Welcome to part 2 of this case study about Rez from NIP who had been dealing with wrist pain because of how he held his mouse. Learn more in part 1 – CHECK IT OUT HERE

All better in 5 weeks - WRIST POSITION FOR THE WIN

After only four weeks of consistent exercise and posture modification, Rez was able to report minor to no issue at his wrist. At this point he felt completely used to his new position and mentioned he was completely diligent with his stretching routine. He was sick for about a week and was unable to perform his exercises during that time.

Final Assessment of Pain Pattern

P1: Rez reported this sensation had completely resolved and understood how to prevent it from returning through consistent exercise and monitoring the position of his wrist P2: He also reported the stiffness and need to stretch his wrist had been resolved. This led me to ask how he had felt overall in terms of returning to 100% for which he stated 95% with the remaining 5% being that he continued to be weak. Rez knew how to prevent the recurrence of his pain through consistently working on building up the endurance for his wrist in addition to maintaining proper body awareness. We reviewed how to approach returning to previous practice schedules and potential increases in volume to ensure he would be prepared to handle the expected increase of stress.

Final measurements

As you can see Rez was able to change his posture and improve the endurance/strength of his wrist slightly (some hiccups with travel and him being sick) in about 5 weeks. While his condition was mild this reduction of pain was expected as we had clearly address the MAJOR CAUSE for his pain

MOUSE POSITION

While Rez still needed to work on the overall condition of his wrist, he was ready to self-manage and understood how to do so. Another big reminder like the previous post…. THIS IS ALWAYS THE GOAL WITH PHYSICAL THERAPY It is our responsibility to teach players and our patients how to self-manage because we cannot be by their sides 24/7. This is why after any Physical Therapy visit or visit with a healthcare professional you should understand:

1. What is the source of the pain?
2. What is the cause of the pain? (Endurance, schedule management, increased pain sensitivity, etc.)
3. What is the exact roadmap of your return to play?
4. What can I expect with the rehab process?

If you learn how to monitor your own symptoms and understand the process of rehabilitation, you’ll be successful in the long-term, not just this one time. As physical therapist we provide guidance and start you on your journey (and sometimes get you back on track) to better health.

What can you learn from this story

Rez had been dealing with minor wrist tendinopathy primarily due to his wrist position and was able to return to professional play without any issue due to better wrist health management. While the major cause of his pain was due to how he held his mouse - it is the behavioral change (consistent stretching and exercise in addition to body awareness) which will lead to continued health in his professional career. Here are the major things you can learn from this story.

Posture & Ergonomics are the foundation of Gaming Health

Wrist position is king - as I mention so many times throughout my content and this piece. How you position your wrist while using the mouse and keyboard can make a significant difference in how your muscles work. So remember to always check this first for both prevention & management! Here is my full guide on posture and ergonomics for gamers On a side note, your shoulder position matters as well - it functions as the base for your arms and as I have stated in one of my HP boosts it can also affect how quickly your wrist muscles fatigue. So the bottom line - OPTIMIZE YOUR POSTURE & ERGONOMICS TO OPTIMIZE YOUR GAMING HEALTH

Everyone is different - it might not just be 5 weeks for you

While Rez was able to completely resolve his pain after 5 weeks – EVERYONE IS DIFFERENT. For some of you the pain might have been bothering you on and off for several of years while others may have only been dealing with the pain for several months. This causes two very different states for not only the tissues but also your pain system. Exercise and all of the methods we use to address in the program address both states, but can take a different amount of time. We always begin with four to six weeks and move forward from there. But just like this case with Rez, most people pain will significantly reduce in six weeks and will be more healthy afterwards from adopting the healthy habits

In-season play needs to be considered

At the professional level practice schedule and competitions have to be considered when incorporating better habits and the rehab routine. Esports is unique when it comes to injury management compared to traditional sports as they are often able to still play without significantly affecting their health. While their performance is often affected - the coaching staff & healthcare professionals associated have to weigh out the most optimal decision for the team’s performance based on the schedule and severity of the injury. In this case with a more mild injury - the staff (and most importantly the player himself) and I were okay with having him modify his wrist position after an important tournament. This prevented the expected performance deficit with a postural change (as one would also expect with keybind changes or sensitivity changes) Additionally, you as a gamer must also consider the VOLUME of play. Professionals at higher intensity and often at a higher volume than casual gamers meaning it is more important to monitor length of play & breaks. For the rest of us - we may be playing 4-5 hours a day but usually grind out those hours consecutively instead of taking occasional breaks to get up and stretch.  Need ideas on what to do during a short 5 min break? Check out my guide here

Take control of your own life:  understand yourself and how your body works

While this is a repeat - it is important to stress. In the end, a medical professional cannot be by your side 24/7. It is up to you to learn more about how your body works and better understand how to modify your schedule, adjust your posture, and incorporate your exercises to ensure the rehab process goes smoothly.