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Archery injuries: what research has measured since 1971

Fifty-five years of studies on archers' injuries, from the first orthopaedic count in kyudo to the survey of elite young archers. This page follows them in order: who counted overuse complaints and who counted acute wounds, in which archers, and why the most quoted figure on low risk rests on hours that were reconstructed rather than measured.

Studies in the registry
25
On archers
19
Years
1971-2026

The question

Archery is often described as a safe sport. Research has been testing that idea since 1971, and the answer depends on what is counted: serious injuries are few, overuse complaints are many. In the registry the claim that archery carries a low risk of injury has been contested since 2018, because the studies measure different things and their conclusions do not meet.

This page follows the studies in chronological order. Practical advice is in the article on injuries in archery; here the subject is what has been counted, in whom and with which instruments.

1971: the first count comes from kyudo

The first study in the bibliography is a Japanese orthopaedic survey of 122 kyudo practitioners aged 18 to 78. Around three in four reported at least one complaint, and the shoulder came first with 62 cases, though only just: the lower back had 59, hand and fingers 53, the elbow 46. The authors examined and X-rayed the thirty most marked cases, and at the elbow the pain was mostly on the outer side, twelve cases against six on the inner side. The same study left a reading that still applies: only one practitioner in four had seen a specialist, so anyone who counts injuries from medical care sees fewer than there are.

1992-2021: the single cases

For decades what arrives is mostly single cases, which show that an injury can happen and say nothing about how often. In 1992 a stress fracture of the first rib on the bow side was described in a 15-year-old girl who had taken up kyudo at secondary school. In 1999 an English hospital reported an eleven-year-old archer with an overuse injury to the shoulder, at the growth cartilage of the coracoid: he shot a 28 lb bow and reached 144 arrows in a day of competition. In 2013 it was an elite Korean archer of 28, whose shoulder vessels and nerves were compressed in the full-draw position itself; in 2021 a Japanese secondary-school beginner in kyudo, in whom the head turned towards the target compressed the cervical cord in a neck that already had a cervical kyphosis. Two of the four stories come from kyudo.

2016-2021: samples of archers arrive

The first sample outside kyudo came in 2016: 239 archers in Florida, from competitions and clubs. Of these, 43.5% reported at least one injury caused by shooting, and among those who had been hurt the shoulder accounted for 70.3%. The same work found more injuries among recurve than compound archers and among those who train on more days a week, with weak correlations; it is a one-page conference abstract, and later studies have found neither link again.

In 2017 156 Indian university archers were interviewed and had both shoulders examined: 54.4% had pain on the day of the visit, and 82.69% had had it at least once. In 2018 62 recurve archers of national and European standard described the injuries of a whole career: 52 overuse, with the shoulder at 52.9%, and only 6 acute, nearly all caused by a bow, an arrow or a string breaking. In the same sample the archers at the European championship, who shot more than twice as many arrows, reported fewer overuse injuries than those at the German championship, 36.4% against 71.8%.

In 2021 two more samples followed: 58 Korean competitive archers, with the shoulder at 65.5% and the pain concentrated in the drawing arm during the draw, and 75 adult German competitive archers, 43% of whom reported a history of shoulder complaints. With these two samples the claim that the shoulder is the most common site of overuse injury became corroborated. On severity the Korean and Indian data agree: shoulder pain is common, almost always mild, and it returns in more than half of cases.

The figure that went round

The 2018 study also produced the most quoted figure on the subject: 0.00536 injuries per thousand hours of shooting, which the authors place among the lowest rates ever calculated. In 2021 a review of thirty-three Olympic sports picked it up and placed archery last among the twelve disciplines measured per thousand hours. The trouble lies in the denominator: the hours were not measured but reconstructed from sessions, arrows and years of practice, and the total, 10,818,080 hours for 62 archers, comes to almost 175,000 hours each, some twenty years of shooting without ever stopping. That total does not square with the training volumes reported in the same paper, and the rate falls with it. For archery, moreover, the review rests on that single study.

Emergency departments, eyes and tendons

In 2023 the large numbers arrived: ten years of US emergency department records, around 43,000 visits related to archery. Here the picture changes, because in men the finger accounts for 66.2% of sites, the hand for 17.1% and the shoulder for 5.4%, with cuts the most common injury. It is a different window: emergency departments see the acute injuries of anyone hurt with a bow and arrows, and the hours of practice needed to turn them into a rate are missing. In 2025 a register of paediatric eye trauma at two Indianapolis hospitals found only two archery cases among 148 related to sport, both affecting the retina and macula; it does not say whether the child was shooting or standing in the line of flight.

