Journal Article Review, September 2018

September, 2018: Video gaming and arm pain in young baseball players

Sekiguchi T et al: Playing video games for more than 3 hours a day is associated with shoulder and elbow pain in elite young male baseball players. J Shoulder Elbow Surg. 2018 Sep;27(9):1629-1635.
This month, investigators from Japan are publishing the results of a simple survey that provides food for thought regarding the perils of prolonged video game playing.
They sent a self-reporting questionnaire to 210 elite male baseball players age 9-12 who were playing in a national tournament. The survey asked how many hours they played video games per day and the same for television and for baseball practice. It also asked them if in the past year they had elbow pain or shoulder pain in their throwing arm.
Two hundred six responded. Six were girls, who were excluded based on their small number, which left 200 surveys for analysis. Over half of respondents practiced more than two hours a day during the week, and 80% of respondents practiced for more than six hours a day on the weekends.
Thirty percent of respondents had experienced shoulder or elbow pain within the last year. Sixty three percent of those who played video games more than 3 hours of day experienced pain, whereas only 24-32% of those playing less time experienced pain. This difference was statistically significant. There was no statistically significant difference in the occurrence of pain with respect to number of hours of television watched daily.
The authors conclude that prolonged video game playing is associated in a statistically significant manner with pain in the throwing shoulder and elbow in young, elite baseball players, whereas prolonged television watching had no effect. Since both activities are sedentary, the investigators speculate that the difference is related to the constant, rapid movements and upper limb stabilization needed to play video games, perhaps most importantly the trapezius. Also, looking down rather than forward tightens up the spine and shoulders.  Once the scapula is not moving properly on the thorax, altered throwing mechanics runs the risk of developing medial collateral ligament injuries, osteonecrosis of the capitellum, and shoulder soft tissue injuries.
This is a simple study. It makes sense intuitively. Do the results translate to older amateurs and to professionals? Does it translate to females? The study did not ascertain how many months a year these boys played baseball and if their symptoms subsided off-season, which is likely short for these aspiring stars. Video gaming does not at first glance seem to be strenuous, but when continued for hours after the throwing arm has already had a stressful day, problems may ensue.