Is it time to regulate the amount of play among young esports athletes?
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Regulation may be unnecessary
The popularity of esports continues to grow in reputation, as well as participation. Despite being perceived as a “sedentary” sport, esports are incredibly demanding, not just cognitively, but physically, as well.
The primary physical demands include those that may seem obvious with hours of game play. “Gamer’s thumb” is a perfect example of the type of overuse injury that is growing in prevalence. Given the variety of ways thumb opposition is required for everyday life, chronic pain in the thumb can become pronounced to the point that basic activities of daily living, such as opening jars or buttoning shirts, can become impacted.
Ocular fatigue is another example of an overuse issue that would be expected with hours of screentime, and this also can have implications, such as chronic headaches, that extend outside of gaming.
A less obvious example of a physical demand endured by dedicated or professional esport gamers is chronic low back pain that can come from prolonged sitting. Lumbar paraspinal and core muscle strengthening exercises can do wonders to help prevent this from occurring. This type of conditioning and training has gained traction in the esports community given the results these athletes have seen “on the screen.”
The above is a small list of the physical challenges esport gamers experience. While regulation of play may not be necessary, with the unique physical and cognitive demands of these athletes, esport gamers would benefit from proper training and conditioning. Fortunately, there are more and more options available to these athletes.
Eric T. Warren, MD, CAQ, is a primary care sports medicine physician and assistant clinical professor at Atrium Health Musculoskeletal Institute in Charlotte, North Carolina.
Promote youth sport specialization recommendations
Yes. Anything not performed in moderation is never a good thing. The esports industry is controlled by the video game publishers whose priority is increased gameplay and resultant profit. Paralleling this, players may perceive “grinding” (ie, recurring long-duration gaming stints) as the only way to increase performance, but this can lead to overuse musculoskeletal pain or injury, eye strain, abnormal sleep patterns or, at the most competitive levels, performance-enhancing drug use. Moreover, while extremely rare, addictive impaired control over gaming could lead to gaming disorder. Unfortunately, many esports teams do not benefit from traditional sport safeguards, such as certified coaches, periodized and regulated practice schedules, in-game recovery breaks (ie, time outs, quarters), athletic trainer support, return-to-play protocols or pre-season physicals.
Popular esports today are primarily sedentary involving little gross motor activity. The 2020 WHO activity guidelines note there is “insufficient evidence to set a precise threshold (or ‘cut-off’) for the amount of sedentary or recreational screen time,” but the potentially outdated 2013 American Academy of Pediatrics policy statement recommends parents limit children’s “entertainment screen time” to less than 2 hours per day. Teams should institute strategies such as activity breaks that can increase performance, as well as implement the 20-20-20 rule (ie, look at something 20 feet away for 20 seconds every 20 minutes) to reduce eye strain. Esports programs should also consider promoting youth sport specialization recommendations (eg, delay specializing; one team at a time; total hours per week of sport should be less than athlete’s age in years; 2 days rest per week; seasonal rest/recovery from organized sport; etc.) to support mental and physical health while reducing burnout. Factoring player health is paramount for the sustainability of the esports ecosystem and regulating the amount of play should be advised.
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- National Athletic Trainers’ Association official statement in support of sport specialization recommendations for adolescent and young athletes. https://www.nata.org/sites/default/files/youth_sports_specialization_recommendations.pdf. Published Oct. 2019. Accessed Dec. 20, 2021.
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Seth E. Jenny, PhD, ACSM-EP, is an assistant professor in the department of exercise and rehabilitative sciences at Slippery Rock University of Pennsylvania in Slippery Rock, Pennsylvania.
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