Nintendo thumb

Although overall video game consoles and remote controllers have moved towards a more ergonomic approach, Nintendo has faced an increase in injuries with their consoles caused by the Nintendo Wii. This is because of its novel style of play which involves more physical and interactive activity on behalf of the user.[23] After the release of this console in 2006, the first case report belongs to an Achilles heel injury presented by a 46-year-old man after playing performing a jogging motion requested by the game which led to the rupture of his Achilles tendon.[23]

Bursitis in elbow is a common Wii related injury

Although the interaction is virtual, the injuries are very real and resemble injuries seen in real-life sports ranging from head to toe.[24] A neck related injury was first reported in 2009 when a 38-year-old man swung his remote control forcefully enough to send him to the emergency department. This injury required a minor surgery to address it due to physical therapy being unable to address the individuals' symptoms.[25] Additionally, a 44-year-old woman needed surgery to recover from an unstable knee due to a prior anterior cruciate ligament (ACL) tear while playing Wii Sports that failed physical therapy recovery just 6 months prior.[24]

A case report from 2004 that was published in The Lancet described a blister on the thumb caused by repetitive use of a Playstation 2 controller. The writer dubbed the condition, "PS2 thumb."[26] While named similarly to Nintendo thumb, the two do not have the same cause. Playstation thumb is caused by friction and affects the skin (though associated symptoms can include pain and stiffness in the hands, shoulders, and neck),[3] while Nintendo thumb is caused by injuries to the tendon.[2]

Wii-itis is the general term that is used for any inflammatory disease or injury due to playing with the Wii console. These injuries are categorized into four major classes: tendinopathy, bursitis (inflammation of fluid filled sacs around joints[7]), enthesitis ("Inflammation of sites where tendons and ligaments are attached to the bone"[27]), and epicondylitis (degeneration of the origin of a tendon in the forearm due to overuse of an extensor muscle).[28][15]

Common forms of injuries related to the Wii include:

Wii knee describes knee-related injuries that happen while playing with the Wii console. According to a case report from 2008, a teenager twisted and fell on his knee while playing the Wii which caused a lateral patella dislocation.[11] The treatment for his injury required surgery, and he recovered well.[11] This injury can cause osteochondral fractures, tears in tendons,[11] and meniscal injury.[29]

Wii shoulder is soreness and pain in shoulder and upper extremities, often due to playing games like Wii tennis or bowling.[15] A case report of a 22-year-old man who injured his left arm after playing a bowling game on Wii was published in 2008.[10] The injury resulted in pain and swelling.[10]

Based on case reports, Achilles tendon injuries can happen with different degrees of severity while playing Wii. These injuries may include tear or complete rupture of Achilles tendon. The rupture of the tendon will require surgery, while minor tears can be addressed with non-surgical treatments like physical therapy and use of NSAIDs[15] In 2009, a case report was published describing a 42-year-old woman who tore her left Achilles tendon after stretching her leg on her Wii Fit board.[9]

PlayStation Thumb is defined similar to Nintendo Thumb, where it refers to a repetitive strain injury (RSI) caused by excessive use of a PlayStation controller. This condition includes blistering of the thumbs due to excessive use of pressure and friction with the PlayStation controller during gameplay. There is also hardening of the skin on the thumb (lichenified hyperkeratotic papules) causing the skin to appear leathery. It can also be accompanied by changes to the nail, such as the nail plate lifting from the skin.[30] Other symptoms include stiffness, swelling, pain, and tingling in the arm joints such as wrists, elbows, and shoulders.[3]

The first case of PlayStation Thumb was recognized in a letter to an editor in 2004 from a 9-year-old boy. The boy played PlayStation 2 in a rapid manner for about 20 minutes and felt his thumb become numb and a blister formed. After ceasing gameplay for one week, the thumb healed.[31] Several other cases have been published as well. A study involving 120 students in South Africa followed up on the 2004 correspondence and found that 7 of the 17 girls and 8 of the 28 boys who played PlayStation had symptoms of PlayStation Thumb.[3]

Hidradenitis has been diagnosed through an examination to confirm the presence of neutrophils (a type of immune cell present during inflammation) in the eccrine sweat glands.[32] Palmar Hidradenitis is the inflammation of the palm, primarily in the eccrine sweat glands, causing lesions on the palmar surface of the hands. These lesions develop when people spend prolonged periods of time using their hands to hold and manipulate PlayStation controllers.[32]

As of 2021, there have been two reported instances of PlayStation Palmar Hidradenitis:

The first case was in 2009 in a 12-year-old girl. She had painful skin lesions on both palms and nowhere else on her body, and the cause of the condition was sourced to playing PlayStation for several hours per day prior to the lesions forming. After the lesions formed, the girl continued to play PlayStation games, but less intensely than before, which caused the lesions to develop more. The lesions went away completely after stopping playing PlayStation for 10 days.[33]

The second case was in 2017 in a 14-year-old boy who had painful palmar nodules after spending prolonged periods of time playing games and using his mobile phone. Similarly to the last case, he had inflammation containing neutrophils in the eccrine sweat glands in his palms. The palmer lesions healed on their own in two weeks after stopping PlayStation gameplay.[34]