“Carpal Tunnel, Carpal Tunnel, a-a-a-ah,” was Kyle’s reaction to a hand injury in the infamous World of Warcraft South Park episode. “Quick we need BENGAY,” says Cartman as he lumbers over to the counter.

While that moment made for a hilarious scene in an episode that still fuels gamer stereotypes to this day, it also made carpal tunnel the go-to meme when talking about gaming injuries. But carpal tunnel is no joke. According to Dr. Todd Sontag from Orlando Health who is working on the care team for Magic Gaming, sometimes the injury can even require surgery.

“Carpal tunnel is a pinched nerve in the finger,” said Sontag. “It starts with numbness or a tingling feeling, then it progresses to pain and if it goes untreated it can become a major injury that sometimes needs surgery.”

But carpal tunnel is only one aspect of the care Sontag is providing for Magic Gaming, the Orlando Magic’s NBA 2K League affiliate. For the Magic Gaming’s players, he is making sure they focus on their cores. Playing video games in a stressful situation for 8-10 hours a day can take a toll on your posture, which affects your performance.

“It doesn’t matter if you are a professional gamer or a professional football player,” Sontag said. “If you are not strengthening those muscles that are required to game for nine hours, it’s going to catch up to you. Endurance is important. Strength training is important. It can’t just be sitting down and playing video games.”

Sontag is part of an increasing focus on players health and wellness in esports. Partnerships with traditional sports teams have helped bring over practices common in physical arenas. Traditional sports owners are buying teams, traditional sports athletes are streaming on Twitch, and traditional sports arenas are carving out space for esports.

This increased professionalization of esports has brought with it mainstream brands and deals on cable TV, but it has also brought on increased pressure. The majority of professional esports players are 18-22 years old. They go immediately from streaming on Twitch and dominating leaderboards to suddenly representing massive organizations in front of sold-out crowds.

For many, it can be a lot. So for Sontag, physical health is important, but mental health is really the area that poses the most concern.

“You always see professional athletes where something gets in their head and they can’t get over it. Even when they have all the skill in the world, sometimes it’s their brain that holds them back,” Sontag said. “In esports, these kids are young and it is a rapid rise from unknown to celebrity.”

Right now, esports has a burnout problem. While professional sports athletes can play until their mid to late 30s before retiring, very few esports players make it past their late 20s. Considering esports take less of a physical toll on your body than traditional sports, that discrepancy seems counter-intuitive.

There are a couple main reasons for esports burnout. To start, most competitive games are heavily weighted on reaction, one of the first things that begin deteriorating with age. Second, esports are often grueling. Before this ongoing professionalization, the standard thought process was that players need to be grinding for over 12 hours a day to succeed. Coupled with that, team houses used to be a common practice, and sometimes still are, making players days be all esports, all the time.

The third reason is the allure of a lucrative streaming career. Why would players continue grinding absurd hours when more money and the ability to set their own schedules was an option through Twitch?

All those are key reasons, and they are all being addressed more in recent years. Team houses are becoming more rare as esports organizations see the importance of work-life balance. Professional contracts are becoming more lucrative making the financial difference between streaming and professional play less impactful.

But reaction time is still going to keep being a problem. Sontag says keeping your reactions keen is one of the key benefits of bringing in care teams to esports.

“Your reactions when you are 29 are not going to be the same as your reactions when you are 19, that’s just science,” said Sontag. “But keeping the players cross-trained, keeping them physically fit and engaged, providing those extra resources will do nothing but help.”

To hear the full conversation with Dr. Sontag with expanded thoughts on mental and physical health be sure to listen to the podcast on EsportzNetworkPodcast.com. The podcast can be found on all the major streaming platforms as well.