Online gaming has become an increasingly popular form of entertainment, especially during the Covid-19 pandemic. While gaming can be a great stress reliever, it can also cause overuse injuries. These most commonly occur in the wrist and hand and can occur with any type of gaming whether you use a computer, controller or handheld device like a Switch. Thankfully there are strategies you can employ to prevent and treat wrist and hand pain that results from gaming.

Gamer’s Thumb is another name for De Quervain’s tenosynovitis. De Quervain’s occurs when repetitive movement causes thickening and swelling in the tendons that travel through a small tunnel on the thumb side of the wrist. Symptoms of de Quervain’s include pain and swelling near the base of the thumb, difficulty moving the wrist and thumb with grasping and pinching movements, and a clicking, locking or catching sensation when moving the thumb. As time goes by pain may spread into the forearm and thumb and weakness may occur.

If you are having pain the most important thing to do is to take a break from gaming. Untreated Gamer’s Thumb can progress and even require injections or surgery if it persists too long. If your pain is constant while playing, or persists throughout the day after playing it is important to rest. Ice the area for 15-20 minutes at a time with a barrier between the ice and your skin. Do this 3 times per day. Gentle massage to the wrist and hand can also be helpful but don’t put too much pressure on any one area for too long, especially around the thumb side of the wrist. If the symptoms do not calm down after rest and icing it is a good idea to check in with a physical therapist.

Stretching the thumb and wrist is beneficial both in treating and preventing Gamer’s Thumb.

There are two stretches that we recommend doing every day:

  1. To stretch the thumb side of the wrist begin by bringing your thumb across your palm. Next, fold your fingers over your thumb and lastly bend the wrist towards your pinky finger. When you do this you should feel a stretch in the thumb and thumb side of the wrist. Hold this stretch for 20 seconds but don’t push too hard into the stretch, it should feel gentle.
  2. Next hold your hand out like you are going to shake someone’s hand, then with your opposite hand gently pull the thumb back towards your wrist keeping it in alignment with your fingers until you feel a gentle stretch. Hold this for 15-20 seconds.

Do these stretches every 30 minutes of play whether or not you have pain. Using a tennis ball or lacrosse ball to massage the muscles at the base of the thumb can also be very effective in releasing tension. It is especially important to stretch after playing.Strengthening the wrist is also important for prevention and treatment. These three exercises are a good place to start and can be performed easily at home.

Wrist Extension

  1. Start holding a 1 lb weight with your forearm supported and your palm facing down.
  2. Gently lift the wrist up, pause and then slowly lower down. If the wrist or thumb is uncomfortable at the top of the movement do not raise the hand as high.
  3. Do 3 sets of 10 repetitions.

Wrist Flexion

  1. Start holding a 1 lb weight with your forearm supported and your palm facing up.
  2. Gently lift the wrist up, pause and then slowly lower down. Like the previous exercise, stay in a range of motion that feels good.
  3. Do 3 sets of 10 repetitions.

Finger Spreading

  1. Put a rubber band around your thumb and fingers.
  2. Gently bring your fingers apart, pause and slowly return to start.
  3. Do 3 sets of 10.

Lastly a major consideration is what position your hand and wrist is in while playing. Holding your wrist in radial or ulnar deviation when holding a controller can cause wrist and thumb pain. Radial deviation is when your wrist is bent towards the thumb side and ulnar deviation is when it is bend towards the pinky finger side. When you hold your controller focus on keeping the wrist in a neutral position and don’t bend too much towards either side. Try not to push down too forcefully on the buttons of the controller and focus on keeping the wrist and hand as relaxed as possible. While a brace is not going to solve Gamer’s Thumb, it can be a useful tool to keep the thumb in a neutral position while playing.

Gaming does not have to cause pain and these are strategies you can use to both prevent and treat pain when gaming. If you are having pain that isn’t going away after taking these steps we recommend making an appointment with a physical therapist. Physical therapy can identify what the problem is and create a detailed and individualized treatment plan to treat and prevent the injury from reoccuring. Happy gaming!