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Mayo Clinic researchers find Wii Sports-related injury

Those who participate in sports or other physical activity know that after a workout could come with some physiological discomfort. Such a concept could be entering the realm of videogames, in a new condition dubbed “wiiitis.”

Michael P. Nett, Mark S. Collins and John W. Sperling of Mayo Clinic have a journal article titled “Magnetic resonance imaging of acute ‘wiiitis’ of the upper extremity” published in the May edition of Skeletal Radiology.

“We present the first reported case of acute ‘wiiitis’ documented clinically and by imaging, of the upper extremity, caused by prolonged participation in a physically interactive virtual video-game,” read the article’s abstract.

The article presented the case of a 22-year old male who reported shoulder soreness after playing Wii Sports Bowling. From the abstract, “Unenhanced magnetic resonance imaging (MRI) demonstrated marked T2-weighted signal abnormality within several muscles of the shoulder and upper arm, without evidence of macroscopic partial- or full-thickness tearing of the muscle or of intramuscular hematoma.”

The diagnosis made by the doctors differed in several ways from a person who experienced discomfort after playing a real-world game of bowling. The journal article explained, quoted by GameCritics, “[L]ittle resistance is offered by the light 200 g handheld controller to the aggressive maneuvers made by the participant, which may lead to awkward deceleration forces being applied to the upper extremity ... It is likely that, during the deceleration phase of swinging the Wii controller, there is significant eccentric loading on the participant’s muscle groups, causing the ultrastructural damage, as demonstrated in this case.”

Nintendo has already remedied various safety concerns with its introduction of Wii Remote additions such as improved wrist straps and rubber jackets. While it’s unlikely that Nintendo will introduce added weights to its controllers, don’t be surprised to see stretching instructions and new disclaimers at the beginning of every game.

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By MrBlastman on 4/7/2008 11:02:01 AM , Rating: 5
"“[L]ittle resistance is offered by the light 200 g handheld controller to the aggressive maneuvers made by the participant, which may lead to awkward deceleration forces being applied to the upper extremity ... It is likely that, during the deceleration phase of swinging the Wii controller, there is significant eccentric loading on the participant’s muscle groups, causing the ultrastructural damage, as demonstrated in this case.”

This is called a side-effect of physical exertion due to manual manipulation of the appendages through excited-state aggressive but pleasurable activity. What are we going to have now, a Surgeon General's warning on all Wii boxes:

"WARNING: Using your Wii controller will cause physical soreness, increased circulation, temporary cardiac tachyardia, elevated di-hidrogen monoxide consumption, increased atmospheric exposure, excessive fluid evaporation, increased body heat and a tendency towards improving your physical-well being. PLEASE EXERCISE EXTREME CAUTION"

I am growing more and more amused with the lengths our world goes today to "protect the innocent people from themselves."

None of what that quote mentions is ANY different from say:

a. Partaking in your favorite Japanese Martial Art
b. Being a Mime
c. Shadowboxing
d. Running around like a chicken with your head cut off flailing your arms uncontrollably through the air
e. Tai Chi

It does NOT increase your physical risk for injury what-so-ever if martial artists engage in the same exact activity every day. Last time I looked, Martial Arts (Kata for instance) has proven to be very beneficial to you physically and mentally over time. You practice 100 kicks or 100 punches into the air, it is the same as swinging your Wii Controller, with one big difference - you are exerting yourself far more with a kick or punch because you are working on power and finesse.

But, as the researchers want us to believe - Wii need to fund them more monies to give us more wonderful studies!




By MrBlastman on 4/7/2008 11:36:27 AM , Rating: 5
I've studied martial arts for over 8 years (probably way longer than that by now), and I disagree with your girlfriend.

There is PLENTY of training time in any contact martial art that involves 0 physical contact (be it pads, punching bags or people). You're simply swinging at and striking the air. Notice I mentioned Kata as one example.

Before you hit a bag, before you hit a person, you should spend hours and hours developing proper form and muscle memory that will prevent what my brother most gloriously performed on our punching back many moons ago - the feat of striking the bag with his hand and squarely fracturing his wrist while the bag dangled with outwright non-aghast amazement. It was spared another strike. Without proper form and practice, you will injure yourself badly.

