Archery Injuries: Why Archers' Shoulders, Necks and Backs Hurt

Archery looks like one of the calmest sports there is. You stand still, breathe, draw and release. No tackles, no sprints, no jumping. So it surprises many people that archers get injured quite often, and that the injuries can keep them away from the range for weeks.

Recently an archer came to see us at the clinic with pain in her mid back, between the shoulder blades. When we assessed her, the main problem was control of the shoulder blade. As she drew the bow, she did not hold the shoulder blade of her drawing arm steady. Our assessment was that the muscles that connect the spine to the inner edge of the shoulder blade, called the rhomboids, were taking too much of the load on every arrow, and that this was why they had become sore. Her question was one we hear from many athletes: is this serious, and do I have to stop? That visit made us look closely at what the research says about archery injuries. Here is what we found, in plain words.

Archery in Cyprus

Archery has a small but steady community in Cyprus. The Cyprus Archery Federation is based in Nicosia and has held a national championship every year since 1991. There are several clubs around the capital, and since 2021 Pyla, near Larnaca, has had the island's first purpose-built archery park, which hosts international competitions. More people shooting means more people who need to know how to keep their shoulders healthy.

Is Archery Really an Injury-Prone Sport?

More than you might think. In a survey of almost 400 archers in Spain, more than half (57%) had been injured while shooting. Half of those with a shoulder, neck or back injury had to stop practising for a while.

The type of injury matters. When researchers look at emergency department visits, most archery injuries are cuts to the fingers and hand: accidents with arrows or the string. When researchers ask archers themselves, a different picture appears: most injuries build up slowly from training. In a study of 165 elite archers in Malaysia, about 7 in 10 injuries came on gradually, from repeating the same movement, and more than 8 in 10 happened during training rather than competition.

What Hurts in Archers

1. The shoulder, by far

The shoulder is the number one problem in every study we read:

• In the Malaysian study, more than half of the archers had had pain in the shoulder of the bow arm (56%) and in the shoulder of the drawing arm (55%).
• In a study of 156 competitive archers in India, more than half had shoulder pain at the time of the study, and more than 8 in 10 had had it at some point.
• At a European youth championship, Greek researchers asked 200 young archers about pain. Nearly half had shoulder pain, and for about half of all the archers the pain had lasted more than three months.

Most of this is overload of the small muscles and tendons that hold the shoulder joint in place, sometimes with pinching of these tendons under the bone at the top of the shoulder. If this sounds familiar, our guide to shoulder impingement explains it in more detail.

2. Both arms, but in different ways

Archery is a one-sided sport, and each arm has a different job:

• The bow arm holds the bow out in front, still, for several seconds on every shot. It is a long, static effort. The shoulder has to stay low and stable while the muscles hold the weight of the bow and resist the pull of the string.
• The drawing arm pulls the string back, against the full weight of the bow, and serious archers repeat this many times in every training session. In a study of elite archers in Korea, most shoulder pain was in the drawing arm and came on while drawing the bow.

3. Neck and upper back

The neck and back come second. In the Spanish survey, about 1 in 5 injuries were in the neck or back. In the Malaysian study, close to 4 in 10 archers had had pain in the upper back, and about as many in the lower back and in the neck. Pain between the shoulder blades, like our archer's, is a typical example. A study in Japan measured muscle activity in 30 archers. In the best archers, the lower part of the trapezius, the large muscle that covers the upper back, worked harder in the drawing arm than in less experienced archers, while the arm muscles worked less. The authors concluded that this muscle helps hold the shoulder blade steady while shooting. In our experience, when the shoulder blade is not held steady, other muscles around it often end up doing extra work on every shot. The other reasons are easy to picture: the head is turned towards the target for every shot, the shoulder blades work hard to hold the draw, and the body stays in the same twisted position for hours.

