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Exercise, Sports and Tourette Syndrome

by Mitzi Waltz

Soccer star Tim Howard, baseball MVP Jim Eisenreich, and NASCAR driver Steve Wallace have something in common. You probably already know that it’s Tourette syndrome. There’s more than a diagnosis connecting these men, however. TS may very well have been a driver in their sporting success, not an impediment to overcome.

That’s because a bit of obsessiveness, repetition and high energy are nothing but helpful for the would-be sports champion. Indeed, neurologist Oliver Sacks has suggested that extraordinarily quick reflexes may be a beneficial core feature of TS1—and obviously this would be an advantage for anyone participating in sports.

In return for their hard work, sports gave these champs many benefits, including self-discipline, better health, and (important for young people who are often the target of cruel taunts) a way to show up those who teased them for ticcing.

Better Health and Fitness

So what is known about the potential benefits of exercise programs and participation in sports for people with TS? Only one thing is certain: your mileage may vary. There is no study proving that a particular form of exercise will reduce tics or improve TS-related symptoms for everyone, although there are many reports of people finding personal benefit from a wide variety of physical pursuits. For some, tic reduction is among these.

Many people find that sports or forms of exercise that are both mentally and physically involving can be especially helpful. The kind of sports that keep you constantly paying attention and moving—obvious examples include ice hockey, soccer, squash and tennis—are more likely to fill the bill than those that easily allow the mind to wander or include periods where you are standing still until the action starts again.

Another way that exercise can be helpful is its power to reduce anxiety and the mental stress that causes it. As Barbara Moe has written, “one of the best and most helpful ways to relieve stress is exercise.”2 Librarian Josh Hanagarne took up weightlifting and found that learning to control his muscles really helped. “My symptoms didn’t change,” he said. “But the discipline I’ve picked up along the way makes everything seem bearable.”3

Another important reason for exercise is the side effect of neuroleptic medications that everyone who takes them dreads most: weight gain. Research has shown that as part of a plan that also includes diet and behavioural therapy, exercise can help prevent and even roll back weight gain from medications like risperidone and olanzapine.4

As with anything that some people with TS find helpful, not everyone finds sports or exercise to be all they’re cracked up to be. Overdoing it to the point of fatigue can make tics worse, pressure to perform well in competitive sports may increase stress, and a few people report that their tics actually increase when they do vigorous exercise. Finally, those with an additional diagnosis of OCD may find that their chosen activity becomes an obsession, and so may need to set personal limits on practice time.

Handling Difficult Situations

Assuming that you find a positive benefit from the sport or exercise of your choice, the only potential down side is dealing with unhelpful attitudes at the gym, in exercise classes, or on sports teams. Different people handle situations in different ways. Here are two different approaches , each with its positives and drawbacks. Approaches that work for one person may or may not work for another.

It helps to be up front, says Lainie, 43, who has been attending yoga and aerobics classes at a community center for about eight years:

“I have vocal tics and because I have some health problems in addition to TS I haven’t been able to take medication for a long time now. I met with the manager of the community center and explained that I really needed to be able to take these classes, and that I didn’t want to anyone to be shocked or to stare if I ticced during a class. She talked to the instructors, who told the other students about my TS before I started. I still felt kind of funny the first couple times I made a noise but everyone has been supportive.”

Jake, 21, says an “in your face” attitude has worked better for him. “I was teased mercilessly in high school football until I put on an act like I could care less,” he says. “I insulted anybody back who got started. It may not be the ‘nice’ way but a lot of guys who play ball are just jerks really and being nice is not going to get you anywhere with them. If they find out something bothers you, they’ll ride you til you’re sick of it. My insults were funnier than theirs so I was able to turn it around.”

Sometimes teasing is part of sports. However in all cases, one must take care to use humor appropriately so that indeed the best aspects of your personality are put forward. Only you can know whether, how and when to take this approach. You do not want use of humor to “backfire” or be seen as provocative when what you mean to do is assert yourself in a positive fashion.

Finally, although most of the examples in this article are of traditional sports, any activity that gets your heart pumping and your motor running can be helpful. Dancing, canoeing, rock-climbing, skateboarding, even “extreme sports” like parkour/freerunning, base jumping and skydiving can provide better fitness and a “legal high” that beats anything else on offer.

References

1 Sacks, Oliver (1985) The Man Who Mistook His Wife for a Hat. New York: Summit Books.

2 Moe, Barbara (2000) Coping With Tourette Syndrome and Tic Disorders. New York: Rosen Publishing Group.

3 Hanagarne, Josh (2009) “Moving my body, saving a life,” Xtreme Human Performance, 8 October. Online at: http://extremehumanperformance.com/blog/moving-my-body-saving-a-life/ [Accessed 10 January 2010]

4 Vreeland, B., et al (2003) “A program for managing weight gain associated with atypical antipsychotics,” Psychiatric Services, 54: 1115-1157.



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