I don't know about you, but when I practiced my punches/kicks/moves etc., I practiced them first for form, secondly at full power to develop advanced muscle memory and build the most important thing any seasoned martial artist possesses - Fast Twitch Muscle.

I've pulled my groin, thrown out my shoulder or other joint quite a few times, and I didn't need a study to prove to me this was possible with physical exertion. It made me stronger in the end.

You don't physically stop your leg or arm, you recoil and strike again. You also stretch a little. I still don't see a non-correlating difference between Wii activity and martial-arts. If anything, in martial arts, you are dramatically exacerbating the actions one might spastically perform with a Wii-mote. That isn't Nintendo's fault.


By omnicronx on 4/7/2008 12:02:42 PM , Rating: 2
quote:
You don't physically stop your leg or arm, you recoil and strike again.
This just about sums up why it is different. With martial arts, you are using momentum or (recoil) to get yourself into position for the next attack/defensive move. This puts totally different forces on the muscles in your body. Essentially Martial arts in itself is the mastering of energy transfer by;

'Linear kinetic energy from the motion of centre of mass (yours or your attackers), Rotational kinetic energy (Around your centre or around your attackers centre or your combined centre) and 3) Gravitational potential energy (of you or your attacker)'

I see why this could easily be confused as you could potentially put alot more strain on your body doing activities such as martial arts, but for how little physical activity is actually done while playing the wii, it can do a considerable amount of damage.


By omnicronx on 4/7/2008 6:22:22 PM , Rating: 1
lol why was I rated down? I've played soccer for 14 years, does that mean I know all physics pertaining to it? I don't think so..

Frankly I do not know why you some of you are even commenting on the article, as obviously none of the content sank in..
quote:
“[L]ittle resistance is offered by the light 200 g handheld controller to the aggressive maneuvers made by the participant, which may lead to awkward deceleration forces being applied to the upper extremity ... It is likely that, during the deceleration phase of swinging the Wii controller, there is significant eccentric loading on the participant’s muscle groups, causing the ultrastructural damage, as demonstrated in this case.”


By MrBlastman on 4/8/2008 10:06:43 AM , Rating: 2
You know, I thought about your post a little more and your example...

If you practiced "soft-style" kung-fu, or in some areas known as circular style, you would realize that awkward deceleration forces can be completely avoided through proper transitioning of the forces in the motion they are being performed.

Tai Chi uses it all the time. I don't think this Wii-itis is a serious problem.


By tmouse on 4/7/2008 12:27:55 PM , Rating: 3
The problem is not necessarily the wii (that just seem wrong to type ;) per se; its people have to learn to warm up and stretch before ANY exercise mild or not. If you start moving muscles in a way they are not use to in rapid ways in both the acceleration and deceleration you probably will see damage. I willing to bet as a martial artist you know enough to warm up; and keep in mind you took small steps when you started out. The games I guess may be fun (novel?) enough that people are going full out on them and since there in limited fatigue they are doing more repetitive damage. Just my best guess. I guess it fair to call it wiitis since it was first observed in wii gamers.


By MrBlastman on 4/7/2008 12:58:34 PM , Rating: 3
I wouldn't warm up all the time that is for sure, but the majority of sessions I would stretch a bit before attempting moves.

The point is, Americans(or the world) don't need another overpaid study to prove to them that:

1. Physical Activity is strenuous
2. Exertion will yield exhaustion
3. Exercise and use of your body could lead to a painful condition known as muscular strengthening and physical growth
4. You can pull a muscle and hurt yourself by doing something rather than doing nothing at all

Rather than exercising your gluteous-lazy-aximous every day, with the Wii you are creating many healthful benefits while maybe causing a little hurt in the beginning.


By tmouse on 4/7/2008 5:56:02 PM , Rating: 2
quote:
The point is, Americans(or the world) don't need another overpaid study to prove to them that:


Well let me explain it for you: this is not; nor has it ever been an "overpaid study". This is a case study in a radiological journal. In case you do not understand; these reports help medical professionals identify previously unknown diseases/ conditions/injuries, and can help other doctors make better diagnoses.

quote:
Rather than exercising your gluteous-lazy-aximous every day, with the Wii you are creating many healthful benefits while maybe causing a little hurt in the beginning.


The bottom line is people should not think just because it’s a "game” and does not have a active load there is no need to warm up and not over do it.

