When Lindsey Migliore was six years old, her grandfather bought her a Nintendo 64 console and a copy of Ocarina of Time. She was captivated. Years later, as a medical school graduate, she still gamed regularly with a group of doctor friends. As they hooked up over the internet to pwn each other in multiplayer shoot ‘em ups, they’d end up talking about the pain many of them had begun noticing now and again: a sore pinky, a disgruntled neck or a strained back.Then, around three years ago, it caught up with Migliore, too. After shoving her ice hockey bag into the boot of a friend’s car and feeling a sudden snap at the back of her wrist, she realised video games had left her soft tissues in a troubled state.
“At the time, I was working at a hospital. The next day, I show up and grab an ultrasound and put it on my muscle,” she recalls. “It had signs of chronic injury.” Migliore could see that the fibres of her muscle, which are supposed to run in neat, parallel lines, were worryingly wavy and irregular. Over the years, activity including long gaming sessions had caused these micro tears to accumulate, she says. And she’s far from alone.
As esports has boomed, professionals and amateurs vying for stardom are committing themselves to long hours of video gaming. But that can be dangerous. Without good nutrition, sleep and care of their physique, many end up suffering from numbing or terrible pain in their wrist, hands, back or neck.
Migliore had a form of tendonitis, which can often afflict gamers. Flinging her hockey gear around had just revealed the extent of it. And although her training had predominantly been in traditional sports medicine – she was the physician for her college football and basketball teams – it wasn’t long before she decided to style herself The Gamer Doc and turn to esports full-time.
Now, she helps esports players take better care of their bodies. She publishes tips on YouTube, Twitter and Instagram, and when gamers often reach out to her with queries about their health she gladly points them in the direction of helpful information and suggests they speak to their own doctors if they are seeking a diagnosis.
Some pro gamers develop chronic injuries, and experience constant pain that doesn’t go away even when they cease playing for long periods. Occasionally it gets so bad that they have to retire from esports altogether. Migliore is adamant that, in many cases, this can be avoided. She dismisses the popular idea that gamers simply retire because their hand-eye coordination has naturally waned in their mid-twenties and they are no longer able to compete with younger contenders.
“We know that’s crap,” she says, referring to basketball stars like LeBron James and Michael Jordan who have excelled at the highest level of their sport well into their late twenties and beyond. “Did we miss the LeBron James of Rocket League because he had a wrist injury when he was 20 and had to retire?”
One big problem is that doctors aren’t familiar enough with the particular kinds of injuries gamers can sustain. In January 2020 she worked with an avid player of Super Smash Bros – a high-paced beat ‘em up that requires lightning quick reactions and extensive button-mashing. The player’s other doctor had told him he had “gamer’s thumb” – inflammation of tendons in the thumb. But she determined that he actually had intersection syndrome, a similar sort of inflammation caused by overuse, but in a different part of the hand, near the wrist. “We iced the correct area and switched the medication he was on and he was better in two months,” she says.
In 2021, Migliore and some of her colleagues in the burgeoning field of esports medicine are due to publish the first book-length guide to preventing and treating esports injuries. And she’s also begun working with two medical schools on curricula that include content on esports and health.
All of this is an attempt to dismantle the scepticism around gaming that Migliore says still lingers in the medical field. She remembers being at a conference only a couple of years ago where the topic of video game injuries came up – to the bewilderment of many doctors present. “Half of the room started laughing,” she says. “They thought that concept was so comical, people playing video games and getting injured.” It’s time, Migliore insists, for doctors to level-up.
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