The same year a preprint looked at tendons with ultrasound: in 12 elite Turkish archers the insertions of the upper limb show more changes than in sedentary people, above all at the supraspinatus. A thickened tendon is not an injury, though, and the authors themselves note that many of the athletes with marked changes, across all the sports examined, had no symptoms.

Elite young archers

In 2024, at the European Youth Championships, 200 archers aged 13 to 20 from 34 countries answered a questionnaire given by physiotherapists: 50.5% reported training-related pain lasting more than three months, with an average intensity of 5.94 out of ten, and 31.8% had had to stop training. The shoulder came first, in around half the participants, with the lower back just behind, as in the kyudo survey of 1971. In 2025, in 13 Turkish youngsters assessed with a questionnaire designed for office work, the back moved ahead of the shoulder: it is the only sample in which this happens, and it is too small to carry weight.

What remains open

After fifty-five years the direction is clear on one point only: when a competitive archer has an overuse complaint, in most cases it is at the shoulder. Everything else rests on cross-sectional surveys built on recall, and no study in the registry has followed a group over time, counting new injuries against the hours actually shot. Prevention is missing too: a 2026 systematic review of fifteen exercise studies in archers found that none reported incidence, severity or days lost, so the idea that rotator cuff strengthening prevents injury remains unstudied. The study that is needed is surveillance over one or more seasons in club and elite archers, with a shared definition of injury and the arrows counted.

