Occasionally, I am asked if the weight of large breasts can be a cause for back pain. Sometimes women are considering a breast reduction, or they may think that they are doomed to a painful back forever because of their anatomy. As with all causes for back pain, the answer is multifactorial, but I think there are things that can be done to reduce the pain without major surgery.
According to the bra company Genie, D cup breasts can weigh 2 pounds each. However, breast weight can vary throughout the month and throughout a woman’s life. The breast is made up of a combination of fatty tissue and glandular tissue with fibrous ligaments providing support and attachment to the skin. The ligaments, called Cooper’s ligaments, originate near the collarbone and support the shape and structure of the breast. Factors such as overall weight gain, pregnancy, and breast implants can rapidly change the weight of the breasts.
So can large breasts cause back pain?
Our bodies are good at adapting to unchanging conditions. For instance, no one complains about the weight of their arm. Your arm has always been there, so your body adapts to that weight and generally doesn’t produce pain, unless there is a change. In the case of your arm, postural changes can cause pain in your upper back. The same thing works for your breasts. When everything is the same as it has been for a long time, they are unlikely to cause pain in your back. However, if something changes – posture, weight, bra support, they can cause a pain in the upper back and neck. Even deconditioning can be a factor. As we age, sometimes we become less active, losing muscle strength. The loss of strength can make it harder to support the breast weight.
Posture is the most important factor in reducing strain on the back resulting from large breasts. A forward shoulder posture is one of the most common reasons for upper back and neck pain. Large breasts exacerbate this forward shoulder posture in a few ways. Primarily, they literally pull the clavicles forward by the force of their weight. Secondarily, I find many women with large breasts have a hard time assuming the correct shoulder posture due to a fear of appearing to be sticking out their chest. This reluctance to stand straight may start right as breasts begin to develop in puberty, and may set up a lifetime of postural issues, including the dreaded humpback. I advise looking at pictures of people with good posture to see if you think they appear vain, or just look healthy and balanced. If that doesn’t work, look at this picture of Quasimodo with a bent back, and realize you need to make a change to avoid that appearance as you age.
You can achieve good posture with attention to three different components.
- Strength of postural muscles
- Flexibility of the spine
You can Strengthen the postural muscles needed to compensate for larger breasts by targeting the muscles between the shoulder blades – the rhomboids and lower trapezius. You can exercise them without weights by performing shoulder retractions. Hold your arms out straight and try to squeeze the shoulder blades down and together without using your upper trapezius (do not shrug your shoulders up). You may be surprised at how hard this simple exercise feels, and you can even feel pulling in your chest muscles while doing the exercise.
Another related technique is to set your shoulders down and back while doing other exercises for your arms. Before you do a biceps curl, set the shoulders down and back. Before an overhead row set the shoulders.
Spinal flexibility is achieved through chiropractic adjustments. If the spine cannot bend correctly for the right posture in the upper back, standing straight will feel very hard. Often a few adjustments can allow for the correct spinal movement and make better posture easier.
Habit is just what it sounds like. If your body is used to a certain position after years and years, it will take a force of will to establish a new normal. You can set some reminders during your day as triggers to remind you to check your posture. Every time you get a text, or every red light – pick something that happens a few times a day that you can set up as a reminder – set the shoulders down and back.
The Bra’s role in back pain
A bra works by redistributing the weight of your breasts from your skin and clavicle to your thoracic spine. The chest strap needs to be tight enough to hold up the weight of the breasts. The shoulder straps are only used to pull the bra closer to the chest wall. A poorly sized bra that fits too loose around the chest can put too much weight on the shoulder straps. The added weight of the shoulder straps used to support your breasts counteracts the support of a bra and can worsen your posture. A correct bra fitting is essential for women with larger breasts. A properly sized bra can immediately reduce back pain.
If you have specific questions, feel free to contact Dr French, we will be happy to help. If you are near Norwalk, CT and would like a spinal evaluation, you can click below to make an appointment.