5 tips to ensure posture, health in esports gamers

Coaches and directors of programs should be monitoring student-athletes' health and safety regularly and getting them the chiropractic care they need.
By: | August 13, 2020
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(This excerpt is from a column written by Dr. Christensen Smith as part of the Academic Esports Guide, which serves as a primer for schools and faculty interested in getting started in competitive video gaming.)

As a chiropractor with 20 years of experience helping people improve their health and posture, I have seen an increase over the past 10 years in people with health problems because of prolonged sitting and poor posture.

More frequently, the X-rays of younger people who spend an increased amount of time gaming, or on electronics, develop a hunched over spine with a forward head carriage. These individuals show up in my office because they have symptoms that range from headaches, back pain, breathing problems, aching necks and carpal tunnel syndrome.

My goal is to help those who lead esports programs understand what they can do to help their athletes eliminate negative health issues and maximize their gaming skills. Chiropractic care is the perfect pairing for gamers who spend a large portion of their time in seated positions in front of screens.

The average age of an esports athlete is 18–25. Although there are opportunities to compete at younger ages, most of the highest tiers of competition and major tournaments are limited to 18 and older. It is uncommon for gamers to sustain top level of play beyond this age range as their reflexes usually begin to get slower and their reaction times begin to decrease.

Many younger gamers spend 2-4 (or more) hours per day practicing while professionals can have intense training sessions up to 12 hours for several days in a row in preparation for a competition.

Along with the intense training comes the high stress and extreme fatigue on their bodies that can cause lifelong symptoms and issues. A knowledgeable and experienced chiropractor can help treat and improve a wide variety of issues that can cause a decrease in the quality of their lives.

What a chiropractor can do for gamers: A chiropractor can take X-rays of an athlete’s neck and spine, review these X-rays for subluxations and perform a detailed exam and evaluation.

Subluxations are spinal bones that are out of place in the spine that place pressure on a nerve(s). This pressure on nerves can cause havoc on a the nervous system, overall health and ability to meet the demands placed on high-level gamers. Identifying subluxations and creating a detailed care plan to address spinal issues is the key to improved health, peak performance and endurance.

What We Know: The worst thing a person can do, when it comes to spine health, is to sit. We don’t think about the amount of compression and degeneration our spine is dealing with. As a gamer, many hours each day are spent sitting.

How a gamer sits while playing factors into in their health. Leaning towards the screen puts the body into a bad position: shoulders are hunched, the neck is hyper-extended, and back muscles are stretched out. Sitting in this posture for long periods of time causes neck-flexor muscles and mid-back muscles to become stretched out and weakened, while the chest (pectoralis) muscles and upper back (trapezius) muscles tighten and shorten.

Long-term muscle imbalances can develop, which results in pulling the head forward. An average head weighs 10-12 lbs. When there is forward head posture, this can increase the pressure on the neck by as much as 50-60 pounds because of gravity. This increased pressure causes long-term damage to the spine, as well as the surrounding nerves, muscles, ligaments. These tight muscles and poor posture cause joints to become misaligned. A misaligned joint puts pressure on the nerves, which causes pain in the neck, back, shoulders, hips, wrists and other symptoms.

Side effects of prolonged sitting and poor posture: Side effects of these imbalances start small with things, such as an achy neck, a burning sensation between the shoulders, general discomfort and headaches. After these symptoms, prolonged, larger symptoms can begin to develop, such as breathing problems, carpal tunnel syndrome, sciatica, posture syndrome (also called upper crossed syndrome), early degeneration of the spine, and disc bulges and herniations.

5 tips coaches and esports directors can impart to students-athletes to reduce the risk of prolonged injury

  1. Watch posture. The better the posture becomes the longer muscles will take to fatigue, and the lower the risk of injury will be.
  • Keep the head back and chin tucked so the ears are directly above the shoulders.
  • Sit back in the seat, resting the back against the back rest of the chair.
  • Allow shoulders to relax instead of shrugging them or pulling them forward towards the monitor in a rounded position. These things keep the muscles in the neck and shoulders relaxed and take the pressure off the discs in the neck.
  • Focus on keeping the chest up. Imagine that someone is pulling up a string that is attached to the sternum.
  • Roll hips into a neutral position. Hips should not be too far forward or too far backward. This keeps the hips parallel with the floor.
  • Keep feet flat on the floor rather than crossing the legs or shifting to one side of the seat. This will keep the lower back more balanced, avoiding conditions such as sciatica and lower back pain.

