E-sport injuries: the surprising physical toll of professional gaming

Paparatto’s story is not unusual in the esports industry. Other top players like ‘League of Legends’ pros Hai Lam and Kurtis ‘Toyz’ Lau Wai-Kin, as well as ‘Dota 2’ Clinton ‘Fear’ Loomis, retired in their twenties due to wrist and hand injuries. Current players on the professional circuit often miss games due to persistent pain.

To casual observers, this may seem odd. How can Tom Brady win a Super Bowl at 43 when young players struggle to participate in seemingly sedentary activity? Chuck Tholl, an associate researcher at the German Sports University in Cologne, says that perception is far from reality.

“E-sports may not seem as active [as traditional sports]“, he said, “but players perform micro-movements and fine motor skills which, without preventive measures, can be very harmful to their body. »

According to Tholl, professional esports gamers perform up to 400 actions per minute – movements like mouse clicks and keystrokes – which put a physical load on their fingers, wrist, neck, back and arms. forearm. Over time, this can lead to a variety of ailments like muscle weakness, tendinopathy, nerve compression, and lower back pain.

While traditional sports often result in obvious and acute injuries, such as a separated shoulder, twisted ankle, or torn ACL, esports ailments are gradual and chronic, making them difficult to detect. As such, players often continue to compete unaware that they are making an existing problem worse.

“It might not hurt on a day-to-day basis,” Tholl explained, “but in the long term it can affect your musculoskeletal system and cause really big problems.” Most of the top professional players, he continued, end their careers before they reach the age of 30, while top athletes in traditional sports like basketball or football play regularly at a high level well into their thirties.

Some leading esports organizations are now taking action to mitigate these injuries and prolong their players’ careers. For example, Evil Geniuses, a Seattle-based esports organization, hired Lindsey Migliore in January to serve as director of player performance, a newly created full-time position.

“We are losing these players in their early twenties to preventable injuries that could have been, and still can be, treated,” she said.

The stress of constant play can structurally damage a player’s tendons, Migliore explained. Treatment plans often include building the strength of these tendons through exercise, regular stretching, improving posture, and frequent breaks during workouts. She also advocates that her players get plenty of sleep – which isn’t easy for teenage players – and adopt a rigorous and lengthy warm-up routine before games. In short: the kind of training that has become routine for athletes in traditional sports.

“Think about it: Tom Brady doesn’t just show up half an hour before kick-off, put pads on and start throwing balls,” she said.

Along with dealing with individual cases, Migliore says popularizing and legitimizing esports medicine among gamers, the general public, and even the wider medical community are among his long-term goals.

“I gave a talk at a medical convention in 2018 on esports medicine to a room full of thousands of people, and half of them started laughing when I said what I said. was doing,” she recalls. “Players often go to pediatricians and primary care doctors for treatment, and they’re the ones who need to know this information…but people don’t take these things seriously.”

Paparatto echoes that sentiment. When he first sought treatment for his thumb injury, he met several doctors who dismissed his concerns.

“[The first few doctors] pretty much told me there was nothing wrong, it’s all in my head,” Paparatto said. “They didn’t take me seriously when I said I played video games for a living. … Most doctors just don’t know about the game.”

For Matt Hwu, an esports medicine specialist who has treated professionals at major esports organizations like Counter Logic Gaming and Immortals, awareness of these types of injuries is critically important to the evolution of the sport. His medical practice, 1-HP, frequently creates infographics and demystify youtube videos to draw attention to the seriousness and prevalence of gambling-related injuries.

“It will take time for us to educate the community on preventive measures,” Hwu said. “That means changing it at the root – in high school, at the college level, and at the lower pipelines where gamers first enter the esports sphere.”

Many professional players today recognize that injuries are a necessary reality, although they are now learning – through organizational support and independent doctors – how to manage them appropriately.

Philippe “Vulcan” Laflamme, a 22-year-old “League of Legends” player for Evil Geniuses, said injuries and the fear of early retirement have always been on his mind. He has suffered from wrist, neck and back pain throughout his career and says the support of professionals like Migliore has changed his approach to the game.

“When I was 16, I just played the game as much as humanly possible,” he said. “Now I’m more aware and I wonder: will these extra games be useful or could they take a year less of my career? Will they do more harm than good?

Signs of gaming-related injuries can show up in professional players of any age. Archie Pickthall, a 16-year-old professional Rocket League player for Semper Esports, began experiencing significant wrist pain eight months ago. “I had a tough time where I could barely do anything because the pain was so bad,” he said. “I wondered if I should quit sooner than I wanted to.”

Pickthall was unlucky to get an accurate diagnosis when he first experienced pain and is now waiting to see a hand specialist. But he notes that he started to improve after adopting regular stretches, warm-up exercises and other techniques he researched. Although the team he plays for does not have a doctor on staff, he hopes that as the issue of gaming-related injuries receives more attention, all esports organizations will eventually provide medical doctors. team to help raise awareness of preventive measures.

“I don’t think a lot of players stretch a lot, and that’s so essential,” he said. “Having team doctors on hand would be great because they know how to prepare players and prevent just about all of these injuries.”

As for Paparatto, he became a content creator and streamer for the famous game brand FaZe Clan. Although he is still heartbroken over his retirement from the Call of Duty League, he hopes his story will serve as a cautionary tale for the next generation of players on the pro circuit.

“I want people in general to know more about the lifestyle of professional players, how difficult it is physically,” he said. “And I’m starting to see players today taking much better care of themselves – exercising and stretching. The game is going in the right direction.

And medical professionals like Hwu and Migliore agree that professional players could – and one day probably will – play in their 30s, 40s and maybe even beyond.

“Imagine having esports couple Tom Brady and Rob Gronkowski,” Migliore said. “It will change the face of the game. It is the future, but it requires investment in the health of the players.

Gregory Leporati is a freelance writer and photographer covering esports, technology and motorsports. His recent work has appeared in GQ, the Los Angeles Times, Pitchfork and Ars Technica. Follow him on Twitter @leporparty.

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