Exercise and injury in archers: Subramaniam 2026

A systematic review of fifteen studies on exercise for archers, published between January 2015 and April 2025 and selected from 767 search results. The finding that matters is an absence: almost none of those studies measured injuries. They measured accuracy, balance, strength, endurance and sway, and everything the review says about prevention is inferred from those measures.

The interventions fall into three families. Core, Pilates and balance: four studies (Pilates plus balance, circuit work on a Bosu ball, Pilates core stability, a bodyweight programme), all reporting improvements below p equal to 0.05 in accuracy, balance or reduced sway. Strength: five studies, with improvements on every outcome they declared. Posture and coordination: three studies, the same.

Some figures from the individual studies. The Bosu ball circuit, in 12 archers aged 14 to 17 over 18 sessions, took the balance test from 44.12 to 51.44 seconds and the accuracy score from 216.50 to 282.83 (p equal to 0.000). The twelve-week lower trapezius programme, in 14 university archers, took the score of a simulated round from 628 to 639 points (p equal to 0.045), lower trapezius strength from 8 to 9 kilograms force (p equal to 0.045), horizontal abductor strength from 81 to 93% of body weight (p equal to 0.048) and the upper-to-lower trapezius ratio from 2.2 to 1.1. The comparison of Pilates and balance training in 30 male national-level archers aged 17 to 27 gave a difference in accuracy (F equal to 5.11, partial eta squared 0.159, p equal to 0.03) and differences in two of four lumbopelvic tests. Four weeks of side bridges in 20 male students reduced bow tremor and changed the median frequency of the middle deltoid, leaving the upper trapezius, lower trapezius and serratus anterior untouched. Nothing was pooled into a single estimate: the designs and outcome measures are too different for a meta-analysis.

The review follows PRISMA-P and is registered in PROSPERO (CRD42023445770). The search covered PubMed (95 results), Web of Science (223), SPORTDiscus (72) and Scopus (377), for 767 records in all, from January 2015 to April 2025, plus a grey literature search in Google Scholar, ProQuest Dissertations and sport science repositories, and hand-searching of the included articles' reference lists.

After duplicates were removed 607 papers remained; filtering on document type, year, language and topic left 111; reading titles and abstracts left 18; reading full texts left 15, since three were single cases or validity and reliability studies. Two reviewers worked independently and a third resolved disagreements.

Deliberately excluded were psychological, nutritional, pharmacological and surgical interventions without an exercise component, technology-based interventions, Paralympic populations and work not published in journals. Methodological quality was assessed with the Standard Quality Assessment Criteria, fourteen items scored 2, 1 or 0 and converted into a percentage, with the entry threshold set at 50%.

The included studies come from Indonesia (five), India (two) and, one each, Japan, Korea, Turkey, Thailand, China, Ukraine, Malaysia and Taiwan. Samples run from 12 to 70 archers. Three studies concern archers at national or international level, two beginners, two high school archers, two university archers, one two levels together, and five do not state the level. The interventions last from a single day to twelve weeks, with two or three sessions a week in the longer programmes.

The central limitation is the authors' own: none of the included studies reports injury incidence, severity or days lost. Everything the review says about management and prevention is an inference from balance, posture, strength and endurance, and the authors write that it should be read that way.

The samples are tiny: from 12 to 70 archers, almost all under thirty, and four studies have no control group at all. Only three of the fifteen are randomised controlled trials; the rest are non-randomised comparisons or plain before-and-after designs. Five do not state the archers' level, several do not state their sex, one does not even state the dose of exercise. Blinding of the assessors is absent throughout.

The quality scores do not match the text. The abstract says every study scored above 50%, the results say each scored above 80%, and the lowest figure in the table is 81.8%. The authors also note that the tool they used does not separate domains of bias the way instruments designed for randomised trials do.

The published text has a physical defect worth knowing about: passages from the included studies' abstracts have ended up inside the review's own sentences, and the same paragraph about side bridges reappears five times in the results section, breaking the sentences that carry it. It does not change the data, but it makes some pages unreadable and says something about the editorial handling.

One inconsistency remains in the criteria: the review excludes interventions on attention, concentration and arousal by design, and then includes a study of attention measured by electroencephalogram. And the closing recommendation, six to twelve weeks at two or three sessions a week, comes out of comparing the durations of studies that were never built to be compared with each other.

For anyone who shoots, this review is a map of what has been tried, not a verdict on what works. It gathers in one place fifteen small studies in which core work, Pilates, balance training, free weights, machines, circuits and lower trapezius exercises were each followed by a better result on some measure. Almost all of them report p below 0.05, which in samples of one or two dozen archers says little on its own.

What the review does not contain is the thing its title promises: nobody counted injuries. So the sentence that circulates, that exercise for archers reduces injuries, cannot be drawn from here. What can be drawn is that it improves measures which elsewhere are associated with risk, and that is a chain of three steps rather than a finding.

The one figure that touches the score is the twelve-week lower trapezius programme, 628 to 639 points in a simulated round in 14 university archers; another record in this registry covers a different study of the same muscle, where the score did not move in eight weeks. The two are worth reading side by side.

For a coach the useful part is the inventory: inside those fifteen papers are protocols described well enough to repeat, with loads between 60 and 80% of one-repetition maximum, three or four sets of 15 to 25 repetitions, two or three sessions a week for six to twelve weeks. That is what was done in the studies, not a prescription that follows from a test.