In archery the shoulder is the most common site of overuse injury

The summary today

Six independent samples of archers, collected in Japan, in Florida, twice in Germany, in Korea and at the European Youth Championships, put the shoulder first, often on the drawing side and during the draw: the figures run from 51% of kyudo practitioners to 70.3% of the injured archers in Florida, and the direction holds even with kyudo left out. The one study that puts the back ahead counts 13 youngsters measured with an office ergonomics questionnaire, while emergency department data, dominated by cuts and trauma to the fingers and hand, look at acute injuries, which are a different matter. The caution concerns the measurement more than the direction: these are cross-sectional studies resting mostly on what athletes report, two of them measure pain without separating overuse from acute injury, and in kyudo as in young archers the lower back comes close behind the shoulder. Because of that one contrary study, weak but on archers, the status today is reported rather than corroborated.

Also phrased as: "shoulder injuries in archery"; "most common archery injuries"; "shoulder pain in archers"; "where archers get injured"

Evidence

• 1971
  For Kyudo archers Published later

  122 kyudo practitioners from the Japanese federation, aged 18 to 78, with a questionnaire plus clinical and radiographic examination of a subgroup: about three in four report at least one complaint, and the shoulder is the most frequent with 62 cases (51%), followed by the lower back with 59 (48%), hand and fingers with 53 (43%) and the elbow with 46 (38%). Several sites often occur together. Kyudo counts as archery, but its technique and equipment differ from the Olympic ones.

  An orthopaedical analysis of the kyudo athlete · Masanobu Tomizawa, Hitoshi Furuya, Sadayoshi Toriyama, Tadahiko ONO

• 1971
  Context Kyudo archers Published later

  The same Japanese survey carries the most important caution: among 122 practitioners the shoulder counts 62 cases and the lower back 59, hand and fingers 53, elbow 46 and neck 44, and the authors note that many have two or more sites at once. The shoulder comes first, but only just, and almost nobody has it alone.

  An orthopaedical analysis of the kyudo athlete · Masanobu Tomizawa, Hitoshi Furuya, Sadayoshi Toriyama, Tadahiko ONO

• 1971
  Context Kyudo archers Published later

  Where the shoulder pain sits, in this sample, is not the rotator cuff but the insertion points: of the roughly 60 shoulder cases, 9 at the glenoid tubercle of the scapula, 6 at the coracoid process, 4 of muscle hardening at the medial border of the scapula, 4 of restricted movement, 3 at the supraspinatus tendon, 3 of joint crepitus and 2 of muscle atrophy. This comes from a clinical examination rather than a questionnaire, which is why it is worth reading.

  An orthopaedical analysis of the kyudo athlete · Masanobu Tomizawa, Hitoshi Furuya, Sadayoshi Toriyama, Tadahiko ONO

• 2016
  For Archers Published later

  239 archers in Florida across different levels and divisions: among those who had been injured, the shoulder is the most frequent site at 70.3%, ahead of the back at 31.7%, the elbow at 18.8%, the wrist at 15.8% and the fingers at 12.9%. Almost all the injuries were overuse ones, with only 7 acute cases, which makes this the most relevant sample after the German one. It is, however, a one-page conference abstract.

  Prevalence And Characteristics Of Archery-related Injuries In Archers · Bryan Prine, Amanda Prine, Trevor Leavitt, Joseph Wasser, Heather K. Vincent

• 2016
  Context Archers Published later

  This is the sample that best separates overuse from acute events: of all the injuries reported only 7 are acute, that is bruises, cuts, burns and a broken thumb, while the rest are overuse ones, with impingement, bursitis, glenoid labral tears and rotator cuff pain. It supports the wording of the claim, which is about overuse.

  Prevalence And Characteristics Of Archery-related Injuries In Archers · Bryan Prine, Amanda Prine, Trevor Leavitt, Joseph Wasser, Heather K. Vincent

• 2016
  Context Archers Published later

  The ranking after the shoulder, in 239 archers from north-central Florida aged 31.7 ± 13.3 and 65.2% male: back at 31.7%, elbow at 18.8%, wrist at 15.8%, fingers at 12.9% and forearm at 11.9%. The sample mixes recreational and competitive archers, which limits comparison with the others.

