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Medical Edge Newspaper Column from Mayo Clinic

GETTING TO THE BOTTOM OF GOLF ‘YIPS’

DEAR MAYO CLINIC: What is the status of the Mayo Clinic study of golf “yips?” — Santa Monica, Calif.

ANSWER: In July 2003, Mayo Clinic hosted a putting tournament to learn more about yips — an uncontrolled jerky movement that often affects golfers when they are putting. Yips can make putting nearly impossible, even for the most experienced golfers.

Previous research suggests that there is a continuum of causes for yips. At one end is performance anxiety — yips most often occur in tournaments. At the other end is a focal or task-specific dystonia — a neurological problem that results in sudden, involuntary contractions of a muscle or group of muscles. Dystonia also occurs most often during stressful conditions.

The putting tournament, complete with gallery and media, offered tournament-like pressure. Sixteen low-handicap golfers plagued by the yips were selected from a pool of 150 interested golfers.

To begin, the golfers had brief screening physicals and completed baseline measures of anxiety, mood and stress hormone levels. During the tournament, their heart rates were monitored and the signal was integrated with video. Golfers used special wired putters that detected grip force.

All study participants competed with three non-yips-affected golfers in their foursome. A subset of golfers was also studied with EEG (brain waves) and EMG (muscle activity).
The participants putted four holes under baseline conditions. Then, by random selection, participants either took a placebo or beta-blocker before the second four holes. Beta-blockers are a class of drugs that blocks the stimulating effect of adrenaline, which the body produces in stressful situations.

Yes, the tournament did cause some golfers to “yip” obviously and repeatedly. Investigators are still analyzing the data, which is expected to be published in 2005. We hope that the results lead to a better understanding of the causes of yips and to treatment options.

Mayo Clinic undertook this research because golf is a great physical activity, especially in an aging population. Yips can be so frustrating that people give up the game — and lose an outlet for an activity and exercise.

So far, there’s no proven cure for the yips. If you have the yips, it may be helpful to work with a golf teaching professional who can recommend techniques to lower your anxiety, or recommend an alternate grip or putter.

Aynsley Smith, R.N., Ph.D., Sports Medicine, Mayo Clinic, Rochester, Minn.

Additional Resources:
Treatment of Yips
Appointment Information for Yips
More Information on Yips

DEAR MAYO CLINIC: I have just been diagnosed with Factor V Leiden. Anything you can tell me about this would help. I’ve never heard of it.

ANSWER: Factor V Leiden (pronounced “Factor 5 LIE-den”) is an inherited blood disorder that puts you at greater risk for deep-vein thrombosis. In DVT, blood clots form in the deep veins of the legs and sometimes break off and travel to the lungs — which is a potentially life-threatening condition. Your doctor likely diagnosed Factor V Leiden by testing your blood’s ability to clot and performing genetic tests for the mutation.

Factor V Leiden refers to a specific mutation in a gene encoding a protein called Factor V, a normal and important component of blood-clotting. But the Factor V Leiden mutation allows blood clotting to proceed longer than necessary, resulting in an increased risk of developing harmful clots.

It is important to emphasize that the Factor V Leiden mutation is only a risk factor for deep-vein thrombosis. It is by no means a guarantee that you will develop a blood clot. A recent Danish study compared people who had one mutated copy and one normal copy of the Factor V gene (heterozygous) and people who had two defective copies of the gene (homozygous).

Results showed that for people under the age of 40 who maintained a healthy body weight and didn’t smoke, only1 percent of heterozygotes and 3 percent of homozygotes developed blood clots over a 10-year period. The people at highest risk of developing a DVT were over age 60, smoked and were overweight.

Additional risk factors for developing DVT include use of oral contraceptives or hormone replacement, prolonged air travel and a sedentary lifestyle. Avoid these risk factors as much as possible. Do not sit for long periods without standing up and stretching your legs. An if you notice swelling or a feeling of soreness or tiredness in one of your legs, see your doctor immediately.

John Heit, M.D., Hematology Research, Mayo Clinic, Rochester, Minn.

Additional Resources:
Factor V Leiden Treatment
Appointment Information
More Information on Factor V Leiden
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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.