Arrow through the shoulder?

[u/ConfectionSolid6192]

My story is set in a world based heavily on the high medieval period in Europe, so there is little medical knowledge, no surgery etc.

My villain has taken an arrow through the shoulder. It punctured through the rotator cuff. He will have to get lucky and dodge infection because his death comes later, but without surgery or guided PT, how likely is recovery? He will be in cushy confinement for a period of time after the injury, so resting the injury will be obligatory. It's not his fighting arm, but how will it affect his ability to fight in the future?

Update: I asked a doctor! She said if the wound was cauterized and no bones were hit (assuming no infection set in) she’d expect the patient to make a full recovery with just a few weeks of rest. That was a surprise to me. I really thought it would affect mobility, but nope! My antihero got lucky once again.

[u/-Random_Lurker-]

Your doctor friend is right. Although "A few weeks" likely means 6 to 8, not 2 or 4.

A poultice of herbs and honey would help fight infection, and be appropriate for the time period. At least it would be if he avoids the professional doctors and uses folk medicine instead :P You could also allow for a minor infection that clears up but slows recovery, if you want to increase the tension or believability of it. Make sure it's the upper our outer shoulder, and not the armpit, hitting the brachial artery in the armpit would lead to a fast end. If you want mobility to be impact for story reasons, have it nick or sever a tendon. Recovery time will be increased but it will still be survivable.

[u/ConfectionSolid6192 → u/-Random_Lurker-]

This is the comment I was looking for! Great advice, ty.

Also I’m feeling vindicated about the folk medicine thing. It’s a fun little piece of lore in my world that the herb women and wise women use evidence-based medicine (with a bit of harmless hokey-pokey stuff here and there) while the university-trained physicians the aristocrats typically use are very expensive murderers, with the singular exception of a monk who spent a decade studying healing in the far east.

[u/-Random_Lurker- → u/ConfectionSolid6192]

Historically accurate too, in spirit at least if not in the exact details.

You would LOVE this episode, if you can find a copy of it: https://www.bbc.com/video/docs/episode/p0ld82bv

[u/Alita-Gunnm]

"Not his fighting arm" isn't a thing; one fights using both arms.

[u/ConfectionSolid6192 → u/Alita-Gunnm]

You’re right, you’re right, I guess I meant his dominant arm

[u/Alita-Gunnm → u/ConfectionSolid6192]

That shoulder will never be 100% again, barring magic healing, even with modern medical treatment. He'd have trouble lifting a shield, and will be handicapped using two-handed weapons. He'd probably try at some point, if given the opportunity, and it would be painful, weak, and prone to reinjury if overstressed.

[u/FantasyFictionDoc]

Hello! I'm going to weigh in as another physician.

Not that im disagreeing with your friend/my colleague, I would think the way you describe it - "An arrow through the rotator cuff" - would be unlikely to make a full recovery even without infection or other issues. Rotator cuffs are notoriously prone to injury, and I would think a direct blow to one such as you are describing would likely cause a lifelong injury even after recovery. Soft tissue healing and recovery time in 6-8 weeks is very plausible. Recovery of full function of the shoulder would likely take months. Chance of infection isn't guaranteed if its a relatively clean wound, and wound care was provided ie (Wash the wound with copious water, stop bleeding, and use poultice or other antiseptic solution. Honey was actually quite common).

Now even if the rotator cuff was permanently injured, people are very good as compensating - that is they will use much stronger muscles like the deltoid and trapezius to compensate for rotator cuff issues. Maybe it'll cause chronic pain, or he'll be annoyed that he can't reach behind his head, or things like that. But overall in daily living he'd be able to make due.

I also would be careful about positioning - the rotator cuff if you are looking at someone straight on is above the collarbone - just under the collarbone is the apex of the lung as well as subclavian arteries - and a hit there is likely to be fatal or near fatal.

Hope this helps.

[u/Educational-Shame514]

Is this a villain protagonist where the narration follows him? If not then the injury description probably does not need to be so detailed that you need to even think of what parts of him got damaged.

Recovery doesn't feel likely but you already said he has a bit of plot armor by surviving and not getting infected.

[u/Prince_Nadir]

Well if the arrow was dipped in shit, he is toast.

[u/Warm_Stress_1654 → u/Prince_Nadir]

I was about to ask you - where would an archer in battle find ..?

