Health on the esports circuit: Competitive video game players can face a range of injuries

ROCHESTER, Minnesota — Competing in esports, also known as electronic sports, can mean training for several hours a day in front of a screen. Whether people participate in video game competitions at the professional or amateur level, they face physical and cognitive demands. Jane Konidis, M.D., a physiatrist and director of Gaming and Esports Medicine at Mayo Clinic in Rochester, shares tips to protect your health, whether you're using a video game console, computer or smartphone for esports activities.

"Esports are extremely demanding," Dr. Konidis says. "They require sustained fine motor movement, upper extremity speed, hand-eye coordination and keen cognitive function, as some games are all strategy. As society moves to more digital platforms, these conditions will become more prevalent not just in esports players but also in people who are on the computer often and for long periods of time."

Esports athletes range from amateur players to professionals. Dr. Konidis and her team treat competitors across all age groups, though most are adults in their 20s to 40s. Interestingly, novice players average 50 action moves a minute, while advanced players can make up to 500 to 600.

Here are common esports injuries:

Eyestrain: Eyestrain is the most frequently reported condition among esports players, with research in BMJ Open Sport & Exercise Medicine indicating that it affects up to 56% of competitive gamers. Extended screen exposure without adequate breaks is the primary risk factor for symptoms, including eye fatigue and irritation, blurred vision, headache, and eye pain.

Gluteal amnesia, also known as dead butt syndrome: Long hours of sitting can cause the glutes to become weak and underactive over time, Dr. Konidis says. Since the gluteus maximus is one of the body’s strongest muscles, poor glute function can contribute to a host of other issues, such as low back and knee pain. Exercises such as squats, glute bridges, and clamshells can help keep the glutes strong and working properly.

Musculoskeletal injuries: Many esports players experience upper extremity pain resulting from repetitive fine motor movements, such as typing, clicking a mouse and manipulating a controller. Over time, the pain can progress to an overuse injury, such as carpal tunnel syndrome or common extensor tendinopathy, also known as gamer's elbow or tennis elbow.

Neck and back pain also are prevalent due to prolonged static postures. Comparative data on whether esports athletes experience higher rates than those of other sedentary populations does exist, but it's unclear whether it is higher than that of the general population.

Metabolic and cardiovascular risks: Esports athletes face metabolic and cardiovascular risks from prolonged sitting, including potential impacts on heart health and body weight.

The term "gamer's thrombosis" has emerged to describe documented cases of venous thromboembolism (VTE) in gamers, which is exceedingly rare, according to research reviewed in the Ochsner Journal.

"The cases reported are usually people with video game addictions who were sitting in front of a computer for four or five days in a row — or with a preexisting medical condition putting them at high risk for VTE," Dr. Konidis says.

Sleep and mental health concerns: Chronic exposure to blue light from electronic devices disrupts circadian rhythms, affecting sleep quality. The impact is often greater in esports athletes who may participate in international events across time zones.

Some players also report depression and anxiety symptoms, though not necessarily at rates higher than those of the general population.

Gamers should receive the same comprehensive health screening that traditional athletes do, Dr. Konidis suggests.

"The basics of what we do for other athletes should be applied to esports athletes, but with a tailored exam that's more focused on their needs for eye, upper extremity and fine motor movements," she adds.

Here are strategies to help prevent esports injuries:

• Engage in pregaming warmups targeting the upper extremities to reduce hand and wrist pain. Take regular movement breaks during play to prevent neck and back discomfort.
• Use the 20-20-20 rule to reduce eye strain: Every 20 minutes, look 20 feet away for 20 seconds.
•  Be physically active.
• Follow good sleep habits. Proper sleep is also important for mental health, optimal performance and recovery.

Athletes can benefit from a multidisciplinary approach to care. At Mayo Clinic, the Gaming and Esports Medicine team includes physical medicine and rehabilitation physicians and physical and occupational therapists. Team members may also consult hand surgeons, psychologists and nutrition and lifestyle counselors to provide care tailored to the needs of esports players.

For more information, visit mayoclinic.org/medical-professionals.

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Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu