Common Gaming Injuries and Ways to Prevent Them

Oct 15, 2021 | Gaming and Your Body

Esports professionals and gaming enthusiasts often spend hours navigating complex games with increasingly challenging levels. This gradually takes a toll on the body, leading to a number of common gaming injuries. Console gamers frequently experience hand injuries, while PC gamers usually develop wrist problems. All avid gamers typically experience some form of back pain.

Common Types of Injuries

Gamer Hand Pain

Gamer’s thumb (De Quervain’s Tenosynovitis) is an overuse injury that develops when tendons in the thumb and wrist become inflamed. It’s caused by repetitive thumb strain [1]. The symptoms include: pain in the hand, thumb, and wrist that worsens with movement; a popping sensation when the thumb is moved; and swelling in the lower region of the thumb.

Ulnar nerve irritation (Cubital tunnel syndrome) is a syndrome that develops due to pressure, stretching, or inflammation of the ulnar nerve where it passes through the cubital tunnel in the elbow [2]. The pain reflects hitting the funny bone. It’s caused by holding the arms and hands in the same position (prolonged elbow flexion) while tightly gripping a controller for extended periods. Pressing the elbows against an armrest or the knees increases the risk of ulnar nerve irritation. The symptoms include: aching pain in the elbow; numbness or tingling in the ring finger and pinky; and hand weakness (loss of grip).

Gamer Wrist Pain

Carpal tunnel syndrome (Median nerve compression) is a syndrome that develops when the median nerve that runs through the carpal tunnel becomes compressed [3]. It’s caused by repeatedly gripping a controller or mouse while gaming. This activity leads to overuse of the tendons and is most prevalent in gamers who play computer video games. 

The symptoms of carpal tunnel syndrome include: pain, numbness, burning, tingling, and weakness in the wrist and hand; pins and needles in the hand; and pain that extends toward the elbow. 

Keyboard wrist pain – pain, irritation, or inflammation of the tendons in the wrist due to repetitive movements. It’s caused by performing the same hand movements repeatedly during long hours of continuous gaming. This type of pain is more common in PC gamers. The symptoms include: aching pain in the wrist that worsens during or after activity, swelling of the wrist, and joint stiffness [1, 2].

Gamer Back Pain

Sciatica is a painful condition that results from the irritation or compression of the sciatic nerve in the gluteal (buttocks) region. It’s caused by inflammation of the piriformis muscle, which is a hip muscle that runs along the same region as the sciatic nerve [4]. The symptoms include: sharp, shooting pain or burning in the lower back, buttocks, thigh, lower leg, or foot; numbness, tingling, or pins and needles in the back or legs.

Other Common Gaming Injuries

Mouse elbow (lateral epicondylitis or tendinopathy) is the development of pain in the extensor tendons of the forearm. These tendons surround the lateral epicondyle, which is a bony structure on the side of the elbow. The extensor muscles that enable the wrists to bend and the hand to open may be also affected. However, lateral epicondylitis is described as a tendinopathy (painful condition of the tendons) because it doesn’t usually cause substantial inflammation [6, 7].

Mouse elbow is caused by constantly pressing or holding the keys on the mouse while moving the arm as this repetitive motion of shifting, squeezing, and gripping the mouse can make extensor tendons and muscles in the forearm fatigued and weak. The symptoms include: elbow pain, wrist pain while using a mouse, pain while bending or flexing the fingers, and mild inflammation immediately following the injury.

Neck strain – a type of pain associated with looking at a screen (e.g., a monitor) for long periods of time. It’s caused by subconsciously leaning forward while gaming [1, 2]. This incorrect posture increases the weight of the head, which places excessive pressure on the neck. Bending the head forward can increase the weight of the head by about five times its regular weight. This may also damage nerves, muscles, and ligaments in the neck.

Eye strain – fatigue or eye pain that develops when the eye muscles (intraocular and extraocular muscles) are overworked. It’s caused by a limited area of gaze and short, static focal distance that accompanies long hours of staring at a screen while gaming [5]. The symptoms include: eye pain, fatigue, blurred vision, headaches, double vision, dry eyes, burning or stinging, sensitivity to light, eye redness, and strained nighttime vision.

