YIPS Makes Putting Hard To Do

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 movement associated with the yips may:

  • Occur at the beginning or middle of your stroke
  • Come and go
  • Worsen during high-pressure situtations
  • The yips may result from neurological factors, psychological factors or a combination of both.

Neurological factors
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 factors
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.

A combination of factors
For some people who have a mild degree of focal dystonia, stress, anxiety or high-pressure situations can worsen the condition.

Neurological yips are associated with:

  • Older age
  • More experience playing golf
  • Lower handicap

Psychological yips can be a problem 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 symptoms worse.

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.

What is Chronic Exertional Compartment Syndrome?

Chronic exertional compartment syndrome is an uncommon, exercise-induced neuromuscular condition that causes pain, swelling and sometimes even disability in affected muscles of your legs or arms.

Anyone can develop chronic exertional compartment syndrome, but it’s more common in athletes who participate in sports that involve repetitive movements, such as running, fast walking, biking and swimming. Chronic exertional compartment syndrome is sometimes called chronic compartment syndrome or exercise-induced compartment syndrome.

Symptoms:

The pain and other symptoms associated with chronic exertional compartment syndrome may be characterized by:

1. Aching, burning or cramping pain in the affected limb — usually the lower leg, but sometimes the thigh, upper arm, forearm or hand

2. Tightness in the affected limb

3. Numbness or tingling in the affected limb

4. Weakness of the affected limb

5. Foot drop, in severe cases, if nerves in your legs are affected

6. Occasionally, swelling or bulging as a result of a muscle hernia

Pain typically happens soon after you start exercising the affected limb, gets progressively worse for as long as you exercise, stops 15 to 30 minutes after the affected limb comes to rest and over time, may begin to persist longer after exercise, possibly lingering for a day or two.

Taking a complete break from exercise may relieve your symptoms, but usually once you take up running again, your symptoms usually come back unless you continue to stretch and do keep up to date with your rehabilitative exercises.

If you experience unusual pain, swelling, weakness, loss of sensation, or soreness related to exercise or sports activities, talk to your doctor because these symptoms may be associated with conditions that require emergency medical treatment. Don’t try to exercise through the pain, as that may lead to permanent muscle or nerve damage — and jeopardize continued participation in your favorite sports.

Sometimes chronic exertional compartment syndrome is mistaken for shin splints. If you think you have shin splints but they don’t get better with self-care, talk to your doctor.

What are the causes?

Your arms and legs have several groupings, or compartments, of muscles, blood vessels and nerves. Each of these compartments is encased by a thick layer of connective tissue called fascia (FASH-ee-uh), which supports the compartments and holds the tissues within each compartment in place. The fascia is inelastic, which means it has little ability to stretch.

In chronic exertional compartment syndrome, exercise or even repetitive muscle contraction causes the tissue pressure within a compartment to increase to an abnormally high level. But because the fascia can’t stretch, the tissues in that compartment aren’t able to expand sufficiently under the increased pressure. Imagine shaking up a soda bottle but leaving the cap on — an enormous amount of pressure builds up.

As the pressure builds up within one of your muscle compartments, with no outlet for release, nerves and blood vessels are compressed. Blood flow may then decrease, causing tissues to get inadequate amounts of oxygen-rich blood, a condition known as ischemia (is-KE-me-uh). Nerves and muscles may sustain damage.

Experts aren’t sure why exercise or muscle contraction creates this excessive pressure in some people, leading to chronic exertional compartment syndrome. Some experts suggest that biomechanics — how you move, such as landing styles when you jog — may have a role. Other causes may include having enlarged muscles, an especially thick or inelastic fascia, or high pressure within your veins (venous hypertension).

In chronic exertional compartment syndrome, exercise or even repetitive muscle contraction causes the tissue pressure within a compartment to increase to an abnormally high level. But because the fascia can’t stretch, the tissues in that compartment aren’t able to expand sufficiently under the increased pressure. Imagine shaking up a soda bottle but leaving the cap on — an enormous amount of pressure builds up.