Unfortunately people DO need to be told to use common sence sometimes. We tend to think its JUST a video game; it cannot possibly do ANY harm and now it appears this is simply not true. It SHOULD be common sence BUT these cases are showing up, and forwarned is better than hearing about some DT story about a BS lawsuit because someone has developed a repitetive stress injury playing a wii game (but we all know it will happen).
Sometimes these types of injuries could cause more serious conditions later on in life. For instance from the current report these types of games could cause meniscus damage quite distinct but just as bad as more strenuous sports. The lack of the sudden pain a load activity could cause probably allows the person to continue the damaging actions far longer. I'm not saying the wii is bad, and the idea of "games" that produce some activity is in general a good idea (you will not get the benefits real sports gives but some is better than none I guess). It is important for people to be aware that there could be some types of damage and again proper form and warm up can prevent this. I have a friend who is in orthopedics and a 5th don black belt, he has told me he has treated MANY older martial artists who were fairly lax about warm ups and over the years did so much damage (they never noticed) and now they are getting new knees because of the accumulated damage. The old sensei's who can do back flips into their 80's always do full stretches ; )


By jhb116 on 4/8/2008 12:22:37 AM , Rating: 2
I think the real point here is we should stop protecting people from themselves. Society shouldn't have to suffer because a few people don't have basic common sense or at least have the guts to say “my bad” because they did something foolish.

Am I the only that thinks that a few hundred years ago, such people would have died at an early age or ruled kingdoms?


By tmouse on 4/8/2008 7:36:02 AM , Rating: 2
quote:
I think the real point here is we should stop protecting people from themselves. Society shouldn't have to suffer because a few people don't have basic common sense or at least have the guts to say “my bad” because they did something foolish.


What am I missing here? Where is the "Harm" ANYONE is "suffering" from here? No one is crying ban the Wii. Maybe people feel that we should not warn anyone about anything. Yes people do things others may feel are "foolish" is there ANYONE here who has NEVER done something foolish that someone else felt was "common sense"? Many people could feel the small level of exertion used in a game could not possibly hurt them, this is simply not true, but may not be obvious. Society is never hurt from warnings, some heed them others do not and may pay the price. I might agree if there was a Ban the Wii campaign started but a simple warning? Come On...


By xakuma on 4/8/2008 7:44:54 PM , Rating: 2
So let me see if I understand your thought process right.

First, you said playing a strenuous game on the Wii is similar to some forms of martial arts.

Then you told us that in martial arts form is important, and if you lack proper form you hurt yourself. You backed this up with the example of your brother, who fractured his wrist because he didn't have proper form.

When your brother went to the hospital for that broken wrist, did they send him home because they decided he lacked proper form? Or did they fix his injury? This isn't a question of whether or not the injury is preventable, it's a documentation of an injury and where it came from, much like there was probably a journal article a long time back about how people can hurt themselves practicing martial arts if they're not careful.

As a separate point, the following is what the journal said about the guy's injury:

quote:
Unenhanced magnetic resonance imaging (MRI) demonstrated marked T2-weighted signal abnormality within several muscles of the shoulder and upper arm, without evidence of macroscopic partial- or full-thickness tearing of the muscle or of intramuscular hematoma.


This means that the muscle was incorrectly exerted, not overexerted. That kind of exercise doesn't strengthen your muscles, it kills them. So your comparison to exercise is invalid, unless you consider spraining your arm to be exercise.

I completely agree with you that most people who play the Wii don't do much physical activity, and I'll admit I'm one of them. But just because your arm hurts doesn't mean you can call it exercise, and of all people to say playing a video game is like martial arts I'd expect it least from someone with a lot of experience in martial arts.


By mikefarinha on 4/7/2008 2:10:35 PM , Rating: 1
quote:
The problem is not necessarily the wii (that just seem wrong to type ;)

Perhaps because it should be typed as Wii instead of wii?

Just a thought.


By jconan on 4/7/2008 5:50:51 PM , Rating: 2
You're correct with that 1 for martial arts. However the problem lies in proper form. How many people play real tennis with a flick of their wrist when swinging the racquet? If people observe most people who have never played the sport will take the short cut like badminton. No wonder they can score with an ace. In real tennis they can't because of real physics comes into play with the added weight of the racquet and the force of the ball. The same goes with bowling, wrong form and repetitive use definitely does lead to injuries.