Blood clots (Gamer’s thrombosis) – deep vein thrombosis, which refers to the formation of blood clots in the legs from sitting for long hours while gaming [8]. Sitting for too long reduces proper blood circulation as this causes coagulation of blood in the veins that leads to clots that can break apart and travel to different parts of the body (e.g., lung, heart) where they can become lodged. This may result in a life-threatening situation if the clot significantly restricts blood flow. The symptoms include: pain and swelling in the leg, warm skin, lower leg cramping, or skin discoloration.

Poor posture, core weakness, and poor balance – incorrect body positioning that accompanies extended hours of gaming [5, 8-10]. Many gamers bend forward or slouch while sitting for long periods of time. Gaming devices such as the mouse, controller, and monitor also cause gamers to hold certain body parts (e.g., wrists, hands, elbows, and head) in fixed positions for hours at a time. The symptoms of poor posture include: body pain, reduced blood circulation, joint stiffness and weakness, and muscle, ligament, tendon, or bone damage.

Mouse shoulder – a condition that develops in the proximal tendon of the biceps brachii muscle. This muscle promotes shoulder and elbow flexion. It is caused by misuse or overuse of the shoulder that leads to an imbalance of the fiber orientation in the proximal tendon. Accordingly, the injury is referred to as tendinopathy, which reflects pain due to dysfunction rather than inflammation [9]. This injury is common in PC gamers. The symptoms include: pain in front of the shoulder or the upper arm; an increase in pain when the shoulder is raised upward and forward; discomfort when the arm is moved backwards; and shoulder weakness.

Repetitive motion pain – reflects a group of muscular conditions that develop due to repeated motions that accompany gaming. The pain is caused by uninterrupted repetitive actions, muscle fatigue, incorrect posture, and awkward or unnatural movements (e.g., overextension, twisting the wrist or arm). This form of pain includes discomfort caused by tendonitis, trigger finger, carpal tunnel syndrome, etc. The symptoms include: pain, numbness, tingling, redness or swelling of the affected area, which are most commonly the wrists, hands, elbows, neck, back, and shoulders [9, 10]. 

Prevention Is the Best Cure

Take a Break

Taking frequent breaks is one of the most important ways to prevent common gaming injuries. Stretching exercises during breaks is another useful strategy. For those who experience recurring injuries, a physical therapist may recommend wearing a wrist splint and hand brace for stabilization. These devices decrease the amount of pressure placed on the hand, wrist, arm, and elbow during movement [1-4]. 

Ice Packs

Minor repetitive stress injuries can be treated by icing an injured hand, wrist, or thumb to target swelling, inflammation, and pain [4, 6]. It’s easy to use an ice pack during a break or after a long gaming session. 

Over-the-Counter Painkillers

Minor repetitive stress injuries can also be treated with non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen [4, 6].

Therapeutic Massage

Therapeutic massage is beneficial for targeting or preventing gaming injuries. This form of treatment boosts the circulation of nutrients and oxygen that promote the rejuvenation of inflamed or damaged tissue. It also helps flush away toxins that are linked to gaming-induced inflammation. Receiving therapeutic massages regularly lessens tension in muscles, tendons, and ligaments. In addition, this approach helps break down scar tissue, allows muscles to regain strength, and lowers the risk of recurring injuries. 

Working closely with a physical therapist can ensure that the appropriate massage techniques are performed. Incorporating positional changes that support proper hand and body positioning also helps reduce the incidence of back pain as well as repetitive strain injuries. 

Good Posture

Finding ways to avoid poor posture while gaming is also beneficial. Slouching can be corrected by firmly pressing the back against a chair until sitting upright becomes a habit [1-3]. 

Overall, trying to keep the hands and body in a neutral position while gaming, taking frequent breaks, and practicing stretching exercises can help lower the risk of common gaming injuries.

