What You Need to Know About Gaming Injuries

Have you joined the Battle (Royale)? Gaming, also known as esports, is wildly popular. And it’s quite lucrative — the top competitive gamers earn up to $6 million a year. And get this: More than 50 universities in the U.S. offer scholarships to entice students to join their esports teams.

“And just as with any professional or collegiate athlete, injuries can occur,” says sports medicine physician Dominic King, DO.

What kind of gaming injuries are common, and how do you know when it’s time to worry? Dr. King answers those burning questions.

Q: What kind of injury can I get from playing esports?

A: First, we need to identify the gaming platforms. Injuries are different depending on which platform you use:

• The console (Nintendo®, Xbox or PlayStation®): Gamers use a hand-held controller to navigate the game and are usually sitting on a couch or cushy chair.
• The personal computer (PC): Gamers sit in a chair at a desk using a keyboard and mouse.
• Virtual reality (VR): Gamers wear a headset and goggles, use a hand-held controller and are not chained to the console.

Q: How do VR gamers get hurt?

A: VR is the most physical gaming environment. Gamers walk around (with literal blinders on) and wave their arms around to play the game. VR is a full-body gaming experience. Common injuries might include:

• Tripping and falling (on the floor or into a wall).
• Hitting things because your hands are flailing rapidly in all directions.

Q: Is the injury risk lower for console gamers?

A: It’s not lower, but there’s less risk of a traumatic injury. Console gamers typically experience:

• Shoulder, neck and back strain because of poor posture (from sitting in a hunched position).
• Eye strain.

Q: Do those same injuries apply to PC gamers?

A: Eye strain for sure does. They have less of the shoulder, neck and back strain because they are sitting in a desk chair or gaming chair. But because they’re tapping the keyboard and moving their mouse quickly, they have a higher incidence of hand and wrist-overuse injuries like:

• Tendonitis: Inflammation and irritation of the thumb, hand or wrist.
• Carpal tunnel syndrome: A pinched nerve in the wrist that causes hand or wrist pain, numbness, tingling or weakness.

And because they may rest their elbow on their chair or desk, they are prone to pinching the ulnar nerve — the nerve inside the elbow. That may lead to ulnar neuritis, also called cubital tunnel syndrome. Cubital tunnel syndrome comes with the same symptoms as carpal tunnel syndrome, but the symptoms extend to the arm as well.

Q: Do we need to be concerned about injury with the casual gamer, like a 12-year-old boy who’s obsessing over Fortnite?

A: Of course there is a difference between casual gaming and competitive gaming. But casual gamers can certainly experience all of the injuries we talked about. For pro gamers, the injury volume is just turned up. (Although professional VR gaming hasn’t taken off — yet!)

Gaming injuries are rare, but when they happen they can be debilitating. Retirement from esports is typically due to having carpal or cubital tunnel syndromes or chronic overuse tendonitis of the wrist and thumb.

Q: So even casual gamers are at risk. What do we look for and when do we see a doctor?

A: If you experience pain during gaming, talk to your doctor. It’s also time to see a provider if you have soreness after gaming that:

• Continues for more than four or five days.
• Interferes with daily living.

Q: Do you have tips for preventing gaming pain or injury?

A: I recommend gamers rest every hour. There should be a hard stop every two hours where you get up, stretch and do a physical activity.

Some providers offer ergonomic evaluations for esports athletes. They help athletes identify the sweet spot for the chair, monitor and keyboard.

Cleveland Clinic is developing guidelines for collegiate and professional esports athletes. Physical fitness helps with strategizing, planning and problem solving. Cardiovascular training also helps sharpen mental fitness. The more physically fit you are, the more stamina you have and the better you can compete.