Sontag, a physician at Orlando Health who oversees the players’ physical and mental care, says that despite being in their teens and early 20s, professional gamers are at risk for injuries that most people associate with middle-age office workers who spend their days planted in front of a computer screen: carpal tunnel syndrome, elbow, shoulder and neck pain, eye strain, as well as musculoskeletal injuries like tendinitis and back pain.
With millions of dollars in prize money on the line each season, and thousands of players hungry for a roster spot, even minor injuries are a cause for serious concern for the young players who know they can text the 43-year-old doctor at any time.
“In a game where you have to make split-second decisions in any moment, those minor hesitations can affect your performance,” said Sontag, who places heavy emphasis on core training and forms or preventative exercise for his players. “If you have pain and weakness in your body, you won’t be able to contribute as much.”
“This is their job and these guys take their training just as seriously as a Kobe Bryant or a Michael Jordan," he added.
With more people watching the League of Legends World Championship than the Major League World Series and the NCAA Basketball Final Four combined, the definition of an athlete is rapidly changing. More than 120 North American colleges offer varsity esport teams, according to ESPN, which keeps a running tally of the programs.
Sontag, who began caring for Magic Gaming this year, is another sign that the hyper-competitive world of electronic sports (known as “esports”) is beginning to resemble the mainstream professional sports world. With prize money increasing and the games becoming more competitive, a growing number of traditional doctors like Sontag are devoting their time to esports injuries. Because gamers often live together and following rigid training schedules for much of the year, with the intensity peaking when they’re preparing for competitions, there is no shortage of injuries, much of them associated with overuse.
“The average eSports athlete conducts more than 400 movements per minute using a mouse or keyboard,” according to the New York Institute of Technology’s Center for eSports Medicine, which provides esport athletes with services like “body composition testing,” “nutritional guidance” and “customized chair-sizing.”
On their website, the center claims that the sedentary nature of esports, as well as altered sleep routines and social interactions, impact players’ wellbeing. Experts say long exposure to bright LED lighting, social anxiety, limited physical activity and hygiene are also issues affecting the gaming community.
“The use of drugs like Ritalin and the excessive intake of caffeine or other stimulants provides additional sources of concern,” the center notes.
There are a growing number of YouTube channels dedicated to gamers’ health, but the most well-known sports doctor treating this new breed of athlete may be Dr. Levi Harrison, a Los Angeles-based orthopedic surgeon who is one of the first medical professionals to focus his practice on esports-related injuries, according to Variety. Harrison’s YouTube channel, which has nearly 67,000 subscribers, includes detailed tutorials on how to keep gamers’ fingers, wrists and forearms in top shape.
One of the most unusual ailments he sees is “gamers thumb,” a condition in which a player’s thumb becomes locked into place after extended periods holding a controller.
Like the conventional athletes he treats as well, Harrison says medical professionals can give gamers a distinct advantage over their competition.
“When it comes to esports players, the brain is the first instrument players use to strategize, and the second instrument is the body, using your hands, wrists, elbows, and arms,” Harrison told Variety. “Teams today are starting to have more medical staff beyond coaches and gaming coordinators. Having a medical professional who’s been a gamer and understands the body as well as the ergonomics of gaming is important to not only win, but to play for a long time.”
Electronic sports have become big business, so much so that the biggest esports tournaments are now providing payouts of nearly $25 million, according to Gamespot, offering salaries that rival or surpass many professional athletes'.
Last year, the video game and software company Epic Games announced that the company would provide $100 million to fund prize pools for Fortnite competitions for the upcoming season. The audience, which spans the globe and flocks to popular gamers on YouTube and streaming platforms like Twitch, is in the tens of millions. More than 67 million people from around the world play League of Legends each month, according to Riot Games.
Esport teams’ keen interest in player health is being driven by another force entirely: the urgency of the moment. Though the monetary payoffs can be big, the window for esport success is a short one, doctors say. A professional basketball or baseball player might be able to extend their career into the mid to late 30′s, but esport athletes hit retirement age a full decade earlier.
“Their eye-hand coordination starts to deteriorate by the time they’re 25 years old,” Sontag said. "The 18-year-olds have already been playing for 10 years and they’re quicker than the older players. It’s hard to continue to compete past their mid 20s and there’s just not that many spots open.”