Jose Altuve, as second baseman for the Houston Astros, stands with the best players in professional baseball. That he also stands 5-foot-6, and so to about the shoulders of many fellow Most Valuable Players, All-Stars and Gold Glove winners, is testament to his command of the game and the obstinacy with which he plays it.

Few, if any, get more from less than Altuve, the Venezuela-born fireball who in a decade-long career won three batting championships, hit 133 home runs and drove his franchise to its only World Series title, one subsequently tainted by a sign-stealing scandal.

That he is again the centerpiece of the Astros and the American League Championship Series is, then, a familiar October refrain. That it is because he is incapable of the simplest task on a baseball field — a throw from his second base position to first or second base, that covering maybe 60 feet — has become a two-day horror show.

Jose Altuve appears to have the yips. His right arm has abandoned him, and with it perhaps the very confidence that helped make Jose Altuve into a towering ballplayer.

In Monday’s Game 2 of the ALCS, Altuve, who had not made a throwing error in the regular season, bounced two throws to first base, one of them leading to three Tampa Bay Rays runs, in a 4-2 defeat. In Game 3, he committed his third throwing error, that instrumental in the Rays’ five-run sixth inning, and a 5-2 Astros loss. The Astros trail in the best-of-seven series, three games to none.

“Nobody feels worse than Jose,” Astros manager Dusty Baker said Tuesday night. “He takes it very serious and takes it to heart. He’s one of ours and we’ve all been through this before, [though] not in the spotlight like this. It hurts us all to see him hurting. And we will give him all the support that he needs.”

The yips are a primarily psychological affliction not uncommon in baseball that, according to some experts, often comes for those who care the most. Also, for those attempting — and now thinking about, and wrestling with — the most common of skills. The yips have damaged or ended the careers of pitchers who could no longer throw a strike, of catchers who could no longer throw the ball back to the pitcher, of second basemen who, after thousands upon thousands of accurate throws, suddenly cannot repeat a motion that safely delivers a baseball from their hand to someone else’s mitt.

“Physical turns mental,” Baker said.

What comes next is a blur of young men who suffer through an affliction of no known cause or cure. Some surrender or disappear or change positions. Some discover the yips leave them as quickly as they came, for no reason other than one normal throw after so many alien throws.

Rick Ankiel, the left-handed pitching phenom with the St. Louis Cardinals 20 years ago, contracted the yips and, spent by the efforts to regain his command, became a successful outfielder. Steve Blass, World Series hero for the Pittsburgh Pirates in 1971, was felled by the yips and out of the game not three years later. For decades the yips were known as Steve Blass disease. Steve Sax, a second baseman for the Los Angeles Dodgers, managed to overcome the yips, as did catcher Jarrod Saltalamacchia years later. Many — baseball players, golfers, place-kickers, basketball players, darts throwers, even surgeons and pianists — do not. They instead opt to leave the yips behind, their careers with them.

Daniel Bard, a back-end reliever for the Boston Red Sox with a 100-mph fastball, retired as a result of the yips and seven years later — in 2020 — pitched well and reliably for the Colorado Rockies. Tyler Matzek, a reliever for the Atlanta Braves, spent five summers searching for the pitcher he was before the yips. He returned this season and on Tuesday night pitched two scoreless innings against the Dodgers in the National League Championship Series.

“If you haven’t stood on a — not just a big-league mound, could be a minor-league mound or a college mound, either way you got a bunch of eyes on you that matter to you,” Bard said this summer. “And you stand out there and things don’t feel right or you feel completely unprepared for the situation, like your ability’s kind of betrayed you, that’s an unusual and pretty terrible feeling.”

For Altuve, like plenty of baseball players, he could find the yips are a momentary wobble. Two games he’d forget, three throws he’d stash away in the same dark place from which the yips came. Maybe they were born of a sore shoulder, an achy wrist or a swollen finger, and not of a moment in October on a baseball field that didn’t seem so big until it was, when one untrue throw became two, then three.

He squatted Tuesday evening at his position, his cap pushed back on his head, in the aftermath of another throw that betrayed him. They come for those who care. They come for those who wouldn’t ever believe they were vulnerable. They come and then nothing matters more than the next chance, the next throw, the next reliable and familiar result. The next breath.

And that’s when they’ve got another one.

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