By MrPoletski on 4/7/2008 10:28:13 PM , Rating: 4
"“[L]ittle resistance is offered by the light 200 g handheld controller to the aggressive maneuvers made by the participant, which may lead to awkward deceleration forces being applied to the upper extremity ... ""

This can cause serious injury? :O

I'd better stop wanking..


By Pembo210 on 4/9/2008 4:12:18 PM , Rating: 2
They are just making sure to put as much caution out there as possible so somebody in this sue happy world doesn't go after them. That'll be next.
"I bought a tennis racket and got tennis elbow. I think I'll sue for compensation on the medical bills..."
Some people just need to grow up and accept that everything you do effects your body in some way. So stop complaining that you played a bowling game(with the same motions) for 18.5 hours and now my shoulder hurts. Use your brain even if it hurs after prolonged usage.


Well...
By i3arracuda on 4/7/2008 7:56:11 AM , Rating: 5
I play with my Wii twice a day, and my eyesight's as good as ever.




RE: Well...
By Alexstarfire on 4/7/2008 8:08:26 AM , Rating: 4
Ehh, I let my friend borrow it because he said he'll "only use it for one day and return it tomorrow." It's been 3 days and I still don't have it. Damn it, I want to play Brawl.


RE: Well...
By psychobriggsy on 4/7/2008 8:30:36 AM , Rating: 4
In the context of the post you replied to, I'm now quite disturbed!

Regarding the article, it seems some problems are because the controller is too light. 5kg WiiMote anyone? God save your TV, or wall, if you let go of that in flight...

Played so much Brawl on Saturday, awesome game. Hurrah for Freeloader (it's not being released in the UK for months for some reason).


RE: Well...
By FITCamaro on 4/7/2008 10:40:30 AM , Rating: 2
quote:
In the context of the post you replied to, I'm now quite disturbed!


You and every other man on the planet. Maybe he had a sex change and let a friend borrow his strap on...


RE: Well...
By FITCamaro on 4/7/2008 10:44:24 AM , Rating: 1
So if there's Wiiitis, is there also masturbationitis? If so every 10 year old who's discovered his dick probably has it.

Just saying do we really need to give Wii related sprains or pulls their own name? Or are they just trying to prove you can injure yourself playing the Wii?


RE: Well...
By MBlueD on 4/7/08, Rating: 0
RE: Well...
By Pembo210 on 4/9/2008 4:14:19 PM , Rating: 2
lol, nice!


oh please
By tastyratz on 4/7/2008 8:10:47 AM , Rating: 2
The nature of the damage would be directly related to the object being swung (I.E. the Wiimote) however if he was swinging around in the same fashion with a pounds instead of grams in his hands the problems could be much worse. Playing any sport whether it be virtual or real with the same motions is going to put you at risk for sports related injuries, who could have guessed.

"new report: being lazy is actually indeed less hazardous for your health than physically interactive videogames analysts say"

I have to say at least with the wii popularity people are getting off their asses.




RE: oh please
By mmntech on 4/7/2008 8:41:19 AM , Rating: 2
Lol. I think the real cause of the injuries is that people are just so out of shape. Wiiitis is better than fatarseitus. Though I love gaming, I think the kids really need to put down the controller and play outside more. I rarely see the kids on my street out in the summer like I used to do back in that quaint time known as the late 80s. It's no wonder they're so flabby.


RE: oh please
By FITCamaro on 4/7/2008 8:46:31 AM , Rating: 2
While I am an avid gamer (when I get to...), when the day comes that I've got kids, I definitely plan to limit their video game time. They'll be in a sport or some kind of physical activity.


RE: oh please
By eetnoyer on 4/7/2008 8:54:26 AM , Rating: 2
Speak for yourself. I have 6 year old daughter that likes to play tennis with me. I have to keep kicking her in the shorts (figuratively) to get her to stand up. Oh well, at least warmer weather is here, and she'll be playing outside alot more.


RE: oh please
By omnicronx on 4/7/2008 10:39:10 AM , Rating: 2
quote:
The nature of the damage would be directly related to the object being swung (I.E. the Wiimote) however if he was swinging around in the same fashion with a pounds instead of grams in his hands the problems could be much worse.
The whole point of the article was that it was stating that it does not take a heavy object to hurt yourself. You can actually do more damage in the slowing down phase of your swing, since there is little resistance. With a bowling ball you would merely be following through, something you can not do with a wiimote.

