In 2006, Nintendo released its fifth generation home console: the Wii. The gaming console was well received after its immediate arrival and has since won many prestigious awards in the gaming industry including Game Critics Awards for Best of Show and Best Hardware. A distinguishing feature of the console is it wireless controller, the Wii Remote, which can be operated as a hand-held pointing device or in some cases, an assault weapon. This revolutionary device introduced to the gaming industry has been both praised and criticized. Many critics and health experts have noted that playing the Nintendo Wii can be dangerous, especially when operating the console while under the influence of alcohol in a college dorm room. Despite warnings from the manufacturer (and a seventeen page illustrated booklet describing proper usage), countless Wii enthusiasts have suffered a medley of injuries, and we are constantly reminded that common sense does not come standard with the console. This isn’t your normal “Nintendinitis”, a term used to describe the thumb tendon pain that users experienced with the older console. The Wii gaming system warns players to use the wrist strap and play cautiously in an open spaced area with adequate room to play.

Common Wiinjury

Through countless warnings, public service announcements, and a major press release, many debate that Nintendo has done a lot to stress the safety issue, but still, many Wii gamers have injured ligaments and tendons since ’06. “Before these types of games were introduced, patients typically presented with ligament injuries of the hand from intensive use of hand-held controls,” noted Karen A. Eley. doctoral candidate at Oxford Radcliffe Hospital in Great Britain. “Now, the injuries seem to affect any region of the body,” Eley added. Health officials have noticed an increasing new number of foot related injuries in conjunction with the increase in popularity of the Wii. Such new injuries have resulted, for example, when otherwise healthy players fall off special pressure-sensitive balance boards that come with the popular Wii Fit game. This type of fall has been seen to result in soft tissue swelling, dislocations, and even small fractures.

The most concerning “Wiinjury” that health officials have discovered recently are fatal head injuries that are sustained from the grouping of gamers in confined spaces, prompting unintentional bumping and striking. “I think that in some respects some people are just rather unlucky. I am sure that many more people twist their ankles when they miss their footing on the Wii fit balance boards, but the injury is not significant enough to seek medical treatment. We only see the ones that are particularly severe.” But on a more positive note, Eley added that Wii does, in fact, encourage people who might otherwise be sedentary to get up and move. “And as with any activity, it is this group that are more likely to sustain strains and sprains,” she said. “[But] hopefully,playing these games will result in people becoming interested in participating in exercise, aiding in our fight against obesity, heart disease and diabetes.”

Robert Gotlin, director of the Sports Rehabilitation department at Beth Israel Medical Center in New York City, concurred with Eley’s sense that while the risk for injury due to Wii gaming is real, it is not a cause for much alarm. “Any physical activity or recreational fad always brings with it the risk of new found injuries. We’ve seen this across the board, ranging from the so-called ‘BlackBerry thumb’ to Nintendo wrist injuries,” Gotlin observed. “And even though everything carries some risk — from jumping off a couch to stepping off a curb — in this case Wii largely involves kids, so we should try to make sure they are safe,” Gotlin noted. “That means — like any activity — it should not be overdone. And it should be part of a kid’s life, not their whole life. And it should come with some parental guidance.” He added, “But then the question is whether kids — who at the age of 7, 8 or 9 are just becoming masters of their own neuromuscular control — get a benefit learning about balance and movement through Wii games that outweighs their risk for injury? Well, I would say that it certainly beats being sedentary and sitting on the couch. And the reality is that problems seem to happen to just a few kids, and the risk-benefit is very low. So I would not go overboard with concern.” Nintendo says it will continue to provide warnings and produce safe equipment — the rest is up to us.

– Anthony Isaac Palacios SOURCES: Karen A. Eley, plastic surgery resident, doctoral candidate, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom; Robert Gotlin, D.O., director, Sports Rehabilitation, Beth Israel Medical Center, New York City; Feb. 4, 2010, New England Journal of Medicine