How to maintain peak performance while sitting at a computer? ChairsFX recently spoke with three world-leading esports doctors. They work with elite esports teams like Cloud9, G2, Team Liquid, and others. All agree that a gaming chair can bring value to a pro player’s regime. However, its importance pales compared with broader health habits. Here are top esports doctor tips to boost performance while gaming or computing.
Playing video games professionally is hard on the body. That’s why burnout is a major problem among esports gamers(1). To stay relevant, competitive players grind through intense year-round schedules.
There are long training sessions, tons of meetings, frequent travel, and shifting schedules. With success, demands become more intense. Burnout and breakdowns are common. To help players cope, many top teams now employ physical therapists.
Non-competitive gamers can also struggle. For example, mega-streamer Pokimane recently suffered from wrist pain. She tried to fix the problem by upgrading to a Herman Miller Aeron chair. It didn’t work.
Pokimane streams many ‘wrist-action’ games like League of Legends. Mouse games constantly exert one wrist to move and click. RSI’s (Repetitive Strain Injuries) are a common result.
In the wrists, pain starts as inflamed tendons (2). Without treatment, the pain can progress into carpal tunnel syndrome. Then, numbness spreads beyond the wrist and up the arm.
How to address such issues when gaming from home? To find out, we reached out to some leading esports doctors.
Esports Doctor Performance Advice
We asked three doctors offering remote therapy services for advice. Here are our questions:
- In your experience, what’s the most common health problem reported by gamers or desk workers?
- If wrist pain emerges, what can people do before reaching out to a professional? Ice? Rest? Tiger Balm? Aspirin?
- Which do you rank as the most important for healthy deskwork?
- Frequent movement breaks
- Proper rest, nutrition, and exercise
- A good ergonomic chair
- Sitting with good posture
- Other
Dr. Jordan Tsai, Respawn Therapy
Dr. Jordan Tsai is a Doctor of Physical Therapy and a board-certified Orthopedic Clinical Specialist. He founded LA-based Respawn Therapy (Esports Performance and Rehab) in 2018.
He’s worked with several pro esports teams. These include Cloud9, TSM, Evil Geniuses, 100 Thieves, and London Spitfire. He’s also treated pros playing specific games (League of Legends, CS: GO, Fortnite, World of Warcraft, and Valorant).
A U.S. Army Veteran, Dr. Tsai is also an avid gamer. He’s also on Secretlab’s Ergonomics Advisory Board and a Titan user himself.
His Respawntherapy.com service is exactly what we imagined cutting-edge esports therapy to be. Via webcam, an esports therapist can assess your symptoms and provide a treatment plan. Bam! When locked down and working from home, this is a perfect solution!
Common Gamer Health Problems
Q: In your experience, what’s the most common health problem faced by hardcore gamers/ full-time desk workers these days?
A: Overuse injuries are by far the most common. These usually involve irritation and pain at the tendons and joints of the hand and elbow. Secondary to that, nerve irritation is very common, as well as pain from postural issues (neck, back pain).
Self-Help For Wrist Pain
Q: If wrist pain or other gaming injuries emerge, what can people do before reaching out to a professional?
A: A regular range of motion exercises, strengthening, and stretching are all critical. I recommend that players I work with do a few of these types of exercises every 2 hours at a minimum.
If they are already having issues, ice can temporarily relieve pain. But I highly recommend seeing a professional as soon as possible since it can drastically reduce healing time. Many of these issues can resolve within a few weeks if addressed quickly. But if left to linger, might take months to resolve.
Health Priorities For Desk Workers
Q: Out of these options, which do you rank as the MOST important for healthy, injury-free deskwork?
- Frequent movement breaks
- Adequate rest, nutrition, exercise
- A good ergonomic chair
- Sitting with good posture
- Other
A: Rest/nutrition/exercises > breaks > good posture > good chair. Developing healthy habits is the most important thing to work on.
Dr. Tsai’s Gaming Chair
Dr. Tsai is a member of Secretlab’s ergonomics advisory board and also a Titan user. He stands 5’9″ and weighs 145 lbs. As a result, he uses a medium-sized Titan EVO 2022 Stealth edition.
Like many people, he upgraded to a Secretlab chair from a standard office chair. He uses it for both gaming and desk work in his home office. “I usually alternate between a forward active position when I play and a relaxed leaning back position for work or watching videos.”
Getting Help From Respawn Therapy
Q: Can gamers or desk workers reach out for help?
