Virtual competition, real injuries: Sports medicine must adapt to dangers of esports, study claims


  • New research shows that four in 10 esports athletes clock little to no physical activity each day, while playing video games for three to 10 hours.
  • Esports gamers report numerous physical ailments as a result of their craft, leading experts to call for greater oversight from sports medicine professionals.

NEW YORK — When most people consider a career in sports medicine, video games usually aren’t what come to mind. That may soon change, though, according to a new study. Researchers say that the excessive number of hours esports athletes typically spend practicing is taking a physical toll on them, resulting in a variety of physical, psychological, and metabolic ailments. Consequently, the sports medicine field is going to need to evolve in order to meet these players’ health needs.

Esports, or high stakes multiplayer video game competitions, have quickly blossomed into a legitimate sport at both the professional and collegiate level. Esports tournaments frequently sell out arenas and air on ESPN, and many of the top professional esports athletes earn millions of dollars annually. However, these pros are also typically practicing their craft for 3-10 hours every single day. Not just any gamer can pick up a controller and earn six figures; pro esports athletes average 500-600 in-game action moves per minute, while novice players usually clock in at 50 action moves per minute.

“Given esports are played while sitting, you’d think it would be literally impossible to get injured,” says study co-author Hallie Zwibel, DO, director of sports medicine at New York Institute of Technology College of Osteopathic Medicine, and overseer of NYIT’s Center for eSports Medicine, in a release. “The truth is they suffer over-use injuries like any other athlete but also significant health concerns from the sedentary nature of the sport.”

According to Dr. Zwibel’s research, 56% of esports athletes deal with eye fatigue, 42% report neck and back pain, 36% experience wrist pain, and 32% feel hand pain. Only 2% of those players, though, actually sought out treatment for what was bothering them. Another interesting statistic: of the esports athletes interviewed for the study, 40% reported getting little to no physical activity in a typical day.

Researchers listed poor posture, blurred vision from excessive screen time, and carpal tunnel syndrome as typical problems experienced by esports athletes. Additionally, metabolic dysregulation due to sitting for long periods of time and or consuming too much caffeine and sugar is a prevalent issue. Depression and anxiety can also occur due to internet gaming disorder.

“We’re really just now realizing how physically and mentally demanding esports can be,” Dr. Zwibel explains. “Like any other college- or pro-level athlete, they need trainers, physical therapists and physicians to help them optimize their performance and maintain long-term health.”

The study’s authors pointed to Hai Lam, a 26-year-old former esports athlete who was forced to retire due to chronic wrist pain, as a prime example of what can happen to professional gamers. They’re hopeful that the next generation of pro esports players will have better access to individualized training programs and appropriate medical support.

Right now, there are 80 U.S. colleges with varsity esports teams, 22 of which offer scholarship programs for qualifying gamers.

“It’s safe to say esports is no longer in its nascent stages,” Dr. Zwibel concludes. “It’s world-class competition and serious business. It’s time we in sports medicine give these athletes the supports we know they need.”

The study is published in The Journal of the American Osteopathic Association.

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