  Prevalence And Characteristics Of Archery-related Injuries In Archers · Bryan Prine, Amanda Prine, Trevor Leavitt, Joseph Wasser, Heather K. Vincent

• 2016
  Context Archers Published later

  The archer's overuse injuries have precise names, and in this sample they are impingement, bursitis, glenoid labral tears and rotator cuff pain; the 7 acute cases are contusions, a cut, forearm burns and a fractured thumb. The diagnosis is the one the archers reported, not an examination.

  Prevalence And Characteristics Of Archery-related Injuries In Archers · Bryan Prine, Amanda Prine, Trevor Leavitt, Joseph Wasser, Heather K. Vincent

• 2017
  Context Archers Published later

  156 Indian archers aged 15 to 28, interviewed and examined on both shoulders during the 2013 inter-university championship: 54.4% have shoulder pain on the day of the examination (85 archers) and 82.7% have had it at least once. Among the 85 with pain the drawing shoulder is the one most affected (41.2%, against 36% for the bow shoulder and 22% for both), and the action that hurts most often is the draw (45.9%); the clinical signs point to overuse of the supraspinatus, the long head of the biceps and the subscapularis. The study looks at the shoulder alone and does not compare it with other sites, so it shows how widespread the problem is but not whether it comes first: that is why it counts as context.

  Prevalence of Shoulder Pain in Competitive Archery · Jasleen Kaur Grover, Akhoury Gourang Kumar Sinha

• 2018
  For Archers Published later

  62 German national and European-level recurve archers, retrospective questionnaire covering their whole careers: 52 overuse and 6 acute injuries, with the shoulder accounting for 52.9% of the overuse ones (27 of 51 in the figure) and on the drawing side in 64.7% of cases; the arm follows at 23.5%, mostly lateral epicondylitis. Tendons, ligaments and joints account for 67.9%.

  Acute and Overuse Injuries in Elite Archers · Claudia K. Niestroj, Volker Schöffl, Thomas Küpper

• 2018
  For Archers Published later

  In the same sample the concentration on the shoulder rises with level: of the 9 overuse injuries in the group competing at European level the shoulder accounts for 88.9% and the arm for 11.1%, whereas across all 51 cases the shoulder is at 52.9% (27 cases), the arm at 23.5% (12 cases) and the back, hand and neck at 5.9% each, with the finger at 3.9%. At the highest levels the sites narrow to two.

  Acute and Overuse Injuries in Elite Archers · Claudia K. Niestroj, Volker Schöffl, Thomas Küpper

• 2018
  Context Archers Published later

  The tissue involved explains why this is called overuse: of 52 cases, 67.9% involve tendons, ligaments and joints, with UIAA grade 1 severity in 62.0% and grade 2 in 30.0%, and almost all the athletes report full recovery. Frequent injuries, usually light, rather than career-ending events.

  Acute and Overuse Injuries in Elite Archers · Claudia K. Niestroj, Volker Schöffl, Thomas Küpper

• 2021
  For Archers Published later

  58 Korean competitive recurve archers, from middle school to corporate teams, with the OSTRC questionnaire, clinical scales, dynamometry and ultrasound: the shoulder is the most affected site in 65.5% of cases (38 of 58), ahead of the hand at 29.3% and the neck at 22.4%. Of the 41 with pain, 80.5% have it on the drawing arm and only 12.2% on the bow arm, and it appears during the draw in 48.8% of cases. Injury here is defined as training-related pain.

