They train for up to 10 hours a day, practicing new moves, quickening reaction times and building chemistry with teammates for the chance to earn millions.
And while the professional, six-player team known as Magic Gaming — members of the NBA 2K esports league — will never set foot on an actual basketball court, that doesn't mean their bodies aren't being pushed to the limit, according to Dr. Todd Sontag, who was recently unveiled as the team's official doctor.
Sontag, a physician at Orlando Health who oversees the players' physical and mental care, says that despite being in their teens and early 20s, professional gamers are at risk for injuries that most people associate with middle-age office workers who spend their days planted in front of a computer screen: carpal tunnel syndrome, elbow, shoulder and neck pain, eye strain, as well as musculoskeletal injuries like tendinitis and back pain.
With millions of dollars in prize money on the line each season, and thousands of players hungry for a roster spot, even minor injuries are a cause for serious concern for the young players who know they can text the 43-year-old doctor at any time.
"In a game where you have to make split-second decisions in any moment, those minor hesitations can affect your performance," said Sonta. "If you have pain and weakness in your body, you won't be able to contribute as much."
"This is their job and these guys take their training just as seriously as a Kobe Bryant or a Michael Jordan," he added.
With more people watching the League of Legends World Championship than the Major League World Series and the NCAA Basketball Final Four combined, the definition of an athlete is rapidly changing. More than 120 North American colleges offer varsity esport teams, according to ESPN, which keeps a running tally of the programs.
Sontag, who began caring for Magic Gaming this year, is another sign that the hyper-competitive world of electronic sports is beginning to resemble the mainstream professional sports world. With prize money increasing and the games becoming more competitive, a growing number of traditional doctors like Sontag are devoting their time to esports injuries. Because gamers often live together and follow rigid training schedules for much of the year, there is no shortage of injuries, much of them associated with overuse.
The New York Institute of Technology's Center for eSports Medicine claims that the sedentary nature of esports, as well as altered sleep routines and social interactions, impact players' wellbeing. Experts say long exposure to bright LED lighting, social anxiety, limited physical activity and hygiene are also issues affecting the gaming community.
"The use of drugs like Ritalin and the excessive intake of caffeine or other stimulants provides additional sources of concern," the center notes.
There are a growing number of YouTube channels dedicated to gamers' health, but the most well-known sports doctor treating this new breed of athlete may be Dr. Levi Harrison, a Los Angeles-based orthopedic surgeon who is one of the first medical professionals to focus his practice on esports-related injuries, according to Variety. Harrison's YouTube channel, which has nearly 67,000 subscribers, includes detailed tutorials on how to keep gamers' fingers, wrists and forearms in top shape.
One of the most unusual ailments he sees is "gamers thumb," a condition in which a player's thumb becomes locked into place after extended periods holding a controller.
Like the conventional athletes he treats as well, Harrison says medical professionals can give gamers a distinct advantage over their competition.
"When it comes to esports players, the brain is the first instrument players use to strategize, and the second instrument is the body, using your hands, wrists, elbows, and arms," Harrison told Variety. "Teams today are starting to have more medical staff beyond coaches and gaming coordinators. Having a medical professional who's been a gamer and understands the body as well as the ergonomics of gaming is important to not only win, but to play for a long time."
Esport teams' keen interest in player health is being driven by another force entirely: the urgency of the moment. Though the monetary payoffs can be big, the window for esport success is a short one, doctors say. A professional basketball or baseball player might be able to extend their career into the mid to late 30′s, but esport athletes hit retirement age a full decade earlier.
"Their eye-hand coordination starts to deteriorate by the time they're 25 years old," Sontag said. "The 18-year-olds have already been playing for 10 years and they're quicker than the older players. It's hard to continue to compete past their mid 20s and there's just not that many spots open."