How we came to know it

  1. 1971OriginTomizawa et al. 1971 An orthopaedical analysis of the kyudo athleteThe first orthopaedic survey of archers: 122 kyudo practitioners, around three in four with at least one complaint, the shoulder first with 62 cases but close to the lower back (59), hand and fingers (53) and elbow (46).
  2. 1992ExtensionKubota et al. 1992 Two Cases of Stress Fracture of the Ribs.The first described stress fracture of the first rib on the bow side, in a 15-year-old girl who practised kyudo at secondary school. It shows that the injury can happen, not how often.
  3. 1999ExtensionNaraen et al. 1999 Overuse Epiphyseal Injury of the Coracoid Process as a Result of ArcheryAn eleven-year-old archer with a 28 lb bow and up to 144 arrows in a day of competition, with an overuse injury to the growth cartilage of the coracoid. It is a single case and the only source of the claim on draw weight in young archers.
  4. 2013ExtensionPark et al. 2013 Case Report: Thoracic Outlet Syndrome in an Elite Archer in Full-draw PositionAn elite Korean archer of 28 whose shoulder vessels and nerves were compressed at full draw: in that position the space between clavicle and first rib fell to 11.7 mm, against 29.9 mm on the opposite side in a neutral position.
  5. 2016ExtensionJeon et al. 2016 Effect of unilateral exercise on spinal and pelvic deformities, and isokinetic trunk muscle strengthFourteen archers with spinal or pelvic pain compared with nineteen people without pain: more lateral trunk tilt and a smaller lordosis in the archers. Nothing about the shot itself was measured.
  6. 2016ExtensionPrine et al. 2016 Prevalence And Characteristics Of Archery-related Injuries In ArchersThe first sample outside kyudo: 239 archers in Florida, 43.5% with at least one injury caused by shooting and the shoulder at 70.3% among those who had been hurt. It is a one-page conference abstract.
  7. 2017ReplicationGrover et al. 2017 Prevalence of Shoulder Pain in Competitive Archery156 Indian university archers interviewed and with both shoulders examined: pain in 54.4% on the day of the visit and in 82.69% at least once.
  8. 2018ExtensionNiestroj et al. 2018 Acute and Overuse Injuries in Elite Archers62 recurve archers of national and European standard recall a whole career: 52 overuse injuries, with the shoulder at 52.9%, and 6 acute ones. This is the source of the rate of 0.00536 injuries per thousand hours, calculated on hours that were reconstructed rather than measured.
  9. 2021ReviewGimigliano et al. 2021 Epidemiology of Musculoskeletal Injuries in Adult Athletes: A Scoping ReviewA review of injuries in 33 Olympic sports: among the twelve disciplines with a rate per thousand hours archery has the lowest, but for archery the review rests on a single study, the one from 2018.
  10. 2021ReplicationKim et al. 2021 Shoulder Pain Caused by Injuries in Korean Elite Archers58 Korean competitive archers, also examined with ultrasound: the shoulder at 65.5%, the pain mostly in the string arm and during the draw, mild in 30 cases out of 40.
  11. 2021ReplicationSchmitt et al. 2021 Unilateral and bilateral training competitive archers differ in some potentially unhealthy neck-shoulder region movement behaviour characteristics75 adult German competitive archers, divided between those who shoot from one side only and those who shoot from both: 43% report past shoulder complaints, against 26% for the trunk.
  12. 2021ExtensionTsuzuki et al. 2021 A case of proximal-type Hirayama disease associated with neck axial rotationA Japanese secondary-school kyudo archer whose shoulder weakness appeared about two months after taking up shooting: with the neck rotated towards the target, as when aiming, the cervical cord was compressed.
  13. 2022ReviewRedža 2022 Specifičnosti povreda u streličarstvuA Serbian review that brings together other authors' data, from the rate of 0.00536 per thousand hours to the shoulder pain of Indian archers, and orders them by site. It adds no new data.
  14. 2023ContradictionKonda et al. 2023 Archery-Related Musculoskeletal Injuries: An Epidemiological Study Revealing Injury Sites, Risk Factors, and Implications for PreventionTen years of US emergency department records, around 43,000 visits: in men the finger accounts for 66.2% of sites and the shoulder for 5.4%, with cuts the most common injury. It is a different window, without the hours of practice needed to turn it into a rate.
  15. 2024ReviewAsy Syahidah et al. 2024 Training Model for Injury Prevention in Archery: A Literature StudyA narrative review of 20 articles presented at an Indonesian seminar: it lists sites, causes and general prevention models, none of which has been tested on archers.
  16. 2024MethodJi et al. 2024 Exploring injury assessment using motion tracking technology and ergonomic tools in archery performance13 university students with inertial sensors and a digital human model: estimated compression at the L4/L5 disc between 511 and 665 newtons, linked more to body weight than to the bow. It estimates a load and counts no injuries.
  17. 2024ExtensionVasilis et al. 2024 Injuries and Persistent Pain in Elite Adolescent Archery Athletes: A Cross-Sectional Epidemiological Study200 archers aged 13 to 20, from 34 countries, at the European Youth Championships: 50.5% with training-related pain lasting more than three months, average intensity 5.94 out of ten, and 31.8% had had to stop training.
  18. 2025MethodJi et al. 2025 The Impact of Draw Weight on Archers’ Posture and Injury Risk Through Motion Capture AnalysisThe same group of 13 students with 20, 25 and 32 lb bows: lumbar compression between 469 and 773 newtons, far from the 3,400 the authors take as a safety limit.
  19. 2025ExtensionBakirci et al. 2025 Questionable venue Sport-Specific Loading Drives Ultrasound-Detected Entheseal Adaptations in Elite AthletesA preprint using ultrasound in 12 elite Turkish archers: more changes than in sedentary people at the insertions of the upper limb, above all at the supraspinatus. A tendon that looks altered on ultrasound is not an injury.
  20. 2025ExtensionChaudhary et al. 2025 An Analysis of Ocular Trauma Resulting From Pediatric Sports InjuriesTen years of paediatric eye trauma at two Indianapolis hospitals: two archery cases among 148 related to sport, both affecting the retina and macula.
  21. 2025ExtensionPrasetyo et al. 2025 Overuse injury treatment: which is more appropriate between Swedish massage and deep tissue massage, especially for archery athletes20 archers aged 15 to 20 with overuse pain, two types of massage compared: pain falls in both groups, from 7.8 to 2.3 and from 7.6 to 4.8 out of ten, with no group left untreated.
  22. 2025ContradictionSarı et al. 2025 Physical characteristics of the pulling and stabilization arm in archers, examination of posture and injury risk13 young Turkish archers measured on both sides and asked to fill in a questionnaire designed for office work: the complaints mentioned most often are in the back, not the shoulder. It is the only sample in which this happens.
  23. 2025ExtensionYoshimoto et al. 2025 International Session 29 AIA conference abstract from Bhutan: six cases of arrow wounds to the head and neck, with no ages, circumstances or denominator.
  24. 2026ReviewSubramaniam et al. 2026 Systematic Review of Exercise Interventions in Archery: Injury Management and Performance OutcomesA systematic review of fifteen exercise studies in archers, published between 2015 and 2025: none reports incidence, severity or days lost, so the preventive benefits are inferred from other measures.

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Cite
APA

Campagna, M. (2026). Archery injuries: what research has measured since 1971. In Research. matteocampagna.com. Retrieved 16 October 2026, from https://matteocampagna.com/en/research/injuries

BibTeX
@misc{campagna2026_enresearchinjuries,
  author = {Campagna, Matteo},
  title = {Archery injuries: what research has measured since 1971},
  year = {2026},
  howpublished = {Research, matteocampagna.com},
  url = {https://matteocampagna.com/en/research/injuries},
  note = {accessed 2026-10-16}
}