  Shoulder Pain Caused by Injuries in Korean Elite Archers · Young-Sook Kim, Doo-Sup Kim, Ji-Su Shin, Sung-Hwa Kim, Bum-Seok Lee, Ji-Su Park, Won-Gil Cho

• 2021
  For Archers Published later

  75 adult competitive archers (mean age 47) across target, field and 3D, compared in matched cohorts of those who train on one side only and those who train on both: 43% report a history of shoulder complaints, against 26% for the trunk and 15% for the neck, and the share is the same in the two training groups (42% and 44%).

  Unilateral and bilateral training competitive archers differ in some potentially unhealthy neck-shoulder region movement behaviour characteristics · Mareike Schmitt, Lutz Vogt, Jan Wilke, Daniel Niederer

• 2021
  Context Archers Published later

  Among the 41 Korean archers with pain, the side and the phase are precise: the drawing arm in 80.5% of cases, the bow arm in 12.2% and both in 7.3%; the pain appears during the draw in 48.8%, at full draw in 36.6% and at release in 14.6%. It points to the part of the shot that loads the shoulder, not just the site.

  Shoulder Pain Caused by Injuries in Korean Elite Archers · Young-Sook Kim, Doo-Sup Kim, Ji-Su Shin, Sung-Hwa Kim, Bum-Seok Lee, Ji-Su Park, Won-Gil Cho

• 2021
  Context Archers Published later

  The same sample reports sites that earlier studies barely registered: of 58 athletes, the neck in 22.4% (13 cases), the ankle in 17.2% (10), the foot in 17.2% (10), the wrist in 10.3% (6), the knee in 10.3% (6), the back in 6.9% (4) and the elbow in 3.5% (2). The authors cite 4.0% for the neck and 2.7% for the back in earlier studies by way of comparison, so the gap is not small.

  Shoulder Pain Caused by Injuries in Korean Elite Archers · Young-Sook Kim, Doo-Sup Kim, Ji-Su Shin, Sung-Hwa Kim, Bum-Seok Lee, Ji-Su Park, Won-Gil Cho

• 2021
  Context Archers Published later

  In the same Korean sample the share of archers with a shoulder injury changes with the age group: 90.0% in the university team (9 of 10), 66.7% in the corporate team (6 of 9), 63.0% at middle school (17 of 27) and 50.0% at high school (6 of 12). The shoulder remains the leading site in every group, but the groups number between nine and twenty-seven athletes, so the differences between them cannot be weighed.

  Shoulder Pain Caused by Injuries in Korean Elite Archers · Young-Sook Kim, Doo-Sup Kim, Ji-Su Shin, Sung-Hwa Kim, Bum-Seok Lee, Ji-Su Park, Won-Gil Cho

• 2021
  Context Review Published later

  Scoping review of injuries across 33 Olympic sports: in archery 86.2% of overuse injuries and 83.4% of acute ones involve the upper limb, mainly the dominant-side shoulder, and it is the sport to which the review attributes the highest share of upper-limb injuries, ahead of baseball at 51.4%. For archery, though, it draws on a single included study, the German one from 2018, so it is not an independent replication.

  Epidemiology of Musculoskeletal Injuries in Adult Athletes: A Scoping Review · Francesca Gimigliano, Giuseppina Resmini, Antimo Moretti, Milena Aulicino, Fiorinda Gargiulo, Alessandra Gimigliano, et al.

• 2021
  Context Review Published later

  In the comparison across the 33 Olympic sports examined, archery is the one with the highest share of upper-limb injuries, 86.2% of its overuse cases, ahead of baseball at 51.4%. It is a share of each sport's own injuries rather than a frequency: in the same review archery has the lowest rate among the twelve disciplines with data per thousand hours. It places the sport relative to the others, but for archery it draws on a single included study, the one from 2018.

  Epidemiology of Musculoskeletal Injuries in Adult Athletes: A Scoping Review · Francesca Gimigliano, Giuseppina Resmini, Antimo Moretti, Milena Aulicino, Fiorinda Gargiulo, Alessandra Gimigliano, et al.

• 2022
  Context Review Published later

  Narrative review in Serbian that draws on a few epidemiological studies and names the shoulder girdle among the most affected sites, with repeated, asymmetric loading as the mechanism. For overuse sites it repeats the figures of the 2018 German study, already counted here, so it adds no new sample.

