Pro Gaming Injuries – What Gamers Need to Know


Every athlete is prone to injury and athletes who compete in esports are no exception. It should be no surprise that using a keyboard, mouse or controller for over a dozen hours a day will come with an inherent risk of injury.

What are the top 3 Pro Injuries in Esports?

  1. Repetitive Strain Injury
  2. Tennis Elbow (i.e., gamer’s elbow)
  3. Back pain

Competitive gaming and esports are not a one-way ticket to repetitive stress injuries (although it certainly increases your risks).

This post looks at two common repetitive strain injuries in esports and competitive gaming: Carpal Tunnel Syndrome (CTS) and Tennis Elbow (or “gamers elbow”) and back pain. After reading, it’s up to you to determine both if and how you want to address these risks.

Esports athletes and competitive gamers should be worried about repetitive stress injuries, but they’re not as common as outsiders might want to believe.

One of the reasons I started this website was to help bring a more sport specific training approach to esports, which I call “esport specific training”. As esports continues to grow, the need for esport specific training needs to grow so that pro gamers have resources available to them that go beyond generic fitness advice. You can check out esport specific training tips on the Athletiks section and the Recommended Gear section. 

Make sure to read to the end as you’ll find a long list of pro gamers who’ve had to either retire or take time off of gaming due to injuries.

SHOULD PRO GAMERS BE WORRIED ABOUT REPETITIVE STRESS INJURIES?

If you are reading this article, you are probably immersed in the esports scene on some level and most likely a gamer yourself. So, think to yourself, is twitter and youtube exploding with stories about pro gamers and esports athletes having to retire due to injury? Is every team you follow constantly changing their roster due to players being injured? Before you uninstall LoL or quit Dota 2, take a moment to reflect on this: some athletes have to retire from esports due to injury, but most don’t.

WHY COMPETITIVE GAMERS SHOULD BE WORRIED

Preventing and managing injury is more about maintaining your ability to compete at a high level, as the slightest pain or discomfort can give your opponent the 0.01% edge they need to win. Don’t wait for a diagnosis from a doctor to start thinking about injury treatment and prevention. What athletes do outside of their sport is often the determining factor in their victory, and esports should be no different.

Esport athletes and gamers are at a higher risk of getting repetitive strain injuries due to their use of the keyboard/mouse or controller. Sure, office workers use computers eight hours a day, but the way they use it is much less aggressive when compared to competitive gaming. Have you ever used a broom to sweep? Well think about curling athletes and how they use a broom, one is more likely to aggravate you over time (a curling reference?…I know, but I’m Canadian).

If you become a powerlifter, you might tear a bicep; if you become an ultra runner, you might mess up a knee; if you become a baseball pitcher, you might ruin your shoulder; and if you’re a competitive gamer, you might get a repetitive stress injury.

CARPAL TUNNEL SYNDROME (CTS) and ESPORTS

CTS is probably the most known about and feared injury for esports athletes and competitive gamers. I want to make clear that carpal tunnel syndrome and repetitive strain injury are not synonymous terms for the same injury. Repetitive strain injury is a term for many different cumulative trauma disorders that include carpal tunnel syndrome. So, if you have CTS then you have RSI, but if you have an RSI, you do not necessarily have CTS (it could be tendinitis, epicondylitis, cubital tunnel syndrome etc.).

According to the American Academy of Family Physician, carpal tunnel syndrome affects approximately 3-6% of adults in the United States. And before you give up gaming altogether, Matt Hwu, an Esports Physical Therapist that has worked with Counter Logic Gaming among other teams, has stated in the past regarding RSI’s:


“It is never something that any pro or casual player needs to retire from. And the main reason is that its rehab is extremely straightforward in how we manage it”.


*Matt Hwu runs 1-hp, an organization that helps treat and manage esports injuries. Check out the amazing work he does over at www.1-hp.org.

WHAT IS CARPAL TUNNEL SYNDROME?

In a nutshell, the Carpal Tunnel is located around your wrist. There’s a small tunnel in your wrist made up of ligaments and bone. Within this small tunnel run tendons that allow you to flex your fingers. Also in the Carpal Tunnel is the Median Nerve, and its job is to communicate with your brain so that you can move and control your thumb, and feel things on the thumb side of your hand.

In case you haven’t guessed, the Carpal Tunnel is very small and limited. Any sort of swelling or inflammation of the tissue surrounding it can put pressure on the nerves. Basically, the symptoms associated with CTS (tingling, numbness and burning) is a result of the breakdown in communication between the nerve in the carpal tunnel and your brain.

