Introduction

Shooting a bow can be an exhilarating experience, but it can also lead to bow arm shoulder pain, a common issue among archers and bowhunters. In this blog post, I will discuss the causes, prevention, and management of bow arm shoulder pain, and provide tips to keep archers and bowhunters pain-free.

Bow arm vs. Draw Arm

It’s important to differentiate the bow arm vs. the draw arm. For a right-handed shooter, the left arm is the bow arm, and the right arm is the draw arm. The bow arm holds the bow up against gravity and steadies the peep on the target, while the draw arm pulls the string and anchors at full draw. The left and right upper extremities perform different movements while shooting a bow, which can lead to pain and dysfunctions in the shoulder and arms if proper care and archery form is neglected.

Causes of Bow Arm Shoulder Pain

Shoulder pain is almost inevitable for archers and bowhunters due to the repetitive motion of shooting a bow. This motion puts significant stress on the shoulder joint. According to a research study by van Doorn et al, shoulder pain is the third most common musculoskeletal complaint treated in physical therapy. From my experience as a physical therapist, I have found that shoulder pain is often caused by repetitive activities. 

Common shoulder issues among archers and bowhunters include shoulder instability, scapular dyskinesis, rotator cuff disorders, biceps tendinopathy, bursitis, and shoulder impingement.

Shoulder instability

Occurs when the shoulder joint (glenohumeral joint) is unable to maintain its proper position due to excessive movement in the ligaments, joint capsule, or from insufficient dynamic stability of the rotator cuff musculature. This instability can result in frequent dislocations, subluxations, or allow excessive movement of the shoulder which causes undue stress and eventual pain, swelling, weakness, or limited range of motion. 

Scapular dyskinesis

Refers to abnormal movement or positioning of the shoulder blades (scapula) during shoulder movements and limits the efficiency of the complex shoulder joint. 

Rotator cuff disorders

Refers to a group of conditions that affect the muscles and tendons that attach the shoulder blade to the upper arm bone. The rotator cuff muscles include: supraspinatus, infraspinatus, teres minor, and subscapularis. These four muscles work to stabilize the shoulder joint and keep the ball and socket joint centered in optimal position. Rotator cuff disorders can include inflammation, tears, or degeneration resulting in pain and weakness. 

Biceps tendinopathy

Refers to pain and inflammation of the biceps tendon, which attaches the biceps muscle to the shoulder and elbow. This pain is usually located on the front of the shoulder and can cause a popping sensation in the shoulder. Biceps tendinopathy can be caused by overuse, degeneration, postural abnormalities, or poor shooting form and technique, and can result in pain, weakness, and limited mobility. 

Bursitis

Refers to inflammation of the small fluid-filled sacs that provide cushion between the tendons and bony structures. Bursitis can be caused by overuse or injury, and can result in pain and limited range of motion. 

Shoulder Impingement

Occurs when the tendons or bursa in the shoulder become compressed or pinched during shoulder movements, resulting in pain and limited mobility. It can be caused by a variety of factors, including overuse, poor posture, or structural abnormalities in the shoulder joint. 

It’s important to understand that the shoulder is a complex joint that involves many muscles, tendons, ligaments, and bones. If the riser and cam, or scapula and humerus, are not in the optimal position, then this may lead to bow failure or shoulder dysfunctions and pain. The aforementioned shoulder dysfunctions can occur separately, but oftentimes, they are interrelated and occur at the same time. 

For example, shoulder instability can lead to scapular dyskinesis because the shoulder blade has to compensate for the unstable joint. Scapular dyskinesis can then cause rotator cuff disorders because it changes the mechanics of how the rotator cuff muscles work. Rotator cuff disorders can also lead to biceps tendinopathy because the biceps tendon works closely with the rotator cuff muscles and, in my opinion, should be considered part of the rotator cuff for all practical purposes. Bursitis can develop as a result of any of these conditions because any abnormal movement or positioning of the shoulder can compress or pinch the tendons or bursae in the shoulder joint. 

This is a brief explanation of how complex the shoulder joint is and highlights the importance of addressing any shoulder pain as early as possible to prevent further dysfunction and pain while shooting a bow and arrow. 

By addressing the underlying dysfunction, archers and bowhunters can prevent the development or progression of other shoulder dysfunctions and minimize the risk of further damage or injury. 

Prevention and Management of Bow Arm Shoulder Pain

Archers and bowhunters can prevent and treat bow arm shoulder pain with archery-specific exercises. Archery-specific exercises should include both compound and accessory exercises that target the rotator cuff, scapula, and arm musculature to help stabilize the shoulder and meet the demands of shooting a bow. 

Core strengthening, balance training, and mobility exercises are also vital in maximizing success and reducing risk of injury. 

Self-filming while shooting a bow and arrow will help identify shooting flaws and provide feedback on what may be contributing to your bow arm shoulder pain. 

Shooting a bow and arrow with poor archery form can compound shoulder problems and increase the risk of injury. 

To manage existing bow arm shoulder pain, modify shooting frequency, reduce draw weight, ice, modify shooting form and technique, or take a 1-2 week break from shooting. 

Step-by-Step Return to Shooting After a Shoulder Injury

1. Start with shorter distances: It’s important to start at a shorter distance, such as 10 yards, and gradually work your way up to longer distances. This will help you ease back into shooting and prevent re-injury.

2. Decrease the draw weight: Using a lighter draw weight can help reduce the strain on your shoulder as you work your way back up to shooting your normal draw weight. Increase the draw weight by no more than 5-10% in one week. 

3. Focus on form: When returning to shooting, it’s important to focus on your form and technique. This can help you prevent future injuries and improve your accuracy. I am a strong believer in self-filming to identify poor shooting form.

4. Incorporate stretching and warm-up exercises: Incorporating stretching and warm-up exercises into your routine can help improve your flexibility and reduce the risk of injury. 

5. Perform supplemental exercises: Progressive archery-specific exercises targeting the rotator cuff, scapula, and core musculature will help restore and build the strength necessary for performing archery and bowhunting at a high level. 

6. Listen to your body: It’s important to listen to your body and take breaks as needed. If you experience pain or discomfort when shooting, it may be a sign that you need to take a break or reduce the volume of your shooting. 

7. Seek professional guidance: If you’re unsure about how to safely return to shooting after a shoulder injury, it’s always a good idea to seek guidance from a healthcare professional or qualified archery coach. They can help you develop a safe and effective plan for returning to shooting.

Return to Archery Guide

Use this table as a guide to your recovery and return to shooting a bow and arrow. It’s important to note that these guidelines are just a starting point and may need to be adjusted based on individual recovery, physical ability, and experience with archery. Additionally, it’s important to always listen to your body and adjust accordingly. It may be a good idea to discuss your return to shooting with a healthcare professional. 

Conclusion

Bow arm shoulder pain is a common issue among archers and bowhunters, but it can be prevented and managed with proper care. Understanding the causes of pain, recognizing symptoms, performing archery-specific exercises, and self-filming archery form are crucial steps to keep archers and bowhunters pain-free.

Check out our blog post on the 19 most common mistakes in archery form for additional tips on improving your shooting technique.

Source: van Doorn PF, de Schepper EIT, Rozendaal RM, Ottenheijm RPG, van der Lei J, Bindels PJ, Schiphof D. The incidence and management of shoulder complaints in general practice: a retrospective cohort study. Fam Pract. 2021 Sep 25;38(5):582-588. doi: 10.1093/fampra/cmab022. PMID: 33860787; PMCID: PMC8463812.