THE BARE FACTS ON BREAST CARE FOR ATHLETES

It has only been about 40 years since the first sports bra was designed. Initially, manufacturers thought that women would feel more comfortable exercising if they were able to reduce the vertical displacement of the breast and therefore eliminate the “bounce factor”. Still, after many modifications to the sports bra, many women still cannot get enough support, or their bra digs into their shoulders and is too tight around the ribs. Breast care for athletes is important, but hardly ever discussed.

DON’T LET BREAST PAIN HOLD YOU BACK

In an age where female athletes are removing the barriers to gender equality in sports one by one, healthy breast care is but another piece in the puzzle to ensure nothing is holding you back. Sometimes, breast pain may affect your ability to train and compete. However, you may not feel comfortable approaching your doctor or physiotherapist about issues related to healthy but painful breasts. At the same time, you may struggle with your self-help solutions. This is where a little knowledge may go a long way in helping you.

Importantly, breasts are no more fragile than are women themselves. In fact, it is very difficult to damage your breasts while exercising, unless you receive a direct and powerful blow to your chest. Contrary to popular belief, competitive sport will not lead to saggy breasts or an inability to breast-feed. Sagging is due to hormonal and tissue changes. Fears of damage to the breast arising from vigorous exercise seem deeply ingrained in women’s (and men’s) minds. Yet, from the beginning of the twentieth century, women have been encouraged to use mild exercise to enhance their bust. One popular arm and chest exercise was accompanied by the chant of “we must, we must, we must increase our bust.”

MYTHS AND FACTS ABOUT BREASTS

Your breast is essentially a “sophisticated sweat gland”. It contains fat, glands, ducts, and connective tissue. The pigmented skin surrounding the nipple is densely innervated. Blood supply comes from the front of your shoulder, armpit, and lower side. Notably, the only muscle is in the ductal system of the nipple and functions to erect the latter. The breasts sit on top of the ribs and breast muscles.

The size of your breast is determined by genetics predominantly. Still, it can vary considerably throughout your life depending on the estrogen stimulation during puberty, pregnancy, oral contraceptive use, and hormone replacement. Variations between left and right in size and shape are normal. They do not mean that anything is wrong.

Myth: The breast is made of muscle.

Fact: Breast is a fatty tissue like a gland. The only muscle is around the nipple and causes it to erect. The chest muscle is called the pectoralis and lies below the breast.

Myth: Nerves are found throughout the breast.

Fact: The nerves are concentrated in the nipple area of the breast, which is the most sensitive area. All other nerves run deep within the tissue.

Myth: Breasts sag if the ligaments are torn.

Fact: The only ligaments in the breast (Cooper’s Ligament) hold the central breast to the chest wall. They are very strong and function as suspension support. They do not easily tear as they are flexible.

Note: Training and vigorous exercise may contribute to increased chest muscle tone and to body fat reduction but will not change the size of your breast itself.

COMMON PROBLEMS

The most common reasons for breast pain during sport are often related to:

  • Improper fit of the sports bra
  • Worn-out garment that has lost its supportive features
  • Poor match of sport demands with garment features

The most common problems encountered are:

  • Chaffing and abrasions
  • Bruising and contusions
  • Breast tenderness and soreness

There are currently two types of sports bras on the market. One is based on compression. It has no defined cup, but the bra functions by exerting compression on the breast and chest (commonly called the “uni-boob”). The second type has a separately formed cup that gives the breast support and definition.

BREAST CARE FOR ATHLETES: BRA SOLUTIONS FOR DIFFERENT PROBLEMS

Issue Bra Solution
Vigorous exercise and training, jumping and bouncing, contact sports Chose garment suited to the type of exercise you do:

  • Impact: supportive, compression, seamless, sweat-absorbent
  • Endurance: Ventilated, scapular reinforcement, porous fabric
  • Contact: protective padding
Bruising

  • Shoulder strap
  • Anterior breast
  • Wider shoulder straps, add strap pads
  • Less anterior compression, separate cup style may help
Nipple Chaffing
  • Seamless cups
  • Ensure proper size and fit
  • Sweat-absorbent material
Breast Displacement
  • Compression style garment
  • Full figure support
  • Spandex Body Suit for additional support
  • Proper Sizing and Fit

BREAST SUPPORT IN SPORTS

Athletes often encounter discomfort or difficulty with their breasts when they exercise. Particularly athletes with large breasts may find it difficult to achieve both support and comfort. The need for breast support also depends on the type of sport or training you are participating in. Any sport with regular up and down movement means that breasts will bounce. Clearly, you need more support as a runner than if you are doing karate or riding a bicycle.

The first sports bra was the Jogbra, invented in 1978 by Hinda Miller and Lisa Lindahl. Their original creation was developed from two jockstraps (yes–a true example of male support to female sport) being sewn together in order to hold their breasts better while they ran. Tellingly, the original name for the bra was the Jock Bra. We have come a long way since, and the sports bra definitely has helped female athletes to feel more comfortable and confident. Yet, the perfect sports bra is still to be found.

WIDE CHOICE CAN BE CONFUSING

Sports bras work by either compressing and thus immobilizing the breasts against the chest wall or by enclosing each breast in a fabric cup made of supportive or heavy-duty material. They come in a wide variety of styles. Mostly, their design is specific for different athletes such as runners and boxers as well as for women who have undergone breast surgery. Styles range from polar fleece versions to tank tops that allow women to wear their bras in public.

Smaller-breasted athletes often report more discomfort from their bras than from the bobbing that the bras intend to prevent. Others may experience mild discomfort due to bobbing or chafing from garments. Occasionally, you may develop a rash in the areas where moisture builds up during training or competition. Properly fitting and well-designed sports bras can go a long way towards alleviating these problems.

BREAST CARE FOR ATHLETES STARTS WITH FINDING YOUR PERSONAL FIT

Beyond support, there are other features that can enhance your comfort. Highly supportive fabrics do not breathe well, so vented panel insets can help. The bra straps come in a variety of styles: crossed, traditional, or “racer-back”. Yet, all of them may enhance or detract from your comfort. This is very individual. Therefore, I strongly recommend that you try different styles out yourself to find your best fit. The straps must not allow vertical movement, nor have abrasive seams or lace. All of the seams should be flat and smooth. If you are large-breasted, you may find that the weight of your breasts causes the straps to dig into your shoulders. The racer back may alleviate this.

Some elements of bra construction directly oppose the natural physiology of the breast. As an example, in the areas that are most important to blood flow, shoulder straps exert pressure, or ribbands compress tissue. Seams and fabric ridges often compress and irritate the sensitive nipple area. Finally, the lateral panels of the bra may compress and pinch the lateral breast, which contains a lot of fatty tissue.

REGULAR BRA FITTING IS ESSENTIAL

As you can see, a better match between female physiology and bra construction may ease some breast problems. The correct fit of your bra is key to your comfort. You may actually not know your correct size or that it varies along with other body changes during your career. In fact, you should be fitted for your bra at least every year.

Author:

  • Julia Alleyne is an associate professor appointed at the University of Toronto, Department of Family and Community Medicine. Her clinical work is based at Toronto Rehab. She has a long history as a Sports Medicine Physician including being selected to five Canadian Olympic Teams and was the Chief Medical Officer for the 2015 Toronto Pan American Games. She was honoured by the Canadian Association for the Advancement of Women in Sport and Physical Activity as a recipient of the 2003 and 2015 Most Influential Women in Sport and Physical Activity Award.