TENNIS ELBOW

Yep, Esport athletes can get tennis elbow, although the esports community would most likely refer to it as “gamer’s elbow” or “mouse elbow”. Whatever the name, the symptoms will be similar. 

Like carpal tunnel syndrome, tennis elbow will affect around 3% of the general population. Of course, this number will increase based on the activities an individual performs regularly. And guess what athletes are at an increased risk of tennis elbow (clue: the answer is in the question). Competitive gaming will also increase that risk due to ergonomics and repetitive stress.

WHAT IS TENNIS ELBOW?

The medical term for tennis elbow is “lateral epicondylitis”, and only a few people actually get it from tennis. Tennis elbow will result in pain where your forearm meets your elbow. It is related to a particular muscle (the extensor carpi radialis brevis) and the tendons in your forearm. Using your elbow in a constant and repetitive motion (FPS gamers come to mind here) can cause small tears, which leads to inflammation and the additional stress of the rest of your arm, as your arm becomes imbalanced.

In a nutshell, tennis elbow is a repetitive stress injury caused by overuse. 

CARPAL TUNNEL SYNDROME & TENNIS ELBOW IN ESPORTS

An important reason gamers and esports athletes should be aware of CTS is due to the differences in how they use a mouse and keyboard (or controller) when compared to the general public. In competitive gaming, there is no break or ability to pause (I mean a real break, to stretch or use the bathroom, not a tactical break). Recreational gamers are more apt to binge every now and then but mostly play in shorter bursts (this is why they’re classed as recreational).

In addition to no breaks, the amount of actions on the keyboard or controller during competitive play is substantially more. A college student writing a paper on their computer gets to lean back every few minutes in their chair, regretting all the decisions they made that landed them in a position to write a paper that’s due in three hours. A competitive gamer must be constantly pressing keys/buttons with no rest and at a rate that far surpasses any office worker. This increase in repetitive motions can put a strain on the carpal tunnel and nerves and cause swelling to a greater degree than your average computer worker.

Imagine a football (soccer) player had a loss of communication in the nerves responsible for their brain and foot interactions. Even the slightest breakdown could mean the difference in making a game-winning shot. So, while a full-blown carpal tunnel diagnosis might be on the rare side for esports athletes (at least nowadays), the early stages of it can have devastating impacts during competition as the athlete’s fine motor skills will become compromised.

Imagine if Serena Williams were to develop tennis elbow before the Wimbledon, imagine the edge her competitor would have. And if Maru were to develop tennis elbow before the WESG, I bet Rogue would have an easier match.

I remember in high school when I was on a counter-strike 1.5 team (before steam ever existed) and would play as soon as I got home until late at night. On the weekends I dish washed in a kitchen. All of these repetitive actions performed with poor ergonomics caused me to get tennis elbow and the beginnings of what my doctor said was CTS. I remember a doctor prescribing a brace that would go around near my elbow and I also tensor bandages wrapped around my wrists…it never really helped.

Here’s an exercise that I find really helpful for helping prevent hand, wrist and elbow pains from gaming:

BACK PAIN

Back pain is becoming a more common complaint in esports and with young competitive gamers. Part of the issue lies in how sedentary modern societies have become. Sure, it’s not great to sit for several hours while gaming, but most of what people do throughout the day requires sitting. Whether it’s travelling, school, work or leisure, sitting makes up most people’s day. So when your sport requires you to be seated, problems can start to happen rather quickly.

Back pain in esports is experienced in all sorts of ways among the players. Sometimes it’s constant, sometimes it comes and goes. Pain can either be dull or throbbing. The good news is that back pain can usually be improved in those that suffer from it.

Why Does Back Pain Effect Esports & Competitive Gamers? Top 5 Reasons.

Posture is usually the first culprit. I do want to point out, however, that while proper posture can certainly help, it does not negate the negative effects associated with sitting.

Reason 1: Sitting often places an individual in a position that requires them to look down. Even if it’s a slight downward look, the human head weighs, on average, 10lbs. Any slight forward angle starts to put significant strain on the muscles around your neck and upper back.

Reason 2: Sitting at a computer or console promotes the shoulders to round forward as the individual slouches more forward. The worse your posture is the worse the forward rounding. Forward rounding shoulders will create imbalances causing your back (posterior chain) to become weakened. A simple test is to stand straight up and see where your arms/hands rest. If your palms are facing behind you, you’ve likely got imbalances going on.

