Competing in e-sports means quick decisions and fast fingers.

Gamers often play for hours, and that can lead to injury.

“Some of the injuries we look at are overuse injuries of the hand — tendonitis, both of the flexor tendons and the extensor tendons,” said Dr. Dominic King of the Cleveland Clinic.

King says carpal tunnel syndrome in the wrist can occur, as well as overuse injury in the shoulder and elbow.

Some games are played on virtual reality consoles or computers.

Poor posture during gaming may cause neck and back strain, and there are problems with eye strain.

King said those injuries are more common among pro e-sports athletes rather than kids.

His advice is to be aware of aches and pains early in order to prevent injury.

“If you’re playing a game, you feel soreness in your wrists or in your hand, you feel numbness or tingling or you feel soreness in your neck or your shoulders, you take a break,” King said.

He recommends players get up, stretch, walk around, then get back to the game.

Because gaming is not a highly athletic or cardiovascular sport, King recommends those athletes find a way to include strength conditioning, fitness and good nutrition in their daily regimen.

Good physical fitness has been shown to improve mental clarity, accuracy and focus.