WEDNESDAY, Feb. 3 (HealthDay News) -- Following the introduction of Wii to video gaming in 2006, more than just the ligaments and tendons in the hands of players are getting injured these days: a new report details foot injuries that have been incurred while playing with the Wii.

"Before these types of games were introduced, patients typically presented with ligament injuries of the hand from intensive use of [video game] hand-held controls," noted Karen A. Eley. A plastic surgery resident and doctoral candidate at Oxford Radcliffe Hospitals NHS Trust in Great Britain, she outlined the specific nature of what is now known as "Wiiitis" in a letter in the Feb. 4 issue of the New England Journal of Medicine.

"Now, the injuries seem to affect any region of the body," Eley added.

In her commentary, Eley said that the so-called "Nintendinitis" of the 1990s -- involving thumb tendon pain -- has given way to an increasing number of foot-related injuries in conjunction with the rise of the popularity of the Wii.

Such injuries can result, for example, when otherwise healthy players fall off special pressure-sensitive "balance boards" that are raised two inches off the ground and are designed to read the body movements of gamers without the need for hand controls.

This type of fall has been seen to result in soft-tissue swelling, dislocations, muscle pulls and even small fractures -- as highlighted by Eley in recounting the case of a 14-year-old girl who sought emergency medical care for such injuries at a British hospital.

Head injuries are another aspect of Wiiitis, Eley pointed out, resulting from the grouping of gamers in confined spaces, prompting unintentional bumping and striking.

Her observations notwithstanding, Eley said that Wiiitis injuries are not yet a frequent hazard of gaming.

"I have not encountered many injuries of this nature," she stressed. "I think that in some respects some people are just rather unlucky. I am sure that many more people twist their ankles when they miss their footing on the Wii-fit balance boards, but the injury is not significant enough to seek medical treatment. We only see the ones that are particularly severe."

And on a more positive note, Eley added that Wii does, in fact, encourage people who might otherwise be sedentary to get up and move.

"And as with any activity, it is this group that are more likely to sustain strains and sprains," she said. "[But] hopefully, playing these games will result in people becoming interested in participating in exercise, aiding in our fight against obesity, heart disease and diabetes."

Robert Gotlin, director of the Sports Rehabilitation department at Beth Israel Medical Center in New York City, concurred with Eley's sense that while the risk for injury due to Wii gaming is real, it is not a cause for alarm.

"Any physical activity or recreational fad always brings with it the risk of newfound injuries. We've seen this across the board, ranging from the so-called 'BlackBerry thumb' to Nintendo wrist injuries," Gotlin observed.

"And even though everything carries some risk -- from jumping off a couch to stepping off a curb -- in this case Wii largely involves kids, so we should try to make sure they are safe," Gotlin noted. "That means -- like any activity -- it should not be overdone. And it should be part of a kid's life, not their whole life. And it should come with some parental guidance."

He added, "But then the question is whether kids -- who at the age of 7, 8 or 9 are just becoming masters of their own neuromuscular control -- get a benefit learning about balance and movement through Wii games that outweighs their risk for injury? Well, I would say that it certainly beats being sedentary and sitting on the couch. And the reality is that problems seem to happen to just a few kids, and the risk-benefit is very low. So I would not go overboard with concern."

More information

For more on fitness and stretching exercises, visit the U.S. Department of Health and Human Services.

MONDAY, Feb. 1 (HealthDay News) -- A blood test can predict rheumatoid arthritis long before a person notices symptoms, say Swedish researchers.

They identified several cytokines, cytokine-related factors and chemokines whose levels increase significantly as much as several years before the onset of rheumatoid arthritis (RA).

People who receive an early and accurate diagnosis of RA and immediately begin treatment are more likely to lead an active life and less likely to suffer joint damage that leads to joint replacement, according to the American College of Rheumatology.

In the study, the researchers analyzed blood samples taken from 86 people before the onset of RA symptoms, from 69 of the same people after RA symptoms began and from a group of 256 people who did not have the disease.

The blood samples were checked for levels of 30 cytokines, related factors and chemokines. The main difference detected between people who later developed RA and those who did not have it was the presence of Th1 cell-, Th2 cell-, and Treg cell-related cytokines. The main difference between people before and after development of RA was the presence of chemokines, stromal cell-derived cytokines and angiogenic-related markers, the study found.

The elevated concentrations of proinflammatory cytokines, cytokine-related factors and chemokines indicate immune system activation before any symptoms of RA-related joint problems, the researchers said.

The study appears in the February issue of Arthritis & Rheumatism.

More information

The American Academy of Family Physicians has more about rheumatoid arthritis  .

SATURDAY, Jan. 30 (HealthDay News) -- Wearing cleats on a natural grass playing field seems to offer athletes some protection from anterior cruciate ligament injury when they make a quick turn, new research shows.

"These are injuries where an athlete plants his or her foot while making a cut and blows out his or her knee," Dr. Mark Drakos, a study co-author who, at the time of the research, was an orthopedic fellow in sports medicine at the Hospital for Special Surgery in New York City, said in a hospital news release. The ligament is commonly referred to as the ACL.

"We don't know all the science behind why ACL injuries may be more common on turf than on grass," Drakos said. The study begins to address that, he said, because "we need to optimize some of those environmental factors.

To that end, the researchers used lower extremities -- knee, foot and ankle -- from cadavers to test the strain placed on the ACL, one of four major ligaments in the knee, by four different combinations of shoes and playing surfaces: turf shoe and Astroturf; turf shoe and modern playing turf; cleat and modern turf; and cleat and natural grass.

Compared with the natural grass/cleat combination, the amount of strain on the ACL was 80 percent greater with the Astroturf/turf shoe, 48 percent greater with the modern playing turf/turf shoe and 45 percent greater with the modern playing surface/cleat combination.

When a similar cut, or quick turn, is made on four different surfaces, "the best strain profile is in grass/cleat combinations," Drakos said. "So, there is less force occurring at your ligament for the same cut on that particular surface using this model."

The finding is published in the January issue of the Journal of Biomechanical Engineering.

"As a former football player, I was always curious about why I was more sore after playing on artificial surfaces than playing on grass, and I wanted to find out the reasons behind that using a biomechanical model," Drakos said.

"There are basically 200,000 ACL injuries every year in the United States alone, and this [type of playing field and type of shoe] is an environmental factor which has been shown to play a role in injury, but has yet to optimized," he said. "I think it is a scenario that deserves attention and further research."

More information

The U.S. National Library of Medicine has more on ACL injury.