Xbox LIVE
Healthy Gaming Guide



This guide is designed to help you be safe and comfortable while using your Xbox 360™ and Xbox® to play video games.

After all, playing video games is supposed to be a relaxing recreational activity. Things to consider:

  • Position: Make sure your position is not encouraging discomfort.
  • Forces: Even low forces can cause injury, especially when repeated over time.
  • Breaks: Stepping away at regular intervals is important.
  • Health: Keep a balanced and healthy lifestyle.
  • Tools for Families: Find out how to use ratings, parental controls, and more.


This guide may also help you reduce your risk of experiencing painful and disabling injuries or disorders described in the following Health Warning.

Health Warning

Use of game controllers, keyboards, mice, or other electronic input devices may be linked to serious injuries or disorders.

When playing video games, as with many activities, you may experience occasional discomfort in your hands, arms, shoulders, neck, or other parts of your body. However, if you experience symptoms such as persistent or recurring discomfort, pain, throbbing, aching, tingling, numbness, burning sensation, or stiffness, DO NOT IGNORE THESE WARNING SIGNS. PROMPTLY SEE A QUALIFIED HEALTH PROFESSIONAL, even if symptoms occur when you are not playing a video game.

When playing video games, adapt your surroundings
and arrange your equipment to promote a
comfortable and relaxed body posture.

Symptoms such as these can be associated with painful and sometimes permanently disabling injuries or disorders of the nerves, muscles, tendons, blood vessels, and other parts of the body.These musculoskeletal disorders (MSDs) include carpal tunnel syndrome, tendonitis, tenosynovitis, vibration syndromes, and other conditions.

While researchers are not yet able to answer many questions about MSDs, there is general agreement that many factors may be linked to their occurrence, including: medical and physical conditions, stress and how one copes with it, overall health, and how a person positions and uses their body during work and other activities (including playing a video game).

Some studies suggest that the amount of time a person performs an activity may also be a factor. Some guidelines that may help you work and play more comfortably and possibly reduce your risk of experiencing an MSD can be found in the following sections of this guide. These guidelines address topics such as:

  • Positioning yourself to use comfortable, not awkward, postures.
  • Keeping your hands, fingers, and other body parts relaxed.
  • Taking breaks.
  • Developing a healthy lifestyle.


Because there are a variety of factors that may contribute to MSDs, this guide cannot provide everything you need to know to prevent an MSD or reduce your risk of experiencing one. For some people, following the suggestions may reduce their risk of experiencing an MSD. For others, it may not. However, many people are likely to experience greater comfort when following these suggestions.

Keep in mind that this guide is not a substitute for the advice of a qualified health professional. If you have questions about how your own lifestyle, activities, or medical or physical condition may be related to MSDs, see a qualified health professional.

Important Health Warning About Playing Video Games

Photosensitive Seizures
A very small percentage of people may experience a seizure when exposed to certain visual images, including flashing lights or patterns that may appear in video games. Even people who have no history of seizures or epilepsy may have an undiagnosed condition that can cause these "photosensitive epileptic seizures" while watching video games.

These seizures may have a variety of symptoms, including lightheadedness, altered vision, eye or face twitching, jerking or shaking of arms or legs, disorientation, confusion, or momentary loss of awareness. Seizures may also cause loss of consciousness or convulsions that can lead to injury from falling down or striking nearby objects.

Immediately stop playing and consult a doctor if you experience any of these symptoms. Parents should watch for or ask their children about the above symptoms, as children and teenagers are more likely than adults to experience these seizures. The risk of photosensitive epileptic seizures may be reduced by taking the following precautions: 

  • Sit farther from the screen  
  • Use a smaller screen  
  • Play in a well-lit room  
  • Do not play when you are drowsy or fatigued.

If you or any of your relatives have a history of seizures or epilepsy, consult a doctor before playing.

Position Yourself

Using your body in comfortable, not awkward, postures is important, whether you're working or playing. Not only can this affect your overall performance, but it can also influence how comfortable you are while playing video games and may help you avoid MSDs. Changing your posture during extended gaming sessions may also help you avoid discomfort and fatigue.

When playing video games, adapt your surroundings and arrange your equipment to promote a comfortable and relaxed body posture. Because everyone has a unique body size and since many factors affect your comfort, we cannot tell you exactly how to set up your area to avoid discomfort; however, the following suggestions may help to provide you with a more comfortable environment.

