Esports Injuries

Esports are extremely taxing, both physically and mentally. And, like all traditional sports or other highly physical activities (e.g., rock climbing, hiking, and exercising), there is a risk for many different physical injuries and ailments. For some unlucky competitors, esports injuries have lead to missed events, surgery, or even early retirement.

The sad truth about the aforementioned injuries, surgeries, and/or retirements is that all esports injuries are preventable, and even if someone has developed an injury, nearly all esports injuries are treatable and reversible when handled correctly.

Simply stated, eye strain is the most common ailment for all gamers from the most casual gamer to the most intense competitor. Of course, this ailment is even more common for those participating in esports due to the excessive amount of time spent looking at a monitor.

Eye strain is a condition that occurs after long hours of strenuous activity for the muscles in and around your eyes. For gamers, this will occur after prolonged screen time which includes short, rapid movements of the eyes and focus only on the monitor(s) in front of you.

Eye strain is exactly what it sounds like. After staring at your screen for hours on end, the muscles in and around your eyes become irritated or strained. There are muscles on the outside of your eyes for eye movement, and there are muscles inside your eyes to contract or relax the lens and pupil. Each of these muscles have the potential to become strained.

Lower back pain is among the most common ailments experienced by gamers of all levels. Similar to eye strain above, lower back pain exists more commonly in people who spend more time seated, regardless of whether or not they are gaming.

In fact, lower back pain is the number one cause of both doctor’s visits and time off from work in the United States. Lower back pain is a complicated ailment with many causes—each of which will affect different tissue(s). On this page, you will learn the anatomy of the lower back as well as common causes, symptoms, and conditions.

Neck pain is also among the most common ailments experienced by gamers of all levels. Neck pain is most commonly caused by poor body position regardless of whether or not you are sitting, but poor seated posture while gaming is certainly a perpetuating factor.

Neck pain is caused by a variety of other factors including injury, muscular imbalance, and stress. Of course, there are other causes of neck pain; however, for this page we will focus specifically on neck pain from gaming. Knowing the cause of pain is just as important as the pain itself. On this page, we discuss the anatomy of the neck as well as common causes, symptoms, and conditions.

Upper crossed syndrome, itself, does not fall in the category of esports injuries; however, it can lead to or exacerbate other physical ailments. Upper crossed syndrome is a postural imbalance that occurs in the muscles of the upper back, scapulae, and shoulder joints. This condition is often a result of prolonged sitting and will be exacerbated by poor posture.

While sitting, some muscles are stuck in a shortened position—a position which begins to take hold. At the same time, other muscles are stuck in a lengthened position, and these muscles become weak or inhibited.

Like its counterpart above, lower crossed syndrome, itself, does not fall into the category of esports injuries. But, like upper crossed syndrome, it can lead to or exacerbate other physical ailments. Lower crossed syndrome is a postural imbalance that occurs in the muscles of lower back, pelvis, and hip joints. This condition is often a result of prolonged sitting and will be exacerbated by poor posture.

While sitting, some muscles are stuck in a shortened position—a position which begins to take hold. At the same time, other muscles are stuck in a lengthened position, and these muscles tend to become weak or inhibited.

Tension-type headaches are considered secondary headaches. In other words, they are not truly pain in the head (e.g., the brain, its protective sheaths, or the skull). Instead, muscles of the upper back, neck, head, and face refer pain to different regions of the head.

Commonly, tension develops in the muscles of the upper back and neck when posture is poor. For gamers, this usually occurs when the head is leaning towards the monitor and the shoulders are rounded forward—a condition known as upper crossed syndrome.

Mouse elbow is one of the most common esports injuries (all the above are better categorized as ailments or conditions). Mouse elbow is a chronic injury to the extensor tendons of the forearm (which control the wrist and fingers) that attach to the outside (thumb side) of the elbow. The muscles involved are the extensor muscles that open the hand and bend back the wrist. As the name suggests, PC gamers are more likely to experience this injury due to the use of the mouse.

Due to misuse and imbalance, the fiber orientation of the extensor tendons on the outside of the elbow become disrupted. This dysfunction is called a tendinopathy, which is different than tendinitis—a common misnomer for this condition. Collectively, tendinopathies are the most common esports injuries.

Gamer’s thumb is the common term for the diagnosis of tenosynovitis from repetitive use of the thumb. Specifically, gamer’s thumb affects the tendon sheaths of the extensor pollicis brevis and abductor pollicis longus muscles. These muscles pull the thumb away from the hand and palm.

This condition is also commonly associated with and precedes de Quervain’s—or stenosing tenosynovitis—of the same tendon sheaths named above. This condition is categorized by thickening and hardening of the tendon sheath and will often require surgery.

In console gaming, these motions are primarily involved in thumb stick movements. This condition has also recently been identified with greater prevalence due to text messaging on mobile devices and is sometimes called “texter’s thumb.” Although possible, a diagnosis of gamer’s thumb is less common for PC gamers than it is for console gamers.

Mouse shoulder is an ailment that occurs in the proximal (closer to the center of the body) tendon attachment of the long head of the biceps [brachii] muscle. The biceps muscle is involved in both elbow and shoulder flexion. As the name suggests, PC gamers are more likely to experience this injury due to the use of the mouse.

