Shooting with Essential Tremors (ET)

[DocMcG]

Greetings!

I have asked several individuals at multiple matches about a condition known as Essential Tremors and shooting, unfortunately, I have not found anyone that can help. A bit of background; Essential Tremors (ET) is an inherited neurological condition that has several symptoms, one of which is exceptionally pesky - crazy shaking! If diet, blood sugar and, yes, even stress are aggravated, the shaking begins. You can imagine how frustrating this is! I shoot three-gun and function with shotgun and rifle while on the move. The problems arise when shooting handgun at any range and rifle at distance (you should see the front sight/reticle dance).

I have spoken with my doctor, but he is not a competitive shooter and I don't want to use the drugs he suggests because they make you groggy. I have spoken with numerous shooters, instructors, etc., but they offer the sage shooting advice that does work when the ET is not in full swing. I have definitely enjoyed and learned from this forum, but have found nothing specific to ET.

So, here is the question - Is there anyone out there who can offer advice/assistance from your experiences? Are there specialized doctors, training, medicines, etc. that may help?

Any help is greatly appreciated!

Cheers,

Kyle

[GrumpyOne]

My wife works at the University of Florida at The Shands Brain Institute and works with some of the top neuro docs in the country. I just asked her and she said that the only thing that might help is drugs for Parkinson's Disease. Either that, or learn to live with it. Is it somethiing like the shake caused by heartbeats? Or is it completely random in the movement?

[DocMcG]

My wife works at the University of Florida at The Shands Brain Institute and works with some of the top neuro docs in the country. I just asked her and she said that the only thing that might help is drugs for Parkinson's Disease. Either that, or learn to live with it. Is it somethiing like the shake caused by heartbeats? Or is it completely random in the movement?

Thanks for the information! Yep, I have heard the reply, "Learn to live with it," numerous times! I have heard/read of the similarities to Parkinson's, but have not heard of using a similar med for treatment - I will check into that.

As for consistency of shake/wobble, there is none! If there were I could teach myself to wait on it as I do with my natural wobble, but there is no consistency or predictability - hence the frustration.

Thank you so much for the post! - Kyle

[GrumpyOne]

My wife works at the University of Florida at The Shands Brain Institute and works with some of the top neuro docs in the country. I just asked her and she said that the only thing that might help is drugs for Parkinson's Disease. Either that, or learn to live with it. Is it somethiing like the shake caused by heartbeats? Or is it completely random in the movement?

Thanks for the information! Yep, I have heard the reply, "Learn to live with it," numerous times! I have heard/read of the similarities to Parkinson's, but have not heard of using a similar med for treatment - I will check into that.

As for consistency of shake/wobble, there is none! If there were I could teach myself to wait on it as I do with my natural wobble, but there is no consistency or predictability - hence the frustration.

Thank you so much for the post! - Kyle

It almost sounds like a Tourettes tic. I don't know, but I'm pretty sure there are meds for that as well.

[DocMcG]

My wife works at the University of Florida at The Shands Brain Institute and works with some of the top neuro docs in the country. I just asked her and she said that the only thing that might help is drugs for Parkinson's Disease. Either that, or learn to live with it. Is it somethiing like the shake caused by heartbeats? Or is it completely random in the movement?

Thanks for the information! Yep, I have heard the reply, "Learn to live with it," numerous times! I have heard/read of the similarities to Parkinson's, but have not heard of using a similar med for treatment - I will check into that.

As for consistency of shake/wobble, there is none! If there were I could teach myself to wait on it as I do with my natural wobble, but there is no consistency or predictability - hence the frustration.

Thank you so much for the post! - Kyle

It almost sounds like a Tourettes tic. I don't know, but I'm pretty sure there are meds for that as well.

Ha! Funny! I am not sure, but will ask my doc. However, I have noticed that it can cause the uncontrollable cursing sometimes associated with Tourettes!

[GrumpyOne]

I'm sorry if I offended, but really, it's what it sounds like. But now that you mention it...... I don't have any of those symptons except the occasional loud cursing as a Mike or No Shoot is called out.

[DocMcG]

I'm sorry if I offended, but really, it's what it sounds like. But now that you mention it...... I don't have any of those symptons except the occasional loud cursing as a Mike or No Shoot is called out.

Definitely no offense taken! Life is too short!

Yep, I had one heck of an outburst in May on the surprise stage at the spring TacPro 3-Gun. A switch activated an IPSC running target that came from behind some bushes directly at you, at what seemed to be warp speed. On the target, in what I still argue was way too small text , were the words "Don't Shoot!" Needless to say that after a center-mass double tap the innocent bystander became a casualty and I incurred one heck of a penalty!

