Esports Teams Turn to Sports Medicine as Repetitive-Strain Injuries Mount

Professional esports is increasingly being treated as a physical-performance environment, as players and teams contend with repetitive-strain injuries, vision problems, sleep disruption and the effects of long hours seated at a screen, according to reporting by Medical Xpress.

The physical cost can be substantial. Chinese “League of Legends” player Jian “Uzi” Zi-hao retired in 2020 at age 25 after chronic wrist and arm injuries, despite earning more than $500,000 in tournament prize money. Another prominent player, Lee “Faker” Sang-hyeok, was sidelined in July 2023 with cubital tunnel syndrome, an overuse injury affecting the arm and hand. The report says that changes to his gaming posture and intensive physical therapy enabled him to return to competition about a month later.

Hand and wrist problems are among the most common concerns in esports. Repetitive button pressing can contribute to carpal tunnel syndrome, tendinitis and “gamer’s thumb,” which involves irritation or overuse of tendons around the thumb and wrist. Similar overuse patterns have also been observed among assembly-line workers, whose jobs can involve repeated movements.

Players may also experience eye fatigue and reduced ability to focus after prolonged screen exposure. The light from screens appears to interfere with melatonin release, potentially contributing to sleep disturbances. Mental strain is another concern: a 2021 study of Portuguese esports players found that 37% reported anxiety and depression, while 45% reported sleep disturbances.

Extended periods without movement create additional risks. Players may sit for three or more hours at a time, contributing to lower-back and spinal discomfort. The report also discusses deep vein thrombosis, a blood clot commonly forming in the leg that can become life-threatening if it travels to the lungs. British gamer Chris Staniforth, who reportedly played for up to 12 hours at a time, died from the condition in 2011.

In response, leading teams have assembled support staff that can include physical therapists, performance psychologists, athletic trainers and massage therapists. Prevention efforts may involve group exercise, posture-focused setup changes, functional-strength training, mobility work and upper-limb stretching.

The field has traditionally borrowed from conventional sports medicine, but the report argues that musicians and dancers may offer equally relevant models. Esports and musical performance both involve prolonged sitting, precise hand movements and performance without continuous real-time coaching. Biomechanics research has found similar forearm-muscle fatigue patterns in esports players and piano players, although no study has directly compared the two groups. Researchers are also considering whether questions studied in performing artists—such as hand size and joint hypermobility—could inform future esports research.