A: Yes. Check out Respawntherapy.com.
Dr. Willian Duncan, Southeast PT
Dr. William Duncan is a Doctor of Physical Therapy. An avid power-lifter, he runs Southeast Physical Therapy near Atlanta, Georgia. The clinic specializes in sports performance therapy and athletic assessments.
The clinic also has telehealth and online physical therapy services. Even if you’re not in Georgia, this service is accessible. Online therapy can be used for a few treatments:
- Esports or deskwork injuries: patients can get diagnoses for their problems and receive recovery plans.
- Recovery consulting: get help recovering from injuries or surgery.
- Movement analyses: improve your body mechanics without need for an in-office visit.
In diagnosing Pokimane’s case, Dr. Duncan went above and beyond. Below, he provides a complete framework for deskwork-related self-treatment before seeking online help.
Common Problems Faced By Modern Gamers
The most common health problem facing hardcore gamers/desk workers is sitting too much. We, as humans, are built and designed to stand upright. The cardiovascular and digestive systems are designed around being vertical.
The spine itself is meant to be vertical as well, supported by muscles, connective tissue, and the inherent shape & stability of the bones. But support by tissues requires energy — and the body’s primary goal is to conserve energy as best it can.
So when we sit for extended periods of time, the body will look for more energy-efficient means of support – a chair. While a chair can be extremely useful for short bouts of sitting, the extended time spent in a chair can create small changes in the body that have a large, long-lasting impact.
For instance, sitting, over time, can create shortening in the hip flexor muscles. That can lead to changes & restrictions in the hip joints, which then drives overuse of the low back. Remember, everything is connected. If one area of the body that is designed to move well (hips) becomes stiff, the brain will find creative workarounds to compensate. Usually, it does so by stealing motion from a joint or joints above or below the area (in this case, the lower back).
How To Address Wrist Pain
Take a break and consider the ergonomics of your setup:
- Proper desk height and armrests: If you play in a chair, check the height of the desk relative to the armrests of the chair. Ideally, the desk should sit slightly higher than the armrests. This supports the elbows without overexerting the shoulder and neck muscles. Also, a desk slightly higher than the elbows allows for a shallow upward elbow bend. That puts the hands in a more ideal position for managing the keyboard/mouse.
- Keep your back straight: Try to sit upright, not slumped. If your posture is shaped more like a banana when sitting I can almost guarantee tissue irritation sooner or later.
- Set a good monitor height: The middle of the monitor should be aligned with your eyes. Scanning the monitor should come more from the eyes than head movement. Subtle head turns and nods to check the outer edges of the monitor are fine. But if you must often move the head up or down to orient your vision, problems will eventually arise.
- Pain relievers aren’t helpful: Things like ice, rest, tiger balm, and aspirin all have a small goal: alleviating symptoms. If you have symptoms but have to get through a tournament, these provide temporary solutions to your problem. But addressing issues begins by identifying the source.
- A good chair is only a partial solution: Postural issues typically arise from poor strength and endurance in the postural muscles — not the type of chair someone uses. A chair alone cannot fix your issues. If you work on strength & endurance and use a good chair, this will most likely resolve the source of your symptoms and allow you to play longer.
Best Base For Healthy Deskwork
Q: Out of these options, which do you rank as the MOST important for healthy, injury-free deskwork?
- Frequent movement breaks
- Adequate rest, nutrition, exercise
- A good ergonomic chair
- Sitting with good posture
- Other
A: If I can only pick one it has to be rest, nutrition, and exercise. Being active in these 3 domains yields large, system-wide effects.
- Adequate rest: If you’re resting well (quality of sleep over quantity of hours), you will be a healthier person. Mental health and processing ability will both improve. As a result, you will feel and interact better with people in both your digital and physical worlds.
- Good nutrition: Eating well counteracts things like excessive weight gain, heart disease, diabetes, obesity, and certain cancers. All of these are also linked to sitting for extended periods.
- Regular exercise: To counteract sedentary effects, do 60-75 minutes of moderate-intensity daily exercise. This will boost your metabolism, immune system, digestive function and ultimately strengthen your heart and lungs.
Getting Online Help From Southeast PT
I offer telehealth visits for anyone interested in discussing their personal aches/pains they want resolved. You can also reach out to learn more about your personal workstation ergonomics.
We can also work together to address low-hanging, easy-to-achieve things that can make you exponentially healthier. Reach out at Southeastpt.net or via email: willduncanpt ‘at’ gmail.com.
