How does Neck pain affect gaming performance?

Did you know that if you have neck pain it can possibly affect your performance with gaming? Neck pain and discomfort is quite common (18-42%) among gamers and it may be the reason some of us are stuck in elo hell. (1,2) 

This recent systematic review explored how neck pain & injury affects the ability to control the arm for specific tasks with the arm (upper limb sensorimotor task performance) and found an association between neck pain and the accuracy of upper limb tasks (3):

• Reaction & response 
• Upper limb tracking tasks
• Joint position sense tasks
• Upper limb goal directed movement

So we might react more slowly, aim with less accuracy and control and possibly even feel as though our sensitivity or movement is “off” as a consequence of some neck pain? There does seem to be some evidence supporting this (3-6).

Sittikraipong et al 2020 (6)

In addition to possibly affecting our coordination, oftentimes the pain itself can help us lose focus and become increasingly distracted by the pain or discomfort. If we are able to make some changes early on when we feel the pain and discomfort we can return to gaming without any problem but…

Let’s be honest. The majority of gamers tend to dismiss minor aches and pains and only seem to want to make some changes when their symptoms get much worse (headaches, dizziness, significant discomfort / pain leading to inability to play a full session, etc.).  While this experience on its own is not anything to worry about – it can sometimes affect our mental health negatively. I am writing this article to help our community better understand how neck pain can affect your performance and how we can take some initial steps to have better mental and physical health. 

By the way if you are here and can relate to the situation above – don’t beat yourself up. It’s human nature. You have come to the right place. 

Gaming Neck Pain and Reaction Time. What is actually going on?

So how can neck pain actually affect our performance? As mentioned earlier there have been quite a few studies including a systematic review showing neck pain or fatigue of neck muscles when the head-neck is required to assume a static posture for a prolonged period is associated with a deterioration of performance in upper limb tasks. 

For those who are interested in science the authors of the systematic review suggest several mechanisms. 

1. Neck Pain or Injury can affect body schema (where the brain maps and continually updates the body’s shape and posture). This may be due to nerve connections providing inputs on our proprioception (body’s awareness of movement and position) possibly being disrupted.(7) If we have a poor understanding of where our body might be in space it can lead to errors in our aim and mechanics. 

2. With injury tissue at the neck (muscles, joints, nerves) muscles may not work properly which can affect the control of key muscles surrounding the neck and shoulder. This can alter the kinematics and ability to control the arm well, especially gaming which requires high levels of fine motor control. 

Maybe neck pain?

3. Avoidance of pain. Specific movements of the arm can lead to some pain in the neck especially if there is poor overall conditioning along the entire kinetic chain (Neck, Shoulder, Elbow, Wrist). We want to avoid pain and so we might adopt different movement strategies which can affect our aim, reaction time and much more in the game. 

So if all of these things are affected as a result of neck pain and even fatigue from gaming… what can we do?

Neck pain with gaming? What can we do?

The first thing we need to understand about neck pain (any pain really) is complex and there are multiple factors that might be contributing to what we are feeling. For gaming however we do know there are a few major contributors

1. Posture & Ergonomics – How we sit and our gaming setup can sometimes lead to neck pain, especially if held for extended periods of time (all gamers). If you are curious about posture or ergonomics you can check out our full guides here and here

2. Lifestyle and Habits – Breaks, schedule management and our habits around gaming can often affect the amount of physical stress affecting our tissues. Even if we have optimal posture and ergonomics, holding any static position for an extended period of time can lead to physical health issues. 

3. Physical Conditioning – The conditioning of the muscles at our neck (deep neck muscles, posterior neck muscles) can not only help reduce AND prevent pain but also improve your posture while you are gaming. If you are interested in some exercises you can perform to develop a strong and thicc neck, check out these exercises! Additionally we are proud to partner up with Iron Neck, a great tool gamers can use to effectively strengthen the muscles necessary for injury prevention and neck strengthening. 

