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Upper Extremity Injury Prevention for Gamers

Common Gamer Injuries & Treatment Options

by Louis Fabicon, OT, CHT7 Comments

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.

Upper Extremity Injury Prevention for GamersWith 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:

Trigger Thumb

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.

Carpal Tunnel Syndrome

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.

Lateral Epiconylitis (Tennis Elbow)

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.

Stay in the Game

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.

Request a Free Assessment

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.

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Louis Fabicon was a physical therapist at Athletico Physical Therapy at the time of this blog.


  1. Elroy R Laukala

    I had carpal tunnel surgery on both hand about 6 months ago. Now Recently retired and and started gaming alot mainly M.W. Call of Duty.
    Well now having major pain at the base of right thumb and wrist. I feel the toggle button sets to high causing back pressure on thumb.
    Taking a break for now, then plan on trying the Elite controller with adjustable buttons…

  2. Athletico

    Thanks for reading our blog Elroy! We recommend scheduling a free assessment to talk to one of our therapists about the pain you are experiencing. You can schedule an appointment here:

  3. Tyron

    Im playing video games since 2011, i personally think i take it to serious.First of all i lay and play,my arms are so lame and there is so much tension and stiffness in my nech and arms it burns… done playing video games,it hasn’t been too long since i gave it up,but symptoms still occur such as lame arms, stiff neck,vertigo sometimes….i would really like to know if these symptoms will go away on its own now that im not playing anymore,im not going to lie its a really bad lame feeling in both my arms on a daily….please give me some advice.

  4. Athletico

    Tyron – Thanks for reading our blog! I would recommend to stop playing while laying down and to play in a seated position. The position you play in is not very ergonomic which may be contributing to your pain. If it’s possible, look into a gaming chair or take a few breaks to stand and stretch during loading times or set a timer to stretch/stand every 20 minutes. Have you tried exercising and stretching before? If not, I highly recommend that you seek the nearest Athletico ( and schedule a free assessment with our expert Physical and Occupational Therapsts, especially since you have a concern over vertigo. Take care and I hope you are able to go back to gaming pain-free!

  5. Christina Richardson

    Do these conditions occur suddenly? Or are they gradual? I’ve been a gamer for years, but this past year I’ve been doing more gaming on a playstation4 and I’ve noticed before that I get times where there is pain that radiates down both of my arms and into my hands (especially my left arm) and it usually hurts to raise my arms over my head when the pain is there. It usually goes away after a couple of days, is gone for a little while, and then it’ll come back again.

    Does that sound like an issue brought on by gaming too much?

  6. Alex

    I’ve been a gamer since I was about 5 or 6 and Im 26 now. I play games pretty much all day from when I wake up to when I go to bed. However latley, a few months ago I started getting problems with my eyes where after about 2-3 hours of gaming my eyes start stinging and my face gets really hot. I’ve been using lubricating eye drops and they do help, but only for a couple hours and it starts stinging again. I’m also seeing a line in my vision when I wake up in the morning but it disappears after 30 secs to 1 minute. If I game for a good 6 hours and ignore the stinging I get a migraine that can last for a week if not longer. Can someone help I just want to be able to game with my friends again.

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