Coping with Video-Game Related Repetitive Stress Injuries

A Few Tips for Alleviating the Pain of Too Much Gaming

Playing video games
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In 2001 I learned that if you are playing video games and your hands start to hurt, you should stop. After ignoring the pain in my right hand for hours while playing the PC game Max Payne, and then a month later ignoring the numbness in my left hand as I obsessively pushed through the PS2 game Ico, I found myself with chronic pain in both hands that I have been struggling with ever since. Last spring a succession of entertaining Wii games proved that I hadn’t learned my lesson very well.

I overplayed once again and wound up in so much pain that I had to stop playing games for about three months.

I have what is called a repetitive stress injury that gives me a lot of pain in my hands. What I have been told is that this is due to swelling or compression along the carpal tunnel, a sheath for a nerve and some tendons that run from the palm to the shoulder. (I do not, however, have Carpal Tunnel Syndrome). It doesn’t happen to everyone – some people can play video games non-stop for 24 hours and be fine – but it happens to a lot of people.

I have tried all sorts of therapies and devices to get the pain under control, and I have found a few things that seem to work for me. For others who have similar problems or feel they are in danger of developing them, here are the things I found most helpful.

(I’m not a doctor, so please don’t consider any of this medical advice. This is just what has worked for one sufferer.)

Basic Hand Stretches and strengthening

Nothing is more important than hand stretches. In fact, if you regularly take breaks from playing games and using your computer to stretch, you have a good chance of avoiding problems altogether.

The most common hand stretches involve holding your hand in front of you,  palm facing away, fingers pointed up or down depending on who you ask and then pulling your fingers towards you gently with the other hand.

Follow this by pointing the fingers down with the palm facing you, putting your free hand against the back of the hand you’re stretching and gently pulling your hand towards you once again. One physical therapist suggested a variation in which instead of pushing on all four fingers when I’m in the fingers up position I do the index and middle and then do the ring and pinky fingers separately.

I can’t find those specific stretches online, but here’s a good set of hand stretches you can try.

For strengthening the best thing to use is Theraputty, which is like a big ball of silly putty that you squeeze. Physical therapists prefer this to squeezing balls or using other devices that are likely to cause you to do the same motion in the same way since that's what caused tee=h trouble to begin with.

I also like the Flex Extend Wrist Roll you can find here. This is a collection of exercises that are supposed to help with Carpal Tunnel issues. Try them and see what works for you.

Cock-up Splints

Recommended by a physical therapist, the cock-up splint wraps around your thumb and wrist in such a way that you have to keep your wrists in a neutral position that puts the least stress on the Carpal Tunnel.

At the height of my pain, I wore them constantly, day and night, to the extent that I could stand it. Now I only wear them when I play video games or work on the computer. They make a huge difference in how long I can work without pain, and I can’t recommend them strongly enough.

Advanced Stretches and Exercises

If you’re in a lot of pain, you may need some more serious exercises to get your hands in shape.

One thing you can try is nerve flossing, in which you try to get the nerve sliding easily along the carpal tunnel. One of my doctors recommended holding your straight arm down, palm forward and hand a few inches from your body, then bending the wrist back and returning it to neutral.

It’s not a stretch, it’s more like your hand is a little wing and you’re flapping it. Do this 30 times.

That same doctor recommended two books that I have found very useful. These are Permanent Pain Cure by Ming Chew (try the Shrug Muscle Stretch on Ming’s sample stretches page) and Muscle Medicine by Rob Destefano. These books offer stretches and exercises to relieve pain in every part of your body, including your hands. If you’re in serious pain, you should really check them out

You can also try BodyMindResources’ online “Heal Yourself Series.” This is also a detailed series of stretches for every part of the body. Some I like, some I don’t. I have no idea if this guy knows what he’s talking about – some of his theories on carpal tunnel syndrome aren’t things I’ve heard anywhere else – but it’s free and some of it does seem helpful.

Physical Therapy

I’ve had physical therapy a few times for my hands. I've down ultrasound and electrostimulation, stretches and strengthening, and the alternative methods Active Release Technique and Graston Technique, which are painful but can help both painful but seemingly effective approaches to chronic pain. 

My main discovery about physical therapy is, do it more. For years I would do just enough to make my hands feel a little better and then stop everything except a few stretches. But when I started doing all my hand PT exercises every day and using more resistant therabands and theraputty (working up to that slowly, of course), I found that I was able to game more with fewer problems.

Once you have an injury you have to think of it as a permanent thing you must constantly work on, rather than something you fix before going back to normal. Sad but true.

Ergonomics

In any article on repetitive stress injuries, you will read that you need to sit and work ergonomically. For example, at the computer, you’re supposed to have your monitor and keyboard set at the right height and you’re supposed to keep your feet flat on the floor. I suspect in playing video games you are also better off seated properly, but honestly, I am always slumped on the couch. Here’s some info on using your computer ergonomically.

I also found a zero-tension mouse like the 3M Ergonomic Mouse helpful when working at the computer. A zero-tension mouse is basically a control stick on a base, allowing you to hold your hand in a vertical position. Using the 3M mouse seemed to help a little, but it can be annoying to use, so I had a second, conventional mouse attached to my PC as well. I used the 3M mouse with my right hand and the conventional mouse with my left hand so I could rest my hands alternately. After a while, the mouse died and I never bothered to get another.

Other Stuff to Try

Anti-inflammatories like ibuprofen (a.k.a. Advil) and naproxen (a.k.a. Aleve) can relieve swelling and reduce pain. Ice packs or a heating pad can also help (my understanding is that ice is used for new injuries and heat is used for chronic ones). However, some studies suggest that while fighting inflammation might lower pain, it doesn't really help the underlying problem, so I rarely bother.

If you also get pain in your shoulders, which can happen (especially with the Wii), the best thing I’ve found is self-massage. Find a tight, sore spot, put your finger on it, press hard and move your finger over the spot. Do this ten times, only in one direction. I found this recommended somewhere when I was having serious shoulder problems and it was a huge help.

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