Repetitive Strain Injury: Managing Gaming’s Biggest Issue – Part 1

IF YOU HAVE BEEN DEALING WITH WRIST PAIN FOR LESS THAN A WEEK – YOU DO NOT HAVE CARPAL TUNNEL SYNDROME.  90% of the time, the pain we are feeling from gaming is due to repetitive strain or overuse.

Carpal tunnel syndrome is a nerve condition and in the early stages, you only feel numbness along the first three fingers (thumb to middle finger). Instead, most of us feel pain associated with playing for longer periods of time:

Muscles fatigue -> we continue to play -> tissues breakdown -> inflammation and pain. It is only after we have not dealt with our injury in the right way carpal tunnel syndrome can develop.

Pain in the wrists has become one of the largest issues in Gaming that we tend to avoid. Why? We know what it has done to the best of us –  Hai Lam: a professional LoL Player who previously retired due to a persistent wrist injury – yet we still ignore the discomfort we feel while we’re playing. It is becoming more and more common to have and play through wrist pain despite its reminder that something is wrong.

I believe it’s because there is a lack of clear and practical information out there regarding wrist RSIs. This is where I come in! I want to provide gamers with simple information about a complex issue.

If you’re here because you have had some wrist pain while gaming. Then you’re in the right place. 

Repetitive Strain Injuries (RSI)

These are the most common type of injury for us gamers. For PC gamer’s, it is a WRIST RSI. For Console gamers, it is most commonly a Thumb RSI. In this article series, I will be focusing primarily on Wrist RSI as it is THE BIGGEST ISSUE for those who play LoL, Dota, CS:GO, HearthStone, MMOs and other PC games.

Part 1 will describe everything you need to know about RSI – what it is, why it happens, how gaming activities damage our wrists and what you will feel.

Part 2 is all about management. I provide a simple 5-method approach to address RSI

The VERY first thing we need to understand with regards to this type of injury, AND our body is that, all of our tissues – muscles, tendons, ligaments and even nerves (we’ll address this later) – have the ability adapt to the stresses that are placed on them… for instance, a muscle will grow when you lift.. Correctly that is.

But our tissues can only adapt.. OVER TIME. I want to emphasize OVER TIME because there NEEDS to be a period of healing to allow for the body to adapt. 

When we go to the gym, its not helpful to workout for 100 hours straight because we won’t allow the muscle to grow. There are little tears that happen every time you are resistance training and if theres no rest. The little tears become big tears. So with normal exercise our body responds, by adding more muscle (actually protein), so that we can lift heavier. Our body adapts by adding more tissue (proteins, not muscle cells). 

The bottom line is that…We are stressing our tissues too much. And not giving it time to heal and adapt

Let’s Dive In…

The small movements that are very typical of PC, Console and Handheld games stress our soft tissues (muscles, nerves, tendons, ligaments, etc.) and cause inflammation and damage.

Stress can occur in several different ways. For gamers, it is shear (sliding things together), tension (pulling on things) and compression (smashing things together) forces that damage our gaming tools (wrists&hand). 

For Example: Side-to-Side mouse movements, flicks of the mouse for reactions within each game, constant clicking of mouse1, button mashing, endless hours of COD managing the joystick with thumbs, etc. 

What is really happening and what will you feel?

Here’s a little more detail about how overuse injuries come about and what is actually happening to your muscles, nerves and tendons.

Because we are all different, some of us have smaller muscles, and some of us have bigger muscles. This works the same with endurance. Some of us can play longer because our muscles have more endurance, and the opposite.  Why do we care about this?

Muscle Endurance is Limited: During prolonged activity, there is not enough time for muscles to recover and thus they slowly become fatigued.

Because our muscles have a limited amount of endurance, they become fatigued over time with activity. Without rest to recover, the tendons begin to take the load and eventually develop tiny tears. The area where the tears are can become inflamed, with scar tissue laying down over the torn area. This happens only for a short amount of time though as our bodies naturally try to repair. But if we continue to play for extended periods of times through mild pain, there is more inflammation, more scar tissue, and more pain.

With continued gaming through pain, structure of the muscle/tendon changes because of the repetitive damage and that’s when gaming time is truly affected. So it’s EXTREMELY important to listen to your body.

What will your body tell you?

Depending on what is being damaged, you will feel different things. Muscle pain is different than Nerve pain:

Credit to atlantaequine.com

Nerves typically have a higher risk for compression type injuries, especially at the wrist! There is a nerve named the “median nerve” that travels through what is known as the carpal tunnel. With increased inflammation at the tendons and their sheath (much like a sword has its sheath), compression is created. When it gets to this point, that’s when you will feel symptoms above

Carpal Tunnel Syndrome is very much related to repetitive strain, however is a whole other beast of its own. 

…Continue to Part 2 and learn how to beat RSI