There should be more laughing while shooting 3-Gun!

Cheers,

Kyle

Edited December 28, 2009 by DocMcG

[GrumpyOne]

Again, if no shoots didn't want to be shot, they should drop and be still!

[SteveU]

This is not the exact scenerio but I've found that Inderal (propranolol) has helped in the past if I've been too jittery for microsurgery. It does tend to make you slightly drowsier (more of a problem for shooting) but pretty sure that effect wears off. I haven't used it in awhile and there may be other meds that do the same thing with less side effects

now this is for everyday jits when working with tiny movements, not a diagnoseable tremor, but the principles are the same.

[Jadeslade]

Try a cigarette.

[badchad]

I work as a physical therapist and see a good deal of neurological patients, though I can’t say that I have any first hand experience with essential tremors. My gut says lift weights and practice your sport. However, when I get condition that I’m not experienced with the first places I go are wikipedia and pubmed.com to see if my gut is any good or not.

At wikipedia I found this…

http://en.wikipedia.org/wiki/Essential_tremor#Treatment

…which lists some drugs for which I know nothing about, but also shows that exercises might be helpful. The latter is what I was looking for as I know research shows that resistance training and gait training often helps with Parkinson’s and some research showed a decrease in tremors with exercise.

I just did a pubmed.com search looking for tremors, exercise, etc. and found theses studies that I thought might be helpful. I’ve only read the abstracts and can not speak to the veracity of the information contained therein but if it were me I might try to order some of the studies read the details and see if it helps. If these links work here’s what I found that seemed interesting:

From a short search weightlifting might help, but not just prior to shooting. The surest quick fix I found might just be applying a cold pack to your forearms right before you shoot (that’s a new one for me).

http://www.ncbi.nlm.nih.gov/pubmed/1079740...mp;ordinalpos=1

http://www.ncbi.nlm.nih.gov/pubmed/1643834...mp;ordinalpos=2

http://www.ncbi.nlm.nih.gov/pubmed/3767624...mp;ordinalpos=3

http://www.ncbi.nlm.nih.gov/pubmed/1992315...mp;ordinalpos=4

http://www.ncbi.nlm.nih.gov/pubmed/1294252...mp;ordinalpos=5

http://www.ncbi.nlm.nih.gov/pubmed/1294252...mp;ordinalpos=5

http://www.ncbi.nlm.nih.gov/pubmed/8301303..._RVMyNcbiDocSum

http://www.ncbi.nlm.nih.gov/sites/entrez?d...amp;querykey=20

If anything helps or doesn’t I’d be interested in hearing about it.

[CSEMARTIN]

+1 on propranolol. One of our surgery residents had a really bad tremor and the propranolol really helped him.

Check out this article too:

http://emedicine.medscape.com/article/1150290-treatment

[DocMcG]

AMAZING BADCHAD! Thank you so much for the volume of research you conducted! I have always heard others mention the level of brother/sisterhood that exists in the shooting sports and I believe you have just personified that!

Well, I do Gorilla Training Concepts (GTC) three times each week, which I picked up as a strength and conditioning tool for three-gun. It is very similar to football 3-a-days and a mini boot camp rolled into one - very rigorous! So, I am pretty solid in the strength and cardio departments at this time, but a little more never hurts! I will check out all of your research.

I know I have to stay away from caffinee, allowing my blood sugar to get too low, eating too much at one setting or eating too much red meat. All seem to trigger excessive tremors. It is funny how sometimes my hands hardly shake at all, but then other times I can be on the couch and look at one of my hands shaking as if I have Parkinson's. I am a teacher and taught agricultural mechanics courses at the secondary level at one point in time and my students have always made comments about my shaking when trying to do small tedious tasks requiring fine motor skills. I also notice the level of shaking increases when stress rises, which is probably a correlate to heart rate and respiration. At TacPro's fall match in October I had one heck of a time, especially with the handgun stages, because my diet, blood sugar, health, etc. were all out of sorts on top of being compounded by stress. It ruined my match, which is when I decided to do something about it.

Cheers for the assistance!

Kyle

I work as a physical therapist and see a good deal of neurological patients, though I can’t say that I have any first hand experience with essential tremors. My gut says lift weights and practice your sport. However, when I get condition that I’m not experienced with the first places I go are wikipedia and pubmed.com to see if my gut is any good or not.

At wikipedia I found this…

http://en.wikipedia.org/wiki/Essential_tremor#Treatment

…which lists some drugs for which I know nothing about, but also shows that exercises might be helpful. The latter is what I was looking for as I know research shows that resistance training and gait training often helps with Parkinson’s and some research showed a decrease in tremors with exercise.