4. Elbow, wrist and fingers

These are less common. Pain on the outside of the elbow appears in some archers, and the fingers of the drawing hand can get sore or blistered from the string. Sudden injuries, such as the string hitting the forearm or a cut from an arrow, are usually a job for first aid, not physiotherapy.

Why Archers Get Injured

Research on archery is still limited, but the same few causes come up again and again:

• Too much, too soon. A sudden jump in the number of arrows per day, a training camp, or a busy competition season. This is the most common story in overload injuries in any sport.
• A bow that is too heavy for you. When the draw weight is more than your muscles can control, your technique changes and the load moves into the shoulder joint instead of the big back muscles.
• Pulling with the arm instead of the back. A good draw is driven by the muscles between and around the shoulder blades. If the arm does most of the work, the small shoulder muscles get overloaded.
• Weak muscles around the shoulder blades, or poor control of them. They are the base the whole shot sits on. Holding the shoulder blade steady at full draw is a skill that top archers have and that can be trained.
• A previous injury. In the Indian study, archers who had been injured before were about two and a half times more likely to have shoulder pain now.
• Poor sleep and stress. The Malaysian study linked injuries to poor sleep and high anxiety. Tired tissues recover more slowly.

Warning Signs: When to Get It Checked

Some muscle tiredness after a long session is normal. These signs are not, and are worth a visit to a physiotherapist:

• Shoulder pain that lasts more than one to two weeks, even after you shoot less.
• Pain that wakes you at night or is there when you are resting.
• Pain that changes how you shoot: you cannot hold full draw, you collapse at release, or your scores drop because of pain.
• A feeling of weakness when you lift your arm, or a painful catch or click.
• Pins and needles or numbness going down the arm, together with neck pain.

See a doctor straight away if you cannot lift your arm after a sudden injury or fall, if the shoulder looks deformed, or if you have chest pain or shortness of breath together with arm pain.

Six Exercises That Help Protect Your Shoulder, Neck and Back

Honestly, there are no large studies yet showing that a prevention programme lowers injury rates in archers. But a small trial in archers with shoulder pain found that eight weeks of shoulder blade exercises improved how their shoulders worked and how well they could sense the position of the joint. The exercises below follow the same idea and are widely used for overhead and throwing athletes.

Do them 2 to 3 times a week, on training days or in between. Aim for 2 to 3 sets of 10 to 15 slow repetitions. They should feel like effort, not sharp pain. A light resistance band is all you need.

1. Band rows

Tie a band at chest height in front of you. Holding one end in each hand, pull your elbows back past your body. Start the movement by drawing your shoulder blades back and down, then let the arms follow. This is the same pattern as a good draw: back first, arm second.

2. Push-up plus

Start in a push-up position against a wall (or on the floor if that is easy). Keep your elbows straight. Let your chest sink a little between your shoulder blades, then push the floor or wall away so your upper back rounds slightly. This strengthens the muscle that holds the shoulder blade flat against the ribs, which the bow arm relies on.

3. Band external rotation

Stand side-on to a band tied at elbow height. Keep your elbow bent to 90 degrees and tucked to your side, with a small rolled towel between the elbow and your body. Rotate your forearm outwards, away from your stomach, then slowly back. Train both arms. This works the small muscles at the back of the shoulder that keep the joint centred.

4. Y raise lying face down

Lie on your stomach on a bench or the floor, arms out above your head in a Y shape, thumbs up. Gently draw your shoulder blades down towards your back pockets and lift both arms a few centimetres. Hold for two seconds and lower. Start without any weight. This targets the lower part of the trapezius, the muscle that worked harder in the best archers in the Japanese study and helps hold the shoulder blade steady at full draw.

5. Open book for the upper back

Lie on your side with your knees bent and both arms straight out in front of you. Keeping your knees together, slowly open the top arm across your body towards the floor on the other side, following your hand with your eyes. Pause, then return. Do 8 to 10 on each side. Archery keeps the upper back twisted one way for hours; this gently moves it the other way.

