Measuring pain and mobility: scales, goniometers and questionnaires

A number the archer reports

Almost everything the registry knows about archers' pain rests on one question: how much does it hurt, from zero to ten. On the visual analogue scale the archer marks a point on a line, on the numerical scale they pick a number, and studies sometimes blur the two: an Indonesian study from 2025 describes its numerical scale in centimetres, from 1 to 10, and another from the same year uses a phone app with a range of 0 to 10 while stating that the top value is 100. The Korean study from 2021 turns the number into bands instead: mild from 1 to 3, moderate from 4 to 6, severe from 7 to 10.

Reliability is not measured in archers but cited from other work: between 0.95 and 0.96 on repeated testing for the numerical scale in the Korean group's 2020 study, 0.86 for the agreement between the phone version and another method in Nugroho's. Figures like these say the scale gives consistent values when the pain does not change, not how far it has to move before the pain has changed.

How much the scale moves on its own

This matters because the measured effects are often a few points out of ten. With lower trapezius strengthening pain falls from 4.56 to 2.88 in those who trained; with massage, in the three Indonesian papers, from 5.5 to 2.4, from 6.4 to 3.2 and from 7.8 to 2.3. None of the archery studies states a threshold beyond which a change on the pain scale counts.

The only clue is the control group of the 2020 Korean study: over eight weeks without exercises, pain goes from 3.20 to 3.67. The same study shows the first trap, because the training group starts at 4.56, more than a point higher, and whoever starts higher has more room to fall. The second is selection: people who join a study because they are in pain at that moment tend to be better next time even without treatment, and none of the three massage studies has an untreated group (the twenty young archers in the Swedish massage study all started between 7 and 9). The third is timing: in Kohar's study pain is asked about straight after the session.

How the scale is used matters too. Among the twenty boys in the study on soreness after weights half chose 10, the extreme value, and the entry on soreness reads it as a grade rather than a measurement.

Shoulder questionnaires

Questionnaires ask what the pain stops you doing. In the 2021 Korean study the ASES score is 82.97 in archers with pain and 99.71 in those without, the Constant-Murley 83.81 against 85.25. Both run from 0 to 100, and archers without pain almost reach the ceiling of the first but stay some fifteen points short of the second's. That a point and a half comes out as significant shows how coarse these scales are in 58 people (the entry is the one on abduction strength).

The other questionnaires were built and validated outside archery. The WOSI, on shoulder instability, has 21 items and a scale the 2020 Korean study describes as running from 0 to 2,100, yet the values it reports run from 62 to 90, with no conversion stated. The SPADI in Nugroho's study has 13 items, 5 on pain and 8 on disability, and falls from 37.4 to 5.5. The 2018 Korean single case is the only one to check itself against a threshold: the sports module of the shoulder disability questionnaire drops from 75.00 to 6.25, beyond the minimal important difference of 10.2 points taken from earlier work, and a fear questionnaire designed for low back pain was adapted by replacing back pain with a clicking shoulder. Its minimal detectable change, 21 points, comes from a validation in workers with upper-limb injuries, not from the clicking version.

Surveys of whole groups use different tools again: the Indian one from 2017 a 76-question interview followed by an examination of both shoulders, the one on 200 young archers at the European championships a questionnaire with the zero-to-ten scale (5.94 on average) and a 25-item inventory with a cut-off of 40, which flags rather than diagnoses. Their percentages only compare with care, as the entries on common but mild shoulder pain and persistent pain in young archers do.

Degrees: goniometer and ultrasound

The goniometer, two arms and a pivot placed over the joint, is the simplest instrument, and the number can depend on who holds it. The Indonesian examiners in Kohar's study find 177 degrees of shoulder flexion after treatment; the Turkish ones, who do not say which instrument they used, measure 157 degrees in ten national-level archers without pain. A shoulder that still hurts and beats a healthy one by twenty degrees says more about who measured than about the shoulder, which is why that comparison needs a lot of caution. In the same Indonesian study adduction goes from 39 to 148.67 degrees after one session, a figure that does not add up.

The German group in 2021 measured the necks of 75 archers with an ultrasound system and a single examiner, but the comparison with the general population goes through values published elsewhere and taken with other instruments, as the entry on neck mobility points out.

Field tests

The first test without a goniometer measures the gap between the hands joined behind the back: the German study uses it, and so does the Turkish one from 2026 behind the entry saying that shooting alone improves mobility. It folds rotation, extension and abduction into a single number, and the Turkish study has no group that does not shoot at all, so nobody knows how much of the gain comes from shooting and how much from having done the test before. The second is the sit and reach: the Indonesian study from 2025 reports a test-retest reliability of 0.89, which it calls validity. The test looks at the posterior chain, not the shoulder, and the thirty archers were chosen because they reached 25 cm at most, which makes a gain easier (the entry is on the mobility programme).

Position sense

Here the units change from study to study. The Iranian study from 2019 uses an inclinometer on the forearm and calls "absolute error" values that carry a sign, so errors with a direction; the Indian one from 2022 does not say whether its numbers are errors or reproduced angles; the Indonesian one from 2025 measures in millimetres the distance between the target point and the one found again; the Cypriot study from 2026 reports the absolute difference in degrees, for example from 4.51 to 4.03 in flexion; the Turkish one from 2025 only the mean reproduced angle. These numbers cannot be pooled, and the entry on kinesiology tape and position sense stays at "reported".

What to check

• which pain scale, from what value to what value, and whether the paper describes it consistently;
• whether the archers were chosen because they had a lot of pain or little mobility;
• whether there is an untreated group, and where it starts compared with the treated one;
• for degrees, the instrument, who measures, and whether the comparison is with values taken by other examiners;
• whether reliability was measured in the study or cited from elsewhere.

The findings on the shoulder, in chronological order, are in the line on the archer's shoulder, the other field tests on the page about fitness tests, and the picture for archers in the article on injuries.

@misc{campagna2026_enresearchmethodspainmobilityscales,
  author = {Campagna, Matteo},
  title = {Measuring pain and mobility: scales and goniometers},
  year = {2026},
  howpublished = {Research, matteocampagna.com},
  url = {https://matteocampagna.com/en/research/methods/pain-mobility-scales},
  note = {accessed 2026-10-16}
}