  • To support your back, consider choosing a chair or seat that provides support for your lower back and allows you to assume a comfortable and natural body posture.
  • To promote comfortable leg postures, consider clearing away items from your legs to allow comfortable leg positions and movement.
  • To promote comfortable shoulder and arm postures, consider allowing your upper arms to fall relaxed at your sides.
  • To promote proper wrist and finger postures, consider keeping your wrists straight while holding and using controllers. Avoid bending your wrists up, down, or to the sides.
  • To minimize neck bending and twisting, consider positioning yourself and/or the television so that you do not have to tilt your head up or down or side-to-side for extended periods.
  • To minimize eyestrain, consider avoiding glare by placing your television away from light sources that produce glare, or use window blinds to control light levels. Also, consider adjusting your television's brightness and contrast to levels that are comfortable for you.

Go Lightly

Physical forces continuously interact with our bodies. We may only think of high-impact forces, such as car crashes, as injuring our bodies. However, low forces may also result in injuries, discomfort, and fatigue if they are repeated or experienced over long periods of time.

Consider the following types of low forces:

  • Dynamic force, or a force that you exert through movement. For example, pressing buttons on a gaming controller or the keys of a computer keyboard.
  • Static force, or a force that you maintain for a period of time. For example, holding your gaming controller or cradling the phone.
  • Contact force, or pressure that occurs when you rest on an edge or hard surface. For example, resting your wrists on the edge of your desk, table, or other hard surface.

Consider the following suggestions to reduce the effects of low forces on your body:

  • Press gaming controller buttons with a light touch, keeping your hands and fingers relaxed; it takes little effort to activate these buttons. Also, apply a light touch when using control sticks or pads on a gaming controller.
  • Avoid resting your palms or wrists on any type of surface while using game controllers.
  • Relax your arms and hands when you're not actually using game controllers. See the "Take Breaks" section below for additional information.
  • Hold the game controller with a relaxed hand. Do not grip the game controller more tightly than is necessary.

Take Breaks

Taking breaks can go a long way in helping your body recover from any activity and may help you avoid MSDs. The length and frequency of breaks that are right for you depend on the type of activity you are doing. Stopping the activity and relaxing is one way to take a break, but there are other ways, also. These include:

  • Changing tasks can help some muscles relax while others remain productive. For example, you might sit while playing video games but stand when not playing.
  • Using different methods to accomplish the same task. For example, using the controller pad instead of the control stick.
  • Relaxing your arms and hands while watching others play or during cut scenes, replays, or other pauses within a game.
  • Learning about software and hardware features by reading the information that came with your game discs and hardware products.

Be Healthy

A healthy lifestyle can help you perform and enjoy your everyday activities, including the time spent playing video games. For overall good health, consider the following:

  • Eat a balanced diet and get adequate rest.
  • Exercise for overall fitness to give strength and flexibility to your body. Keep in mind that you should consult a qualified health professional to help you choose the stretches and exercises that are right for you.
  • Learn to manage stress.
  • See a qualified health professional if you have questions about how your medical and physical conditions may be related to MSDs. While researchers are not yet able to answer many questions about MSDs, there is general agreement that many factors may be linked to their occurrence, including previous injuries, diabetes, hormonal changes (such as pregnancy), and rheumatoid arthritis

Tools for Families

As more people discover the wealth of entertainment possible on Xbox 360 and the original Xbox, we encourage parents to take an active role in their children's gaming interests. That includes knowing what games are appropriate for each age group, and understanding the ratings system enforced by the Entertainment Software Rating Board (ESRB). You can learn all about the ESRB age ratings and descriptors here.

Both the Xbox 360 and Xbox have parental tools included on every machine that allow you to set limits as to what content your children are able to play. This not only applies to video games, but can be used to limit the types of DVD movies you allow them to watch when you're not at home. To apply these functions, you must first enable them from the Dashboard interface of your console.

Xbox 360 Family Settings

Parents can give their children an even safer entertainment experience. The  Xbox 360 Family Settings allow you to:

  • Grant or restrict access to games based on the ESRB rating.
  • Make sure the movies your children watch are appropriate based on the MPAA rating.
  • Override your own restrictions so you can decide, case by case, which games and movies your children can play when there are "exceptions to the rule."Use a pass code to protect your own Family Settings. Set limits on console play time using the Family Timer.
  • Control access to the online Xbox LIVE® service:
    • Manage who your child can communicate with on Xbox LIVE using video.
    • Decide who can see your child's gamer profile and online status.
    • Limit your child's exposure to content created by other members of the Xbox LIVE community.
    • Create personal settings for each child, which applies to their Xbox Live account even when they use it outside the home (for example, on a friend's Xbox 360 console).

Xbox Parental Controls

The original Xbox is the only console from the previous generation to feature Parental Controls. With these tools, you can:

  • Decide which games your children can play based on the ESRB rating.
  • Make sure the movies your children watch are appropriate based on the MPAA rating.
  • Control access to Xbox Live:
    • Control voice communications.
    • Disable content purchases.
    • Limit your child's exposure to content created by other members of the Xbox Live community.