Try throwing a baseball as hard as you can, and then try pretending to throw a baseball as hard as you can. Which one hurts your arm more?


Common sense?
By englisboa on 4/7/2008 9:03:08 AM , Rating: 3
Well aren't there any people with common sense? I mean, if you aren't used to do exercise and play wii like a nut, obviously your going to do a lot of work out...
Then again only in US you see "Doesn't allow you to fly" warnings in Superman costumes...




RE: Common sense?
By AlphaVirus on 4/7/2008 12:49:57 PM , Rating: 2
quote:
Well aren't there any people with common sense?

Have you never heard that common sense is the most uncommon thing?


RE: Common sense?
By VashHT on 4/7/2008 2:22:06 PM , Rating: 2
I don't think this is the case really, its more akin to say throwing your shoulder out. For example, even a healthy person can throw out their shoulder tossing a tennis ball too hard, not all injuries in sports are due to being "out of shape".


??
By Marvlarv on 4/7/2008 7:53:03 AM , Rating: 2
quote:
“We present the first reported case of acute ‘wiiitis’ documented clinically and by imaging, of the upper extremity, caused by prolonged participation in a physically interactive virtual video-game,”


I wonder how many went unreported




RE: ??
By Lamont Wooten on 4/7/2008 1:46:25 PM , Rating: 2
The MRI machines is most likely owned by a radiologist group, and private insurance most likely paid for the exam.
I seriously doubt there is funding for MRI studies of WI addicts physical frailities.

Lamont Wooten


RE: ??
By Pembo210 on 4/9/2008 4:17:59 PM , Rating: 2
... or they may have not had insurance and I, along with everyone else on this forum, paid for the exam.


what a waste
By Lamont Wooten on 4/7/2008 1:05:44 PM , Rating: 2
What a waste of medical resources and unnecessary expense using an MRI scan, orthopaedic surgeon consult, and radiologist reading on such a trivial complaint and diagosis. This is part of the reason for we can't afford healthcare for the poor who have real medical problems and need real treatment.

Lamont Wooten




RE: what a waste
By omnicronx on 4/7/2008 1:27:40 PM , Rating: 2
Where do you think your hospitals and universities get their money for such machines? It's called research, and as trivial and stupid as it may be, it's the backbone of progress in the medical field. Make fun of it as you will, but chances are you would not have an MRI machine at all, if not for someone 'wasting their time' on something that at the time seemed trivial.


RE: what a waste
By tmouse on 4/7/2008 6:07:50 PM , Rating: 2
My guess the person had a problem, his doctor ordered the MRI and when they narrowed the probable cause to playing a Wii game the medical group published a case study. There was No waste of resources and it did not raise the cost of health care in America. This was for treatment not research, the observation was novel and these types of things are often published as case studies. If enough appear there may be enough evidence to do a study to prove the relationship (case studies do not have to do this) and maybe bring this to a broader warning to the public. Traditionally these case studies are not read by people out of the medical profession, and it is important to note they do not have to be peer reviewed and many are just observations.


aggressive maneuvers
By GaryJohnson on 4/7/2008 7:54:52 AM , Rating: 2
quote:
...aggressive maneuvers made by the participant...


There's the problem. Agressive maneuvers aren't necessary; it's all about subtlety and finesse.




RE: aggressive maneuvers
By VoodooChicken on 4/7/2008 10:13:01 AM , Rating: 2
Agreed. This is just the latest version of Nintendo Thumb (or even Atari Chaffe if you want to go that far back). Pounding, mashing, flailing, wooshing, etc. with a lot of force and/or speed won't make a difference as opposed to smaller, controlled movements. I had a bad case of Nintendo Thumb 20 years ago, but that's because I sprained my wrist on my bike and tried playing baseball (Nintendo) with a splint.


Typo in title
By astrodemoniac on 4/7/2008 7:04:55 AM , Rating: 2
Should be "Injury" not "Inury" :P




We Call It...
By kelmon on 4/7/2008 8:12:05 AM , Rating: 2
...Wii Elbow. Anyway, I think it's safe to say that this is another article from the publishers of "No Shit, Sherlock" and other articles of the blatantly obvious. I suspect that the doctors publishing this probably got a grant for the study and that just makes me mad.




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