Carpal Tunnel Syndrome is truly one of the biggest issues in gaming today, especially PC gaming. We spend hours on end sitting in front of our computers competitive matchmaking in CS GO, playing consecutive games of LoL or Dota 2, grinding for loot and gear in MMOs – all of which put us at risk for developing our biggest fear:

Numbness and Pain in our hands!

Numbness is definitely not a normal thing to experience while gaming, and yet it is quite a common occurrence. And while it seems to be something that most of us ignore, understanding it and TREATING IT is extremely important to prolong our gaming careers.

So… What is it?

Carpal Tunnel Syndrome (CTS) is one of the most frequent causes of discomfort, numbness and pain in the wrist/hand. With overuse of the tendons that travel through the carpal tunnel, inflammation develops and compresses the Median Nerve in the tunnel. This causes pain and numbness in the hand and wrist.

credit to wikicommonsCredit to wikicommons

Gamers have an elevated risk of developing CTS for several reasons.

  1. Gaming binges are inevitable. The nature of how games are structured, especially with competitive play makes it hard for us to play for just short amounts of time.
  2. Poor Ergonomics and Posture causing excessive use of our wrist and hand muscles
  3. Small, Repetitive Movements of the Wrists for long periods of time: This is the big one. It is the small mouse movements that we make for countless hours that cause compression of the nerve within the tunnel.

When the nerve becomes compressed, that is when you will feel:

Where you will feel Pain and Numbness

Where you will feel Pain and Numbness

  1. Intermittent Numbness in the Thumb, Index and Middle Fingers (Sometimes the ring finger depending on the individual) that occurs during wrist activity
  2. Pain in the same distribution (Thumb, Index, Middle and Sometimes Ring Finger)
  3. Tingling or a prickly sensation along the wrist and again into the same distribution of the hand.
  4. It can wake you up at night (often because we sleep with our hands in a compressed position)
  5. Sensation that fingers are swollen even though little or no swelling is apparent
  6. Loss of strength with the thumb

These are all things we don’t really want to think about when we’re gaming. It is because of this that I want to teach you gamers three simple ways to manage and significantly reduce any symptoms you may be feeling.

1: Rest

Never underestimate the power of rest. We need time to have those tiny tears in our muscles or the compression in the nerves to heal. A day or two off of gaming can be beneficial not only physically, but also mentally.  

Rest is a principle that has been lost in our culture and if often an afterthought when it comes to the work/activity or exercise that we do.  I truly believe that it should be thought of as a part of the activity, work and exercise that we do.   And it comes to no surprise that there are countless studies that show how if we appropriately rest with the things that we do, we can become more productive, perform better and excel in our endeavors.

What is resting?  For us gamers, rest can mean several things. It can mean that we avoid the positions, activities and movements that cause or reproduce our pain. This way, we can provide the tissues that are strained the best environment to heal.

It also means taking a gaming break throughout your sessions or days off to allow for inflammation to settle from repetitive injury. The power of rest should not be underestimated. As I stated above, we need time to have those tiny tears in our muscles or the compression in the nerves to heal. Breaks during your sessions or a day or two off of gaming can be beneficial not only physically, but also mentally.

With CTS, it is always beneficial to minimize the amount of pressure that is present at the carpal tunnel. During our waking hours, avoid all positions and movements that cause or reproduce the sensations in your wrist or hand. We spend half of our day sleeping, which means it is also extremely important for us to address our carpal tunnel during this time.

A basic splint like the ones provided at any pharmacy can significantly reduce pressure while we’re sleeping.

Many of us have the tendency to toss and turn throughout the night, especially if there is some discomfort or pain that we’re dealing with. Sometimes we move into a position in which our wrists are bent. A splint prevents this from happening and allows more blood flow to the area. It has also been shown to reduce the pressure on the median nerve.

When you are already feeling pain, you should follow general rules – the length of time you have been dealing with the pain should be proportional to how long you need to rest.

