This article which was published in the Journal of Orthopaedic & Sports Physical Therapy was written by some of our very own esports medicine staff here at the Esports Health and Performance Institute.

This article explores the role of physical therapy in esports medicine, the need for best-practice guidelines for musculoskeletal health care, and the current research evidence and gaps in the field.

Esports competitors require high-level cognitive function and dexterity, with repetitive fine motor movements of the upper extremity for consecutive hours while maintaining stable static seated postures. The load on esports players is nearly triple that of office workers, with 500-600 actions per minute compared to 130-180 actions per minute for office workers. Esports “seasons” can involve weekly competition, multiple days of training matches, and individual practice for several hours per day, depending on the game and competitive structure.

The potential musculoskeletal pathologies in esports include cervical pain, cervicogenic headache, cervical radiculopathies, thoracic pain, upper crossed syndrome, thoracic outlet syndrome, scapular dyskinesia, impingement syndrome, epicondylopathy, cubital tunnel syndrome, hand/wrist muscle overuse, olecranon bursitis, tendinopathies in the wrist and fingers, and osteoarthritis in the fingers. Ergonomic factors such as monitor height/distance, keyboard/mouse position, armrest use, backrest use, wrist flexion/extension, wrist radial/ulnar deviation, grip style, and mouse biomechanics also play a role in esports-related musculoskeletal issues.

Despite the physical demands of esports, there is limited data and few practitioners with experience in the field, making it challenging to establish evidence-based esports healthcare practices. Clinicians have relied on extrapolating research findings from other populations, such as athletes, office workers, air traffic controllers, and musicians, to inform their approach to assessing and managing injuries in esports competitors.

The authors of the editorial emphasize the need for best-practice guidelines for musculoskeletal health care in esports, taking into account the unique physical demands of different games, platforms, and play styles. They also highlight the current research evidence and gaps in the field, calling for more esports medicine research to better understand the prevalence, risk factors, and management of musculoskeletal injuries in esports competitors.

In conclusion, as esports continues to gain popularity and more people engage in competitive gaming, the role of physical therapy in managing esports-related musculoskeletal injuries becomes increasingly important. Evidence-based practice guidelines and further research are needed to better understand the unique physical health demands of esports competitors and to develop effective strategies for injury prevention and management in this population.

Clinical Takeaways from the Article:

1. Esports, or competitive video gaming, has grown exponentially in popularity, with millions of viewers and billions of dollars in revenue. Esports competitors, often earning significant incomes, require high-level cognitive function and dexterity.
2. Esports competitors face unique physical health demands, including repetitive fine motor movements of the upper extremity for hours at a time, while maintaining stable static seated postures. The physical load of esports is nearly triple that of office workers, putting esports competitors at risk for musculoskeletal injuries.
3. Physical therapy can play a key role in managing musculoskeletal injuries in esports competitors at all levels of play, including amateur, semi-professional, and professional. However, there are currently limited data and practitioners with experience in esports, making it challenging to establish evidence-based health care practices in this field.
4. Clinicians can rely on general musculoskeletal principles and extrapolate research findings from analogous populations, such as athletes, office workers, air traffic controllers, and musicians, to inform an evidence-based practice approach to assessing and managing injuries in esports competitors.
5. There is a need for best-practice guidelines for musculoskeletal health care in esports, as well as further research to better understand the unique physical demands and injury patterns in this population. Current research evidence in esports-related injuries is limited, and there are significant research gaps in the field.
6. Athleticism should not be the defining requirement for appropriate interventions to support esports competitors, as they have unique performance and injury-related requirements due to the physical and cognitive demands of the competitive activity. Physical therapists can play a critical role in managing and preventing musculoskeletal injuries in esports competitors, and further research is needed to establish evidence-based practices in this emerging field.

Source:
McGee, C., Hwu, M., Nicholson, L. L., & Ho, K. K. N. (2021). More Than a Game: Musculoskeletal Injuries and a Key Role for the Physical Therapist in Esports. Journal of Orthopaedic & Sports Physical Therapy, 51(9), 415-417. DOI: 10.2519/jospt.2021.0109

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