NAECAD Interview: Dr. Matthew Hwu, 1 Health Providence

January 4, 2022

Dr. Matthew Hwu is the Founder of 1HP, has a background in physical therapy, and has worked with esports teams since 2015. 1HP has worked with players and teams across multiple game titles, from CS: GO and Overwatch to League of Legends and Dota 2 to Fortnite and the fighting games community.

Why is it important for collegiate esports programs to build awareness about healthcare in esports?

Dr. Matthew Hwu: One crucial thing to understand is how early we are in developing professional esports. A few years ago, there was little to no collegiate infrastructure for esports players. Still, most are signed straight from high school or without going through any developmental pipeline.

I always say the professionals are expected to develop a high school, collegiate and professional athlete all in the span of 6months to a year. They have to learn how to take care of themselves, operate in a team environment, learn how to communicate at various levels (management, peers, coaches, etc.), and be expected to perform. Suppose we can educate players early about some of the self-management and health behaviors in college or earlier structures. In that case, it can help the players with longevity as they continue to progress into the professional scene.

Essentially it helps keep them healthy during college and well into their careers as pros. 

What are some of the common injures you deal with when working with esports teams?

Dr. Matthew Hwu:  Oh man, this is a great question. Tendinopathy and overuse is probably the best way to describe the types of injuries I see. I think it's interesting because it can depend on the game title, the peripherals being used, etc. BUT I would say the most common region is wrist and hand followed by neck and back.

I can confidently say it is doubtful to be carpal tunnel syndrome of the wrist and hand injuries. In 6 years, with our team seeing over 1000 injuries, we have yet to see an actual case of carpal tunnel syndrome. Instead, it is most often a form of tendinopathy of the muscles that travel through the carpal tunnel. So it is the tendon as the source of pain vs. the nerve. Flexor digitorum superficialis / profundus tendinopathy or extensor digitorum tendinopathy for those interested.

How can esports coaches and directors identify healthcare problems within their program?

Dr. Matthew Hwu: One is providing the appropriate training and awareness to the management/coaches to be conscious and aware of the possible issues. This means both a top-down and bottom-up approach, so there is a level of awareness at both the player and management levels. From there can be structures integrated into the esports program to allow for better player health and wellness check-ins: 

It takes time, but key positioned or central organizations such as NAECAD and others (NASEF, HSEL, PLAYVS, COPE, etc.) are crucial in developing the esports infrastructure to allow better education and awareness across all programs.

What can esports programs do to create a safe environment for their players?

Dr. Matthew Hwu: They can help the players improve their lifestyle, gaming setup, and overall approach for gaming health. To elaborate, meaning ensuring the players are educated early on about how they can set up their desks, what habits they should regularly incorporate (exercise, stretching, warming up, cooling down, etc.), why it is essential for them to take care of themselves. 

Then it is just about being patient with their development and understanding, they are still teens learning as they experience different challenges and stressors in their lives. It takes time for them to learn these new skills within their reference and skillset.

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