As the pressure builds up within one of your muscle compartments, with no outlet for release, nerves and blood vessels are compressed. Blood flow may then decrease, causing tissues to get inadequate amounts of oxygen-rich blood, a condition known as ischemia (is-KE-me-uh). Nerves and muscles may sustain damage.

Experts aren’t sure why exercise or muscle contraction creates this excessive pressure in some people, leading to chronic exertional compartment syndrome. Some experts suggest that biomechanics — how you move, such as landing styles when you jog — may have a role. Other causes may include having enlarged muscles, an especially thick or inelastic fascia, or high presse within your veins (venous hypertension).

What are the risk factors?

The condition is most common in athletes under 40, although people of any age can develop chronic exertional compartment syndrome.

People most at risk of developing chronic exertional compartment syndrome are those who engage in exercise that involves repetitive motions or activity. Young female athletes may be at particular risk, for reasons unknown.

Risk factors include engaging in such sports, exercises and activities as:

  • Running
  • Football
  • Soccer
  • Biking
  • Tennis
  • Gymnastics

Overuse of your muscles or overtraining — that is, working out too intensely or too frequently — also can raise your risk of chronic exertional compartment syndrome.

Chronic exertional compartment syndrome isn’t a life-threatening condition and usually doesn’t cause any lasting or permanent damage if you seek appropriate treatment. However, if you continue to exercise despite pain, the repeated increases in compartment pressure can lead to muscle, nerve and blood vessel damage. As a result, you may develop permanent numbness or weakness in affected muscles.

Perhaps the biggest complication of untreated chronic exertional compartment syndrome is its impact on participation in your favorite sports — the pain may prevent you from being active.


Don’t try to exercise through your pain. Limit your physical activities to those that don’t cause pain. For example, if running bothers your legs, you may be able to swim. Use ice or take omega 3s until you can see your doctor and make sure this is NOT an emergency.

The following basic sports and fitness guidelines can help protect your health and safety during exercise:

  • Warm up before starting exercise.
  • Cool down when you’re done exercising.
  • Stop if you’re in pain.
  • Check with your doctor before starting a new exercise program if you have any health issues.
  • Eat a healthy, balanced diet.
  • Stay hydrated.
  • Engage in a variety of physical activities.

Sections of this article are published on https://www.mayoclinic.com/health/chronic-exertional-compartment-syndrome/DS00789

How To Prevent Tommy John Surgery

Tommy John surgery has become something that most big league pitchers and players have to consider when having elbow pain.  Throwing, especially at high speeds puts a lot of stress on the elbow.  Repetitive throwing can lead to swelling and tearing of the Ulnar Collateral Ligament in the arm. This ligament keeps the Humerus, Radius and Ulna in place and provides mobility of the elbow.

Compared to the larger muscles and ligaments in the body, this ligament is not as strong as knee ligaments (Anterior Cruciate Ligament).   Our body also wasn’t designed to perform high velocity throwing for years.  In time, if enough pressure is applied to the elbow, it will tear apart causing pain and effecting the velocity of throwing.

It is common for major league pitchers to have Tommy John Surgery.  Surgeons take some of the tendon of the players “good” forearm or hamstring and put it into the “bad” elbow.

They also drill holes in the ulna and humerus bones to sew it in.  Sounds easy huh?  Well, there are some concerns with this surgery.  In order to move the ulnar nerve away, surgeons have to cut or detach major muscles.  This can lead to infection, fractures, nerve irritation, numbness and inability for the muscle to function properly.  It is also pricey.  This surgery can run between $10,000 and $20,000.

Proper stretching, weight lifting can help pitchers stay away from this painful and expensive surgery.  Exercises with elbow pronation, supination and flexion are key to keeping the elbow in proper condition and ready to take the added stress of throwing a ball 100mph.

As chiropractors, we help keep prevent this surgery by keeping the joint in its proper position,  allowing the muscles and ligament to remain strong and work out any tissue damage that may have occurred.  We are a great option.

Complex Regional Pain Syndrome

Complex regional pain syndrome “CRPS” occurs when a you have severe pain typically affecting one arm or leg. Often this problem begins after an extreme injury.

