Developing Healthy Routines for Gaming Teens

This information is provided by the University of North Dakota’s academic program in Esports. To learn more esports at UND, click here or email

Are your habits as a player preventing you from gaming at your best? Chances are that one or more health issues are getting in the way of optimal performance. A 2018 survey of collegiate esports players found the following: 

  • 45% complained of eye fatigue 
  • 34% complained of back and neck pain 
  • 27% reported wrist injuries 
  • 24% said they did no regular exercise 

If your eyes, neck, back, and/or wrists are bothering you, how can you stay at the top of your game? Just as importantly, if these are recurring issues, then how long can you realistically stay in esports? 

The links below on health and wellness in esports are meant to 1) inform you of the facts and 2) show you smart habits so that you can perform better and enjoy a longer playing career. Whether you play for fun or for championships, no one wants to burn out of their esport early. Moreover, embracing better habits is something that you can take with you to your life beyond esports. There’s a pretty good chance that your profession will involve work with screens, time spent at a desk, and/or hours of focused attention; by building smart habits now, you’ll reap benefits and avoid injury in the long term. 


DiFrancisco-Donoghue, J., & Balentine, J. R. (2018). Collegiate eSport: Where do we fit in?. Current sports medicine reports, 17(4), 117-118. 

Schary, D. P., Jenny, S. E., & Koshy, A. (2022). Leveling up esports health: Current status and call to action. International Journal of Esports, 3(3). 

Visit any of the modules below to see research-based information to improve your performance through the right habits. 


Freeze. Without moving a muscle, take stock of how you are seated in your chair (or standing, or lying down as you read this). Is this the chair you usually game in? Is this the way you usually sit? If so, how many hours per day do you sit like this? 
Research has shown that video game players have a tendency to lean forward, displacing their head in front of their spine instead of aligned with it. As the head comes further forward, it puts greater strain on your back muscles. As one study describes: “in addition to cervical strain, esports athletes are at an increased risk of cervicogenic and tension headaches” from all this poor posture. And unfortunately, our chairs don’t always help: “seats with backrests, which are common in gaming chairs, promote flattened lumbar lordosis and posterior pelvic tilt causing increased muscle tension in the paraspinal muscles and weakness of the transversus abdominus.”  
What can we do about this? One simple way to address your posture is to take regular breaks. After half an hour of play, stand up, get some water, move your body, etc. Getting up will snap you out of any bad posture you’ve slumped into. To address the issue of posture more directly, you should stretch regularly, especially stretches for your back such as toe touches. Finally, to strengthen your back, you should engage in exercises including (but not necessarily limited to) face pull, back row, and deadlift.


Zwibel, H., DiFrancisco-Donoghue, J., DeFeo, A., & Yao, S. (2019). An osteopathic physician’s approach to the Esports athlete. Journal of Osteopathic Medicine, 119(11), 756-762. 


As much as esports players might joke with each other for not knowing what “going outside” means or tell a friend to go “touch grass,” the benefits of an active lifestyle are clear to just about everyone. What you might not expect, however, is that getting cardiovascular exercise can actually improve your in-game performance. 
In an article titled “Exercise Improves Video Game Performance: A Win-Win Situation,” a team of researchers found that esports players who engaged in high-intensity interval training (HIIT) twenty minutes before a skill-testing task in League of Legends ended up performing better than their peers who rested their bodies instead. The researchers found that “exercise improved significantly… the capacity to eliminate targets” and “enhanced accuracy… during the video game task, with fewer mistakes to eliminate targets in one single attack after exercise.” In League of Legends terms, the players who exercised did better at last hitting minions and missed fewer shots. At the same time, exercise improved “immediate positive affect” among the players in the study – meaning they felt better, too. 
This research suggests that an active lifestyle can actually give you an edge in-game: getting your muscles moving and your blood pumping regularly is a win-win. So break up your long gaming session with aerobic physical activities like jogging, biking, rowing, etc. Not only can this help you blow off steam after a frustrating loss (it happens to everyone), but you may find yourself playing with better accuracy and effectiveness when you log back in. 

Figure 1 from “Exercise improves video game performance: A win-win situation” (used with permission). 

de Las Heras, B., Li, O., Rodrigues, L., Nepveu, J. F., & Roig, M. (2020). Exercise improves video game performance: A win–win situation. Medicine & Science in Sports & Exercise, 52(7), 1595-1602. 

Eye Health 

An intense match can hold our focused, unblinking attention while we’re locked in a struggle to come out on top. How often do you finish a match and immediately hop into the next one, win or lose? After a few more times of “one more game,” we might look up and realize we haven’t moved from our chair for hours.  

This is hard on our eyes, as research shows. A 2018 study monitored 43 college students playing a game for a four-hour session. Afterwards, participants’ eye discomfort was measured across nine characteristics in a questionnaire (including irritated eyes, blurred vision, and aching eyes), and participants felt significantly more discomfort post-gaming. The researchers concluded that although “these symptoms are usually temporary, the accumulation of fatigues could be potential risk factors for irreversible physical and visual disturbances.” In other words, a single four-hour session probably isn’t going to cause lasting damage to your eyes, but making a habit of gaming like that every night is liable to raise the risk of permanent harm.  

