Editorial: Injuries, Esports’ Biggest Threat
eSports Injuries

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Physical injury can be a death nail in any athlete’s career. The long hours and repetitive motions mean that esports professionals are facing similar risks to those in other sports. Gaming injuries are nothing new, but the rising popularity of esports, with competition payouts and sponsorship deals, mean the stakes have never been higher. Unexpected injuries have caused pro-players to drop-out of tournaments, potentially costing them thousands. Taking proper preventative measures can help the next generation of esports professionals sustain long careers.

‘Nintendinitis’, ‘Playstation Thumb’ and Other Ailments

Gaming injuries are nothing new. The arrival of popular home systems in the 80’s came with a swath of video game related injuries, according to this 2014 article in the British Medical Journal. The term ‘nintendinitis’ was coined to describe hand and wrist injuries from excessive play. People reported sore necks from long Game Boy sessions. There were even some reports of Nintendo related incontinence. Children would become so transfixed by the games that they would forget to go to the bathroom and soil themselves. These cases were successfully treated by teaching the children how to pause the game.

As controllers changed so did the injuries. Central palmar ulcers (blisters on the palm) from spinning the Nintendo 64 joystick with the palm while playing Mario Party led the company to send protective gloves to game owners. In the early 2000’s there was even concern that ‘playstation thumb’ might be an epidemic. The repetitive strain injuries (RSI) that doctors were seeing in children were what they would expect from adults working repetitive jobs like meat packing.

With the availability of motion sensing systems such as the Wii came a rise in injuries from people hitting themselves or each other, and bumping into things. There was also a rise in injuries similar to what you would expect from playing the sports that these systems imitated such as tennis elbow.

Going Pro

The big difference now is that playing video games professionally has become a more viable way to make a living. The prize pool for Dota 2 tournament The International 2017 was around $25 million. People are training hard to be competitive. Some train 10 hours a day, 6 or 7 days a week. This means that they face much higher risk of injury than casual gamers.

The obvious risk is RSI from doing repetitive motions for hours. Numerous pro players have retired due to RSI. Famous League of Legends (LOL) player Hai Du Lam retired in 2015 due to a wrist injury; though he later returned to the sport. Similarly, Smash Bros player Aziz “Hax” Al-Yami has had his career set back by a severe wrist injury that has required multiple surgeries.

Pro Smash Bros Player Hax wears a wrist brace after suffering severe wrist problems source

Focus on Prevention

Health care professionals advise that these athletes should focus on prevention. If you begin to feel pain, it means that the overstrain has been going on for a long time. In an interview with Dexerto, sports therapist Scott Kingdon makes a number of recommendations for esports players. Players should warm up before matches or training sessions. Try out Dr. Levi Harrison’s hand and wrist exercises for gamers here. Other stretches could include stretching your fingers with an elastic band for resistance and doing wrist curls with a weight.

Another important step he recommends is taking breaks. It is recommended to take micro-rests. After every hour of gaming take a short break, get up, walk around and do some exercises to get your blood circulating. Getting blood flowing in your muscles and tendons will significantly help reduce the risk of injury.

People tend to assume that because esports players are sitting in chairs they are in a resting, low-impact position. The reality is that when people are at a computer focusing on a task, their upper bodies are tensed. This tension can reduce blood circulation to tendons and when held for a long time, can increase the risk of injury.

Health professionals also point to poor posture as a big problem. Bad posture can worsen circulation problems and add unnecessary strain to areas that are already under pressure. Try combating poor posture with a proper gaming chair, ergonomically designed to reduce injury.

Spontaneous Lung Collapse

A more surprising injury popping up in the profession is spontaneous lung collapse. Several pro-players have experienced collapsed lungs. LOL player Hai Du Lam, whose wrist injury we already mentioned, had a collapsed lung in 2014. Song “Janus” Jun-hwa, an Overwatch player, was rushed to the hospital with a collapsed lung in March 2017. Lukas “gla1ve” Rossander, a competitive CSGO player, has suffered three collapsed lung injuries.

Lol player Hai Du Lam gaming in the hospital after a collapsed lung source

No direct link has been made between esports and spontaneously collapsed lungs. However, several doctors have pointed to general health problems common among pro-gamers that may contribute to lung collapse. This includes poor diet and being underweight, poor posture, being out of shape, and being in high stress situations. To avoid collapsed lungs, they recommend practicing good posture, having a proper diet, regular exercise and getting enough rest.

The Future of Esports

In more established sports, the long term health impacts are better understood. The long term health impact of esports in not yet entirely known. In other professional sports leagues, there are typically resources available to athletes such as physical therapists and dietitians. Esports are slowly catching up with some teams engaging medical professionals to help reduce the risk of injury.

Another big difference is athlete lifestyle. Your typical athlete such as someone training for the Olympics follows a strict diet and sleep regiment. The culture of esports, though changing, is typified by poor diet and sacrificing sleep to play. The stereotypical image is someone pounding monster energy drinks and playing until the sun comes up. Most pro-gamers are underweight and have a low level of general fitness. The reality is that poor general health can hurt performance and cut careers short.

More established teams are trying to address this problem. For instance, LOL team the Immortals have a fitness coach making sure that their athletes like Eugene “Pobelter” Park consume enough calories. The new generation of esports athletes has the benefit of learning from their predecessors. Adopting good practices early on can help increase the length of a professional career. As the various leagues become more established, athletes are gaining more resources such as access to fitness coaches and physical therapists.

As people become more dependent on esports to make a living, the leagues need to develop ways to support injured athletes. An injury could mean that supporting your family or even feeding yourself is at risk. As the leagues develop, contract provisions and insurance will likely help to address this problem. In the meantime, if you are contemplating a career in esports make sure to adopt preventative measures to help sustain a long and profitable career.


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Fiona works with passionate groups of gaming enthusiasts covering competitive gaming products, services and industry trends.

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