This article was originally published by Lindsey Piercy and Hillary Smith of UKNow.
LEXINGTON, Ky. (March 16, 2026) — When the clock ticks down and a game hangs in the balance, some athletes thrive while others falter.
March Madness is full of buzzer-beaters and heart-stopping moments, but what separates a player who rises to the occasion from one who freezes under pressure?
Matt Moore, Ph.D., associate dean of academic and student affairs in the UK College of Social Work, brings nearly two decades of competitive tennis coaching experience to the question. He is co-founder and president of the Alliance of Social Workers in Sports, editor of the Sport Social Work Journal and co-director of the International Institute for Sport and Behavioral Health.
Moore has coached at Butler University, Anderson University and Miami University, racking up more than 250 career dual match wins and helping Miami claim the 2025 Mid-American Conference championship.
But high-stakes moments aren’t just psychological — they are also neurological. Understanding how the brain processes stress, focus and split-second decision-making adds another layer to why some athletes stay composed while others struggle when the stakes are highest.
That’s where Taylor Achtyl, Psy.D., a postdoctoral fellow in clinical neuropsychology in the UK College of Medicine, offers insight into what’s happening inside the brain during those critical moments. She works within the Kentucky Neuroscience Institute, where she conducts neurocognitive evaluations to assist in the diagnosis of neurological disorders.
Achtyl earned her doctorate in clinical psychology from D’Youville University, where her dissertation research examined executive function and emotion regulation in university athletes with a history of sports concussion; this work was presented at the International Brain Injury Association’s 15th World Congress on Brain Injury. She also has experience conducting neurocognitive evaluations to inform return-to-play decisions and providing psychotherapy to student-athletes.
UKNow: Why do some athletes seem to thrive under pressure while others struggle?
Moore: Some athletes interpret physical signs of stress as excitement and readiness, while others read the same signals as doubt, overthinking and tightness. Though the shift in mindset may sound simple, it’s more complex than it seems. Often, the difference between rising to the moment and shrinking from it comes down to seeing pressure as a challenge rather than a threat.
UKNow: What actually happens in the brain and body during a high-pressure moment like a last-second shot?
Achtyl: In a high-pressure moment like a last-second shot, the brain quickly prioritizes information that is most relevant to the situation. Attention narrows toward key cues such as the position of defenders, the basket and the remaining time on the clock. Brain regions involved in decision-making and motor planning work together to translate that information into a rapid action. At the same time, the body becomes more physiologically activated, increasing alertness and readiness to move.
Moore: The first thing that happens is that your brain realizes, “these moments matter.” This activates a response in your body. Your adrenaline kicks in. Your heart beats faster. Your breathing speeds up. Your muscles tighten. Your focus gets sharper. You might also feel nervous.
UKNow: Is being “clutch” a real psychological trait, or is it something we assign after the fact?
Moore: When you’re in high-pressure moments, there’s a difference between your body feeling clutch and feeling frozen. A clutch athlete might think, “I’m ready for this,” channeling that energy in a positive way. An athlete who feels frozen might think, “Not me — I’m nervous,” which can lead to overthinking and tightening up.
Most of the time, we label someone clutch after we see the outcome. In reality, being clutch is about preparation, repetition and confidence built over time. In my opinion, it has far less to do with who you are and far more to do with how you train your body and mind to handle pressure.
Science + storytelling
UKNow: What role do stress hormones like cortisol and adrenaline play in performance?
Achtyl: Adrenaline and cortisol are part of the body’s natural response to pressure. When stakes are high, such as during the final minutes of a close game, these hormones increase heart rate, blood flow and alertness, preparing the body to respond quickly. Stress hormones can enhance performance by helping athletes sharpen focus and reaction time, which is why athletes often describe feeling “locked in” during important moments. However, when stress hormone levels become too high, they can start to interfere with performance. It may become more difficult to concentrate, remember plays or control fine motor movements.
UKNow: How does anxiety affect motor skills and decision-making in athletes?
Achtyl: Anxiety can interfere with athletic performance by affecting the brain systems that coordinate thinking and movement. Skilled motor actions rely on communication between the prefrontal cortex, which supports attention and decision-making, and the striatum, which helps automate well-practiced movements. In high-pressure situations, stress and increased self-monitoring can disrupt this coordination — causing athletes to overthink movements that would normally feel automatic, such as passing or shooting a ball. When that happens, decisions may become slower and movements less fluid, which is often what people are describing when they talk about athletes “choking” under pressure. Athletes who perform well in these moments are often better able to maintain focus and allow practiced skills to run more automatically.