I just did a pubmed.com search looking for tremors, exercise, etc. and found theses studies that I thought might be helpful. I’ve only read the abstracts and can not speak to the veracity of the information contained therein but if it were me I might try to order some of the studies read the details and see if it helps. If these links work here’s what I found that seemed interesting:

From a short search weightlifting might help, but not just prior to shooting. The surest quick fix I found might just be applying a cold pack to your forearms right before you shoot (that’s a new one for me).

http://www.ncbi.nlm.nih.gov/pubmed/1079740...mp;ordinalpos=1

http://www.ncbi.nlm.nih.gov/pubmed/1643834...mp;ordinalpos=2

http://www.ncbi.nlm.nih.gov/pubmed/3767624...mp;ordinalpos=3

http://www.ncbi.nlm.nih.gov/pubmed/1992315...mp;ordinalpos=4

http://www.ncbi.nlm.nih.gov/pubmed/1294252...mp;ordinalpos=5

http://www.ncbi.nlm.nih.gov/pubmed/1294252...mp;ordinalpos=5

http://www.ncbi.nlm.nih.gov/pubmed/8301303..._RVMyNcbiDocSum

http://www.ncbi.nlm.nih.gov/sites/entrez?d...amp;querykey=20

If anything helps or doesn’t I’d be interested in hearing about it.

[DocMcG]

+1 on propranolol. One of our surgery residents had a really bad tremor and the propranolol really helped him.

Check out this article too:

http://emedicine.medscape.com/article/1150290-treatment

Thanks so much for the direction and the article CSEMARTIN!

Kyle

[badchad]

AMAZING BADCHAD! Thank you so much for the volume of research you conducted!

You’re welcome, once you get used to working with the medline database on pubmed.com the research is very easy to do. It takes me longer to write a response than it does to find the information. Also I learned a good deal myself in looking this stuff up.

I've did a bit more research on pubmed, and like the physicians here said, propranolol does seem effective. Reading briefly, I gather it works in part because the tremors are often aggravated by stress/performance/pressure situations and propranolol blocks or decreases the stress response. That’s part of why it’s a banned “performance enhancing” substance in the Olympics, and Olympic shooters have been had their medals stripped for taking it.

What else I found was a lower incidence of essential tremors with people who followed a Mediterranean type diet.

http://www.ncbi.nlm.nih.gov/pubmed/1804300...p;ordinalpos=12

http://en.wikipedia.org/wiki/Mediterranean_diet

One study showed that alcohol decreased essential tremors more than propranolol.

http://www.ncbi.nlm.nih.gov/pubmed/6538013...mp;ordinalpos=8

I looked up gorilla training, and if this is it…

http://www.crassfit.com/tag/gorilla-training/

… it sounds like a good exercise program so I would stick with it.

As stress increases the tremors according to the research, and according to you, then (thinking out loud here) I would imagine that a good comprehensive program would maybe include seeing a physician about a script for the propranolol, continuing with your exercise program (a stronger body should make shooting relatively less physically stressful). Lots of practice shooting, both live and dryfire, which should decrease the stress response or at least get you better at dealing with it. I would also try experimenting with a looser style grip on the gun. I know some top shooters grip the gun hard (which might induce tremors in your case) and some other top shooters keep a pretty light grip on the gun (which might reduce stress/tremors in your case). The Mediterranean diet might be a good idea, and it includes mild alcohol consumption that might be part of the reason why. Last I would think that match conditions would increase stress/tremors so if possible just shooting a lot of matches would lessen the stress response. And maybe try the cold packs on your arms, I’m real curious about that one.

[DocMcG]

Once again, thank you! Several have emailed me and shared similar documentation concerning propanolol. I was not, however, aware that it is considered a performance-enhancing drug. YIKES! I am not sure of the ethical implications surrounding its use for competition. All that is legal is not ethical. Yet another angle to ponder.

Since starting this thread and learning of the benefits of alcohol for ET I have joked with several on my team that I plan to move our post-match tradition of a couple of drinks to a pre-match regiment! Could you imagine seeing me in the parking lot before a match slamming beer? Kinda' flies in the face of everything we learned about shooting safety! Very funny concept!

You found Gorilla Training! It is great! Yep, we sling sledge hammers, flip old tractor tires, throw rocks and kettle bells, do all sorts of pull-ups/push-ups/sit-ups, run, jump, balance, climb ropes, etc. It is tough, but gets you into great shape! Most of our trainers are very creative and have us doing crazy stuff with moderate to light weight or just the resistance of our body weight. It is one of the few programs I have engaged in that targets cardio, strength and endurance all at the same time rather that one at a time.

