Rothman Orthopaedic doctors give insight into esports injuries

Injuries in esports and gaming are more common than you think. In 2020, one of the most famous League of Legends players in China retired for health reasons. The then-23-year-old Jian “Uzi” Zi-Hao noted pain in his arms, shoulders and legs due to playing League for hours on end. The LOL superstar only just recently announced his return to competitive play after taking a year-and-a-half-long break to recover.

Other notable pros who have dealt with injuries include Overwatch’s Elliot "ELLIVOTE" Vaneryd, Patiphan “Patiphan” Chaiwong of VALORANT and Overwatch fame, and Counter-Strike: Global Offensive players Olof "olofmeister" Kajbjer Gustafsson, Richard "shox" Papillon and Kristian "k0nfig" Wienecke. Many of their injuries involve wrists and hands and can be attributed to overuse.

Nerd Street recently caught up with a couple of doctors who work at the Rothman Orthopaedic Institute, which has had a partnership with Nerd Street since 2020, to learn more about common ailments that affect esports pros and serious gamers, and what those players can do to stay healthy.

According to Drs. Edward Rosero and Bradley J. Smith, the most common injuries they tend to see among gamers are wrist injuries and hand tendinitis, along with upper back and shoulder pain. The wrist and hand injuries tend to crop up due to continual clicking of a keyboard or mouse, as well as from flicking a mouse. Back and neck problems often stem from bad posture and are a result of being slumped over in front of a computer screen for many hours at a time without breaks.

Smith also noted that there are even some differences in terms of common injuries among PC players versus console players. He said the thumbs of console players tend to be impacted more, whereas PC players are more likely to experience wrist tendinitis in their mouse hand.

The importance of good posture

Back problems are an issue for both types of players, however, and it’s often a result of posture and the chair they’re sitting in.

“You want a chair that’s going to sit you in an upright position,” Rosero said. “It might have a little bit of back or lumbar support to it … You don’t necessarily need a fancy chair or an expensive chair to do it, but if you have a chair that you find comfortable, you can adjust to a proper ergonomic position.”

Smith agreed and underscored how important posture is.

“You want to be able to have your shoulders back and your elbows back when you’re gaming, and so the chairs can make a big difference,” he said.

Making time to take breaks

In addition to posture, both doctors emphasized the importance of taking breaks from the competition.

“Professional athletes who dedicate 12 hours a day to their game and sport, the same principle should apply to esports,” Rosero said. “There should be a regimen of breaks, whether it’s one day a week, two days a week or even put a set time limit on hours that you play.”

Smith said it’s necessary not only to take breaks, but to get up and do something else for a while. He likened gamers and esports players dedicated solely to sitting in front of the computer all day to athletes who only play one sport year-round.

“A lot of overuse injuries we see are from just sitting the same way, being in the same position for hours on end, and, you know, I see it in business folks as well like adults who are sitting at a computer all day for work,” Smith said.

Focusing on mental health

Mental health can be every bit as important as physical health and has increasingly come to the forefront in many industries, including gaming and esports.

In just the past couple of years, high-profile figures like League’s Luka “Perkz” Perković and Call of Duty legend James “Clayster” Eubanks have publicly acknowledged they were taking breaks for mental health reasons. Clayster told the Dallas Morning News that prior to stepping away from his team, he “struggled a lot and even felt guilty about struggles.”

Several teams are even putting more of a priority on mental health, including Misfits, Complexity, Acend, Cloud9 and FlyQuest. In an interview with Nerd Street last year, Complexity CEO Jason Lake said “at Complexity, we are definitely trying to normalize speaking about mental health in esports. We openly encourage people to seek a therapist, to seek counseling, at the first sign of any feeling of being overwhelmed.”

Smith said mental health is “hugely important,” and Rosero added he believes mental and physical health go hand-in-hand.

Rosero said that if you find yourself raging, you should put the game down, stand up and walk away from the screen — and if you’re playing with someone who’s toxic, get away, period.

Smith noted that it can be difficult for young gamers to modulate their emotions, but it’s always good to keep things in perspective.

“At the end of it, you know if you get sniped from 200 yards, like you were digitally sniped, you’re still fine, you’re still alive, it’s still a game. It’s like you gotta remember I'm gonna live to play another game,” Smith said. “It’s hard, even myself sometimes I’ll get frustrated when I’m playing, but you gotta try to not let it get you down as much.”