Background There is a high prevalence of musculoskeletal (MSK) pain and extensive training volume among professional and amateur esport players. MSK pain has been found to limit esports participation in 6% of players. Further, there is an increasing concern that the training volume may lead to activity-limiting burnout in esports. However, it remains to be investigated if MSK pain and activity-limiting burnout is more prevalent in esports compared to traditional sports such as handball. The objectives were 1) to compare MSK pain prevalence between esports players and handball players and 2) to investigate if MSK pain is associated with training volume in the two groups. Methods Eligible players had to engage in either structured esports or handball and be 15-25 years of age to participate in this questionnaire-based cross-sectional study. Esports players had to engage in esports primarily through a computer-based game. Demographic data, self-reported MSK pain prevalence, training volume, sleep patterns, physical activity level and activity-limiting pain and burnout were obtained through online questionnaires. The primary outcome was any MSK pain during the previous week (yes/no). Results 76 esports players and 175 handball players were included. 48% of esports players and 80% of handball players experienced MSK pain during the previous week. The likelihood of MSK pain was significantly lower in esport compared to handball (OR 0.24, 95%CI [0.13-0.43], Chi2 p-value < 0.001). No significant differences in training volume among participants with or without MSK pain were found in neither esports (p-value = 0.727) nor in handball (p-value = 0.128). There was a significant difference in training volume with esports player practicing for additional 12 hours per week compared to handball players (p-value < 0.001). The occurrence of activity-limiting burnout was high in both esports (34%) and handball (37%). Conclusion These findings suggest that young esports players are not at increased health risk in terms of experiencing MSK pain compared to young players participating in handball. This despite esports players practiced their activity for 12 hours more per week compared to handball players. More than 1 in every 3 had experienced activity-limiting burnout in both esports and handball despite a significant difference in weekly training volume. This indicate that other factors besides type of activity and training volume may influence the occurrence of activity-limiting burnout.

The authors have declared no competing interest.

The authors did not receive external funding to conduct this study.

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Approval to conduct the study was sought from the Ethical Committee of Northern Denmark. The committee replied that no approval was necessary for the current study (journal number: 2022-000764).

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