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Golfers: A Cure for the 'Yips'?

<ѻý class="mpt-content-deck">— Beta blockers could improve golfer's cramp in patients who look dystonic
MedpageToday

In this exclusive ѻý video, , of the Mayo Clinic in Arizona, explains that golfers who have a dystonic etiology of the yips have improved with the drug propranolol. At the 2019 in Philadelphia, he described his research.

Following is a transcript of his remarks:

We know that individuals with dystonia can develop what's called a task-specific dystonia. We know people can develop musician's cramp, typist's cramp, writer's cramp. I've been following a line of research trying to determine if golfers have something called the yips, which is a colloquial term. Golfers describe this involuntary jerk or twitch at the time of putting or chipping making an accurate, smooth swing. We've been trying to determine if a subgroup of those individuals have evidence of a dystonia or golfer's cramp.

We've reported in a journal -- and we've been doing this work for a while -- that certain golfers have co-contraction of the wrist flexors and extensors at a time when they have what appears to be an involuntary jerk that looks like dystonia. At the meeting [tomorrow], I'll be reporting that golfers who do have that form of the yips, what looks like golfer's cramp, have improved with the drug propranolol. A beta blocker has actually improved that. There's also improvement if they actually look at the hole, so as they're putting, if they look at the hole, there's some improvement, even more improvement if they took the drug propranolol.

That's opposed to golfers with the yips who don't look dystonic. There's not this consistent, involuntary movement. There's not nearly as much co-contraction of the wrist extensors and flexors. Those golfers did not improve with propranolol and did not improve when looking at the hole. Potentially, one of the first treatments, very small study, something that would need to be followed up on. Very few people have been doing work on dystonia in athletes, and we've tried to follow that line of research, and now not only look for markers of it, but also look for treatments.

Propranolol is banned by the PGA Tour, and it's banned by many different sports authorities because of the potential that it is performance enhancing. I think the most important thing for me as a scientist, as a neurologist, is are there people who need a drug that's banned for an underlying neurologic disease. Then there's really the question of is that the appropriate treatment? We've not tried other treatments in terms of this study. We do know that there are a few treatments that help people with task-specific dystonias in terms of oral medications. We know that botulinum toxin can be beneficial for people with task-specific dystonias. I've not studied botulinum toxin injections in golfers, but the first step for me was to use a very safe and easy medication to use in an outpatient clinical setting. Now that we've done that, first of all, we now have methods we believe we can use to study it and study the treatment. Now the question is what other treatments should we be studying and certainly, again, very small study that needs to be replicated.