Biomechanical and Musculoskeletal Disorders in E-Sports Player: An Integrative Review of Literature

The e-sports world is rapidly professionalizing, creating a highly risky performance environment concerning long hours of static posture, intense and repetitive movements of the upper limbs, and sustained visual and cognitive loads. The biomechanical stresses are leading to a high prevalence of musculoskeletal diseases amongst e-sports athletes. Training regimes for these athletes span from 5 to 12 hours with a myriad of exposures causing serious risks for their cervical, thoracic, lumbar spine and upper extremities due to bad ergonomics, lack of variability of movements, and sustained flexed postures. Such worldwide participation is on the rise but there exists scant evidence synthesis of the biomechanical and musculoskeletal implications of e-sports, especially concerning injury mechanisms and preventive intervention avenues.  Aims: The aim of this integrative literature review is to identify, synthesize and critically analyse the current evidence analysing the biomechanical risk factors, musculoskeletal disorders, and intervention strategies resulting from esports participation.  Design: Integrative literature review.  Methods: A thorough search system of the peer-reviewed primary studies was conducted across electronic databases. Participating studies had to involve e-sport athletes and provide biomechanical, postural, ergonomic, or muscular outcomes. Data were then extracted and appraised using the Crowe Critical Appraisal Tool (CCAT) before being grouped thematically, following Burnard's (2011) content analysis framework.  Results: Nine different primary studies met the eligibility criteria. In studies with cross-sectional and experimental designs, a high prevalence of musculoskeletal disorders was noted, with neck, shoulder, upper back, lumbar spine, wrist, and hand regions being the most affected. Most significant contributors to biomechanics were prolonged gaming hours, maladaptive postures including forward head posture and thoracic kyphosis, decreased craniovertebral angle, poor screen ergonomics, and high levels of digital engagement or even gaming addiction. While research does not correlate forward head posture to MSDs, almost all have emphasized the cumulative effect of static loading and repetitive movement. Intervention studies indicate that ergonomic training coupled with physical exercise has produced positive outcomes.  Conclusion: Musculoskeletal disorders among e-sports athletes are not rare, seemingly associated with modifiable biomechanical and ergonomic factors. The evidence supports a multiple-hurdle approach toward the active prevention of MSD: workstation optimization, postural corrections, load management, and physiotherapist-supervised exercise interventions. This finding is reshaping clinical inspection, athlete management, and injury prevention within the burgeoning field of esports.