Staying A-Breast of Things

by Elzi Volk

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Here in Texas where it is warm people like to show their skin regardless of size or stature. All too common I see women on the treadmills or in the aerobics classes who have double-C breasts crammed into flimsy size-B sports bras, their breast mass bouncing up and down like swinging water balloons. Many women wear so-called �sports� bras made of non-supportive and flimsy fabric, opting for appearances rather than functionality. They make me cringe in pain. Most of these women don�t realize that they are destroying their natural breast support and, if continued, their breasts will become "belly ornaments" in a matter of years.

As a personal trainer, I have several female clients who are pregnant or lactating mothers. Their breasts become a more functional part of their anatomy than usually considered and they are justifiably concerned with taking care of them. Additionally, overweight female clients are also urged to provide for the welfare of their breasts while exercising to minimize damage to the supportive tissues. This article presents anatomical features of the breast, discussion of changes in breast structures, and sports bra design.

Although breast motion and sports bra design have been given little attention in most of the sports and athletic journals, a 1987 biomechanical study which analyzed breast motion while jogging, reported 56% of their female subjects experienced sports-related breast discomfort. Not surprisingly, excessive breast motion was the most common cause of the discomfort. Page and Steele, of the University of Wollongong, Australia, authored the most current review (Sports Medicine, April, 1999). As their article pointedly mentions, current sports bra design does not always place function as the major design criteria. Why is this so important? Let us first look at the anatomy of the breast.

Major development of female breasts occurs during puberty. Internally, milk ducts grow longer and form a tree-like formation. The duct branches result in lobules and terminal ducts with fibrous and fatty tissue between them. Researchers have not determined if breasts are fully developed during puberty or if the final stages are during pregnancy.

The breast lies on the anterior serratus and pectoralis major and over the upper rib cage. In women of reproductive age, glandular tissue makes up about 20% of the breast volume. Enclosed by skin and fascia is the major structural components of the female breast: the subcutaneous tissue and the glandular, or functional, section. Two subcomponents make up the glandular mass: the parenchyma, which consists of ductular, lobular and alveolar structures, and the stroma consisting of connective tissue, lymphatics, fat tissue, blood vessels and nerves. In physiology texts the connective tissue is often referred to as ligamentous tissue (Cooper�s ligaments); however, they are actually thin sheets of fibrous bands located in the superficial fascia and which separate the lobules. These fibrous bands attach to the deep fascia which overlays the pectoralis muscles.

Although their mechanical properties have not been fully reported in the literature, the Cooper�s ligaments are thought to provide the primary anatomical support since the breast has no muscle tissue. Because the overlying skin of the breast offers only secondary support, these ligaments are easily stretched, especially from repeated loading during any type of physical activity. As many of us know, over time the result is breast sag. Consequently, external physical support should be the prime consideration when choosing a bra for sports and other physical activity.

The extensive vascular supply of the stroma can make the breast vulnerable to internal bleeding from impact of some sports. Therefore, some sports bras are designed with padding in the cups for breast protection in addition to providing support. The padding dissipates the brunt of a blow over a greater period of time lessening the potential damage.

Breast size and shape vary tremendously. Although no reason has ever been stated, typically, the left breast is larger than the right. Generally, each adult female breast weighs approximately 200 grams; differences in size is usually due to variations in the amount of fat tissue in the breast. The breast increases in volume during pregnancy and generally weighs between 400-600 grams, increasing up to 800 grams during lactation. Additionally, breast volume changes during the menstrual cycle and menopause. Let us see how various hormonal factors affect the breast.

Although the breasts of non-pregnant women are generally considered inactive, they undergo cyclic changes associated with normal ovulation. Many women experience a premenstrual increase in breast size and density. Many women also feel breast tenderness in relation to these changes. This slight engorgement is probably due to tissue edema (holding water in the tissue). Older women who have fibrotic lumps may experience an increase in pain, usually along the perimeter of the breast mass. The volume and density changes are thought to be resultant of the changing levels of estrogens and progesterone during the menstrual cycle.

Hormone therapy, such as birth contraceptives, can also influence breast density. A constant inrush of estrogens and progestins can simulate premenstrual breast changes, often making the breasts tender. During menopause the changes in gonadotropins, estrogens and progesterone induce changes in both glandular and ductal components. Without hormone replacement therapy, the number and size of the glandular elements decrease and the volume of the breast becomes smaller. Likewise, there is a loss of contour due to the decrease in structure.