2. Position equipment properly. Having equipment in the right position will alleviate stress on the joints.

  • The top third of the monitor should be at eye level. Also, the size of the screen in inches is the distance the eyes should be from the screen (20 inches minimum).
  • The height of the desk should be low enough that the forearms are resting parallel with the floor. This reduces the strain that causes carpal tunnel syndrome.
  • The arm rests are just high enough so that the elbows are bent 90 degrees.
  • The chair should be high enough so that the feet rest flat on the floor and that knees are bent at a 90-degree angle.
  • Sit with the back all the way against the back rest to avoid slouching or hunching towards the screen. Using a chair that has the option to recline slightly reduces the pressure on the discs in the lower back.

3. Don’t forget to stretch. In addition to a warm-up stretch before gaming, these stretches will help your athletes loosen tight muscles and become more mobile.

  • Chest Stretch: Athletes can lay on a foam roller that is placed parallel with the spine. Stretch the arms out away from the body, allowing the pectoralis muscles to stretch out.
  • Overhead Stretch: Lay on the back on an exercise ball and extend the arms up and over the head, reaching for the floor behind the body. This will stretch out hip flexors, pectoralis and neck flexors. Proper stretching of the neck is essential.
  • Towel Pulls: In a seated position, place a rolled-up towel behind the neck. Grasp the ends of the towel and extend the head all the way back to stretch out the front of the neck. Slowly repeat this stretch eight times.
  • Chin Tucks: Place a finger on the chin. Without moving the finger, pull the chin and head straight back until a good stretch is felt at the base of the head and top of the neck. Hold for five seconds.
  • Shoulder Squeezes: Pull the shoulders back and down as if squeezing an orange between the shoulder blades. Hold for five seconds and repeat 10 times.

4. Lean on physical therapy and training. With the help of a physical therapist, or a certified trainer, muscle strength and posture for your athletes will improve:

  • Bench press can strengthen the pectoralis muscles.
  • Seated row can strengthen the latissimus dorsi (lats) muscles.
  • Dead lifts and planks can strengthen the core.
  • Always have athletes consult a certified trainer or physical therapist before starting a training program.

5. Seek chiropractic care. The healthier the spine and nervous system is the healthier they will be.

The most important system in the body is the nervous system. The nervous system consists of the brain, spinal cord and nerves throughout the entire body. Everything in the body is controlled by the nervous system, including muscles, organs, and even the cells of skin. Nerve messages travel through the nerves from the brain to every part of the body and back up to the brain. It’s how our body regulates all of our systems.

The nervous system is so important that it is covered by bone. The brain is protected by the skull, and the spinal cord is protected by the spinal bones. As long as all the bones are in place, the nerve messages travel at 100%, and everything works perfectly. When posture is poor or there are repetitive motions, the spinal bones move out of place and put pressure on the nerves. This is called a spinal subluxation. A subluxation, put simply, is a bone out of place putting pressure on a nerve. When that occurs, the nerve messages become distorted. If left untreated, these distortions cause symptoms in the body.

Symptoms for a gamer can include headaches, neck pain, pain between the shoulders, low back pain, carpal tunnel syndrome, sciatica and jaw pain.

Chiropractic adjustments put the spinal bones back where they belong. When the spinal bone is no longer putting pressure on the nerve, the brain and the parts of the body once again can communicate at 100%, and health is restored. In addition to removing the pressure on nerves, chiropractic care has added benefits for gamers, including:

  • Chiropractic adjustments help correct postural syndrome. If the syndrome is not corrected at a young age, there is an increased risk for hunchback and other issues in the future.
  • Adjustments help create a sound body and relaxed mind that is necessary for a high-level gamer.
  • Adjustments aid in better muscle control and faster reflexes.

It is pretty amazing how a few simple things and some help from experienced professionals can improve your athletes’ gaming performance and make an improvement on their health. Their health and well-being are important issues, and you should take all precautions to ensure they are performing at their maximum level.

As with any recommendation, the results of these can vary depending on how dedicated they are to the protocols that have been laid out in this chapter.

In my opinion, if possible, gamers should have a team consisting of a chiropractor and either a trainer, or physical therapist, who can implement these five key things that they can do to improve their gaming and overall health.

They have to live in their bodies for the rest of their lives. It’s definitely much better to fix smaller problems now than to have much bigger health concerns down the road.


Dr. Sherry Christensen Smith is a chiropractor with 20 years of experience helping young adults improve their health and posture through chiropractic adjustments.  During the past decade, Sherry has seen an increase in symptoms and health concerns due primarily to an increase in sitting of young adults, both those in an office setting and those who are gaming. This increase has led her to do specific case studies with high-level competitive gamers to show how certain behaviors and activities by gamers can decrease risk of injury and increase performance. She has combined chiropractic adjustments and posture therapy to normalize the spines and health of those who come to her for help and has had excellent results working with a wide range of athletes, including gamers. For more information you can connect with Sherry at  drsherry06@gmail.com and on Facebook: The Body Shoppe.