During the past four years, Dr. Jordan Tsai, also known as Dr. Respawn has been working in esport as a physical therapist. He’s been involved in a variety of scenes like League of Legends, CSGO, Valorant, Fortnite, and World of Warcraft.
One of the writers for OutsiderGaming; Fabrice Samedy, was able to obtain an interview with Dr. “Respawn” aka Dr. Jordan Tsai to chat about his personal life, his work, and a variety of other topics.
Click below to listen to the interview OR keep scrolling to read the full-length Q&A!
Fab: Hi everyone, my name is Fabrice Samedy and I will be your host for this awesome interview that we have lined up today. Today I have the opportunity to speak with Dr. Respawn, a physical therapist in the world of esport for the past few years. Today we will talk about a variety of subjects. So let’s not waste any more time and jump right in.
Fab: So Dr. Respawn, thank you for taking the time to answer my question today. Can you give a small introduction about who you are?
Respawn: Hi, my name is Dr. Respawn online or I go by Jordan. And yeah, I’m a physical therapist, as well as a board-certified orthopedic clinical specialist. I’ve been working in outpatient orthopedics for about four years and in professional esport for almost the same time. I’m currently the team physical therapist for tier one organizations, including Cloud 9 and Evil Geniuses. I’ve worked with 100 Thieves and TSM and a few other orgs as well in the past. My main primary objective is player performance and Player Health. And thank you for having me.
Fab: I always wanted to ask, but do you have any fun anecdote or something that the public might not know about you that you want to share?
Respawn: A fun fact about me is that I used to be an art student. In high school, I went to an art school, I used to do visual arts, and I still enjoy painting, drawing, and sculpting, but it is more of a hobby now instead of a career. After high school, I went to the army. So I’m also a US Army veteran. I served in Iraq from 2007 to 2008. I was a combat medic, which kind of got me into the medical route. I’ve been a gamer my whole life and being able to work in professional eSports is something of a dream come true for me. So I really enjoy it.
Fab: Alright, so you said you were an art student? That is quite a shift in career path. Can you explain why did you decide to change from an art job to a medical one?
Respawn: I was a bit lost in my life at that time when I was 18. I wasn’t really sure what I was going to do in the future. I started my first quarter of college as a studio art major, but I really just didn’t enjoy it so I decided that I’m just going to change my entire trajectory. I wanted to figure out what I want to do in life because, in the US, you’re paying so much money for college every semester. So I dropped out and joined the military. They also pay for your college, if you do your time. I ended up spending three years in the military, as a combat medic made me really enjoy the thought process of working with people as well as trying to figure out how to help them. After my deployment, I decided I’d like to go back to college and decided to pursue medicine.
Fab: All right, so we’re gonna go right in. Can you explain what you do for a living?
Respawn: As a physical therapist, I primarily see patients in the outpatient world for injuries, post surgeries, and basically rehab if they have pain, or discomfort while working. With the esport side, this is something I’ve kind of built out myself. It was definitely not a position that is very common for most people. For me, it was cool to be able to get into an industry that I really love. I’ve always liked playing and watching games, while still being able to help people. With teams, I do regular check-ins with mostly League of Legends players, but I work on ergonomics and preventative health. I make sure they know exercises, what to do between games, how to stretch, how to work, etc. If there are any potential issues that arise during practice like wrist pain or shoulder pain, then I work to resolve that. I teach them what they can do posturally as well as with a specific treatment program to basically keep players at 100% through the year.
Fab: How long have you been a physical therapist?
Respawn: I graduated in 2018 so four years.
Fab: What brought you into this world of esport and what is keeping you in it?
Respawn: I’ve always really enjoyed gaming. It’s always been my pastime. I think I started playing on the original Nintendo and I just always loved games. So for me to have the opportunity to actually do something for the community of gamers is a really cool opportunity because not many people are doing this stuff. There are not many rehab specialists out there period. The fact that it was wide open, I feel like I can benefit people. All of that together was something I should just pursue.
Fab: Can you describe what are your responsibilities as a physical therapist?
Respawn: I mostly work for musculoskeletal pain and injury. I also do movement rehabilitation, which means teaching people how to move better, exercise better, and how to do their daily living better. How you sit when you game and all of that stuff is really important.
Fab: What does a typical day or week look like for you?
Respawn: Right now it is a little bit weird, but when I first started out with gaming and my outpatient job, I would go to work like everyone else and then I would go see one of my teams after work. I would do a couple of hours at their house or their facility and then I would go home. I also try to work out every day. That’s six days a week minimum and I go to the gym as well after work. Right now, it’s a little bit less, it’s about 50/50 between esport and general physical therapy.
Fab: What do you cover during a session? What do you do with your clients?
