Injuries in archers: Prine 2016 study

A questionnaire given to 239 archers in north central Florida (mean age 31.67 years, standard deviation 13.28; 65.2% male) found that 43.5% reported at least one archery-related injury. The figure was 57.6% among women and 35.3% among men, 53.9% among recurve users and 35.3% among compound users. The highest value, 70.7%, is for women shooting recurve, against a range of 30.4% to 45.5% in female and male compound users.

Among those who had been injured, the site most often named is the shoulder (70.3%), then the back (31.7%), the elbow (18.8%), the wrist (15.8%), the fingers (12.9%) and the forearm (11.9%). Seven cases were acute injuries, namely bruising, cuts, forearm burns and a broken thumb; all the rest were overuse injuries, with reported diagnoses of impingement, bursitis, labral tear and rotator cuff pain.

The link between having an injury and training load is weak: the correlation with training days per week and months per year runs between 0.148 and 0.167, and with bow type it is 0.186. In practice, bow type and self-reported volume account for only a small part of who was injured and who was not.

This is a cross-sectional study using a questionnaire administered in two ways: in person at competitions and electronically to local club teams in the region. The questions covered bow type, draw weight, years of practice, current training and its volume, and the history of archery-related injuries. The results are proportions computed on the sample, plus correlations between the presence of injury and the training variables.

It is worth saying what this document is: a conference abstract from the annual meeting of the American College of Sports Medicine, under four hundred words, presented as a poster. There is no full paper behind this source. The questionnaire is not reproduced, no definition of injury is given, the period over which the injuries occurred is not stated, nor how many bows of each type were in the sample, and the response rate is unknown. All that can be checked is what stands in the lines of the results.

Injuries are recalled and reported by the archer, with no examination and no clinical record, and the diagnoses mentioned (impingement, bursitis, labral tear) come from the respondent's memory. Without a definition of injury, any comparison with other figures is loose, and the question covers a lifetime rather than a season: there is no exposure denominator, so these are not rates per hour of shooting but percentages of people who were hurt at some point.

Recruiting at competition venues and by email to clubs selects those who were present and those willing to answer, and an archer with a troublesome shoulder has one more reason to fill in a questionnaire about injuries. The sample comes from a single region and stops at 2016.

The difference between recurve and compound, and between women and men, is not adjusted for anything: not for draw weight, not for years of practice, not for training volume, although all of that was collected. The 70.7% for women shooting recurve is a percentage of a subgroup whose size is never given.

The authors conclude that the prevalence of chronic archery injuries is comparable to that of other vigorous or contact sports, but the abstract contains no comparison with data from other sports: that is the authors' reading, not a result of this work.

What this source contributes is an order of magnitude and a ranking of sites: in a sample of club and competition archers, four in ten had a history of archery-related complaints, and where there was one, seven times in ten it involved the shoulder. The rest, back and elbow, come a long way behind.

On why, the study is silent. The weak link with training days says that self-reported volume is not enough to predict who gets hurt, and that what matters lies elsewhere, perhaps in draw weight, in technique or in individual history, none of which was analysed here. The finding about women shooting recurve is the most quoted and the most fragile, because none of the variables that might explain it was taken into account.

For an archer whose shoulder is giving trouble, this work establishes that the problem is common, not what to do about it: the assessment belongs to a doctor or a physiotherapist.