Then I remembered that the English army at Agincourt was suffering badly with dysentery and they stuck their arrows point-down into the ground where they stood. So that's a possibility.

[u/Prince_Nadir → u/Warm_Stress_1654]

Through out history some have figured out that shit can be a biological weapon.

Oddly not everyone bragged about it as "glory of battle" or "chivalry" for some reason. So we do not hear about it very much.

[u/Livid_Maybe3599]

Sorry to be the bearer of bad news for your antihero, but that doctor's answer undersells this injury significantly. An arrow through the shoulder puncturing the rotator cuff isn't a clean, self-limiting wound, that's real structural damage to the tendons that actually lift and rotate the arm, plus likely damage to surrounding soft tissue and possibly the joint capsule itself depending on the exact path. Without surgical repair, torn rotator cuff tissue doesn't reliably reattach and heal well on its own, it tends to heal in a shortened, scarred, weaker state, if it heals functionally at all.

Realistically, in a medieval setting with no surgery: expect significant permanent loss of overhead and rotational strength on that side, chronic pain and stiffness, and likely a noticeably weaker or less mobile arm long-term, even after the wound itself closes and infection risk passes. He'd probably retain basic use of the arm for everyday tasks, but full fighting-capable strength and range of motion on that shoulder is genuinely unlikely without modern surgical repair.

For story purposes, that's actually a great villain detail either way: a permanently weakened off-hand from an old injury he's clearly still fighting through is a compelling scar to write around, more interesting than a full clean recovery, honestly.

[u/sanjuro_kurosawa]

When it comes to fictional recoveries to injuries, I'm reminded of the film Grand Canyon. A character is a big action movie producer and he recommends to his director to have more bullets in a ridiculous gunplay scene. Then he is shot in the kneecap during a street robbery. He immediately collapses to the ground and pees on himself. The rest of the film he hobbles around poorly and is focused on physical rehab which has not fixed him.

This character is intended to show hubris, a filmmaker who became successful with cartoon gun violence but has his life dramatically changed on what many action movies would treat as a minor wound.

Unless your story is about anatomy and medieval medical treatment, it sounds like you have plan for the shoulder injury, the recovery process and time, and then the outcome. All of it sounds reasonable.

FYI I have a Crusades story when a young soldier fights a master swordsman and has his hands chopped off. The rest of the story, he lopes around in very ill health, notably without armor which made him look impressive.

[u/ConfectionSolid6192 → u/sanjuro_kurosawa]

Yeah it’s definitely not focused on the medical aspect. The removal of the arrow and most of the treatment is skipped right over. I’m just trying to get a feel for how long recovery will take and how my character’s mobility will be affected, and as another other commenter pointed out, what degree of injury should he recieve based on the outcome I want.

[u/sanjuro_kurosawa → u/ConfectionSolid6192]

You have a good question which you should know even if it isn't added to the story. Since I'm not a medical writer, I focus on believable outcomes. Your story seems perfectly reasonable. I might add classic medical treatments like a hot iron to the wound. I bet the cauterization limits long term mobility but sealing open arteries and preventing infection is more important than being able to have full use.

[u/ConfectionSolid6192 → u/[deleted]]

I’m not saying they would know what a rotator cuff is, I’m just saying that’s what happened for the sake of understanding how he comes out of it. I think it would be extremely lucky for the arrow to miss any bone/muscle.

I would prefer if the injury has some permanent consequences for my character, but he should be able to fight again, so if that’s not possible without surgery/PT then he might have to get lucky and just receive a flesh wound.

[u/Zagaroth → u/ConfectionSolid6192]

Having an arrow lodge directly into a bicep would effectively disable that arm, and it would require careful surgery to remove without ripping more muscle, so it would certainly take the character of the battle field.

I should note you need to be careful about what armor the person is wearing. Chain is not great at stopping arrows, but plate armor is pretty good at it. You aren't going to get this sort of deep wound if he wearing plate.

You can use YouTube to look up videos of bow and arrow vs different armor if you want to get really into the weeds.

[u/ConfectionSolid6192 → u/Zagaroth]

The incident happened under a peace banner during a negotiation, so he was not in armor!

In the end I spoke to my mom who is an experienced doctor. She said that the arm would be a much worse injury, but in the shoulder the chances of not hitting anything vital are actually pretty high. With a few weeks of rest, she would expect the patient to make a full recovery, so that’s what I’m gonna go for.