Esports team doctor: Games are on video, but injuries all too real

The COVID-19 pandemic has driven people indoors, leading to an explosive interest in video games. Children and teenagers use gaming to connect with their friends, and more adults are pursuing careers in esports.

Nithin V. Natwa, MD, often sees “gamer’s thumb” or other overuse injuries—ones that typically take years to develop—in patients playing video games. Esports have led to more injuries in the general population, according to Dr. Natwa, a sports and family physician at Henry Ford Health System and team doctor for the esports team of Oakland University.

It’s important to diagnose these injuries right away, “because by the time the symptoms present, there’s already been some degree of damage,” urged Dr. Natwa. This isn’t like a broken arm or leg, where the problem is immediate and obvious. Gaming injuries develop over time, he noted.

Henry Ford is a member of the AMA Health System Program, an initiative that advances leadership and offers enterprise solutions to drive the future of medicine.

Gaming isn’t just a teenage pastime—it’s also taken off among adults 40 to 60 years old, and professionally, as more gaming leagues are founded. The emergence of the COVID-19 pandemic only partially explains the rise in gaming and gaming-related injuries.

“The population as a whole is gearing more toward digital worlds, with Xbox Live, PlayStation Live and the metaverse,” said Dr. Natwa. It’s a different world than his own childhood. “When I was growing up, we went to people’s houses to visit with friends or play video games. Now, it’s much easier to sign on to the game and not leave the house.”

Learn more about how Henry Ford Health System drives GM employees to better health.

With gaming injuries, Dr. Natwa has seen conditions that otherwise reflect decades of overuse. The rapid movements associated with gaming accelerates this timeline, he explained.

Carpal tunnel syndrome, lateral epicondylitis, aka tennis elbow, and De Quervain’s tenosynovitis or gamer’s thumb—thumb joint pain—are common esports-related injuries. People who sit for long periods of time in front of a video game system can also develop back pain.

These types of injuries are often seen in more traditional sports such as tennis and golf, and jobs that involve repetitive movements, said Dr. Natwa.

Read about how Henry Ford is moving telehealth forward with a virtual exam kit.

There’s more than one way to treat an esports injury. First, place limits on daily and weekly playing time. Training users to change the way they do a movement can reduce repetition and the chances of injury. Users should be thinking more about seating posture to avoid back problems.

If that fails, physical therapy can help strengthen injured tendons and increase blood flow to the injured area. If the patient is a professional gamer and there’s a time sensitive deadline for resolving the injury, a one-time steroid injection can provide relief and get them ready to compete.

In very rare cases, patients may need surgery. For soft-tissue injuries, Henry Ford offers tendon or ligament needling, and ultrasound therapy and electrical stimulation to treat tendon inflammation and pain.

Competitive gamers might have to cut down their gaming time. However, some players may decide it’s worth risking longtime degeneration. Like any other professional sport, the player must understand the risks, opting for injections to alleviate symptoms, says Dr. Natwa.

Video games have their benefits. They’re important to strategy development and hand-eye coordination, and they also improve attention and visual acuity, said Dr. Natwa. Physicians play a role in bridging the connection gap between parents and kids who want to keep playing video games.

“If you reach an impasse with the patient, you can tell them if they don’t modify their activity, they might develop chronic pain, and chronic tendinopathy. With parents, you can tell them that this is a new, different generation,” and gaming is a part of their culture, said Dr. Natwa. Parents and physicians can guide children in varying their type of game playing to avoid repetitive movements.