We have used the Iron neck with professional esports players for over the past 3-4 years to help reduce headaches, improve neck strength and control and develop the appropriate conditioning to prevent injuries as gamers. Here are a few exercises you can do with the iron neck to develop the basic strength you need to prevent neck pain.

Concentric Chin Tucks –

This is a staple neck training exercise meant to target commonly weak areas associated with suboptimal postures w/ prolonged sitting. The purpose of this exercise is to build both strength and endurance. Work up the repetitions to 15-20 over time!
Target: Cervical Extensors, Deep Neck Flexors
Exercise Rx: 3×10, build up from there

2. Deep Neck Flexion –

Another exercise targeting the deep neck flexors which provide stability in the front of the neck. These muscles are often weak due to being over lengthened in the nerd neck position. For this exercise you are holding the tuck of the chin with each repetition. Steadily build up hold duration and repetitions over time!
Target: Deep Neck Flexors
Exercise Rx: 3×10 (3”), build up from there

3. Deep Neck Rotations

This exercise allows us to target different fibers of all of the muscles around the neck by modifying the line of pull. This is an advanced exercise 
Target: Deep Neck Flexors, Cervical Extensors
Exercise Rx: 3×10, build up from there

References

1. DiFrancisco-Donoghue J, Balentine J, Schmidt G, Zwibel H. Managing the health of the esport athlete: an integrated health management model. BMJ Open Sport Exerc Med. 2019 Jan 10;5(1):e000467. doi: 10.1136/bmjsem-2018-000467. PMID: 30792883; PMCID: PMC6350739.
2. Hwu, M., Mcgee, C., & Smithson, E. (2019, February 8). “How do we stay healthy as gamers?” Questionnaire Raw Data. Reddit;

3. Harman, Samantha C.; Zheng, Zhen; Kendall, Julie C.; et al. (1AD): „Does my neck make me clumsy? A systematic review of clinical and neurophysiological studies in humans“. Frontiers. Frontiers Retrieved am 05.04.2022 from https://www.frontiersin.org/articles/10.3389/fpain.2021.756771/full.

4. Silva, Flavio M; Brismée, Jean-Michel; Sizer, Phillip S; et al. (2018): Musicians injuries: Upper quarter motor control deficits in musicians with prolonged symptoms – A case-control study“. Musculoskeletal science & practice. U.S. National Library of Medicine Retrieved am 05.04.2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015783/.

5. Karen V Lomond, Julie N Cote. (2010, October). Movement timing and reach to reach variability during a repetitive reaching task in persons with chronic neck/shoulder pain and healthy subjects. Experimental brain research. Retrieved April 5, 2022, from https://pubmed.ncbi.nlm.nih.gov/20848276

6. Sittikraipong, K., Silsupadol, P., & Uthaikhup, S. (2020, October 14). Slower reaction and response times and impaired hand-eye coordination in individuals with Neck Pain. Musculoskeletal Science and Practice. Retrieved April 5, 2022, from https://www.sciencedirect.com/science/article/abs/pii/S2468781220305786?via%3Dihub

7. Sensorimotor Function and Dizziness in Neck Pain: Implications for Assessment and Management. Eythor Kristjansson and Julia Treleaven. Journal of Orthopaedic & Sports Physical Therapy 2009 39:5, 364-377
8. Deborah Falla, Gwendolen Jull, Trevor Russell, Bill Vicenzino, Paul Hodges, Effect of Neck Exercise on Sitting Posture in Patients With Chronic Neck Pain, Physical Therapy, Volume 87, Issue 4, 1 April 2007, Pages 408–417, https://doi.org/10.2522/ptj.20060009
9. Jull GA, Falla D, Vicenzino B, Hodges PW. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009 Dec;14(6):696-701. doi: 10.1016/j.math.2009.05.004. Epub 2009 Jul 25. PMID: 19632880.