Abstract
Competitive gaming presents unique musculoskeletal challenges due to prolonged sitting and repetitive hand and arm movements. This study explores gender-specific regional lean body mass (LBM) differences and their associations with musculoskeletal discomfort in competitive gamers. Sixty participants (30 gamers and 30 matched controls; 15 males and 15 females in each group) underwent DXA scans to assess total and regional LBM, handgrip strength tests, and self-reported musculoskeletal pain surveys. Controls were matched for age and BMI and reported comparable academic and screen time but were not engaged in competitive gaming. Male gamers exhibited significantly reduced forearm (p < 0.05) and upper body LBM (p < 0.001), alongside lower grip strength (p < 0.001), compared to controls. Female gamers demonstrated lower upper body LBM (p = 0.01) but showed no significant differences in forearm lean mass or grip strength. In male gamers, negative correlations were observed between forearm LBM and lower back pain (r = -0.59, p < 0.01), highlighting the protective role of regional LBM against discomfort. Extended gaming duration was associated with increased musculoskeletal pain in both sexes (p < 0.05). These findings emphasize the need for targeted ergonomic interventions and physical conditioning programs to address muscle imbalances and reduce injury risk in esports athletes. Future research should focus on longitudinal and interventional designs to optimize musculoskeletal health and performance in this growing population.