The prevalence of injuries in eSports has become a major drawback for the sport. More and more video gamers are experiencing the effects of a static posture and long hours full of intense fights. Although not as much as the injuries to the wrist and the hands, injuries to the elbow should still be something to worry about, since the shoulder, the elbow, and the hand work as a unit, providing the range for arm movements and a stable base for the forearm, hand and wrist motions. Lateral epicondylosis is one of those elbow conditions that has been frequently encountered by gamers and often a cause of withdrawal from a game.
Relevant Anatomy of the Elbow: The Lateral Epicondyle
Your elbow is made up of three bones: an upper arm bone or the humerus, and two forearm bones, the radius and the ulna. Your humerus ends at your elbow with two bony bumps on both sides, the medial epicondyle on the inside and the lateral epicondyle at the outside.
The lateral epicondyle is the bony prominence on the outer side of your elbow where several muscle tendons of the forearm are attached to, collectively termed as the common extensor tendon, which serves to extend the wrists and the fingers. The following are the muscles that extend your wrist with their other functions:
The Extensor Carpi Radialis Longus attaches slightly higher to this area, specifically at the lateral supracondylar ridge, and shares the same function as the ECRB, that is, wrist extension and radial deviation. Another muscle associated with this bony projection is the Anconeus, which has the same attachment site as the ECRB but functions as an elbow extensor, together with your triceps. The anconeus also functions as an elbow stabilizer during forearm pronation movement (inward rotation of the forearm) in which your forearm rotates towards your body so that your thumb points directly to you.
In lateral epicondylosis, the area where maximal tenderness is usually felt is a spot lower than the common attachment of the extensor muscles of the forearm. The most commonly involved tendon is the ECRB, but other tendons may be affected because of the proximity.
The Biomechanics of a Gamer’s Mouse Elbow
To racket players, lateral epicondylosis is known as the tennis elbow and is a condition associated with repetitive stress to the common extensor tendon from the powerful backhand stroke. To video gamers, this is known as the mouse elbow, referring to the overuse of a computer mouse, particularly in PC gamers. Repetitive finger motion, frequent wrist extension, or when the wrist is held in extension when using the mouse for long periods can strain the muscles of the forearm and develop pain in the area of the lateral epicondyle. Studies show that mouse elbow is often due to the damage to ECRB, the muscle that stabilizes the wrist when the elbow is straight, particularly in cases where the muscle is activated as it elongates (eccentric contraction). The ECRB is weakened from overuse and irritation, microscopic tears form in the tendon, leading to elbow pain. Although lateral epicondylosis has been identified as an inflammatory condition, inflammation is only present in the early stages of the disease and painful symptoms are usually felt when the condition has already progressed to a degenerative state due to “wear and tear,” causing the affected tissues to undergo a reduction in blood flow and scar tissue formation, a process known as angiofibroblastic tendinosis.
The ECRB is also prone to be affected because of its position. As the elbow bends and straightens, the ECRB rubs against the bony spot.
How to Know If You’re Experiencing a Mouse Elbow
The most common complaint by gamers with lateral epicondylosis is a gradual onset of pain and tenderness over the lateral epicondyle, which can radiate up along the upper arm and down into your forearm and wrist. A decrease in flexibility and strength of the wrist and hand muscles are also often seen.
Common signs and symptoms of a gamer's elbow:
The following provocative maneuvers reproduce pain at the lateral epicondyle:
How to Treat a Gamer’s Mouse Elbow
Among the most important of the early management of lateral epicondylosis is withdrawal or avoidance of the activities that cause the symptoms. This ensures that the condition is not aggravated and appropriate treatment can be given safely and effectively.
ACUTE (IMMEDIATELY AFTER THE INJURY):Management is geared toward relieving the elbow pain. The RICE (rest, ice, compression, and elevation) protocol can be helpful to relieve pain at the initial stage.
REHABILITATION AND PREVENTION:Rehab goals include maintaining or improving the flexibility and strength of the wrist and finger extensors, as well as the related muscles, and preventing the recurrence or onset of the condition. Frequent stretching along with high‑repetition, low-resistance exercise program can help with deal with elbow pain from lateral epicondylosis.
Extend your arm in front of you with elbow straight, forearm rotated inward (palm facing down), and your shoulders pulled back. Curl your fingers down and with your free hand, push the back of the affected hand down and pull it towards your body. Hold for 15-30 seconds and repeat three times.
Follow the procedure as above but turn your forearm more into pronation with your thumb pointing the floor. Feel the stretch and hold for 15-30 seconds.
This is a variation of the above stretches. Stand in front of a table and place the back of your hand against a tabletop with a straight elbow. Hold for 15-30 seconds.
Preventive Measures for Mouse Elbow
PC gamers’ mouse and keyboard tray are the usual cause of mouse elbow because it put their arms in almost static, tensed postures for long periods, straining the tendons at the outer elbow. Apart from performing the simple exercises mentioned, the following ergonomic adjustments can also be made to address this issue and reduces the risks of acquiring a mouse elbow:
Soft Tissue Mobilization: Recover like a Pro with Recovapro
Avoid lateral epicondylosis with Recovapro. A variety of soft tissue mobilization techniques can be applied using Percussive Vibration Therapy by Recovapro. Goals include reducing lateral elbow pain, promoting faster tissue healing by increasing blood flow, and increasing soft tissue extensibility.
Note:Terms used to describe the techniques are just for reference and comparison to actual manual therapy. The procedures are presented as if a manual massage is applied using the Recovapro massage gun.
PRECAUTION: avoid the bony prominence while using the massage gun. This may cause discomfort and may aggravate the condition.