Hai Lam. Paul “sOAZ” Boyer. Clinton Loomis. While these names do not have the same mass recognition as popular athletes like Lebron James, Drew Brees, or even Mitch Trubisky, they certainly are recognized as the best in their sport. Not just any sport, but “esports,” if you will. Their offensive weapons aren’t balls, bats or sticks, but rather keyboards, headsets and hand-held controllers. Instead of defeating their opponent on an athletic field, their fields of play lie in the digital battlefields of games such as Defense of the Ancients (DOTA), League of Legends and Warcraft 3. These men were once at the height of their game. Veritable legends. Unfortunately their ascent into gaming immortality was cut short by upper extremity (UE) injuries from overuse and improper ergonomics.
With the rise of Esports and the popularity of home gaming (Red Dead Redemption 2 earned a record-breaking $725 million in sales in 3 days), UE injuries can be common and can sideline gamers from their beloved recreational activity. While the typical gamer may not game for the average of 10-12 hours per day like the Epsorts professional, the excitement of a new game can lead to a marathon of button-mashing and spirited commentary through a Bluetooth headset. With that said, it’s important that gamers should be aware of the UE injuries common among the gaming community and how these injuries can be prevented.
Dr. Levi Harrison is an orthopedic surgeon from Glendale, California. He specializes in treating gaming injuries. His patients range from the professional gamers, players as young as 9 to his oldest at 90, and from all platforms and genres, including mobile, console, and desktop.
“I take care of everyone from elite gamers to weekend gamers to everyday gamers,” Harrison said in an interview with Engadget. “And the major issue I find is overuse. [My patients] are gaming for up to 16 hours a day, especially the elite gamers. They don’t have the proper ergonomic balance of their mouse and their desk, they don’t have the proper backrest, or they don’t know how to engage their posture. They have to learn how to sit properly and how to place their hands and elbows properly.”
Gamers should be aware of common overuse UE injuries that can result from gaming for an extended amount of time. Some of these injuries and treatment options include:
What is it: Inflammation of the flexor tendon of the thumb that causes the tendon to become stuck in a structure near the base of your hand called the A1 pulley.
Symptoms: Pain in thumb that can result in the thumb locking in a flexed position. The thumb may bend or straighten with a snap, similar to releasing a tight rubber band.
Treatment: Icing, splinting, rest, cortisone injection, or a surgical procedure involving loosening the A1 pulley. Outpatient occupational therapy is highly recommend to help with symptoms. An occupational therapist may issue a home exercise program (HEP), orthosis fabrications and activity modifications.
Prevention: Gamers should rest their thumbs for at least 1-2 minutes for every 20 minutes of game time.
What is it: Pressure of the median nerve in the carpal tunnel of the wrist due to overuse.
Symptoms: Numbness, tingling, and/or pain of the thumb, index finger, middle finger and the thumb side of the ring finger.
Treatment: Wearing an overnight wrist orthosis (brace) with wrist in a neutral position can help with night and morning pain. Outpatient occupational therapy can also help. An occupational therapist may issue a HEP that includes manual therapy, instruction in home treatment techniques like ice massages and contrast baths, hand strengthening, and education on computer ergonomics to prevent symptoms. Invasive treatments include cortisone injections and a carpal tunnel release surgery to relieve pressure on the median nerve.
Prevention: Similar to treatment for trigger thumb, gamers should take rest breaks. Gamers can also use a vertical mouse/keyboard for desktop gaming.
What is it: Micro damage of the tendon that extends your wrist and fingers called the common extensor tendon. The damage originates from a part of a bone called the lateral epicondyle, most likely through overuse.
Symptoms: Pain along the lateral elbow and forearm which may radiate up and the down arm.
Treatment: Outpatient occupational therapy can help with tennis elbow, including instruction on ice massage and a HEP that includes wrist stretches and wrist extension strengthening exercises. The occupational therapist may also recommend devices such as a band-it arm counterforce brace or an overnight wrist brace. Additionally, a doctor may be able to provide treatment in the form of a cortisone injection for the painful area.
Prevention: Proper rest while gaming can help prevent tennis elbow, as well as a vertical keyboard/mouse, lifting with the palm in neutral or up (supination) and proper ergonomics.
If you or someone you know are a gamer and have any concerns about UE injuries, contact your local Athletico to schedule an in-clinic or virtual free assessment with one of our occupational therapists or certified hand therapists.
The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.