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to ensure that the procedure is performed competently. Frequently, the focus of initial training is to ensure that a trainee has the skills to technically complete the procedure before assimilating some of the more cognitive elements of endoscopic practice. Eagerness to complete the procedure by trainees is often facilitated by trainers, who can be guilty of training technical completion with little if any attention given to the ergonomics involved in endoscopy. The consequences of poor ergonomics may result in acute or persistent musculoskeletal problems for the endoscopist, which can result in periods of inability to work or train. Many athletes also require training in complex skills acquisition. In contrast to endoscopy, athletic training invests heavily in the all aspects of the motor challenges early during training. This helps to inform a tailored training program designed to ensure optimal physical performance. Training involves focus on relevant muscle groups and their coordination, to develop strength, stamina and flexibility. Once the basic skill is mastered, other elements including strategy and tactics are added to try to achieve a competitive advantage. Throughout training, individuals are managed to minimize fatigue, strain or injury. One could argue that endoscopists should be trained more like athletes in relation to ergonomics. Ergonomics (Greek: ergos: work; nomos: custom) relates to the study of interactions between humans and the work environment to optimize well-being and performance. In endoscopy, the “custom of work” is relevant as practitioners are at high risk of musculoskeletal injuries (MSI), with an estimated prevalence of 39% to 89% [1]. Although global efforts have strived to improve patient safety, attention to the safety of endoscopists in relation to MSIs has been underwhelming. This poses a significant challenge as MSIs can be detrimental to the individual (chronic pain, disability, confidence, premature retirement), endoscopy service (missed days at work) and the patient (impaired performance) [2, 3]. Moreover, the burden of MSIs in trainees is relatively unknown. In this issue, Villa and colleagues present their US survey of MSIs in 156 gastrointestinal endoscopy fellows [4]. The authors reported that 47% had succumbed to an endoscopy-related MSI, 69% of which occurred within the first 6 months of training, with the wrist, thumb, back, and neck being predominantly affected [4]. Such data point to an impending “ergonomics crisis” in a relatively evidence-free zone within endoscopy. Can endoscopy learn from sports? Certain sports that involve use of equipment may be comparable to endoscopy, e. g. archery, javelin, rifling, snooker etc. In archery, one arm is dedicated to stabilizing an accessory against gravity, whereas the other arm draws the arrow under tension and subjects the fingers to high pinch forces. Like endoscopists, archers require a stable core stance with consideration given to placement of the feet, hip, spine, and neck to provide proper posture and balance. Other similarities and differences may be appraised using the mnemonic ERGONOMICS (▶Table 1), which covers ergonomically-relevant considerations. Ergonomics training in sports training involves analysis of how athletes apply their core and task-dependent muscles and joints to deliver optimal performance. Athletes also benefit by Ergonomics in endoscopy: Should the endoscopist be considered and trained like an athlete?