Time Dealing with Symptoms Suggested Rest Period
 <10 Days 1-2 Days
10 Days – 3 Months 2-4 Days
> 3 Months 6-7 Days

2: Exercise Program

As a Physical Therapist and Strengthening & Conditioning Coach, Exercise is something I preach on a daily basis.  And for a good reason as there are an abundance of studies that prove the benefits of it. Gamers can especially benefit from proper exercise to improve their health. Our Hands, forearms and wrists are used for endless hours. Exercising to improve strength, endurance, mobility, speed, coordination and even agility can not only improve our gaming performance, but also prevent us from going down to 1 HP in the first place.

Because Carpal Tunnel Syndrome is a unique condition involving nerves, it is important for us to focus on exercises that help relieve pressure on the nerves and within the carpal tunnel itself. Maintaining forearm and hand strength also plays a large role in preventing recurrence of symptoms.

Before I provide the exercise program, it is important for us to understand how to perform it, especially if we have pain.

The rule of thumb is to perform the exercise right before the point of pain. So that means if I am asking you to perform a biceps curl. If it hurts halfway through the range, then curl it to the point right before it hurts. Mild Discomfort is okay, as long as the pain is not sharp.

There are three types of exercises that we perform to help manage CTS

1: Forearm and Hand Strengthening

We perform the following exercises to improve the strength, endurance and coordination of our gaming tools 

Eccentric Wrist Flexion with Finger Curl

Eccentric Wrist Extension

Grip Strengthening Exercises

2: Tendon and Nerve Gliding

These exercises are important to relieve any potential stickiness between the layers of tissue (What we call adhesions) and improve the blood flow to the tendon sheaths. Specific to CTS, Tendon and Nerve gliding exercise maximizes the amount of movement of the median nerve within the tunnel.

Hand Tendon Gliding Exercise Tendon Glide with Thumb Stretch A Glide for the Median Nerve

3: Stretching

Stretching improves circulation and helps to maintain the proper ROM with your hand, wrist and forearm joints. It is also beneficial in providing relief to muscles that are being overused.

Thumb Flexor Stretch Carpal Tunnel Traction Thumb Adductor Stretch
Wrist Flexor Stretch Wrist Extensor Stretch Hand Stretching Series

3: Self-Massage

Massaging specific areas along the hand, forearm and hand can provide relief to areas of compression and improve blood flow; allowing a proper environment to heal. The goal of massage is typically to provide relaxation of muscles that are contracting to protect the area. With contraction, it provides further reduction of blood flow. Relief with self-massage can be achieved in several ways.

Instrument Assisted: Typically we prefer the use of tools to massage areas that are painful or sore.  Whether it be a tennisball, foam roller or even canned food, applying pressure through the use of these instruments can help greatly with relieving compression.

With Carpal Tunnel Syndrome, we target muscles on the palm-side of your forearm that can increase pressure in the carpal tunnel. These are typically the muscles we use most when we’re gaming. Clicking, typing moving the mouse are all movements that utilize the muscles on the palm-side of our forearm.

Irritation or overuse of these tendons can increase the pressure in the tunnel.

Muscle Group with Tendons in the Carpal Tunnel – Irritation or overuse of these tendons can increase the pressure in the tunnel.

Forearm and Hand Muscles Self Massage 

Massage Each Region between 45 seconds and 1 Minute, twice if you feel that it is extra tight.

Palm Side of Forearm/Wrist Massage

Hand Massage Regions and Technique

The Bottom Line

Carpal Tunnel Syndrome involves a nerve and the tendons that travel through a tunnel in the wrist. It can be considered a consequence of repetitive strain injury in which tendons and their protective sheaths to become inflamed and swell. This compresses the Median Nerve in the tunnel. You will typically feel:

  • Nerve-related sensations: prickling, burning or tingling sensations along the palm side of the Thumb, index and middle fingers

3 Simple ways to address the pain and sensations you feel are:

  1. Rest
  2. Exercises
  3. Self-Massage

The tips in this post are meant to help you take the first steps in reducing some of the symptoms you feel with Carpal Tunnel Syndrome. It is important to realize though that as a medical professional, there is only so much I can do for you through the internet. If I could, I would love to have every gamer come to my clinic so I could relieve them of their pain.

Regardless, following the three methods above can go a long way in prolonging your gaming careers.

My work is not done. I hope to provide the best possible guides and tips for the 1 HP horde to improve your quality of gaming. Till my next post,

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