During pregnancy, the numerous changes in the breast induce gradual increases in weight and size as it produces and stores milk. The lactating breast is continually changing density, and the sensitive nipple is extremely vulnerable to chaffing by fabric rubbing. Therefore, pregnant and lactating women are highly encouraged to wear appropriate supportive bras while participating in physical activities.

As we have seen, the lack of internal anatomical support of the breast structures requires some type of external support. Excessive movement of the breasts during physical exercise may increase this need for some women because of the structural changes during pregnancy and menstruation. Since this support can come in many guises, some inadequate, let us turn to sports bra design.

The first sports bras appeared in the late 1970�s based on the male jockstrap. Since then there are many types on the market to choose from. However, there are basic design factors that should be considered when choosing a sports bra based on overall structure and fit. Ironically, the most popular sports bras being worn in the gyms today are designed more for appearance than support. Depending on the individual�s specific needs, support and sizing should be the major considerations. Cosmetics should be secondary.

Sports bras are of two major design types: compression and encapsulation. The compression-type bra is designed to restrict movement of the breasts by flattening them against the body. This design may be more effective for smaller breasted women, sizes A or B. However, larger breasted women, sizes C and above, need more support. The encapsulation design bra normally has molded cups that support and separate the individual breasts. This type may be more effective for large breasted female athletes than the compression bras.

Basically, sports bras attempt to limit breast movement by holding them to the body. The fabric used can affect the effectiveness of the support and should be closely considered when choosing a bra. It should have enough elasticity to accommodate upper torso movement but prevent breast movement. It should also allow the skin to �breath� since perspiration may increase during most physical exercise. Lycra� and Coolmax� are two fabrics that allow sweat evaporation and are commonly included in sports bras, especially under the arms and in between the breasts. Some bras contain vented panels, such as mesh. These may enhance perspiration evaporation. Also, cotton is recommended as the primary fiber because it is non-allergenic to avoid rashes.

The sports bra should be sufficiently elastic in the horizontal plane to allow for chest expansion while breathing. On the other hand, elasticity in the vertical plane should be limited to minimize vertical breast movement. Straps should have limited elasticity as well for the same reason. To prevent chaffing, cups should be seamless or have covered seams. Cotton lining in cups also helps prevent discomfort during exercise. Fasteners, hooks and underwires should be covered to avoid irritations.

Some women prefer cross-strap bras, or commonly called �racerback� straps, because they do not slip off the shoulders during activity like some of the conventional style straps. Some women also find the cross-strap designs more supportive. In either style, the front straps should be positioned so that they lie in a direct line of pull over the nipples, allowing for optimal vertical breast support. The strap fabric should also be wide to allow for greater force distribution.

Regardless of a sports bra design, if it is the wrong size it will be ineffectual. Probably one-half of all women in the gym wear the incorrect bra size. Wearing the wrong-sized sports bra reduces its ability to effectively minimize breast movement. As well, the sizing system used can be confusing. Some brands size their bras very generally, for example, as small, medium and large. For small-breasted women who wear a compression-type bra, this may be adequate. However, larger breasted women who require more support have to consider cup size (usually A-D and up) and the measurement around the bust (generally a dress size measurement).

Unfortunately, these two measurements are relative to each other. In other words, a B-cup is not the same across all dress-size measurements. As well, for a female bodybuilder whose chest/back measurement is normally larger than the average woman�s, finding a cup size to fit her often presents problems. The best approach is to talk to other female athletes who are of similar size and search for the brands that best fit and support their needs. Additionally, always try on a prospective sports bra. Consider shrinkage as well. I prefer bras made of cotton, but I found quickly that they would shrink. I therefore choose a size accordingly. Another consideration, especially for those whose breast size may fluctuate due to changes in breast volume (influenced by hormones or dieting), is to have bras of two sizes to accommodate breast size differences.

An additional consideration is breast implants. As one female bodybuilder friend remarked to me: "I paid a lot for these things; I take good care of them!" She suggests choosing a good supportive encapsulation-type sports bra, preferably with light padding to protect the tissue from compression or direct pressure of certain movements and equipment. Wide straps are also recommended to restrict vertical movement of the breasts and chafing of nipples.

Consideration of a suitable sports bra design and fit can enhance enjoyment and reduce embarrassment when participating in physical activity. As well, taking care of your breasts now will ensure their pleasing shape and appearance many years ahead. So invest in a proper sport bra to wear when exercising.