Protecting gamers’ health

Physicians want college eSports players to be treated like athletes

Athletes who play eSports suffer health concerns and chronic overuse injuries, some of which are career-ending, says Hallie Zwibel, DO.

With more than 80 U.S. colleges offering varsity eSports—or competitive video gaming—teams, DOs say collegiate players should be treated as athletes, with an appropriate level of medical care to promote continuing health.

Sports medicine physicians at New York Institute of Technology College of Osteopathic Medicine surveyed 65 collegiate varsity eSports players from nine American universities, finding that the players’ training schedules averaged five to 10 hours per day, with many players reporting physical injuries. The findings were published in the British Medical Journal.

The most common reported complaint was eye fatigue (56 percent), followed by neck and back pain (42 percent), wrist pain (36 percent), and hand pain (32 percent). Only two percent of those who suffered an ailment sought medical attention.

“When we think of an eSports player, we don’t typically think he or she needs a physician’s clearance to participate in a sedentary activity with little chance of injury,” says Hallie Zwibel, DO, director of sports medicine at New York Institute of Technology College of Osteopathic Medicine, who also oversees NYIT’s Center for eSports Medicine, and is co-author on this study.

“Quite contrary to that belief, these athletes suffer health concerns and chronic overuse injuries—some of which are career ending. It’s time we begin to proactively manage these issues.”

Causes of injury

eSports players must focus on LED computer monitors for long periods of time. Recent research has demonstrated that excessive exposure to LED light can damage retinas and disrupt melatonin levels and natural circadian rhythm. As a result, players often experience eye strain and impaired sleep patterns.

Given the necessity of being seated for hours on end, posture is also negatively affected in eSports gamers, resulting in neck and back pain. In addition, the survey found 40 percent of players get no physical activity, furthering susceptibility to injury due to weakened musculature.

The high number of hours dedicated to practice could easily cause overuse injuries, and that risk is compounded by the intensity of game play. The average novice players make approximately 50 action moves per minute. However, higher level players make 500-600 action moves per minute—or about 10 moves per second.

In addition to overuse injuries, there are mental health issues related to eSports, including addictive behavior, personal hygiene issues, social anxiety, and sleep disturbances.

Catching up

Colleges, universities, and high schools are adding eSports teams at a rapid pace. In the U.S., There are more than 50 colleges with varsity eSports teams under the National Association of Collegiate eSports, and 22 colleges in the U.S. currently offer scholarships for gaming. The NCAA is currently investigating whether to recognize eSports.

Researchers say schools need to also provide the same level of preventive training and care and injury treatment they offer traditional athletes.

Dr. Zwibel says college eSports teams require the support of multidisciplinary medical staff who can identify and address social or addictive behaviors, like changes in academic or work performance, and chronic eSports gaming injuries, such as wrist or hand problems, eye strain and posture problems.

“The common concerns and injuries that are seen in eSports athletes are not the typical injuries seen in traditional student athletes,” says Dr. Zwibel. “Many physicians and athletic trainers may not identify these injuries because eSports are relatively new and the health consequences are emerging as these teams become more common.”

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