Have a great day!

AMAZING BADCHAD! Thank you so much for the volume of research you conducted!

You’re welcome, once you get used to working with the medline database on pubmed.com the research is very easy to do. It takes me longer to write a response than it does to find the information. Also I learned a good deal myself in looking this stuff up.

I've did a bit more research on pubmed, and like the physicians here said, propranolol does seem effective. Reading briefly, I gather it works in part because the tremors are often aggravated by stress/performance/pressure situations and propranolol blocks or decreases the stress response. That’s part of why it’s a banned “performance enhancing” substance in the Olympics, and Olympic shooters have been had their medals stripped for taking it.

What else I found was a lower incidence of essential tremors with people who followed a Mediterranean type diet.

http://www.ncbi.nlm.nih.gov/pubmed/1804300...p;ordinalpos=12

http://en.wikipedia.org/wiki/Mediterranean_diet

One study showed that alcohol decreased essential tremors more than propranolol.

http://www.ncbi.nlm.nih.gov/pubmed/6538013...mp;ordinalpos=8

I looked up gorilla training, and if this is it…

http://www.crassfit.com/tag/gorilla-training/

… it sounds like a good exercise program so I would stick with it.

As stress increases the tremors according to the research, and according to you, then (thinking out loud here) I would imagine that a good comprehensive program would maybe include seeing a physician about a script for the propranolol, continuing with your exercise program (a stronger body should make shooting relatively less physically stressful). Lots of practice shooting, both live and dryfire, which should decrease the stress response or at least get you better at dealing with it. I would also try experimenting with a looser style grip on the gun. I know some top shooters grip the gun hard (which might induce tremors in your case) and some other top shooters keep a pretty light grip on the gun (which might reduce stress/tremors in your case). The Mediterranean diet might be a good idea, and it includes mild alcohol consumption that might be part of the reason why. Last I would think that match conditions would increase stress/tremors so if possible just shooting a lot of matches would lessen the stress response. And maybe try the cold packs on your arms, I’m real curious about that one.

[JeffWard]

I agree with Bad Chad, often.

In addition: Make sure your strength training includes some slow and controlled movements along with explosive stuff. Forcing the mind-muscle connection (as required when lifting slow and heavy) to work intensely, simply "exercises" the mind-muscle pathways. My past clients with Parkinson's, MS, etc, had significant reductions in tremor activity after regular weight training, specifically focused on form, instead of power or speed.

Non-afflicted adults lose neurological control much faster than muscle mass, just like we gain neurological-induced strength must faster than hypertrophy (muscle gain). In non-afflicted adults, the term "use-it-or-lose-it" is very true. If you do not train the mind-muscle connection regularly, you will lose it incrementally. You can lose a lot of strength, without losing much muscle.

In afflicted people, and I assume Essential Tremors is a progressive neurological condition, it is just magnified. I would suggest slow and controlled weighted movements, including gripping, wrist curls, extensions, and all arm and shoulder exercises, focusing INTENSELY on form and making the muscles work. Every fiber. It won't stop it, but it can slow the progression.

As Chad mentioned, it definitely works with Parkinson's, it should help you.

Jeff Ward

Director of Education

National Personal Training Institute, Tampa, FL

[badchad]

Once again, thank you! Several have emailed me and shared similar documentation concerning propanolol. I was not, however, aware that it is considered a performance-enhancing drug. YIKES! I am not sure of the ethical implications surrounding its use for competition. All that is legal is not ethical. Yet another angle to ponder.

I wouldn't concern myself with the ethical issues in your case. First your not in the Olympics so I don't think you are at risk for a drug test, and second you have a legit condition for which the drug might be of help, so I wouldn't think it was like you were cheating. With a Physicians script I think you should be in the clear. I don't know really anything else about the drug, so their may or may not be some side effects that are undesirable. I'd talk to one of the Docs about that.

[LChico]

Once again, thank you! Several have emailed me and shared similar documentation concerning propanolol. I was not, however, aware that it is considered a performance-enhancing drug. YIKES! I am not sure of the ethical implications surrounding its use for competition. All that is legal is not ethical. Yet another angle to ponder.

I wouldn't concern myself with the ethical issues in your case. First your not in the Olympics so I don't think you are at risk for a drug test, and second you have a legit condition for which the drug might be of help, so I wouldn't think it was like you were cheating. With a Physicians script I think you should be in the clear. I don't know really anything else about the drug, so their may or may not be some side effects that are undesirable. I'd talk to one of the Docs about that.

