Motion control videogames have gained popularity with many people since the introduction of the Nintendo Wii, and with the introduction of Microsoft's Kinect and Sony's Move add-ons for their respective video game consoles, many more people are playing these types of games than ever before. This group of people now include many who have traditionally not played video games (in particular many middle-aged and older players), as well as some who are in the stereotypical category of the sedentary person spending much of their time playing video and computer games. It is for those people in the above groups that this article is written, as motion control gaming can be just as physically intense as some exercise, and foot injuries are a distinct possibility.

Many games using motion control have begun to integrate standing and leg motion, or at least create the need for players to stabilize themselves with their feet while their arms are used. Some games even simulate running and jumping. Since running, leaping, and even actively balancing in place while twisting and bending one's torso would be clearly considered forms of exercise anywhere else, it is curious that similar activities in motion controlled video games are thought to be still more part of sedentary household activity than the exercise they actually are. While these activities certainly are not part of a serious exercise routine for the most part, the mobility and balance required to perform them demands that one is well stretched and supporting their feet properly. This is especially needed in older players or those who are in poorer physical condition. It must be kept in mind that the body cannot generally differentiate between a living room and a sports field when it comes to demand on the feet in similar activities.

Motion controlled video games can potentially cause injury to the lower extremity. This can include back, hip, and knee injuries in extreme cases. However, foot injuries are much more likely for a couple distinct reasons that will be discussed below. Examples of these injuries can include conditions affecting the heel and arch like plantar fasciitis, injuries to various tendons (including the Achilles tendon), and injuries to the toes, such as stubbing or fractures. The main reason why the foot can become more injured during motion controlled games lies in the location these games are played: indoors, and many times in playing spaces that still contain furniture. People often do many things in their home either barefoot, in socks, or in house slippers. The same applies to when they are playing video games. In essence, by playing these active motion control games, especially when there is little to no support under the feet, there is a greater chance for one to strain the arch, develop heel pain from pounding the ground in place, or straining one of several tendons in the foot and ankle. This is especially true if one is in poor physical shape, or older with weaker ligaments and tendons. Conditions such as plantar fasciitis, the most common cause of heel pain, can develop when the foot is subjected to increased activity under poor arch support. Excessive shock to the heel, such as what can be present when running in place on a hard floor, can also cause heel pain and fasciitis. Tendon injuries can occur during vigorous motion control gaming, or during extended gaming sessions where the tendons are subjected to prolonged strain with little shoe support. The tendon injuries can be just as real and painful as if they were sustained in a traditional athletic event, even if the activity is not as intense. Finally, since many people play around furniture when playing motion control video games, it is not uncommon for people to accidentally kick the furniture around them. Toe sprains and fractures can easily occur, especially if one is barefoot. Older players with poor bone density are particularly at risk for toe fractures.

The key to injury prevention when playing these games is to be aware that although these games are fun, invigorating, and inclusive of the whole family, some precaution still needs to be observed in order to keep oneself safe. Once again, these precautions are especially helpful for those in poor physical condition or for older players. First and foremost, athletic shoes should be worn while playing, just as they are in any other physical activity. This is important, and can help reduce pressure and strain to the arch, heel, and foot in general. If one wears orthotics or shoe inserts in general, they should be used when playing motion gaming as well. Stretching before the game is also important, just as it is in other physical activities. This limbers up muscles and tendons, and makes tendon injuries less likely. Adequate physical rest in between actively playing each game is important for those in poor physical condition, and the length of play time should be limited if one has not played the game previously, or has not played it for an extended period. Like any other activity, some limited endurance is needed to keep muscles and tendons from injury while playing motion controlled video games. Once one develops this endurance, the incidence of injury and physical fatigue is lower. Finally, an adequate play space needs to be maintained, with careful removal of surrounding furniture, and care being taken not to contact other players during the game. This makes stubbing injuries and toe fractures less likely to occur, and keeps all players safe.

Clearly many young adult and adolescent gamers have less likelihood of suffering strains, sprains, and other injuries occurring during the game than those who are much older in age or are in bad physical condition. However, their relative endurance and physical fitness does not exclude them from some of these injuries, and it is important that all players follow these precautions. Motion control video games are great fun for the family, and all participants should simply be aware that a little bit of common sense and activity preparation can keep the game going strong for everyone all evening long.