Treatments that can help include: (Beacon Health Systems, 2024)

Alternate Hand Positions

• This can provide relief from dystonia and overthinking.

Using Different Equipment or Stabilizers

• This allows the immobilization of certain muscles and the activation of different muscles.

Mindfulness

• Reducing anxiety and distress can help relax the body.
• Practicing mindfulness before games or tournaments can help reduce psychological triggers.

Botox Injections

• Botox injections can treat certain types of dystonia.

Sports Psychology

• A sports psychologist is a healthcare provider who studies individual athletes' sports performance and how it affects their minds and skills.
• A sports psychologist can help individuals create a program that reduces stress or anxiety around games and performance.

Injury Medical Chiropractic and Functional Medicine Clinic

Yips are common among athletes. It is important to address the physical and psychological components to treat the condition. Talking with a coach or a sports psychologist, other athletes, and supporting staff like trainers can help you find a solution. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Sports Injuries

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Beacon Health Systems. (2024). Yips. https://www.beaconhealthsystem.org/library/diseases-and-conditions/yips/

Clarke, P., Sheffield, D., & Akehurst, S. (2020). Personality Predictors of Yips and Choking Susceptibility. Frontiers in psychology, 10, 2784. https://doi.org/10.3389/fpsyg.2019.02784

Aoyama, T., Ae, K., Souma, H., Miyata, K., Kajita, K., Kawamura, T., & Iwai, K. (2021). Difference in Personality Traits and Symptom Intensity According to the Trigger-Based Classification of Throwing Yips in Baseball Players. Frontiers in sports and active living, 3, 652792. https://doi.org/10.3389/fspor.2021.652792

Nerves control muscle fibers. Muscle twitching is an involuntary contraction of the muscle fibers. When individuals play sports/work out vigorously or for a long time, they may experience muscle twitching and can often see and/or feel the twitches happening. The most worked-out muscles are likely to twitch, which includes the biceps, thighs, and calves, but twitches can occur in any muscle. Chiropractic care, massage therapy, and functional medicine can help relax the muscles, improve circulation, restore function, and train individuals to prevent future episodes.

Muscle Twitching

A muscle twitch often occurs after intense physical activity or a hard workout because the muscle or muscles have been overworked, and there is hyper-excitability of the nerve/s that makes the muscle/s continue to contract.

• A muscle twitch that can be seen is called fasciculation.
• A muscle twitch that cannot be seen is called fibrillation.
• If there is pain or the twitching is prolonged, it is a muscle spasm.

Causes

The most common causes include the following:

• Intense exercise and rigorous physical activity build up lactic acid in the muscles.
• Dehydration is a very common factor for shaky muscles.
• Vitamin D and calcium deficiencies could cause muscle spasms in the hand, calves, and eyelids.
• Using caffeinated products to increase physical performance.
• Not enough or a lack of healthy sleep.
• Anxiety or stress.
• Certain medications like estrogen and corticosteroids.
• Nicotine and tobacco use.

Physical Activity/Exercise

• Intense exercise and physical activity can cause muscle fatigue.
• Muscle fatigue triggers twitching and cramping in overworked muscle fibers.
• Electrolytes play a role in muscle contraction.
• Electrolyte loss and imbalances within muscle fibers through sweating can lead to twitching.

Dehydration

• Muscle mass comprises 75% water.
• Water carries nutrients and minerals to muscles to support function.
• Not being properly hydrated can cause twitching and cramping.

Vitamin D Deficiency

• Nerves need vitamin D to relay messages to and from the brain to the body's muscles.
• A vitamin D deficiency can cause muscle weakness and twitching.

Magnesium Deficiency

• Magnesium deficiency is known as hypomagnesemia.
• Magnesium plays a role in maintaining nerve and muscle health.
• Magnesium helps transport calcium across cell membranes to support nerve and muscle function.
• A magnesium deficiency can cause twitching anywhere in the body, including the face.

Causes of magnesium deficiency include:

• Poor diet
• Diarrhea
• Drinking too much alcohol
• Not addressing magnesium deficiency can increase the risk of cardiovascular disease.

Caffeine

• Caffeine is a stimulant.
• Drinking too much coffee, tea, or energy drinks can cause fasciculation.

Not Enough Sleep

• Brain chemicals or neurotransmitters transmit information from the brain to the nerves that control muscle contraction.
• Sleep deprivation can affect how neurotransmitter receptors work.
• This means excess neurotransmitters can build up in the brain.
• Lack of sleep can affect neurotransmitter function.
• A common site of fasciculation tiredness occurs in the eyelids.

Anxiety and Stress 

• Experiencing psychological stress or high anxiety levels can cause excess muscle tension.
• This can lead to muscle twitching.
• Muscle fasciculation caused by stress can occur anywhere in the body.

Certain Medications

• Certain medications can lead to involuntary muscle twitching.
• The reaction can be a side effect due to interactions with other medications.
• Individuals should discuss side effects and medication interactions with their doctor when taking a new medication.

Chiropractic Care

Chiropractors are experts on the musculoskeletal system and have many techniques to treat muscle fasciculation and spasms. It often depends on the cause/s, and specific treatment varies on a case-by-case basis. Common chiropractic treatments include:

• Massage therapy
• Heat and ice therapy
• Manual manipulation
• Joint adjustments
• Ultrasound
• Stretches to keep the muscles flexible
• Exercises to strengthen the muscles
• Nutritional recommendations

Fasciculation

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Bergeron, Michael F.. Muscle Cramps during Exercise-Is It Fatigue or Electrolyte Deficit?. Current Sports Medicine Reports July 2008 - Volume 7 - Issue 4 - p S50-S55 doi: 10.1249/JSR.0b013e31817f476a

Gragossian A, Bashir K, Friede R. Hypomagnesemia. [Updated 2022 May 15]. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500003/

Küçükali, Cem Ismail, et al. "Peripheral nerve hyperexcitability syndromes." Reviews in the neurosciences vol. 26,2 (2015): 239-51. doi:10.1515/revneuro-2014-0066

Maughan, Ronald J, and Susan M Shirreffs. "Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining." Sports medicine (Auckland, N.Z.) vol. 49, Suppl 2 (2019): 115-124. doi:10.1007/s40279-019-01162-1

Miller, Kevin C et al. "Exercise-associated muscle cramps: causes, treatment, and prevention." Sports health vol. 2,4 (2010): 279-83. doi:10.1177/1941738109357299

Riebl, Shaun K, and Brenda M Davy. "The Hydration Equation: Update on Water Balance and Cognitive Performance." ACSM's health & fitness journal vol. 17,6 (2013): 21-28. doi:10.1249/FIT.0b013e3182a9570f