Respawn: My first thing is that I want to know if they have a current problem that they’re trying to address, do they have a very specific issue. Then my assessment becomes much more dedicated towards that. So if they say that they have wrist pain, I’m not gonna spend too much time addressing everything else and I’m probably going to look at what’s influencing the wrist. If not, then I generally look at posture. How do you sit when you play? How are your computer peripherals? To make sure that those are ergonomically sound. After that, I go into what are your habits when you play. Are you grinding the game and then not taking breaks or are you actually making sure to take regular rest breaks? From there, it depends. If they have questions about specific exercises, if they want to know stretches, a lot of it is preventative, but I also really believe that it should be individual with the person. If you can find a goal that they have it becomes much more meaningful when you give them the stuff to work on.
Fab: What do you value the most? What do you get the most out of your job?
Respawn: What do I get the most out of my job? I guess at the end of the day, I just really enjoy working with people and helping them. I know that’s kind of cliche, but I do find a lot of satisfaction. At the end of the day when my primary mission was to make somebody feel better that day. My goal and my mission are to basically help people live their lives with less pain and fewer issues.
Fab: In your experience, what are the most common injuries or discomfort that you had to treat?
Respawn: Well, if we’re talking specifically about PC gamers, I would say that the number one thing I see is tendinopathies, meaning irritation of the common extensor tendons usually, those are the muscles that control your finger muscles. In games like League of Legends, you’re clicking the mouse 1000s of times per game and that can really irritate the tendon and really adds up. I also see forearm pain, neck pain, and shoulder pain as well.
Fab: So you explained the injuries, but what are the ways of treating or preventing them?
Respawn: It’s usually building capacity. This means having more strength and endurance because it will inevitably just make everything much easier for you. You want to be strengthening as well as regular stretching. When overuse injuries arise they are either caused by excessive use or insufficient capacity. What that does is it generates stress on the tendons, on the muscles, etc. If you can control the rate of stress accrual then you can also limit how much capacity or how fast the stress actually a cruise then you can recover faster. You can actually make it so you don’t have any of these problems. What I mean by that is you can increase endurance and the strength of the muscle which will increase capacity. You can also limit stress rate accrual by having good ergonomics and good habits. Regular stretching, rest, sleep, and eating well are all super important. They all factor into recovery. Managing those two areas can prevent 99% of gaming injuries. I actually think that almost every injury in gaming is basically preventable.
Fab: What exercise do you recommend for people that play a lot of video games to do to prevent those types of injuries that you mentioned earlier?
Respawn: This could go all day but mainly focus on strengthening the postural muscles which mean the muscles that govern your, ability to like pull you out of the positions that you find yourself in when you game. So if you’re playing on a PC, you tend to sit with your shoulders forward and your arms out in front of you. You want to be strengthening the muscles that pull your shoulders back and actually bring your shoulders into a better position. So a lot of strengthening of the muscles between your shoulder blades, the row motions, etc. I also really value wrist strengthening so building capacity by training players to use dumbbells when they do exercise helps increase the stability of the wrist. All of that stuff is really helpful.
Fab: All right, so we’ve talked a lot about the injuries and all that, but I want to pick your brain for a second. In your mind, what are the benefits of physical therapy?
Respawn: I’m biased, but I would say that everyone could benefit from physical therapy because our job is to basically identify what areas of your life would be made better by changing small things. Good small habit changes equate to massive change over time. Let’s say that you fix your posture, that eight hours a day multiplies over weeks and months is actually a massive amount of stress you’re taking off your body. In the end, I think PT is really uniquely placed to be able to assess and treat that kind of stuff and people.
Fab: Alright, so that’s really all I wanted to ask about your job. But now I want to ask some questions about how your job is treated in the NA ecosystem. Were there any significant difficulties or differences that you saw over the years in the way that organizations or CEOs took your job?
Respawn: I think there’s been a lot more interest lately, which is great. I think I’ve seen more organizations start to take more of an interest in the health and wellness of their players as well as streamers. I think it’s a really good thing overall, I do think the gaming industry is starting to realize that the longer we’re doing this that the more we have to actually think about how to take care of ourselves. Because everyone who games wants to do that for a long time. You don’t want to have to retire. Especially at the pro level. There’s really no reason for these guys to be retiring so early, but until now, we haven’t really had a lot of information out there. That’s starting to change, which I think is really good. I think that orgs have a good amount of performance understanding now so they understand the benefits of if the players feel good they will generally play better. I think that’s important to just maintain practice and all that stuff to be able to keep the consistency up for their scrims. I think all of that is a huge factor that we’re seeing more and more of which is good.
Fab: Do you think that physical therapy is treated the same as other aspects like psychology or the mental aspect of the game?
Respawn: I’ll be honest, I think having a good sports psychologist or having a good psych focus specialist on the team is probably more meaningful in esport than physical therapy. I think you can make a bigger impact as a psychologist than you could as a physical therapist. That being said, I don’t think that the benefits that we provide are different. A sports psychologist can actually improve the performance of a team. A physical therapist’s job is to prevent the degradation of the team. So my job is not to make the team actually better for the most part. As a physical therapist, my job is to prevent them from getting worse because of something preventable like an injury. Now, that being said, without physical therapists on staff, teams are significantly more likely to suffer injuries, which you could then argue would potentially cause more issues long term, but it’s hard to say that. We deserve more of a slice than a psychologist. If I was building an org and had to choose one or the other, I would personally take the psych over the physical therapist.