What can we do to better take care of our eyes? One simple piece of advice is the 20-20-20 rule: every 20 minutes of screen use, look at something 20 feet away that isn’t a screen for 20 seconds. So when your League of Legends or Valorant match is over, take a minute to get up, stretch, and take your eyes off the screen. Your eyes will be experiencing less fatigue when you need to make a clutch play in the next round, and you’ll be less likely to have aching eyes when you’re done for the night.  


Lee, J. W., Cho, H. G., Moon, B. Y., Kim, S. Y., & Yu, D. S. (2019). Effects of prolonged continuous computer gaming on physical and ocular symptoms and binocular vision functions in young healthy individuals. PeerJ, 7, e7050. 


The esports environment is flooded with advertisements for carbonated energy drinks and salty junk foods. It’s perfectly fine to have the occasional treat like a soda or bag of chips, but do you really think the pros are thriving on a diet of these snack foods? Professional esports teams tend to pay close attention to what their players are eating because they want these players to perform at their best. As the saying goes, “garbage in, garbage out.” 

A 2022 study of esports nutrition found that the esports players they examined didn’t tend to eat all that many foods that have been shown to aid in cognitive function, which is central to esports play. These foods include “fish, nuts, pumpkin seeds, sunflower seeds and other oil seeds.” Instead, the players they studied tended toward “unhealthy dietary habits that were associated with irregular eating of meals, frequent snacking, at least three meals a day and composition of snacks, the use of frying meat dishes and sweetening hot drinks.” There’s a lot to improve about esports nutrition in general. 

We can do nutrition better by following some straightforward advice: keep your diet regular, don’t forget breakfast, stay hydrated throughout the day, and eliminate saturated and trans fats. Out-snack your opponents with fresh fruit, carrots & hummus, and PB&J sandwiches instead of bags of processed salty junk foods and carbonated sugary drinks. Leveling up your diet will help you improve your game while keeping your body healthy. 


Szot, M., Frączek, B., & Tyrała, F. (2022). Nutrition Patterns of Polish Esports Players. Nutrients, 15(1), 149. 

Ribeiro, F. J., Viana, V., Borges, N., & Teixeira, V. H. (2021). The emergence of eSports nutrition: A review. 


What’s better: staying up late cramming for your final exam tomorrow, or studying less and getting a good night’s sleep before the test? You’ve probably heard from people who know that staying up all night (even to study) is counterproductive to your performance on a test. In the same way, grinding competitive matches the night before a big tournament isn’t doing you any favors if it’s eating up precious hours of sleep.  

As one overview of sleep research argues, esports performance relies on cognitive skills. The authors explain that “sleep restriction results in decreased reaction times, reduced processing speed, and slower processing of visual information, leading to impaired visuomotor performance,” which altogether could put esports players “at a competitive disadvantage.” How much sleep is adequate for teenagers? The Centers for Disease Control and Prevention (CDC) recommends 8-10 hours of sleep per 24-hour period.  

To say that not everyone gets their recommended hours of sleep is an understatement, but this is something you can control. In order to keep your gaming from interfering with your sleep, coordinate with your team to practice during daylight hours, avoid marathon sessions that eat into your sleep, and set limits on yourself (such as alarms or device managing software) so that you don’t get carried away with “one more game” again and again. You can’t play at your best when you’re sleep deprived and your reaction times are sluggish, so stop giving your opponents easy wins and get the sleep you need. 


Bonnar, D., Castine, B., Kakoschke, N., & Sharp, G. (2019). Sleep and performance in Eathletes: for the win!. Sleep health, 5(6), 647-650.

Addressing Toxicity 

If you’ve gamed in an online public lobby with voice and/or text chat, chances are unfortunately high that you have heard a racist/ableist/homophobic slur, a sexist comment, an otherwise shocking remark, or all of the above. And even maybe in a moment you aren’t proud of, you repeated something you heard online. Toxicity online has been a known problem in gaming in general, and it can be even more intense in esports, where the stakes are higher than casual gaming in your leisure time.  

As ubiquitous as toxicity in gaming is, we don’t have to accept it, and there are things we can do about it. Take the glhf pledge at, add the AnyKey badge to your Twitch account, and refer your friends to it to start changing the landscape of communication in games. When you see a chat or hear a voice making a toxic comment, tell them that’s not cool – especially when it’s someone you know. Learn your game’s block and report features, and use them when needed. If your friends stream, let them know you’d be happy to help moderate their channel, and use the mod tools available to keep the chat welcoming and boot hostility out.  

Finally, engage your coaches in conversations about how they can address toxicity and make esports a welcoming place for everyone. Together we’ll make a difference for our fellow players, whether teammates or rivals.  


Darvin, L., Vooris, R., & Mahoney, T. (2020). The playing experiences of esport participants: An analysis of treatment discrimination and hostility in esport environments. Journal of Athlete Development and Experience, 2(1), 3. 


If you’re reading this because you’re active in esports, you probably understand what it means to be passionate about a game. Games can be deeply engaging, rewarding, entertaining experiences that we find compelling and worthy of our sustained attention. Surely, however, there must be a limit to how much we should be playing them.

