Learn about Physical Therapy in Esports by Jordan Tsai of Respawn Therapy

There are an estimated 2.7 billion gamers in the world according to Statista.com in 2020. Studies show that the average gamer will spend around 7 hours a week playing games. In comparison, the average professional esports athlete will practice for 12-14 hours a day and usually 6 days a week. This added playtime can lead to significant strain on the body causing pain and disability limiting the ability to continue practising. As teams continue to invest more money into their rosters, it becomes increasingly more important to focus on player health to ensure that they are not ending their careers due to preventable or treatable problems.

-

How can Physical Therapy (PT) help?

In the world of sports, physical therapists (PTs) are typically perceived as medical professionals who address issues related to movement such as those seen in typical traditional sports such as jumping, throwing, catching, etc. However, PTs are also trained and skilled in addressing problems related to posture and static positions as seen in individuals who spend prolonged periods of time sitting at a desk doing computer work or playing games. An article published in 2019 found that only 2% of collegiate esports athletes (with shorter practice schedules than that of professionals) reported their injuries to medical providers. This means that many potential injuries are going unnoticed and untreated. Over time, these seemingly insignificant issues can spiral into full-blown injuries that cause loss of playing time or even premature retirement in some cases. Studies have shown that physical therapy can significantly reduce neck, arm, and low back pain in people who sit for long periods of time at a desk which is the typical position for most gamers. PTs will first evaluate and make an assessment of the musculoskeletal system involved to determine the source of pain or problem before prescribing a treatment plan usually involving a combination of manual therapy, mobility/strengthening exercises, ergonomics corrections, and activity modification recommendations. The primary goal of a typical PT treatment plan involves resolving or managing pain, returning to sport/activity, improving long term longevity, avoiding the use of pharmaceuticals, and preventing the need for more invasive treatments such as injections and surgeries.

-

Typical Pathologies

Currently, very little evidence exists in regards to common injuries in esports but that is changing rapidly as more research is being conducted. As a Doctor of Physical Therapy with a Clinical Specialty in Orthopedics, I have been working with professional esports organizations over the last few years including Cloud9, Evil Geniuses, and Team Solo Mid. Over that time, I have seen and treated various injuries including nerve entrapment, muscle strains, tendinopathies, and various types of joint irritation. Aside from pain alone, individuals experiencing these types of injuries may also have numbness/tingling, stiffness, and changes in sensation. Many of these injuries can be prevented with adjustments to the player’s playing position followed by exercises to address muscular imbalances and improve body awareness before the injuries progress into more serious problems that may require longer courses of treatment to resolve. However, a full assessment of the entire body region is ideal to fully diagnose and treat the problem. I emphasize the need for good habits such as optimal ergonomic desk set up, regular flexibility and cardiovascular/strengthening exercise, diet, and healthy sleep habits to ensure that my players are fully recovering from their training schedules. These practices are helpful for gamers of every level but grow increasingly more critical the
more hours players spend gaming each day.

-

Here are a few basic exercises that will help most players between games

Wrist Extensor Stretch

Extend one arm out straight.
Lightly pull the hand down from the knuckles until you feel a light pull in the forearm.
Hold for 30sec.

-

Upper Trapezius Stretch

Place one hand behind your back to stabilize the shoulder blade.
Using your other hand, gently pull your head to the opposite side until you feel a stretch in the
side of your neck and upper shoulder.
Hold for 30sec.

-

Scapular Squeeze

Pinch your shoulder blades together.
Hold for 10sec.

-

Professional esports organizations will need to continue improving their player health and wellness programs as they grow. Physical therapists also need to continue developing their treatment methodology to better suit this population if they want to provide optimal treatment to gamers. Regardless of the patient population, a physical therapist’s role is to adjust to the expectations and demands of the activity while providing the appropriate recommendations for activity modifications and exercises. Overall, gamers need to realize that even though it may not be apparent that playing games can cause injury, there is actually significant strain on many structures and receiving proper medical attention can greatly improve their ability to play longer and improve their longevity in esports.

*The information provided is educational and not intended to substitute medical advice. If you are experiencing pain, please see your medical provider.*

-

Works Cited:

• DiFrancisco-Donoghue J, Balentine J, Schmidt G, et al. Managing the health of the eSport athlete: an integrated health management model. BMJ Open Sport & Exercise Medicine 2019. 5:e000467. doi: 10.1136/bmjsem-2018-000467

• Lajka, A. (2018, December 21). Esports players burn out young as the grind takes mental, physical toll. Retrieved October 21, 2020, from https://www.cbsnews.com/news/esports-burnout-in-video-gaming-cbsn-originals/

• THE STATE OF ONLINE GAMING – 2020. (n.d.). Retrieved October 21, 2020, from https://www.limelight.com/resources/white-paper/state-of-online-gaming-2020/

• Sjögren, Tuulikki & Nissinen, Kari & Järvenpää, Salme & Ojanen, Markku & Vanharanta, Heikki & Mälkiä, Esko. (2005). Effects of a workplace physical exercise intervention intensity of low back symptoms in office workers: A cluster randomized controlled cross-over design. Journal of Back and Musculoskeletal Rehabilitation. 18. 1-12. 10.3233/BMR-2006-19103.

•  Xiaoqi Chen, Brooke K Coombes, Gisela Sjøgaard, Deokhoon Jun, Shaun O’Leary, Venerina Johnston, Workplace-Based Interventions for Neck Pain in Office Workers: Systematic Review and Meta-Analysis, Physical Therapy, Volume 98, Issue 1, January 2018, Pages 40–62, https://doi.org/10.1093/ptj/pzx101