References

1. Helliwell PS, Taylor WJ. Repetitive strain injury. Postgrad Med J. 2004;80(946):438-43.
2. van Tulder M, Malmivaara A, Koes B. Repetitive strain injury. Lancet. 2007; 369(9575):1815-22.
3. Bhanderi DJ, et al. Computer Use and Carpal Tunnel Syndrome: A Case-control Study. Indian J Occup Environ Med. 2017;21(3):109-114.
4. Jankovic D, Peng P, van Zundert A. Brief review: Piriformis syndrome: Etiology, diagnosis, and management. Can J Anesth. 2013; 60:1003-12.
5. Randolph SA. Computer vision syndrome. Workplace Health Saf. 2017 Jul;65(7):328.
6. Kahlenberg CA, et al. New Developments in the Use of Biologics and Other Modalities in the Management of Lateral Epicondylitis. Biomed Res Int. 2015; 2015: 439309. 
7. Andres BM, et al. Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon. Clin Orthop Relat Res. 2008;466(7):1539-1554.  
8. Rambaran KA, Alzghari SK. Gamer’s Thrombosis: A Review of Published Reports. Ochsner Journal. 2020;20(2):182-186.
9. Ratzlaff CR, Gillies JH, Koehoorn MW. Work-related repetitive strain injury and leisure-time physical activity. Arthritis Rheum. 2007;57(3):495-500.
10. Tjepkema M. Repetitive strain injury. Health Rep. 2003;14(4):11-30.

Is Gaming Giving you a Headache?

Aug 20, 2021 | Gaming and Your Body

When you’re in the middle of a gaming marathon, you’re probably sitting slouched in front of a TV or computer. You may even subconsciously tilt your head forward to get a closer view of the screen. This can compress nerves in your neck [1]. If this poor posture persists, it can make gaming a real headache. [3]. In other words, this posture can lead to tension headaches, neck pain, fatigue, poor concentration, and muscle tension [2]. Other gaming habits that may contribute to headaches include eye strain, a lack of sleep, stress, a poor diet, and fatigue. 

How Poor Posture Hurts 

When your head is straight, the levator scapulae and trapezius muscles in the back easily support the weight of your head and neck. Alternately, when your head is tilted toward a TV or computer screen the weight of your head and neck increases. This may overextend your deep neck flexors muscles. Over time, this can lead to a stiff neck, shoulder discomfort, back problems, and pain in the pectorals. Spinal bones in the neck area may even become damaged making it hard to turn your head properly. 

As a result, some gamers may develop upper crossed syndrome. Symptoms include persistent pain after sitting in a forward head position too long, or pain after slouching in a chair for lengthy periods. When you slouch instead of pressing your lower back against the back of the chair, the back shifts forward and your shoulders lean against the chair back. The extra tension on your shoulder muscles can cause shoulder pain[4]. 

Slouching can also lead to joint degeneration in your lower spine as poor posture stretches spinal ligaments as well as lower back and hip muscles (e.g., lumbar erector spinae, gluteus, iliopsoas) beyond a healthy limit. Poor posture can further worsen this condition by straining spinal discs, causing disc bulging or abnormal disc pressure (herniated disc). 

Keyboards, controllers… The types of gaming devices you use can also affect your body position and cause poor posture. For example, gamers who use a keyboard tend to curl their upper bodies and head forward. They’re also more likely to use their thumb, finger and wrist muscles. Conversely, eSports professionals or gamers who use console controllers tend to lean back and slouch. In both cases, poor posture is linked to upper body pain. The combination of poor posture with the repeated use of hand and finger muscles increases your risk of developing musculoskeletal disorders [4, 5]. In most cases, the irritation of nerves or muscles in the neck region is the primary cause of chronic pain [6].

How Good Posture Helps 

Good gaming posture—sitting in an upright position—helps increase energy levels, while decreasing frustration and restlessness [1]. This means that good gaming posture doesn’t just reduce your risk of pain. It also boosts your overall performance. 

Improve Posture, Reduce Pain

So how do you avoid poor posture while gaming? Here are some helpful tips, tailored to your gaming style.  

Leaners

Do you often lean towards the screen, tilting your head forward? Try applying therapeutic tape to both sides of your neck. This will help keep your head and neck upright [7].

Slouchers

If you’re a sloucher, practice pressing your back firmly against the chair until sitting in an upright position becomes a habit. 

Play Your Best Game

So now you know why chronic head, neck or shoulder pain makes it hard to enjoy gaming or eSports and impacts your performance [1, 4]. You also know poor posture can even lead to serious musculoskeletal problems that prevent you from playing at all. Well, knowledge is power! Use our products to improve your posture, maintain your health, and always play your best game!

