Current esports health research practices create unsustainable burden on limited participant pools whilst failing to advance knowledge efficiently. This analysis examines three interconnected problems: excessive research participation burden on esports communities, limited adoption of open science practices, and fragmented research efforts that perpetuate redundant investigations. Small, accessible competitive esports populations amplify these concerns, particularly when researchers misinterpret non-significant results as evidence of absent effects, leading to unnecessary replication attempts. Open science approaches including data sharing, preregistration, and collaborative networks offer solutions that could reduce participant burden whilst improving research quality. However, critics question whether the field is ready to implement such changes given resource constraints and the early-career status of many researchers. Practical frameworks for operationalising these recommendations remain underdeveloped. Implementation faces technological, cultural, and commercial barriers requiring coordinated action from researchers, institutions, and funding agencies. Establishing collaborative frameworks and proper statistical approaches could transform esports health research into a model for ethical, efficient investigation of rapidly evolving phenomena.