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Archery can cause a stress fracture of the first rib on the bow side

1 study · 1 archers measured

ForContextAgainst19952000200520102015202020251992, for, n = 11992, context, n = 1
Each circle is a study: its position gives the year, its row whether it is for, against or context, its size how many participants it measured. Light circles are studies on other populations or without archers.

There is a single described case, and it comes from kyudo. A 15-year-old Japanese girl, right-handed, who had started at secondary school with two or three hours of practice a day, began to feel pain in the left shoulder blade and upper back after seven months; a few weeks later, while drawing the bow, she heard a sharp crack and the pain suddenly worsened, and an X-ray found a stress fracture of the left first rib, that is, on the bow side. With rest and a clavicle brace the pain was gone within a month, but after a year the bone had still not united, although she had no symptoms. The authors attribute the fracture to the head turned towards the target with the scalene muscles under tension while the arm holds the bow, without measuring it, and write that no such case had been described before. One case shows it can happen, not how often: reported, and only in kyudo.

Also phrased as: "first rib fracture in archery"; "rib stress fracture in kyudo"; "pain above the collarbone on the bow side"; "broken rib from archery"

In practice

Pain between the shoulder blade and the base of the neck on the bow side is usually treated as a muscle strain, and archers keep shooting until it goes away.

Evidence

  • 1992
    For Kyudo archers Published later

    One case: a 15-year-old Japanese girl, right-handed, who had started kyudo on entering secondary school with 2-3 hours of practice a day. After about 7 months, pain in the left shoulder blade and upper back, ignored; a month later, while drawing the bow, a sharp crack and a sudden increase in pain. The X-ray shows a fracture line in the left first rib, with no callus and no neurological signs in the limbs. Regional journal.

    Two Cases of Stress Fracture of the Ribs. · Hideaki Kubota, Yoshiichi Sasaki, Hiroyuki Yamamoto, Ken Arai, Naotaka Ibi, Kazunari Terado

  • 1992
    Context Kyudo archers Published later

    Immediate stop to kyudo and a clavicle brace: pain gone within a month; after a year, abundant callus but no union, with a palpable mass above the collarbone and no other symptoms. The authors recall that many reports describe healing within 3-8 weeks of rest and that in other cases excessive callus required removal of the first rib because of nerve compression or persistent pain.

    Two Cases of Stress Fracture of the Ribs. · Hideaki Kubota, Yoshiichi Sasaki, Hiroyuki Yamamoto, Ken Arai, Naotaka Ibi, Kazunari Terado

  • 1992
    Context Kyudo archers Published later

    The mechanism is the authors' hypothesis, not a measurement: the fracture is on the non-dominant side, so it is linked to the bow arm rather than the draw, and they explain it by the head turned towards the target and the scalene muscles under tension while the arm holds the bow. According to their literature search, by 1992 no kyudo case had ever been described; the rib stress fractures known in sport came from swinging actions, as in baseball, or lifting, as in judo.

    Two Cases of Stress Fracture of the Ribs. · Hideaki Kubota, Yoshiichi Sasaki, Hiroyuki Yamamoto, Ken Arai, Naotaka Ibi, Kazunari Terado

Status history

  1. 1992 Reported A single described case, in a kyudo practitioner who trained every day: a stress fracture of the first rib on the bow side, appearing after a few months of very intensive practice and announced by an audible crack during the draw. The pain fades within a month of rest, but the X-ray shows no union even after a year. The authors attribute it to the head turned towards the target with the scalene muscles under tension while the arm holds the bow, and write that no such case had been described until then. One case: reported.

Related

Related articles

Research lines

Cite
APA

Campagna, M. (2026). Archery can cause a stress fracture of the first rib on the bow side (Version 1). In Evidence Registry. Retrieved 16 October 2026, from https://matteocampagna.com/en/registry/health/first-rib-stress-fracture-archery

BibTeX
@misc{campagna2026_fratturastresscostola,
  author = {Campagna, Matteo},
  title = {Archery can cause a stress fracture of the first rib on the bow side},
  year = {2026},
  howpublished = {Evidence Registry, matteocampagna.com},
  url = {https://matteocampagna.com/en/registry/health/first-rib-stress-fracture-archery},
  note = {Version 1; accessed 2026-10-16}
}

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