Esports & Health - Violeta Ivanova

Can you introduce yourself? What is your area of expertise? How are you connected to esports?

I’m Violeta Ivanova, a physiotherapist based in Finland. My latest clinical work has been in neurological and school-aged paediatric rehabilitation, and on the side, I have been involved in the development process of exergames aimed at rehabilitation (Gamification+ and Yetitablet).

My approach to physiotherapy is to gamify the process and have fun. It’s not realistic to expect that someone will follow a piece of paper with exercises on it for the next months or years, and yet that is the most common treatment method prescribed. Exercise and physical activity don’t have to be a chore, they can be fun and interactive, while still evidence-based and achieving the specific goals of rehabilitation.

My interest in Esports comes from passion for gaming and care for the players’ well-being. A lot of focus is put on mental support, while the physical improvement is not really a priority for most teams, even though there is a lot of clinical evidence for positive exercise influence on cognitive performance and mental health. The lack of insight within the Esports industry is partially due to not having many healthcare professionals and research data involved, so my aim is to help bridge the gap between gaming and being healthy.

Tell us a bit about your work in esports. What impact do you aim to have on the team and athletes you work with?

For the past year I have been working on a study about Carpal Tunnel syndrome (CTS) symptoms prevalence among Esports players as my BSc Physiotherapy thesis. It was done in collaboration with a local CSGO/PubG team called Tikka eSports, as well as a couple independent Overwatch players in France.

The main question I wanted to answer is – does playing computer games for longer equal higher risk of developing CTS symptoms? The general answer was “Yes, of course!”, but it wasn’t based on any actual data. I wanted to understand what physical stress is in the wrist, that could potentially act as a risk factor, but also to differentiate gaming from office work that is usually being compared to. Part of my study was to record mouse movement for what a typical competitive player’s use of a mouse may be. The data was then compared against a symptom diary that the players recorded for both hands, as well as their perceived performance increase or decrease.

My findings were not of any significance for the Esports industry; however, the study opens a discussion about potential physical risk factors that are being overlooked, as well as how physiotherapy can help improve player performance, prevent more serious conditions requiring surgical procedures and causing early retirement of a pro player.

I’d like to use that expertise to help coaches and players in being able to spot early signs/symptoms and address them appropriately. Through injury prevention we can ensure safe high-level performance for as long as possible.

Do you think physical activity could benefit esports athletes? How?

Absolutely! We know from research that general physical activity has positive impact on every aspect of a person, including Esports-related performance skills such as cognitive function. There are ongoing studies on what areas are affected the most during gaming – breathing, heart rate, eye movement, etc. after which we’ll know what specific training can be of biggest benefit to players. At the same time, we’re also looking into common health complaints by players and trying to address that in planning injury prevention strategies.

My suggestion to players would be to try out different types of activities – whether it’s gym, martial arts, climbing or playing VR games like Beat Saber at home. The possibilities in which people can move their bodies are about as many as finding a game you like to play and I’m certain that there is a physical activity to fit everyone’s preference and ability.

If you need help in finding options or are not sure where to start from, feel free to contact Violeta. You can reach Violeta at:

Discord: violeta#7785

Email: vio.ivanova@outlook.com