Inderal is a beta blocker. It is a VERY common cardiac medication (it's original usage), but it is also used for hypertension, migraine headaches and "stress reactions" as noted in other posts. It is banned in competition when used exclusively to lower heartrate and reduce stress in a non-medical setting. Healthy young athletes should not be taking it simply to enhance performance. In the case of essential tremors, it reduces the likelyhood of tremors and can increase safety.

One thing you have probably not considered, is to use meditation or bio-feedback techniques to decrease your stress reaction. There has been some success with decreasing hypertension and decreasing phobic responses by using these techniques in addition to medication. It can help reduce your dosage or frequency of medication.

Linda Chico (L-2035)

Columbia SC

Edited December 30, 2009 by LChico

[magicald_223]

Hey a close friend of mine had ET and in Medical school we had Oral exams every 6 weeks which were nerve racking and his tremor was BADDD when he was nervous, so he would do a couple shots of vodka before the exam and it smoothed his tremor right out. Otherwise, beta-blockers like low dose propranolol work. I'm not sure about the performance enhancing aspect?

[DocMcG]

Once again, thank you! Several have emailed me and shared similar documentation concerning propanolol. I was not, however, aware that it is considered a performance-enhancing drug. YIKES! I am not sure of the ethical implications surrounding its use for competition. All that is legal is not ethical. Yet another angle to ponder.

I wouldn't concern myself with the ethical issues in your case. First your not in the Olympics so I don't think you are at risk for a drug test, and second you have a legit condition for which the drug might be of help, so I wouldn't think it was like you were cheating. With a Physicians script I think you should be in the clear. I don't know really anything else about the drug, so their may or may not be some side effects that are undesirable. I'd talk to one of the Docs about that.

Inderal is a beta blocker. It is a VERY common cardiac medication (it's original usage), but it is also used for hypertension, migraine headaches and "stress reactions" as noted in other posts. It is banned in competition when used exclusively to lower heartrate and reduce stress in a non-medical setting. Healthy young athletes should not be taking it simply to enhance performance. In the case of essential tremors, it reduces the likelyhood of tremors and can increase safety.

One thing you have probably not considered, is to use meditation or bio-feedback techniques to decrease your stress reaction. There has been some success with decreasing hypertension and decreasing phobic responses by using these techniques in addition to medication. It can help reduce your dosage or frequency of medication.

Linda Chico (L-2035)

Columbia SC

Linda,

I know very little about meditation techniques or bio-feedback. Could you point me in the right direction?

Kyle

[AlamoShooter]

Kyle

asking for direction for meditation is kind of what meditation is. most people that aply them self to meditation spend years to reach a basic level.

Some equipment / electrodes can be places on you head to povide a sound of the brain waves. As a person clears their thoughts lets go of some mental tention the brain changes wave leangth

levels of conciousness. The mental state during exstreem pleasure is normaly the " Alapha state" a few people can reach this brain level in just a few moments of preperation. Some people only reach it during an orgasm.

Bio Feedback helps you learn with an aid what each brain level "feels like"

What can be learned is to use "Triggers" to bring about brain level changes.

my Dad used to teach this type thing

send me an email if you like

Jamie

[badchad]

I'm not sure about the performance enhancing aspect?

When I was reading up on it, they talked about musicians using it to avoid stage fright. The shooters using it IIRC were more of the Olympic pistol and rifle variety where you have to stand real still and shoot.

I read the abstract of an older study where it did improve rifle accuracy in a controlled setting. For our sport, where speed is important I imagine it would have it's pros and cons.

[Jadeslade]

Beta-blockers can ruin your "nature".

[Sam]

one of which is exceptionally pesky - crazy shaking! If diet, blood sugar and, yes, even stress are aggravated, the shaking begins.

This is an interesting subject, Doc. I can recall shooting several stages over the years where stress induced some very pronounced shaking in my hands right before the beep.

BTW, I've discovered over the years that I'm a pretty screwed up person in plenty of ways. (Ma'am, your oldest boy just ain't normal.) Some conditions they have names for (ADD),and some so exclusive to me that they don't have names. But I know.

So, being so fearfully and wonderfully made, I often wonder why someone calls a certain set of circumstances " a condition" or "a disease"?

I understand that there are valid medical reasons for such judgments, but I still find them somewhat subjective. Basically, I see it like this: If you are outside the norm, you are by definition, "different". If you are different in some way that some "authority" sees as deleterious, you are adjudicated, by that authority, have a "condition". The whole process seems rather spurious to me. Ain't we all special?

Ponder this point the next time you hear that somebody is different. It is a statistical fact that half of the people in the country have below average intelligence.

Acceptance of this fact had lead me to clarity on many things.