Symptoms include strong, burning pain in your extremity (leg, foot, arm or hand). You may also experience swelling, stiffness and damage to the area involved. Decreased movement, muscle loss, weakness or spasms may also become frequent. Skin temperature changes from hot to cold, alterations of color from white to red and blue with tender, thin and shiny skin are also common with this type of problem.  This pain, if untreated will get worse.

This syndrome happens after experiencing a Shrapnel blast, gunshot wound, surgery, heart attack, fractures or infections. Your nerves can be highly affected by this type of trauma to your body.

If you are experiencing this problem, please give us a call we can help!

Anterior Compartment Syndrome Can Be Serious

Compartment syndrome is a serious condition that involves increased pressure in the lower leg.  It can lead to muscle and nerve damage and problems with blood flow.

Causes:
There are tissues called fascia that are wrapped around groups of muscles which separate them from one another so we can move each of them individually.   Inside each layer of fascia is a space known as a compartment. Inside this compartment includes muscle tissue, nerves, and blood vessels. Fascia surrounds these structures and allows them to work properly.

Fascia has trouble expanding.  If there is swelling it will increase the pressure in that area, pressing muscles, blood vessels, and nerves.  This pressure if it is high enough, blocks blood flow to the area.  If not treated, the tissues can become permanently injured because of the lack of oxygen and blood flow. Muscles can die and the leg may actually be amputated.   So treating this condition is imperative.

Swelling can occur from car accidents, crushing the muscles and tissue, fractures, or numerous soft tissues.

Life-time athletes can get compartment syndrome from the repetitiveness of their sport.  It is very common in runners.

The most common areas in the body where this syndrome occurs is in the lower leg and forearm.  It can also occur in any extremity in the body.

What are the symptoms?
The most common way of determining if you have compartment syndrome is severe pain that doesn’t go away when moving the affected extremity even if on pain medication!  Here are some other symptoms:

  • Decreased sensation
  • Loss of color on the skin
  • Severe pain that keeps getting worse
  • Weakness in the affected area
  • Severe pain when squeezing or moving the affected area
  • Swollen and shiny skinHow do we manage this problem?
    If not severe and in early stages, Graston Technique can be very effective.  Graston allows tools to get into the muscle and fascia and release the pressure and blood will begin to filter instead of pool in the area.  Adjustments of the joint can also help with better movement and releasing of the fascia.  If pain and symptoms still persist, surgery is sometimes performed to release the pressure.Surgery consists of long cuts made to the fascia to relieve the pressure and get blood flow.  After the surgery it is important to recondition the tissues and keep blood flowing to the area and allow for proper re-growth.  Graston, Cold Laser, exercises and chiropractic treatment are helpful after surgery as well.

The good news is that if you have this problem and it is managed correctly, you can go back to your daily activities without a problem.  It is hard work but the body can be restored.

If you are having extremity pain, call us at our Redwood City Office, we can help.

Tennis Elbow… What Can Be Done?

“Tennis elbow” or what may be referred to as “lateral epicondylitis” is caused by misuse or overuse of the forearm muscles. It normally results in pain on the outside of the elbow (lateral epicondyle). It is common with tennis players but anyone can have this problem.

When can you tell if you have Tennis Elbow?

  1. Pain on the outside of the elbow
  2. Pain occurs when shaking hands or gripping objects
  3. Pain with twisting with force, opening jars, even using a toothbrush or holding a knife or fork may cause pain.

Proper function is key to help you prevent chronic problems with your elbow. Chiropractors can help alleviate this pain and dysfunction in the body without drugs, cortisone shots or surgery! We can diagnose this problem using orthopedic tests and by studying the way your arm moves and functions. We perform soft tissue work, muscle and bone alignment to make sure your arm is operating properly. After your pain is gone, we will incorporate exercises in your treatment to prevent further tearing and stress on the joint and teach you proper body movement.

If you think you may have tennis elbow, chiropractic can help. Give us a call at 650.353.1133.

Dr. Amie B. Gregory
Precise Moves Chiropractic
Sports and Extremity Chiropractor located in Redwood City, CA