Archers Elbow

what do you get if you shoot a training bow without a bracer?

Archery is a physical activity and its inevitable we as archers will suffer minor injuries. Skelf’s (wood splinters) from frames, shoulder aches, bruising from string slap (see right) are common. Less common are strains from moving heavy bosses, which admittedly are more likely if you don’t take care. Extremely rare is having bosses fall on you, frames fall on you or stabbing yourself in the leg with an arrow! However, one of the most insidious, annoying archery related injuries we can suffer is “Archers Elbow”.
Yes, we have our own named injury!

You may know this injury as Tennis Elbow but archery was around long before tennis and since we suffered it first – OUR injury! More formally this is known as lateral epicondylitis and is caused by repeated contractions of, or excessive strain to, the muscles in the forearm. These stress the tendons attaching the forearm muscles to the outside of your elbow causing tiny tears. You will know all about this injury when you try to grip something, turn a handle or hold your caf. Pain and often weakness will radiate out from the outside of your elbow and into your forearm and wrist. This can persist for months especially if you keep doing what caused the problem … like drawing your bow.

So what can you do about this? The bad news is only rest and abstention from what caused the problem will cure the issue. If this was shooting, you need to put the bow away. You’re done for a while! Now I can already hear the cries of grief but good people, be of good cheer. You can mitigate the problem and speed up the down time by getting some advice and some physiotherapy because physio’s have been dealing with this for decades … even if some of that advice gets a little strange and possibly suspect.

Note: This article IS NOT medical advice. I’m a whiny archer Jim, not a doctor! Talk to a physio for proper guidance and treatment of your injury. This is just a heads up in what to expect.

Most common advice from physio’s involves rest. It takes time to heal so patience will be required as things calm down over the first 1-2 weeks from the time of the injury. Ibuprofen will reduce inflammation as will icepacks 2-3 times a day for 15 mins at a time. Try not to aggravate the injury doing things that hurt. Worth waiting these 1-2 weeks before seeing a physio as they like the injury to have moved on from the initial trauma.

Next up exercises. Now this does sound a bit counter intuitive, given it was exercise that caused the injury but as archery is mostly counter intuitive: Meh, bring it on! After the rest, small weights (1-2kg) and wrist exercises to strengthen the forearm and by association the tendons is the advice. Stronger tendons will be less likely to fail under stress. Stretching the forearm with non-weight wrist exercises will help. Also, a little frictional massage to break up the fibres in the tendon and stop them sticking together. Be aware it hurts! This is pretty much the mainstream advice you will get from a physio.
Your Mantra needs to be: Patience. Rehab. Patience. Rehab.

Dentist or Physio stainless steel is never good!

And then there’s YouTube. Do a search for Tennis Elbow on the indispensable advice platform and you get videos out the wazoo! This is a Buyer Beware moment. There are videos on correct fitting of the elbow strap (which in theory protects the damaged tendons by forcing your arm to use a different part of the tendon). More intensive deep massage using metal “scrapers” (Graston Technique). KT tape (Kinesiology Tape – sometimes referred to as “the placebo that works”!). Extreme stretching. Heat to promote healing. More radical exercises than noted above. Ultrasound therapy. Finally, and probably the most bizarre on YT, a massage gun. Think hand drill that pummels you with rapid impacts. The logic behind this is a tad bizarre but seems to involve lengthening and shortening tendons with massage (read repeated impacts) and somehow promoting healing through blood flow (aka bruised to heck).

The most radical cure is surgery. The operation involves making a cut above the bone on the side of your elbow. The damaged piece of tendon is removed and the unattached end of the tendon is reattached to your elbow. Takes 3-6 months to heal and you’ll be doing exercises for up to a year. Pretty drastic and only done in extreme cases.

GA Case Study: At GA we’ve had a few archers go down with this problem recently. For one archer, it was 4 months rest and he is back shooting limited arrows on somewhat reduced poundage on an occasional basis. For the other, the approach was more proactive physio/exercises/ibuprofen and frictional massage including the steel tools! At two months in, about 80% of the pain was gone. At just over three months he was back shooting his own bow. At four hitting the gym gently and at five months 95% of the pain was gone with a little residual discomfort. Ironically, he seems to have forgotten all his bad habits so it’s taking him a little time to find some new ones as well as his stamina!

So, to sum up … get some advice, expect to be out for a while, rehab is boring & monotonous and finally be patient. This is a nasty injury for archers and needs time to heal. If you have this, although we want to see you back on the shooting line, it shouldn’t be before you are ready to chase those badges once more pain free.

Note: This article was read and approved by the Vice Chair’s physio.

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References: (Boots products shown because we all know the brand, not because we’re on commission! ;o)

Lateral Epicondylitis
Boots Tennis/Golf Elbow Strap
Boots Massage Gun
Graston Technique
Kinesiology Tape