If you’re a sports fan, you’ve very likely heard of the “yips” at some point in your life. Chuck Knoblauch’s inability to throw the ball to first base. Markelle Fultz’s hitch while shooting a standstill three or free throw. Rick Ankiel tossing wild pitch after wild pitch for the Cardinals during the playoffs. Countless golfers who whisper about it in the shadows.

The official diagnosis for “yips” is task-specific focal dystonia. It’s characterized by involuntary changes in muscle activation, and in some cases, changes in the brain’s basal ganglia—a key area that coordinates movement. This results in an inability to perform the task and, naturally, a ton of internal anxiety from internal expectations and external commentary, ie. “WTF is wrong with him/her, OMG, so weird…is it mental?”

It’s almost certainly mental and that’s perfectly okay. Everything is mental and in our heads. There are multiple purported causes for task-specific focal dystonia, one of which is pain related.

In my last piece (which you can read here), I detailed how an athlete being medically cleared to play doesn’t mean they’re pain-free because pain is inherently a multifactorial experience. Damaged tissue contributes, especially in the short-term, but things like expectations, previous experiences, and stress also contribute to the lens of what is painful or not. This visual sums up the relationship quite well.

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To add to that foundation of pain science, the following is critical to understand: The brain is the ultimate librarian. It categorizes and files everything. Information is power. Organized and actionable information is even more powerful. In many cases, the brain will capture all the ingredients of a moment and mix it into a common cookie dough of memory. This is termed a “neuro-tag.” The more impactful the moment, the stronger the tag.

For example: ever had a certain smell, taste, or see something that triggers certain feelings or sensations? Yup, that’s a neuro-tag at work. The same thing goes for movements that are painful.

The brain will “tag” movements that are painful and the body needs to avoid, often including the specific environment and context in which the painful movement happened. The “strength” of the tag can be based on how impactful the original injury was. For example, in ACL ruptures, one of the last things to subside for athletes is the fear of re-injury/movement, aka kinesiophobia.

Or it can be based on how often that pain is triggered. If an athlete feels pain during a certain movement but continues to play through it due to internal pressure like having their livelihood on the line or external pressures like coaches, fans, and teammates expecting you to the be the final piece of “the process,” that neuro-tag and association between that specific movement and pain grows stronger and stronger.

This pain association naturally causes a mismatch between desire and survival, leading to a tug of war. Think of it like this: the first time you touch a hot stove, you immediately recoil and the brain associates the stove with pain and “we’re not doing that again.” If you now went to touch that stove, your reaching movement toward the stove won’t be nice, relaxed and fluid. Rather, your hand may tremble, the arm may reach and recoil, other muscles may tense up, and even though you’re internally yelling at yourself to “just touch the damn stove, because deep down in places you talk about at parties, you want me on that stove! You need me on that stove!”, there’s still hesitation.

That description sounds pretty similar to a hitch. Does that mean you’re “mental” or anything else like that? Absolutely not. I’d be worried if you didn’t have a hitch! In that case, I’m raising my eyebrow at why your brain isn’t trying to protect its container and vessel – the body.

It’s no different for an athlete. If he or she has been conditioned to feel pain with a certain movement/context and is now saying, “Hell nah, brah,” as the athlete approaches a specific part of the movement that it interprets as painful, the red-hot stove if you will, that “hell nah” results in hesitation, muscle tensioning and improper sequencing. All reinforced & potentially exacerbated by internal anxiety and external expectations.

I’ve personally seen and handled cases with individuals who had “the yips,” and it’s a process that requires a lot of work and addressing multiple factors. However, I hope this piece pulled back the curtain a bit so next time you’re on Twitter about to type “WTF? TRADE ASAP,” you think about it and type, “Damn, that must really suck. I feel for him and hope he gets through this with the necessary help and support network.”

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