References

1. Harvey R. The effect of head and neck position on head rotation, cervical muscle tension, and symptoms. Biofeedback. 2018;46(3):65-71.
2. Bader EE. The psychology and neurobiology of mediation. CJCR. 2015;17:363-392.
3. Fernandez-de-Las-Penas C, Alonso-Blanco C, Cuadrado ML, Pareja JA. Forward head posture and neck mobility in chronic tension-type headache: A blinded, controlled study. Cephalalgia. 2006;26(3):314-319.
4. Kietrys DM, et al. Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting. Appl Ergon. 2015;50:98-104.
5. Nahar S, Sayed A. Prevalence of musculoskeletal dysfunction in computer science students and analysis of workstation characteristics—An explorative study. IJARCS. 2018;9(2):21-27.
6. Xie Y, Szeto G, Dai J. Prevalence and risk factors associated with musculoskeletal complaints among users of mobile handheld devices: A systematic review. Appl Ergon. 2017;59:132-142.
7. Yoo WG. Effect of the neck retraction taping (NRT) on forward head posture and the upper trapezius muscle during computer work. J Phys Ther Sci. 2013;25(5) 581-582.

Did Gaming Give You Mouse Elbow?

Apr 16, 2021 | Gaming and Your Body

How to Treat Mouse Elbow

Mouse Elbow… it’s a Thing

So what exactly is mouse elbow? Also known as lateral epicondylitis, it refers to inflammation in the extensor tendons of your forearm. It may also include inflammation in the extensor muscles that allow your hand to open and your wrist to bend [1, 2]. People who constantly use a computer mouse, like avid gamers or eSports professionals, are more susceptible to this type of injury. 

The Anatomy of a Mouse… Elbow

To get a better understanding of how this condition develops, it’s important to learn about the anatomical structure of the forearm, hand and wrist. The tendons affected by mouse elbow are collectively known as the common extensor tendon. It consists of four muscles and tendons that join in one area called the lateral epicondyle. Additional structures that may be involved include:

• The extensor digitorum
• The extensor digiti minimi
• The extensor carpi ulnaris
• The extensor carpi radialis brevis
• The extensor carpi radialis longus 
• The supracondylar ridge

These structures enable fine motor movements of the fingers, hands, wrist and forearm. The tendons and muscles also extend into the elbow region. Gaming and eSports enthusiasts develop mouse elbow after repeatedly holding and pressing mouse buttons while moving their arm. This causes the extensor tendons and muscles to constrict and contract repeatedly, leading to pain in the common extensor tendon (the outer region of the elbow) that may extend toward the forearm, wrist and hand [2]. This occurs because over time, repetitive gaming motions weaken and tire the extensor muscles and tendons in the forearm. These motions include gripping, squeezing and shifting a mouse, as well as pressing controller buttons or using a scroll wheel. If mouse elbow is left untreated, it can lead to the degeneration of collagen, a structural protein that supports connective tissue in the common extensor tendon [1-3].

The Symptoms

Symptoms of mouse elbow include…

• Pain in the outer elbow area
• Pain in your wrist when gripping or squeezing the mouse
• Pain bending your fingers or wrist backward (this contracts extensor muscles)
• Pain while flexing your fingers and wrist forward (this stretches extensor muscles)
• A weakened grip due to constant pain while gaming 

Prevention Methods and Treatment

Here are a few strategies that can help treat mouse elbow and prevent it from worsening. 

• Rest the affected arm so it has time to heal
• Gradually try strengthening and mobilizing exercises to improve circulation and muscle tone [4] 
• Work with a specialist to make sure you’re performing these exercises properly [5] 
• If you think you have mouse elbow, seek treatment right away, before it gets worse

Addressing mouse elbow early is the key to getting back into the game! 

References

1. Kahlenberg CA, et al. New Developments in the Use of Biologics and Other Modalities in the Management of Lateral Epicondylitis. Biomed Res Int. 2015; 2015: 439309. 
2. Andres BM, et al. Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon. Clin Orthop Relat Res. 2008;466(7):1539-1554.  
3. Calfee RP, Patel A, DaSilva MF, Akelman E. Management of lateral epicondylitis: current concepts. Journal of the American Academy of Orthopaedic Surgeons. 2008;16(1):19-29.
4. Croisier JL, Foidart-Dessalle M, Tinant F, Crielaard JM, Forthomme B. An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy. Br J Sports Med. 2007;41:269-275.
5. Smidt N, van der Windt DA, Assendelft WJ, Deville WL, Korthals-de Bos IB, Bouter LM. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Lancet. 2002;359:657-662.