  Specifičnosti povreda u streličarstvu · Đorđe Redža

• 2023
  Context Archers Published later

  US emergency departments from 2013 to 2022, about 43,000 archery-related visits and not only among competitors: in men 66.2% involve the fingers, 17.1% the hand and only 5.4% the shoulder, mainly cuts and acute trauma. In women the database reports 100% to the fingers, an anomalous figure. It looks through a different window, that of acute injury and of recreational and hunting use.

  Archery-Related Musculoskeletal Injuries: An Epidemiological Study Revealing Injury Sites, Risk Factors, and Implications for Prevention · Meghana Konda, Rohan Mangal, Anjali Daniel, Thor S. Stead, Latha Ganti

• 2024
  For Archers Published later

  200 archers aged 13 to 20 from 34 countries at the European Youth Championships, questionnaire administered by physiotherapists: shoulder pain affects 49.1% of the participants in the results (43.5% in the abstract, for pain during training) and is the most frequent site, ahead of the lower back; the elbow follows at 8%, the fingers at 7% and the thoracic spine at 4.6%. It measures reported pain, not overuse injury.

  Injuries and Persistent Pain in Elite Adolescent Archery Athletes: A Cross-Sectional Epidemiological Study · Nikolaos Vasilis, Athanasios Kyriakides, George Vasilopoulos, Maria Chatzitimotheou, Grigorios Gonidakis, Athanasios Kotsakis, et al.

• 2024
  Context Archers Published later

  In the juniors the second site after the shoulder is the lower back, and it is clear of the rest: lateral epicondylitis at 8%, fingers at 7%, thoracic spine at 4.6%. The junior ranking therefore resembles the 1971 kyudo one more than that of competitive adults, where the back counts for less.

  Injuries and Persistent Pain in Elite Adolescent Archery Athletes: A Cross-Sectional Epidemiological Study · Nikolaos Vasilis, Athanasios Kyriakides, George Vasilopoulos, Maria Chatzitimotheou, Grigorios Gonidakis, Athanasios Kotsakis, et al.

• 2024
  Context Archers Published later

  What does not appear in the juniors is just as useful: the hip stands at 0% and the thoracic spine at 4.6%, against 8% for lateral epicondylitis and 7% for the fingers. The load of shooting stays in the upper half of the body, even in athletes aged thirteen to twenty.

  Injuries and Persistent Pain in Elite Adolescent Archery Athletes: A Cross-Sectional Epidemiological Study · Nikolaos Vasilis, Athanasios Kyriakides, George Vasilopoulos, Maria Chatzitimotheou, Grigorios Gonidakis, Athanasios Kotsakis, et al.

• 2025
  Against Archers Published later

  13 registered Turkish archers aged 11 to 18 with at least two years of practice: on the questionnaire the most frequent pain is in the back and lower back, ahead of the knee and neck, and the shoulder does not stand out. It is the only study of archers in which the shoulder does not come first, and it counts as contrary, though weak, because of how it is built: the questionnaire used is the Cornell one, designed for office work rather than sports injury, the percentages are not reported and the sample is 13 people. The authors add that upper-limb pain is reported more often than lower-limb pain, again without percentages.

  Physical characteristics of the pulling and stabilization arm in archers, examination of posture and injury risk · Pakize Nurgül Sarı, Ramazan Çevik, Tamer Çankaya

• 2025
  Context Archers Published later

  12 elite Turkish archers compared with other athletes and with sedentary controls, ultrasound of twenty entheses per side: in the archers the supraspinatus tendon is thicker (p = 0.001) and more often shows erosions (p = 0.036) and enthesophytes (p = 0.036), with the frequencies not reported in the text. It is a sign of load on the shoulder rather than a count of injuries, and it comes from a preprint that has not been peer reviewed: context.