Reason 3: Leaning forward from your lower back. This position puts unnecessary amounts of pressure on your lumbar (lower spine) and starts to compress your disks.

Reason 4: Having your elbows too far in front of your body. When lifting weights, the closer the weight is to your body the less stress it causes on your back and spine. Although using a keyboard and mouse isn’t exactly heavy lifting, being in a position where your arms are far away from the front of your body for eight or so hours, day after day, takes its toll on the back.

Reason 5: Sitting too long. Sitting means you’re sedentary, and when you’re sedentary your muscles get less oxygen and nutrients from blood because your blood flow is constricted. Less blood to your muscles means your back muscles can get weak and not perform optimally.

Competitive gamers and esports athletes will likely have several if not all of these reasons present in their back pain. That’s the reality of competitive gaming and esports. When you’re competing to be the best, proper posture and ergonomics kind of goes out the window.

Don’t worry, you’re not in a competition to see who’s the healthiest. But hopefully, you realize how debilitating an injury can be to performance. Cyber Athletiks aims to “bulletproof” a gamer’s body as much as possible. Not to make a healthy gamer, but to make a more competitive gamer than performs at a higher level.

PRO GAMERS WHO’VE SUFFERED FROM AN ESPORTS INJURY

  1. Flame (wrist)
  2. PawN (back)
  3. We1less (hand)
  4. Flash (wrist)
  5. BackHo (back)
  6. Jaedong (wrist)
  7. iloveoov (wrist)
  8. Light (wrist)
  9. Mvp (back; cervical kyphosis)
  10. Mazur (hand)
  11. ajuk12 (hand)
  12. mason (forearm)
  13. Chessie (back)
  14. YaphetS (arm)
  15. Fear (wrist)
  16. Riser (back)
  17. Faith_bian (arm)
  18. TLO (wrist)
  19. KinG (wrist)
  20. DeMusliM (arm)
  21. Denver (wrist)
  22. Ball (hand)
  23. MystiC (wrist)
  24. TooDming (wrist)
  25. FluX (wrist)
  26. dsl (wrist)
  27. Hax (hand)
  28. Isai (hand)
  29. Fiction (hand)
  30. KoreanDJ (hand)
  31. Druggedfox (hand)
  32. olofmeister (wrist)
  33. MusambaN1 (wrist)
  34. NENO (hand)
  35. ponczek (arm)
  36. pyth (wrist)
  37. GuardiaN (wrist)
  38. shadder2k (wrist)
  39. Fl0w3R (wrist)
  40. Life (hand)

*This is by no means a “complete” list. Please comment down below if you’re aware of others.

CONCLUSION

Should Esport athletes and competitive gamers be worried about repetitive stress injuries? Are esports to blame for tennis elbow in pro gamers?

Competitive gaming and esports will increase the risks associated with repetitive stress and back injuries, but that’s only half the story. What are pro gamers doing outside of their sport? Are they doing activities that will promote healing and preventing repetitive stress injuries? Or are they simply increasing their risks with similar activities (e.g., hunched over their phones typing) or worse, with crappy exercises that exacerbate the problem. Please, take a look at my Exercises to Avoid post so you don’t make matters worse.

Imagine having any of the above-listed symptoms while getting ready for a final match. The point of this article isn’t to instill fear into gamers and esport athletes. I am trying to get across the idea that the more optimal your body is functioning, the more likely you are going to succeed in competition, and the longer you will remain in the competition. So yes, gamers and esports athletes should be worried about repetitive stress injuries, as any decline in performance can mean the difference between a win or loss.

In case this post has you thinking about solutions like a standing desk, make sure you check out my post Should Gamers & Esports Use a Standing Desk? as it may not be the solution you’re looking for (and that’s coming from someone who uses a standing desk).

WHAT ARE SOME OTHER INJURIES FOR ESPORTS AND GAMERS?

CTS and tennis elbow are by no means a complete list of injuries that gamers should be aware of.

One of the surprising ones I’ve read about is “collapsed lung”. A collapsed lung is due to prolonged poor posture and an inactive lifestyle. This should never happen to gamers, and I hope I don’t read about it again anytime soon.

Wrist pain. Another common complaint among gamers. Wrist pain is typically a case of tendinopathy or tendonitis in the wrist and comes from overuse and inadequate recovery.

 

gl;hf

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Stuart Cameron

I'm the owner of Cyber Athletiks. I live in Canada and began competitive gaming near the dawn of esports. I've loved watching the scene grow to where it's at today.

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