Esports, Injuries, and Non-Virtual Pain

Reviewed by: Dr. Steven Knauf, D.C.

By: Paul Rothbart

Not long ago, connecting with someone across the country meant writing letters or paying for long-distance calls. Today, technology has turned those barriers into relics of the past. Imagine a teenager in Portland, Oregon, teaming up with a friend in Portland, Maine, to compete in an online esports tournament. They strategize, laugh, and share victory—all in real-time, as if they were sitting side by side. Technology hasn’t just changed how we work or play—it’s redefined how we connect, bringing the world closer with every click.

Sports and gaming have also felt the impact. Home video games have come a long way from Pong in the 1970s when an entire generation was captivated by blips on a screen. But now, a new competition arena has been created around virtual sports and other computer games. Pong has been replaced by dragons, zombies, gangsters, warriors, armies, airplanes, and racecars. Virtual as they may be, esports are real, and they are here to stay. There is even a National Esports Association.

According to Statista.com, the number of esports players in the United States surpassed 47 million in 2023. This figure is projected to climb to 57.43 million by 2025 and reach 72.46 million by 2029. The U.S. esports market is booming, with big numbers and business opportunities. It is valued at approximately $871 million in 2023 and is expected to grow to $1.07 billion in 2024. About 190.6 million people in the U.S. play video games at least one hour per week.

Esports are great for those with good reflexes and hand-eye coordination who don’t like to get too physical. You don’t feel the crush of a tackle playing Madden or suffer bullet wounds playing Call of Duty. However, there is such a thing as esports injuries. Virtual athletes must be as careful as their real-life counterparts to avoid getting hurt or suffering pain and discomfort.

We help many athletes stay healthy and competitive—and we can do the same for esports players. Parents, especially, need to be aware of the types of injuries their kids might experience from playing video games for long hours—or even injuries they might face themselves.

What are the most common injuries experienced by esport athletes?

Just as sports-related injuries in athletics, like ACL injuries in football, are common for virtual athletes, anyone who sits at a desk in front of a computer monitor for a living knows the toll it can take on the body.

Esports athletes do almost the same thing, except they often do it for more hours a day or week. This can cause painful injuries that take time to heal and will keep an athlete out of the game for some time. Let’s look at some of the perils of the gamepad.

Digital eye strain

Looking at a computer monitor for long periods is hard on the eyes. This is especially true in esports, where competitors must quickly look all over the screen during a game. This can strain the muscles that move the eyes and cause pain, blurred vision, and dry eyes.

Lower back and neck pain

Sitting for long periods frequently strains the lower back and causes pain. Poor posture exacerbates the problem and can also cause neck pain.

Tension headaches

The strain that long periods of sitting and poor posture put on the neck can cause painful tension headaches. Sitting with your head toward the monitor is a sure way to unlock this achievement.

Mouse elbow and mouse shoulder

Not just tennis players; golfers and swimmers have specific joint injuries. Gripping and manipulating a computer mouse for long periods can strain the muscles and tendons of the elbow and shoulder. This often leads to tendonitis or tendinopathy, painful and damaging injuries.

Gamer’s thumb

Many esports games require moving a directional stick around with the thumb. This frequently damages the tendons, causing tenosynovitis, the technical term for the injury. Non-doctors know it as “gamer's thumb.”

Carpal tunnel syndrome

Another common hand and wrist injury, carpal tunnel syndrome, is caused by irritation to the median nerve, which sits in the carpal tunnel at the base of the hand. Excessive wrist use causes inflammation and pain.

Deep vein thrombosis

The lack of movement experienced by people who drive work at a desk, or game for long hours can cause reduced blood flow in the legs and lead to clots. This is a serious issue because the clot could break loose and travel to the heart or lungs, which can kill you—and there’s no reset button for that.

What are the differences between boys and girls regarding esports injuries?

The personality differences between men and women can make female athletes and their male counterparts more prone to different injuries. Parents should be aware of this.

Boys tend to engage in longer gaming sessions, which makes them more susceptible to repetitive strain injuries in the wrists, elbows, shoulders, and back. Although girls tend to spend less time gaming, they appear more prone to digital eye strain. This is believed to be due to a preference for a different screen brightness level and gaming habits.

What can parents do to help their children avoid injuries during gaming?

Parents play an important role in preventing gaming injuries in their children. Kids are not yet mature enough to know how to care for their bodies. They can easily get caught up in the thrill of the game and lose track of time.

Limit gaming time

Esports injuries are generally caused by overuse. Setting limits on how long your child can play per day and the length of sessions goes a long way toward preventing injuries. Ensure they sleep enough and aren’t playing late into the night. Protect their eyes by teaching them the 20-20-20 rule. This states that after every 20 minutes of screen time, the gamer looks away from the monitor at an object 20 feet away for 20 seconds. It helps the eyes relax and avoids strain.

Proper posture

Good posture is vital to good health. Ensure your little gamer sits up straight with feet flat on the floor. Their heads should be held up while looking at the monitor, which should be at eye level, and they should not lean forward. Ensure their elbows are bent, and their wrists are straight while using gaming devices.

Encourage them to take breaks

Set a timer and have the kids step away from the game every hour for at least five minutes. Have them move around, take a walk, and drink some water.

Provide good ergonomics

You can significantly reduce the risk of esports injuries by providing ergonomic gear. Buy a quality computer chair with good lumbar support. Ergonomic keyboards, mice, and game controllers are designed to be comfortable and stress the hands and fingers less. A desk that holds the keyboard and monitor so the lower arms are straight, and the eyes see the top of the monitor when looking straight ahead will help prevent injuries and digital eye strain.

Stretching

All athletes, including gamers, should stretch. Light stretching before, after, and during long sessions helps keep the muscles and tendons warm and flexible and can help prevent pain and injury.

How can chiropractic care help manage or prevent gaming-related injuries?

Many professional athletes, including some of the all-time greats, credit chiropractic care with helping them reach the levels of success they attained. Esports stars can benefit from seeing a chiropractor, too.

When the spine or joints have subluxations or other issues, a gamer is much more likely to suffer pain or injury after sessions. A chiropractor performs exams and finds these problems. Spinal adjustments, or adjustments to other joints, help get the body properly aligned and better able to navigate the real-life rigors of virtual competitions.

Coupled with proper posture, regular chiropractic treatments are an important part of the routine to keep esports athletes injury-free and able to participate in their game of choice. Chiropractic might even boost performance. Studies show that adjustments may help reduce reaction time and speed up reflexes. Any gamer can tell you that can be the difference between defeat and victory.

Esports are a legitimate form of competition, and virtual athletes need to train and protect themselves from injury just like their on-the-field counterparts. With clinics nationwide, we make it easy to bring your gamer in for an exam and adjustment. Let’s help them stay injury-free and keep enjoying the game they love.

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