  Sport-Specific Loading Drives Ultrasound-Detected Entheseal Adaptations in Elite Athletes Questionable venue · Sibel Bakirci, Tuba Melekoglu, Gufat Arslan, Seyyid Bilal Acıkgoz, Yilmaz Sungur, Sibel Zehra Aydin

Status history

1. 1971 Reported The earliest survey available in the registry is Japanese and covers 122 kyudo practitioners from the federation, some of them examined and x-rayed: three in four have at least one complaint and the shoulder is the most frequent, at 51%. The same questionnaire warns, though, that the lower back follows immediately at 48%, and that most practitioners have complaints at several sites at once. A single study, in a discipline that shoots differently from the Olympic bow: the question is opened rather than settled, and kyudo on its own takes it no further than reported.
2. 2016 Reported The first sample outside kyudo arrives: 239 archers in Florida, where among those who had been injured the shoulder accounts for 70.3%, ahead of the back, elbow, wrist and fingers, and almost all the injuries are overuse ones. The independent samples now number two, in two different disciplines, but both are retrospective questionnaires and the second is a one-page conference abstract on recreational and competitive archers mixed together: the status stays at reported.
3. 2017 Reported The first survey with a clinical examination of competitive archers outside kyudo arrives: 156 Indian university archers, just over half with shoulder pain on the day of the examination and four in five who have had it at least once, more often in the drawing shoulder and during the draw. The study looks at the shoulder alone, though, and does not set it beside other sites, so it confirms that the problem is widespread without saying anything about the ranking. The samples that put the shoulder first are still two, the 1971 kyudo survey and the 2016 Florida one: the status stays at reported.
4. 2018 Reported The third sample is the first on top-level athletes: 62 national and European-level recurve archers put the shoulder at 52.9% of overuse injuries, more often the drawing-arm shoulder, and in the group competing in Europe the complaints concentrate on shoulder and arm. The direction now rests on three samples, still retrospective questionnaires with no clinical examination: that is why the status does not yet rise.
5. 2021 Corroborated Two new samples and a review arrive within a year. 58 Korean competitors, examined with dynamometry and ultrasound as well, put the shoulder at 65.5%, ahead of the hand, with the pain concentrated on the drawing arm and on the drawing phase; 75 adult German competitors report past shoulder complaints in 43% of cases, against 26% for the trunk; a review of Olympic sports reports that in archers 86.2% of overuse and 83.4% of acute injuries involve the upper limb, although for archery it relies on the 2018 study alone. The samples of archers now number five, collected in different countries by groups that do not cite one another, with designs suited to the question and no contrary study of comparable quality: the status rises to corroborated. The limit remains, and it bears on the status as much as on the figures, namely that these are all cross-sectional studies of what the athletes report.
6. 2023 Corroborated Ten years of US emergency department visits put the fingers first, with the shoulder at 5.4%. The picture does not change, because what reaches an emergency department is acute injury and recreational or hunting use, whereas the claim is about overuse: a useful comparison for the reader rather than a contrary result.
7. 2024 Corroborated 200 young archers at the European Youth Championships confirm the picture, with 49.1% reporting shoulder pain and the lower back second, while the hip never appears and the thoracic spine stays below 5%. It is the sixth sample and the first on juniors, collected by physiotherapists across thirty-four countries: the status holds.
8. 2025 Reported The first result on archers pointing the other way arrives. In 13 young Turkish archers the most reported pain is in the back and lower back and the shoulder does not stand out; the sample is tiny and the instrument is an office ergonomics questionnaire, so it weighs little against six consistent samples and is not enough to make the picture contested, but corroborated requires nothing pointing against, and on the more cautious reading the status drops to reported. On ultrasound the supraspinatus of elite archers turns out thicker and more often eroded, which is a sign of load on the shoulder rather than a count of injuries, and it comes from a preprint that has not been peer reviewed.

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Research lines

• 25 studiesArchery injuries: what research has measured since 1971
• 28 studiesThe archer's shoulder: pain, injury and recovery

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