Better understanding of esport demands needed to adapt rehab, return to play
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The excitement of sports competition has returned. There is a new sport of interest that many did not play as children. This sport fills arenas, has highly paid professional competitors, business support and cultural impact.
Esports refers to professional and amateur video gaming events where athletes compete through videogaming platforms. Some experts question whether this truly meets the standard definition of sports. However, with a growing understanding of the mental and physical demands of esports, and recognition of typical musculoskeletal injuries, orthopedic surgeons cannot ignore the need to improve their knowledge of the physical demands required of competitive esport athletes.
Esports originated with home videogame consoles in the 1970s, then grew significantly in the 1980s with the introduction of tournaments based on popular arcade games. The 1990s saw the expansion of competitions to online formats. Media coverage grew in the 2000s, and with it came advertising dollars and sponsorships.
Global phenomenon
With the potential for money and fame comes increased participation in esports at competitive and recreational levels. More than 170 schools are members of the National Association of Collegiate Esports with more than $16 million available in scholarships. Overall, 234 million people regularly watched esports events in 2021. The audience is expected to increase as esports is a global phenomenon that spans cultures and regions.
For competitive esport athletes, average practice time can rival that of high-level swimmers, tennis players, classical musicians, ballet dancers or football players with often more than 5 hours a day focused on training. Typical injuries are categorized as overuse injuries, and often classified as tendinopathies or neurologic disorders. The more active the play, the more likely traumatic injuries, including ligament strains and joint instability, will be a concern.
As with any sport, specific injury patterns and physical problems can develop. Patients who present with musculoskeletal concerns should be asked about participation in esports. A quarterback may come to the office for evaluation of elbow discomfort related to lateral epicondylitis, however, throwing a football is highly unlikely to be the underlying cause in comparison to the 3 to 5 hours of esport competition in the evening. Evaluation should include typical parameters, such as range of motion and strength, as well as neurological testing. When developing a treatment plan, other factors, such as sleep, nutrition and overall physical fitness, should be considered.
An area of growing interest is activity modification without totally stopping participation, as well as adaptation of the various devices used in esports. Asking esport athletes to stop playing without a comprehensive treatment plan is unlikely to be followed. In addition to direct care of the musculoskeletal injury using physical modalities, such as cryotherapy, anti-inflammatory medication, compressive or therapeutic sleeves, and home-based stretching and strengthening, esport athletes benefit from discussion of proper sleep habits and nutrition. The role of orthobiologics has not been studied, but use of these treatments is escalating. It is valuable to have occupational or physical therapists help with rehabilitation and modify participation to reduce stress on affected areas.
Principles of care
Esports and its athletes should be accepted as part of the sports medicine world. We should apply the same principles of care that we use for the musculoskeletal problems of other athletes.
We need to better understand the demands of esports, so we can adapt rehabilitation, recovery and return to sport models to fit esport athletes’ unique injuries and concerns. A team approach with contributions from multiple professionals will provide a successful program of injury prevention and recovery.
- References:
- https://playtoday.co/blog/stats/esports-viewership-statistics
- www.nacesports.org
- www.healio.com/news/orthopedics/20220110/game-on-orthopedists-integrate-esports-into-practice
- For more information:
- Anthony A. Romeo, MD, is the Chief Medical Editor of Orthopedics Today. He can be reached at Orthopedics Today, 6900 Grove Road, Thorofare, NJ 08086; email: orthopedics@healio.com.
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