Massage for archers' shoulder pain: Nugroho 2025

Twenty-four archers from the Sleman squad for the 2025 regional sports games (Porda), all with shoulder pain and limited movement, received Manurak massage, an Indonesian method that combines manipulation (effleurage, friction and tapotement) with passive and dynamic stretching and proprioceptive neuromuscular facilitation (PNF). Before and after, pain was measured on a 0 to 10 visual analogue scale and shoulder function with the SPADI questionnaire, where a lower value means fewer problems.

Mean pain fell from 5.5 to 2.4 and SPADI from 37.4 to 5.5, both changes with p 0.000 on the Wilcoxon test. Half the participants were aged 10 to 20, and the rest were split equally across the bands from 31 to 60. The authors conclude that Manurak massage reduces pain and improves shoulder function in archers.

The design has a single group, measured before and after treatment, with no control group. Participants were chosen from squad archers with shoulder pain and limited movement, aged 15 to 60, excluding frozen shoulder, degenerative disease, fractures and tumours of the area. Pain was recorded with a smartphone app on which the person marks a point on a line; SPADI has 13 questions, 5 on pain and 8 on disability.

The paper describes the techniques that make up Manurak, but does not say how many sessions were given, how long they lasted, who gave them or how much time passed between the first and second measurement. Bow type, draw weight, the athletes' level and any diagnosis beyond pain and restricted movement are not reported. The analysis planned a paired t-test or a Wilcoxon test depending on the distribution; the post-treatment data were not normal, so Wilcoxon was used.

Without a control group the improvement cannot be attributed to the massage. Overuse shoulder pain tends to ease on its own with time and reduced load, people who receive a treatment often report less pain through expectation, and a group chosen precisely because it was in pain tends to look better at the second measurement through regression to the mean. Since the time between measurements is not given, it is not even possible to estimate how much these factors weigh.

The fall in SPADI from 37.4 to 5.5 is very large and brings almost everyone close to no problems at all, but without knowing over how many days and sessions it is unclear whether this is an immediate effect after one session or a recovery over weeks. There are inconsistencies too: the criteria set a minimum age of 15, yet the table uses a 10 to 20 band; the pain scale is described as 0 to 10 and then with 100 as its upper end. In the paper, "shoulder injury" means pain with restricted movement, with no clinical assessment saying what the problem actually is. The journal is flagged in the registry for questionable editorial standards.

For an archer with a sore shoulder, the study gives no reliable guidance. It reports that 24 squad members, after an unstated number of sessions of a massage combining manipulation and stretching, described less pain and less difficulty with everyday movements; without a comparison group, though, much of that improvement might have come anyway. It measures nothing about shooting: not the score, not the return to full training, not recurrences.

Massage and stretching can make people feel better, and this study does not rule that out; what is missing is evidence that this particular method treats an injury. For shoulder pain that persists or limits movement, assessment remains a job for a doctor or physiotherapist, who can work out where it comes from before a treatment is chosen.