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Beware repetitive strains and accidents if you are a Wii addict - it may bevirtual, but it is exercise; They are one of the most popular Christmas presents and have been heavily marketed as a way of getting exercise. Kate Hodal investigates whether a Nintendo Wii will leave you with more than a pounds 199 dent in your finances.

Byline: Kate Hodal

EXPERTS have warned that people spending hours playing Nintendo Wii games can suffer inflammation of the wrist, knees and shoulders and even torn ligaments.

The phenomenon has coined its own language to describe the injuries - Wii-knee and Wii-itis.

Wii-related injuries were found to have hospitalised up to 10 people a week in the UK last year.

And with Wii sales increasing as families buy them for Christmas, doctors could see more patients with Wii-related problems this year. s

Video and computer games have long been derided for their allegedly detrimental effects on the mind, with anti-social behaviour and social alienation often cited as the result of too much time spent gaming.

But medical reports over the years have also highlighted concerns over the physical ailments caused by gaming - where long hours are spent in front of video game screens.

These include deep vein thrombosis, poor memory function, loss of sleep, faecal incontinence, an inability to control urination and epilepsy.

Injuries specific to the games themselves began appearing not long after the first video game - the Magnavox Odyssey, launched in 1972.

Within a decade "Space Invader's wrist" became the symbol of overenthusiastic gaming. It was followed by "Nintendinitis", coined in 1990 to describe a repetitive strain-type injury on the wrist and elbow and "Nintendonitis", the pressure injuries induced by repeatedly pressing the same buttons.

"PS2 thumb" - a flaky and blistered thumb from punching Playstation buttons - was a popular complaint until the advent of the Wii in 2006 and the resulting Wii-itis.

Unlike its predecessors, the Nintendo Wii boasts accelerators and infra-red, 3D motion detectors on its wireless computer console, which renders the game more physically challenging than its standard counterparts.

Users can play simulated games like tennis, bowling, boxing, golf and baseball, or be taught how to hula hoop or do yoga positions.

But all this fun hasn't been without its drawbacks.

While the games have been praised for encouraging people to be more active, playing them incorrectly, or for sustained periods, can lead to injury - especially for those unused to exercise.

One such injury - dubbed Wii-itis - is characterised by pain in the shoulder or wrist and is usually the result of sudden movements incurred during tennis or running games, which can stretch or tear tendons.

Some doctors, including Dr Dev Mukerjee, who works at Broomfield Hospital in Essex, have warned that gaming could also cause damage further down the line.

"It's possible 'Wii-itis' may lead to rheumatism or arthritis later in life," he said. "Patients often have inflammation of the shoulder or wrist."

But it's not just Wii-itis that gamers need to look out for. Wii-knee - the inflammation or tearing of ligaments or, in extreme cases, the dislocation of the kneecap - is another potential health hazard.

Coined after a 16-year-old boy tore several knee ligaments, Wii-knee is thought to be the result of the Wii Fit game, which requires players to stand and bend on a special platform to perform yoga and strength-training moves.

Then there's a round-up of more mundane, but equally painful, accidents, says Dr Thomas Fysh of the Royal Devon and Exeter NHS Foundation Trust, who has seen first-hand the effects of Wii gaming.

"Many of the injuries we see can be attributed to gamers sometimes falling over furniture or flinging their hands upwards into light fixtures," he says, having recently written a report, A Wii Problem, published in the Journal of the Royal Society of Medicine, on the matter.

Even the controls themselves can be dangerous. The British Society for Surgery of the Hand (BSSH) has seen patients with fractured bones due to controls being flung around incorrectly, while one eight-year-old girl suffered deep scalp lacerations because of a flying remote, according to Dr Fysh.

Indeed, Wii injuries are so common that several websites and blogs have been set up to account for them, such as Wii Injury - - and Wii Have A Problem -

On the sites, users are encouraged to send in their photographs and tales of their latest Wii injuries.

Because Wii sports are simulated, users tend not to stretch before playing. And because the games encourage players to mimic real sport actions, people can often become "engrossed" and sustain resulting sprains and fractures when they should have stopped playing hours earlier.

Dr Julio Bonis, a Spanish physician who unwittingly became the victim of Wii-itis himself, said: "If a player gets too engrossed, he may play tennis on the video screen for many hours.

"Unlike in the real sport, physical strength and endurance are not limiting factors."

US talk show host and fitness guru Michael Torchia claims Nintendo is concealing the dangers of its product. He also argues that Wii could actually be contributing to the obesity epidemic in America by brainwashing people into thinking they're exercising when, by any proper definition of exercise, they're not.

"It is unwise to encourage users of video games to give in to the coach-potato lifestyle and not expect their health to suffer," says Torchia.

"Neither is it wise for Nintendo to release a video game without proper warnings that requires Wii users to suddenly get up from their couches and begin stomping around without a proper warm-up."

But Dr Fysh says that, as long as you read the instructions, you should be quite safe.

"To be fair to Nintendo, it provides good safety advice and if you follow it, you shouldn't get into trouble," he added.

"The bottom line is that if grandpa gets excited over a couple of sherries, he might fall over because of the Wii, yes. But in the olden days, that might have been due to football in the garden. Now it's by trying to serve a Boris Becker in the living room."

Warm-up tips for Wii fans The Chartered Society of Physiotherapy (CSP) has advised all Wii players to appreciate that many of the virtual games simulate sport and so count as genuine exercise.

Physiotherapists generally encourage the use of games consoles that motivate players to get up from the sofa and become more active - especially for people who are not usually interested in participating in sport.

Playing virtual games like tennis or boxing will contribute to the 30 minutes of exercise everyone should aim for each day.

But the CSP said that people who aren't used to physical activity are launching themselves into demanding workouts with the Wii and finding themselves faced with injuries as a result.

Chartered physiotherapist Sammy Margo said people should take the sports-based games on the Wii as seriously as if they were doing normal sport and should do appropriate warm-up and cool-down exercises.

Sammy's top five tips to avoid any unnecessary injuries while using the Wii are: Shoulders - loosen up before you start playing, stand evenly on two feet and roll your shoulders backwards 10 times; Neck - to loosen your neck, take your left ear to your left shoulder until you can just feel a pull on the right side of your neck.

Do the same on the other side.

Take your chin to your chest until you feel a slight pull at the back of your neck. Tip your head backwards so you're looking at the ceiling.

Hold each of these stretches for five seconds and repeat three times; Back - to limber up your lower back, stand with your feet hip-width apart and circle your hips five times clockwise and five times anti-clockwise.

Clench your buttocks 10 times and pull in your stomach muscles 10 times; Wrists - Hold your left arm out in front of you and point your fingers to the ceiling, with your right hand pull your left hand backwards until you feel a stretch on the front of your wrist.

Without rotating your arm, point your fingers downwards and with your right hand push your hand down until you feel the stretch in the back of your wrist. Then swap hands. Pay special attention to the hand you use most to play the Wii; And digital dexterity - fingers and thumbs can be used a lot with console controllers so making sure they are ready for quick action is really important to ensure you're playing to your best ability and to reduce the risk of repetitive strain injuries.

Clench and open your fist 10 times. Do this on both hands to increase circulation.

RSI: 'PlayStation thumb' has become a recognised injury in the gaming community


REAL DEAL: Physiotherapists have warned you should warm up before attempting to try any of the Wii Fit exercises
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Publication:Western Mail (Cardiff, Wales)
Date:Dec 28, 2009
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