6. Chin tucks

Sit or stand tall. Without tipping your head down, gently slide your chin straight back, as if making a double chin. Hold for 5 seconds, relax, and repeat 10 times. This trains the deep muscles at the front of the neck that support the head while it is turned towards the target.

Training Habits That Protect You

• Warm up before you shoot. A few minutes of arm circles, band pulls and some light draws with a band or a lighter bow. In a Turkish study of 151 archers, the authors recommended warm-ups that target exactly the shoulders, neck and back.
• Count your arrows. Increase the number of arrows per week gradually, not in big jumps. Plan lighter weeks after competitions.
• Choose a draw weight you can control. If you cannot hold full draw steadily for a few seconds, the bow is probably too heavy for now. When you come back from a break or an injury, drop the draw weight first.
• Work on technique with your coach. Drawing with the back, a low and stable bow shoulder, and a smooth release protect the shoulder as well as your score.
• Train the rest of your body. Leg and core strength help you stand stable for hours. Half of the young archers in the European study said they skipped lower body training.
• Sleep and recovery count. Rest days are part of training, not a break from it.

How a Physiotherapist Helps

1. A full assessment of the shoulder, shoulder blade, neck and upper back, and your training load: arrows per day, draw weight, recent changes.
2. A clear explanation of what is causing the pain and what is safe to keep doing. Most archers do not need to stop completely.
3. A plan to adjust load, for example fewer arrows or a lighter bow for a few weeks, rather than full rest.
4. Step-by-step strengthening of the shoulder and shoulder blade muscles, with hands-on treatment where it helps you move.
5. A return-to-shooting plan, built up arrow by arrow, and working with your coach on technique if needed.

Is Physiotherapy for Archery Injuries Covered by GESY?

Yes. Physiotherapy for muscle and joint pain is covered by GESY with a referral from your personal doctor or a specialist, with a small co-payment per session. Antonis Petri (GESY Reg: A2825) and Alice Kazanjian (GESY Reg: A3509) are GESY-registered providers. You can also book privately without a referral. Our GESY physiotherapy guide explains referrals and session numbers in detail.

Frequently Asked Questions

Is archery a sport with many injuries?

More than people expect. In a survey of almost 400 archers, more than half had been injured while shooting. Most of these injuries are not accidents but overload: the same movement repeated hundreds of times a day. The shoulder is affected most often, followed by the neck and back.

Which shoulder hurts more in archery: the bow arm or the drawing arm?

Both can hurt, and studies show similar numbers for each. The bow arm holds a long, still effort on every shot, while the drawing arm pulls the string back hundreds of times a day. In a study of elite archers in Korea, most shoulder pain was in the drawing arm and came on while drawing the bow.

Should I stop shooting if my shoulder hurts?

Usually not completely. Most archers do better by reducing the load for a while, with fewer arrows, shorter sessions or a lighter bow, while they strengthen the shoulder. If the pain lasts more than one to two weeks, wakes you at night or changes your technique, have it assessed by a physiotherapist.

Can a lighter bow help with shoulder pain?

Often, yes. If the draw weight is more than your muscles can control, your technique changes and the shoulder joint takes more load. Dropping the draw weight for a few weeks is a common part of a return-to-shooting plan. Discuss the exact weight with your coach and physiotherapist.

Is physiotherapy for archery injuries covered by GESY in Cyprus?

Yes. Physiotherapy for muscle and joint pain is covered by GESY with a referral from your personal doctor or a specialist, with a small co-payment per session. Right Track is a GESY-registered clinic. You can also book privately without a referral.

Sources & Further Reading

Antonis Petri, BSc, OMPT

Founder & Lead Clinician at Right Track Physiotherapy. Clinical Instructor in the Department of Life and Health Sciences at Frederick University. A former amateur footballer with over a decade on the pitch, he specializes in sports rehabilitation and return-to-performance programs for athletes in Cyprus.