The World Health Organization (WHO) has recognized Gaming Disorder since 2018 as a medical condition. It affects “only a small proportion of people,” so just because someone is deeply engaged in games such as esports, that doesn’t necessarily mean they’re suffering from Gaming Disorder. However, we should be well aware of what the conditions for Gaming Disorder are: “impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.”

Stop and think – and be honest with yourself. Do I have trouble stopping myself from playing even when I say I’m going to? Am I losing sleep, skipping meals, and/or missing commitments so that I can game a little more? Am I able to correct my habits when I start to notice undesirable consequences of my time spent gaming? If you’re having difficulty with any of these, talk with an adult about it. Make a system for limiting your gaming to certain hours or a certain number of matches played. Maybe you should uninstall that one game that’s a black hole for all of your time. There’s a lot to love about gaming and esports, but everything in moderation.


Chung, T., Sum, S., Chan, M., Lai, E., & Cheng, N. (2019). Will esports result in a higher prevalence of problematic gaming? A review of the global situation. Journal of behavioral addictions, 8(3), 384-394.


How long would you estimate a professional esports player’s career lasts on average? According to a 2019 study, only about one in five pro careers last longer than two years. Some careers last a lot longer – Faker, for example, won a pair of League of Legends World Championships ten years apart (2013 and 2023). But that’s an exception. There are some important factors as to why esports careers tend to be so short, as a 2020 article by Smithies et al. explains:

· Esports rosters tend to be volatile, with players jumping from team to team or getting dropped between seasons.

· Mental processes esports players rely on tend to peak around the age of 24.

· The time commitment of pro esports players can result in burnout and/or injury.

· Not all pro players can make a sustainable living when prize distribution is skewed toward the top.

· Lack of players’ unions means little protections for professionals.

Clearly, a volatile labor market that the vast majority of pro players can’t stay in for two full years is a problem.

What does all this mean for high school players? Whatever your dreams are of playing at a pro level, be realistic about your chances of making it long-term. While you are competing, use your experiences to acquire skills that can serve you beyond esports – teamwork, communication, digital media fluency, leadership, etc. And if you do beat the odds and go pro, you would benefit from returning to school later to get your college degree.


Ward, M. R., and Harmon, A. D. (2019). ESport superstars. J. Sports Econ. 20, 987–1013.

Smithies, T. D., Toth, A. J., Conroy, E., Ramsbottom, N., Kowal, M., & Campbell, M. J. (2020). Life after esports: a grand field challenge. Frontiers in Psychology, 11, 883.

Positive Visualization

You’re on stage during match point of the grand finals, and you’re head-to-head against the star player on the other team. You feel the heat of the stage lights and hear your teammates’ excited voices as you anticipate your opponent’s move and counter it with a perfectly executed technique. When it matters most, when the pressure is on, you persevere and secure victory for your team. You get up from your chairs and congratulate each other before shaking hands with the other team and hoisting the championship trophy.

This imaginative exercise, commonly referred to as positive visualization, is an effective technique for your mental game. Visualization, or as its referred to in esports scholarship, “imagery,” can help you quiet your doubts and replace them with confidence when you’re in the moment of competition. Because you’ve already seen yourself succeed in that crucial moment, you arrive ready to succeed again.

As Moritz (2023) explains, imagery entails a set of questions such as “where,” “when,” “who,” etc. (Table 1). When we use imagery in esports, we should do so “for a specific reason with an outcome in mind.” That might mean improving an aspect of our play in order to execute a new technique in-game, or it might mean blocking out distractions in order to lead our team to victory. Whatever your reason and outcome, be specific in your imagery. Spend time out-of-game visualizing your future success; the results may surprise you.


Moritz, S. (2023). Translating the applied model of deliberate imagery use to esports. Journal of Imagery Research in Sport and Physical Activity, 18(s1), 20230014.

Collegiate Esports

In addition to location of school, size, tuition, strength of the major you want to study, and a number of other important factors, an esports program may influence whether you want to go to a specific college or university. Your high school esports experiences may have introduced you to your best friends and provided camaraderie that you hadn’t found elsewhere. Maybe esports gave you a chance to excel at something, and maybe you’ve even been in touch with recruiters who want you to play for their schools after graduation.

There are a lot of things to look for in a college esports program. Some schools have officially sanctioned teams, some have clubs with moderate support from administrators, some have student-led organizations, and some don’t really have an organized esports presence. You should ask yourself what you want to see in an esports program and how important its presence or absence might be in your decision. Do you want to play for fun on intramurals? Do you want to try out for a team and compete against other schools? Are you looking for an especially prestigious team that has won national championships? Or are you planning to put the controller down when you graduate high school and focus on your studies?

You should absolutely find the school that’s right for you. These modules have been provided the University of North Dakota, which has an officially sanctioned esports program with several teams, a recreational facility in the Wellness Center, and an academic program in which students can major in Esports or earn a certificate in it. If any of those things mean that UND might be the right school for you, please learn more about the competitive program and the academic program.


National Association of Collegiate Esports (NACE) school directory (250+ participating schools):