In young archers the load of shooting, from draw weight and arrows shot in competition, can cause an overuse injury to the shoulder

The summary today

There is a single documented case on this question, from 1999. An eleven-year-old boy who competed almost every summer Sunday with a 28 lb bow, shooting up to 144 arrows in a day, arrives at the emergency department with acute pain in his left shoulder, on his non-dominant side, after feeling a click while shooting in a tournament: the final diagnosis is an overuse injury of the growth plate at the base of the coracoid process, the projection of the shoulder blade where several shoulder and arm muscles attach. Ten months earlier he had had a similar, milder episode in the same circumstances, which settled after a few days of rest, and the first X-rays were read as normal: the diagnosis came only with a bone scan. After four months off he went back to shooting with a 24 lb bow, which the authors consider more suitable for his age, and at six months he was free of pain. It is one case, and the authors write that no overuse injury of the shoulder linked to archery had been described until then: it shows that this can happen, not how often or above what load.

Also phrased as: "bow too heavy for a child"; "right draw weight for young archers"; "how many arrows can a child shoot"; "shoulder pain in young archers"; "shoulder overuse in children who shoot"

Evidence

• 1999
  For Archers Published later

  An eleven-year-old archer seen at an English hospital, with a 28 lb bow, training one or two sessions a week in summer and one in winter, up to 50 arrows in an hour, and competing almost every summer Sunday with up to twelve dozen arrows, that is 144, in a day: he arrives with acute pain in his left shoulder, on his non-dominant side, after feeling a click while shooting in a tournament. The final diagnosis is an overuse injury of the growth plate at the base of the coracoid process. The link with the load is the authors' reading of a single case.

  Overuse Epiphyseal Injury of the Coracoid Process as a Result of Archery · A. Naraen, K. Giannikas, P. Livesley

• 1999
  Context Archers Published later

  The first X-rays were read as normal and the boy was sent home with a diagnosis of an injury to the acromioclavicular joint; only at the follow-up visit was the still-open growth plate at the base of the coracoid noticed, and two weeks later a bone scan confirmed the injury. Ten months earlier the same archer had had a similar, milder episode, also in competition with the 28 lb bow, which settled on its own after a few days of rest.

  Overuse Epiphyseal Injury of the Coracoid Process as a Result of Archery · A. Naraen, K. Giannikas, P. Livesley

• 1999
  Context Archers Published later

  Treatment was conservative: the arm rested in a collar and cuff for two weeks, training stopped, and he returned after four months with a 24 lb bow, which the authors describe as more suitable for his age. At six months the archer was free of pain and training again for the following summer's competitions.

  Overuse Epiphyseal Injury of the Coracoid Process as a Result of Archery · A. Naraen, K. Giannikas, P. Livesley

Status history

1. 1999 Reported The question enters the bibliography with a single, well-documented case: an eleven-year-old archer with a 28 lb bow, who shot up to 144 arrows a day in competition, develops an overuse injury of the growth plate in the shoulder of his non-dominant arm, recovers with four months off and returns to shooting with a 24 lb bow. Two details matter to anyone coaching young archers: the first X-rays were read as normal and a bone scan was needed to recognise the injury, and ten months earlier a milder episode had settled after a few days of rest. One case, pointing in the direction of the claim: reported.

Related

Related articles

• At what age can you start archery? A child is not a small adultWhen children can start archery, which bow young competitors choose, how much draw weight matters and what the data say about pain in young archers.
• Injuries in archery: where they happen and how to prevent themFew serious injuries, frequent overuse: where archers get hurt, what the studies say about risk, and what can be done to prevent the damage.
• What draw weight to choose: how to find it and when to change itWhat draw weight to choose and when to change it: marked versus actual poundage, how much strength to use, three criteria, young archers and each division.

Research lines

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

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