ORIGINAL RESEARCH article
Front. Psychol.
Sec. Sport Psychology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1640559
This article is part of the Research TopicThe Cognitive Era in Sports Performance: Mental Fatigue, Cognitive Training, Sleep and Psychological Ergogenic Substances-Volume IIView all 9 articles
Gaming Through the Pain: Psychological Flow and Self-Efficacy Amid Musculoskeletal Challenges in Esports
Provisionally accepted
Samiah Alqabbani1
Reema Alhussaini1Shumukh Alsaedan1Manar Alfaqi1Reema Almudaifer1Najd Zain Aldeen1Hanan Alsaeed1
Maha Algabbani2
Afrah Almuwais1
Madawi Alotaibi1*
Wafa Alahmari1- 1Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- 2Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia, Riyadh, Saudi Arabia
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The rapid expansion of esports has highlighted concerns regarding the physical and psychological well-being of professional gamers, which have intensified. This study examined the prevalence of musculoskeletal (MSK) pain and its association with flow states and selfefficacy among 232 male professional gamers registered with the Saudi Esports Federation. Participants completed validated tools: the Extended Nordic Musculoskeletal Questionnaire, Flow 4D16, and General Self-Efficacy Scale (GSE-3). Descriptive and multivariate analyses were used. MSK pain was highly prevalent (72%), especially in the neck (38.4%), lower back (31.5%), and wrists/hands (24.1%). Logistic regression identified input tool and device category as significant predictors of shoulder pain (p < 0.05). Despite widespread pain, flow and selfefficacy scores remained moderate to high, with no significant associations between psychological outcomes and MSK pain (MANCOVA, Pillai's Trace = 0.044, p = 0.069). These findings suggest a degree of psychological resilience among esports athletes, underscoring the complexity of physical-psychological interplay in gaming contexts. Future studies should explore mediating factors such as pain coping, motivation, and recovery behaviors.
Keywords: eSports, Musculoskeletal Pain, Flow state, self-efficacy, Gaming performance, Digital Athletes, Saudi Arabia
Received: 03 Jun 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Alqabbani, Alhussaini, Alsaedan, Alfaqi, Almudaifer, Zain Aldeen, Alsaeed, Algabbani, Almuwais, Alotaibi and Alahmari. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Madawi Alotaibi, Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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