UKNow: Can pressure ever improve performance? If so, how and why?
Achtyl: Yes, pressure can improve performance. A moderate level of pressure can increase focus, motivation and engagement with the task at hand. In these moments, athletes may become more attentive to relevant cues, react more quickly and perform with greater intensity. Psychological research often describes this relationship using the idea that performance tends to improve as arousal increases, but only up to a certain point. When pressure stays within this optimal range, it can help athletes feel energized and fully focused on the moment.
Moore: Building on everything shared so far, the body’s stress response isn’t automatically a bad thing. Adrenaline can sharpen focus, increase energy and prepare muscles to respond quickly. When athletes interpret those sensations as readiness rather than danger, pressure can actually enhance concentration, reaction time and confidence.
The difference comes down to perception and preparation. When pressure is viewed as a challenge and athletes trust their training, it can elevate performance. When pressure is viewed as a threat, that same stress can lead to tension, doubt and overthinking.
Training + preparation
UKNow: Are clutch performers born that way, or can mental toughness be trained?
Moore: Mental toughness is not something you are simply born with. It is a skill that can be developed through intentional practice. It grows when you set clear, achievable goals and challenge yourself to perform under pressure. It grows by learning to manage stress and maintain focus. It grows with integration of evidence-based approaches into your practice regime. Practices such as positive self-talk, visualizing successful outcomes and reflecting on your experiences all strengthen your ability to stay calm and confident when faced with obstacles. Most importantly to me, you have to be able to simulate high pressure moments consistently in your training.
UKNow: What psychological techniques do elite athletes use to stay focused in big moments?
Moore: There are numerous techniques that elite athletes use. What works for one athlete might not work for another. That being said, there are three overarching techniques that I use with my athletes. First, we try to be really intentional with our goal setting. This might also be the social worker in me, but I want my athletes to all have SMART goals — specific, measurable, achievable, relevant and time-bound) that help them stay focused on the controllables. Second, we use mental imagery on a regular basis to rehearse high-pressure scenarios. Third, we try to ensure that each of our players have techniques that help with emotional regulation. Here we are talking about preperformance routines, consistent routines between points and how to utilize changeovers to your advantage. I find these three approaches work together. Clear goals provide direction, rehearsal prepares execution and emotional regulation keeps performance steady.
UKNow: How important are routines, like free-throw rituals or breathing patterns, in managing pressure?
Moore: I find routines to be extremely important. By engaging in familiar actions like free-throw rituals or breathing patterns, an athlete can shift their mind from the stress of the situation to controlled, automatic behavior. It helps to remind an athlete that they have shot thousands of free throws in their lives. Why does this free throw need to be any different than the rest?
Fans + broader relevance
UKNow: Why do fans feel nervous or stressed watching these moments — even though they’re not playing?
Moore: I am a fan of many teams. I am no different than others. There are days where it feels like I live and die by outcomes. Fans live vicariously through the team and athletes they support. The pressure created on the court extends to those watching. The brain and body responses of a fan, to a lesser degree, can mirror those of the players. Their investment in the outcome creates a sense of personal pressure, even without direct physical involvement.
Achtyl: Even when we’re just watching, our brains respond to the tension of the moment. In close games, the brain’s stress response can activate in ways that look similar to what the athletes are experiencing. Part of this response is related to mirror neurons — a system in the brain that helps us simulate and understand the actions and emotions of others. When we watch an athlete take a high-pressure shot, the brain partially mirrors the action and emotional intensity of that moment. That shared neural response is part of what makes big moments in sports feel so exciting and nerve-wracking for fans.
UKNow: What can everyday people learn from athletes about handling pressure at work or in life?
Moore: Here are a few suggestions:
- Focus on controllable actions, not outcomes. Athletes are great at breaking tasks into small, actionable steps to reduce anxiety and to stay present.
- Develop consistent routines. Athletes perform best with consistent rituals. These rituals help regulate behavior and provider a sharper focus.
- Reflect and learn from experiences. Athletes are required to consistently reflect on what worked and what did not. It helps athletes to create concurrent plans that present option versus the need to feel desperate in a situation.
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