Clumsy is a disorder of kinesthetic senses (decreased performance) that occurs in growing children, and is said to be caused by the brain's inability to keep up with the rapid growth of the body.

Yips is a phenomenon in which athletes lose their physical and mental balance, making it difficult to perform the initial movements of a game. In the manga "Ashita no Joe", there is a scene in which the main character is unable to punch the opponent's face (he can only punch the body) due to emotional trauma.

Osgood's disease (hereinafter abbreviated as Osgood's disease) is said to cause pain below the knee (near the tibial tubercle) in a background similar to that of Clumsy (rapid growth during the growth period).

Expressed from the perspective of brain science and cognitive neuroscience, Clumsy is a motor circuit error that occurs during growth, Yips is a motor circuit error that can occur in all generations, not just during growth, and Osgood is a motor circuit error that occurs during growth. It is a pain below the knee associated with an easy motor circuit error.

Clumsy and Osgood pointed out that the rapid growth of the musculoskeletal system (hard expansion) cannot keep up with the brain's neural response (soft update), resulting in ataxia of kinesthetic sense (performance decline) and pain. cause

Both are well-known concepts among junior sports leaders, coaches, primary care medical staff, and sports trainers as phenomena that plague children.

On the other hand, there are various styles of onset of yips, and it can be roughly divided into transient yips that spontaneously recovers and intractable yips, and the latter is often diagnosed as focal dystonia. In other words, before a patient with focal dystonia is diagnosed with it at a neurology department, someone else asks, "Isn't that Yips?" There is a case that I have been thinking about it ….

focal dystonia

A phenomenon in which abnormalities occur in motor circuits in the brain, causing abnormal contraction of local muscles against the person's will. In Japan, neurology is the main medical field, but in recent years, applying electrical stimulation to the brain has become an option.

In other words, yips and focal dystonia are similar but different in the first place, but recently there are medical professionals who insist that yips is not a mental problem. so be careful.

Many transient ips have problems in the dimension of the initial firing of the motor circuit (exercise motivation, etc.), and there are many reports of spontaneous recovery through psychological approaches and the athlete's own mental training and image training.

In recent years, Mr. Ichiro, who was in high school, looked back, ``Throwing the ball to the third-year catcher by a first-year pitcher was like throwing the ball to God in the atmosphere of the athletic meet at the time, and the mental pressure made it impossible to pitch.'' Experience story is famous.

After that, Ichiro overcame Yips by mastering his own self-control. The person himself looks back on his own resilience (recovery) with the word "sense". Athletes with excellent metacognition can overcome it with this method... A historical athlete teaches us the actual situation of yips.

On the other hand, the detailed mechanism of whether focal dystonia affects a wide area of the motor circuit or only one area, and what kind of disorder it specifically causes is unknown. Although the pathology has not been elucidated, in Japan, treatment is performed by applying electrical stimulation to the relevant areas in the brain.

For example, a well-known example is the recovery from focal dystonia (involuntary contraction of muscles that occurs in musical instrument players) by electrical stimulation of the brain.

What is diagnosed as dystonia by a neurologist is basically a pathological condition on a different dimension from the yips that Ichiro experienced.

Clumsy is a concept widely recognized internationally among coaches and trainers of junior soccer and junior tennis, and it is known that the incidence varies according to race and country.

In soccer, many complained that they could not run fast, had a bad feeling when kicking the ball, and became easily tired. There are complaints such as feeling worse).

For Clumsy athletes, many sites focus on avoiding overtraining and encouraging large-scale exercises that use the entire body. It seems that the response is such as "I will watch over the players so that they will not be cornered."

Japan's success in the 2022 World Cup has become a hot topic, but Daichi Kamata is known to have suffered from crumsey when he was a junior. There is an episode that when I belonged to the junior youth team of Gamba Osaka, I told my father, "When will my body be able to move the way I want?"

Professional soccer players such as Kiyotake and Honda are said to have experienced clumsy.

It's a change of environment. In general, when an athlete falls into a slump, it is often caused by a change in the team he belongs to, a change in the training environment, a change in the personal relationships surrounding the athlete, such as a coach or teammate, etc. It is said that.

After working as a tennis instructor, I turned to the medical profession, and since then I have worked as an exclusive trainer for top athletes. More than 80% of the participants observed some kind of environmental change.

For example, in the case of Kamata, who was mentioned earlier, when he developed clumsy when he was in junior high school, he was left in the care of his grandparents in Osaka, far from his home in Ehime Prefecture, and spent his days attending clubs.

At that time, my relationship with my grandmother was strained, and she once told me to go back to Ehime. and expressed gratitude).

Also, after entering junior high school, I had the misfortune to break my hips and hands almost every year and be out for several months. Under these circumstances, Kamata's experience of Clumsy was that she began to experience discrepancies in her own senses and suffered from declining performance.

From here, it is my personal opinion. I believe that there is a mechanism that does not exist.

In other words, it is not just a physical problem, such as a sudden increase in height, but also the problem of mental and physical environmental factors. That's the view.

Therefore, in my field, I focus on listening counseling for Clumsy players, and while grasping the various internal factors, I take all measures that contribute to improving the metacognition of the players themselves. In fact, our clinical data show that such an approach leads to a smoother recovery.

In fact, the same can be said for Yips and Osgood. Especially in Osgood, it seems that there are many patients who generally receive treatment at plastic surgery or osteopathic clinics. Treatment system) and take an approach that is close to the person's feelings will lead to a smooth recovery.

So far, I have spoken to Clumsey, Yips, and Osgood from the perspective of Cognitive Science Integrated Approach (COSIA). I would appreciate it if you could give me some hints for those who read this article.

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For those interested in Cognitive Science Integrated Approach (COSIA)

The Cognitive Science Integrated Approach (COSIA) is a concept that represents the “integration of cognitive science and medicine” and has its origins in pain management in musculoskeletal primary care.

In the current situation where image labeling and diagnosis of the cause of pain diverge, the International Association for the Study of Pain (IASP) has revised the definition of pain and is shifting to the "emotional origin theory of pain."

If you are interested in COSIA, please visit the "Special Site for Medical Professionals and Therapists". We look forward to your participation.