The explosive growth of competitive gaming has created an unexpected public health consideration: nearly one in three esports athletes now experiences musculoskeletal injuries that could impact their long-term physical function. This finding challenges the notion that sedentary activities are inherently safe from athletic-style injuries and suggests the need for injury prevention protocols in digital sports. Analysis of 365 Brazilian esports players revealed that 31% sustained musculoskeletal injuries within a 12-month period, with wrist injuries comprising 28% of all reported cases. The upper extremities bore the brunt of repetitive strain, reflecting the intensive finger, wrist, and forearm movements required for competitive gaming. Players with longer gaming careers and higher weekly practice frequencies showed significantly elevated injury risk, with each additional year of experience increasing odds by 11%. The injury pattern mirrors repetitive strain injuries seen in traditional occupations requiring fine motor control, suggesting that competitive gaming has crossed the threshold from recreational activity to physically demanding performance sport. This research fills a critical gap in understanding the physical toll of esports, which now attracts millions of participants worldwide. The concentration of wrist injuries particularly warrants attention given the potential for chronic conditions that could affect both gaming performance and daily functional activities. Unlike traditional sports medicine, esports injury prevention lacks established protocols, equipment standards, or training guidelines. The dose-response relationship between practice volume and injury risk suggests that current training approaches may be unsustainable without proper ergonomic interventions and recovery protocols.