Due to misuse and imbalance, the fiber orientation of the tendon becomes disrupted. This dysfunction is called a tendinopathy, which is different than tendinitis—a common misnomer for this condition. Collectively, tendinopathies are the most common esports injuries.

The sacroiliac (SI) joints are where the two halves of the pelvis connect to the spinal column. Sacroiliac joint dysfunction is the term used when describing restriction or fixation of the SI joints.

Restriction in these joints is common, but if left untreated, the restriction may cause a cascade of other issues. For example, restriction can alter gait (walking pattern), which may affect the hips, knees, ankles, or feet.

Alternatively, restriction may cause an imbalance where one half of the pelvis is higher or lower than the other side. This imbalance, known as pelvic obliquity, may cause a mild corrective curve in the spine to keep your head upright. This is known as functional scoliosis, and this may cause pain and tightness in different areas of the spine.

Sciatica is the name for pain patterns caused by direct irritation of the sciatic nerve—most notably in the back of the thigh and leg. The sciatic nerve is most often irritated by the piriformis muscle, a hip muscle that exits the pelvis through the same opening as the sciatic nerve.

For gamers, sciatica usually occurs due to prolonged sitting and is exacerbated by poor posture. Refer to our guide for gamer posture to reduce your risk for the piriformis muscle causing sciatica.

Another condition that causes sciatic-type symptoms is spinal nerve root impingement. This condition is also known as lumbar radiculopathy and can present with pain patterns mirroring sciatica. However, true sciatica is direct impingement of the sciatic nerve in the gluteal region, and this page will focus on this condition.

Migraine headaches are true, primary headaches affecting the brain and its surrounding tissues. There are different theories about migraines, but one of the more widely accepted theories describes a phenomenon called cortical spreading depression.

Note: This information is based on a well-researched theory. This theory is currently the best available. As new research is published, this information will be updated and changed, if necessary.

Thoracic outlet syndrome occurs when there is impingement on the nerves or blood vessels in an area between your clavicle (collar bone) and ribs in the space between your neck and shoulder joint.

Most often, thoracic outlet syndrome in gamers will come secondary to poor posture—slouching forward in their chairs and leaning towards the screen while gaming. Another condition which may lead to thoracic outlet syndrome is upper crossed syndrome.

Medial epicondylosis is an ailment that occurs in the flexor tendons of the forearm (which control the wrist and fingers) that attach to the inside (pinky side) of the elbow. The muscles involved are the flexor muscles that close the hand and flex down the wrist.

This injury tends to be more common in console gamers. It would not be surprising if this condition earned a gamer name—perhaps along the lines of “trigger elbow” or “console elbow.”

Due to misuse and imbalance, the fiber orientation of the flexor tendons on the inside of the elbow become disrupted. This dysfunction is called a tendinopathy, which is different than tendinitis—a common misnomer for this condition. Collectively, tendinopathies are the most common esports injuries.

Cubital tunnel syndrome is an impingement or irritation of the ulnar nerve within the cubital tunnel at the elbow. This is the area commonly referred to as the funny bone. If the ulnar nerve becomes irritated in this region due to pressure, inflammation, and/or stretching, symptoms will occur.

Cubital tunnel syndrome is more prevalent in console gamers due to the position of the hands and arms while gripping a controller. If you’re a console gamer, you’re more likely to develop cubital tunnel syndrome if you lean your elbows on your knees or on the armrests of your chair.

Note: although more common in console gamers, PC gamers are not completely excluded from experiencing cubital tunnel syndrome. If you’re a PC gamer, you may still be at risk for developing cubital tunnel syndrome.

Carpal tunnel syndrome is impingement or irritation of the median nerve within the carpal tunnel—an anatomical structure found at the base of your hand. When the median nerve becomes irritated in this region due to pressure, inflammation, and/or stretching, symptoms are likely to occur. Despite its attention, carpal tunnel syndrome is actually not among the most common esports injuries.

However, carpal tunnel syndrome tends to occur in people who spend a lot of time using a PC with poor body mechanics; therefore, if you’re a PC gamer, you are more likely to experience this ailment. More specifically, carpal tunnel syndrome is more likely to occur in your right hand due to prolonged extension of the wrist to hold the mouse.

Note: if you’re a console gamer, you are not necessarily excluded from the risk of developing carpal tunnel syndrome. However, due to the hand positions and movement patterns involved in gripping a console controller, it is significantly less common.

Deep vein thrombosis is clot formation in the deep veins—most commonly in the lower leg. This may occur in gamers due to the lack of movement during long sessions of gaming and/or streaming. The lack of movement can cause the blood flow in the legs to become stagnant, and stagnation triggers the formation of clotting.

If a clot, called a thrombus, forms in the deep veins of the lower leg, the clot could eventually break free. This is a severe health risk. If this occurs, the embolus (free floating clot fragment) will go through the vascular system, through the heart, and eventually may become lodged in the lungs. This condition is known as a pulmonary embolism and is a medical emergency!