Dr. Elliot Smithson, 1-HP.org
Dr. Elliot Smithson (DPT, PT, MS, ATC, EMT-b.) is a physical therapist with 1-HP.org. Their website serves up tons of resources for pro esport teams and gamers to game without pain.
1HP therapists have worked with major teams like G2, Team Liquid, 100 Thieves, and Fnatic. Beyond esports teams, they also provide telehealth consulting for individuals and institutions.
From the 1-HP.org website: “Whether you are a casual or professional gamer, esports organization or academic institution we can work with you to achieve your goals for health or performance.”
Common Gamer Health Problems
Q: In your experience, what’s the most common health problem faced by hardcore gamers/ full-time desk workers these days?
A: One of the biggest issues we see is wrist and hand pain due to repetitive use and under preparation of the tissues. This problem is due to the high APMs (Actions Per Minute) and low endurance of the muscles of the wrist and hand.
The next most common issue we deal with is neck and back pain caused by hours of maintaining poor forward head and rounded shoulder posture.
This pain can also radiate down into the arms and hands due to compression of nerves in the neck and shoulder. It’s important to see a health professional who can help you to differentiate the source of the pain.
Self-Help For Wrist Pain
Q: If wrist pain or other gaming injuries emerge, what can people do before reaching out to a professional?
A: Your next posture is your best posture, we recommend taking breaks every 45 minutes and standing up to do some light stretching.
It’s also important to make sure you are exercising daily to build up the endurance of your muscles and tendons to avoid postural and overuse pain! The Infographic dives into more detail.
Health Priorities For Desk Workers
Q: Out of these options, which do you rank as the MOST important for healthy, injury-free deskwork?
- Frequent movement breaks
- Adequate rest, nutrition, exercise
- A good ergonomic chair
- Sitting with good posture
- Other
A: Having a solid ergonomic base is incredibly important to make sure you are decreasing the stress on your tissues as much as possible. This includes a well-fitting chair, desk, properly adjusted arm rests, etc.
The infographic explains the principles of maintaining good posture through ergonomics. But no matter how good your ergonomic setup is, when it comes to injuries, there’s no substitute for taking breaks, strength training, cardiovascular exercise, quality sleep, and solid nutrition.
Getting Help From 1-HP.org
Q: How can gamers or desk workers reach out for help?
A: We have tons of resources for gamers on our website and socials (Youtube and Twitter). For formal health coaching or support, please check out 1-hp.org/game-without-pain.
Conclusion
The fifth edition of the Handbook of Human Factors and Ergonomics recently came out. Healthy sitting fundamentals only cover 20 of its 1580 pages. The rest focuses on a global shift from an industrial to information-driven world.
The emerging Internet of things (IoT) describes sensors exchanging data with other systems (3). The Handbook describes this as a convergence of physical, cyber, and sociotechnical systems. Thus, the modern ergonomist seeks to optimize human-machine interaction.
Under this deluge of data, human breakdowns are likely. To avoid these, ChairsFX advises that you get a good ergonomic chair. Then, learn how to use the chair correctly. That will ensure good posture while you sit.
With good posture, you should enjoy more energy and greater focus while you work. But what if you don’t? For instance, if any part of your setup is misconfigured, pain issues may emerge.
As well, if you don’t get enough sleep, your ability to focus might drop. In some cases, the game you love playing might overwork certain tendons or muscles.
Thus, the concept of online esports physical therapy makes perfect sense. When millions are locked down and working from home, pain problems may arise. Then, you have three options. First, endure the pain and cripple your productivity.
Second, visit an overcrowded hospital during a pandemic. Alternatively, fire up a Zoom chat and get help from an esports therapist online.
Footnotes
- Michael Jeong. ‘What to do about the increasing problem of player burnout in esports’, Opinion Esports, 31 August 2020 https://www.esports.net/news/self-care-and-burnout-in-esports/, (accessed 23 Feb. 2022).
- Matthew Hwu, ‘Repetitive Strain Injury: Managing Gaming’s Biggest Issue’, 2015, https://1-hp.org/blog/healthy-movement/repetitive-strain-injury-managing-gamings-biggest-issue/, (accessed 15 Dec. 2021).
- Wikipedia. 2016. “Internet of things.” Last modified Dec. 25, 2021. https://en.wikipedia.org/wiki/Internet_of_things.