Fab: The way I’m interpreting your last answer is that it is still difficult to sell the benefits of physical therapy to CEOs or bosses of teams.
Respawn: Maybe, I don’t know if I would say that it’s hard. I would say that it depends on how you want to sell it. I think that there are all these benefits. I think it’s really clear what a lot of the benefits are. I wouldn’t put my field over psychology in this case. It’s easy to sell the benefits, but it’s just it’s not necessarily something that every team needs. If you’re short on funds and you need to build a solid squad for as little money as possible, I would say that your basic minimums would not include physiotherapy, it would include psychology. If you’re trying to build a tier one org and you want to be the absolute best in the game, you absolutely have to have physical therapy.
Fab: So how do you manage to sell the benefits to the management of a team?
Respawn: I feel like I just explained that. I tell them what it is that we can do. In my mind, the benefits are pretty self-explanatory. It comes down to just the basics of what do you want to do to build a tier one org. In that case, you have to have these things in place or your team is not going to be in the same realm as teams who are doing all of that. So it’s an easy sell. If you want to be the absolute best, you have to think of everything you can do to achieve that. Everything has to be addressed. You can’t have weak areas. If you’re talking about the top orgs, they have to account for everything and every little performance change is massive. At that level, I just feel like they’re too close together. If you are missing 1% performance compared to the other teams, you’re just gonna lose.
Fab: So in your mind, do you see a huge disparity between the top and the rest of the race?
Respawn: Yes 100%. If we’re talking specifically about the LCS, we’ve seen the same four organizations dominate playoffs for the last three to five years. There really hasn’t been much of a challenge to the top four teams. It’s gotten better this year, but overall that’s kind of been the trend. I think we see that across the board in every region. The vast majority of the playoffs are dominated by the same few teams so I don’t think it’s an outlier. I think it’s definitely more than the norm.
Fab: I’m gonna ask you a question that’s more appealing to the fan side. The League of Legends Worlds Championship is currently happening right now and yet again, North America and Europe are not doing well compared to the rest of the world. In your opinion, what are the differences between the Western world and the rest of the world?
Respawn: This is actually a huge question. This is something that I debate all the time with people. I think that we’re just slightly behind. Well, we’re very behind in terms of solo queue. Our solo queue environment in the West is so inferior compared to Korea and China. The other thing is our practice is not the same. When you have an environment in which you have a very strong solo queue, what happens is that the players get more benefits from playing. If you have a great solo queue environment, you get way more benefits from grinding the game 10 hours a day than someone with a terrible solo queue environment, because you are wasting time. So because they have a better environment, it gives them options to practice way more and actually benefit from it. Whereas in NA, there’s to some degree a negative effect on how many hours you play because the solo queue environment is so much worse. A lot of times, it ends up tilting players, and they just get frustrated. They don’t want to play the game which is not ideal. The other thing is that our organizational structure is different compared to Asia. They have a very robust Academy system. All of those players are phenomenal players and this is in part secondarily because of the solo queue environment. They have much better talent coming up to draw from. And so because they have a great Academy system, they can use that to keep the competition high in their regional leagues. That means that even the bottom teams are getting better and better every year, which is really hard for NA or EU to replicate to the same degree. Although, I think EU does better than Na. If you look at the trend there, it’s also because EU has a great Academy system like ERL or the European masters. Those are great tournaments to develop young talent in order to go to LEC so it’s almost directly correlated. There are better players coming up and that makes the league better. We don’t see that as much in NA, although I hope it’s changing. What we see is players staying around LCS kind of jumping teams. We don’t see a whole bunch of native talent being developed and it’s not entirely due to orgs. It’s also partially due to just the fact that solo queue in this region is not very conducive to improving players.
Fab: My last question is, what are your wishes for the NA ecosystem in the next few years?
Respawn: Obviously I want us to do better than we have. I want our academy, amateur talent pool, and development side to improve significantly. I’m not going to even say I want us to win Worlds because I think that’s ridiculous. I think what we need to do in the next couple of years is to demonstrate a clear shift in our mentality and our approach to developing players. If we can do that, then we have a shot of winning worlds later on down the line, but if we can’t even do that, then everything else is kind of a pipe dream. It just doesn’t make sense.
Fab: Well, that’s all the question I had in mind. Again, it’s always a pleasure to talk to you. Is there any way that people can find you?
Respawn: I’m most active on Twitter at Dr. Jordan Tsai. You can also find me on Instagram at Respawn therapy. Other than that, I try to stream every once in a while. If you’re ever on Twitch, my handle is Respawn_Therapy. If you have questions, feel free to reach out via DMS on Twitter or whatever I always try to answer those. I appreciate your time.
Fab: Thank you very much for taking the time and I wish you a good day.
Respawn: You too.
*This interview has been edited from the audio version for clarity*
Follow Jordan on Twitter: https://twitter.com/drjordantsai
OR connect with him on LinkedIn: https://www.linkedin.com/in/dr-jordan-tsai-pt-dpt-2647b739