I have avoided this topic for some time with good reason. I have not wanted to broach a subject as a man that might make my female patients uncomfortable. My mind was changed while working with one of my shoulder patients because she asked me straight out, “Do you think my breasts have anything to do with my shoulder pain?” My response was a definite yes, but I had previously avoided mentioning it mostly because I did not think she would benefit from that piece of information. I wasn’t going to volunteer:  “By the way, the reason you are having this mid-back and/or shoulder pain has a lot to do with how your breasts are constantly pulling forward and your shoulders are slumping forward in response.” I did not think, at the time, that sharing this information would be helpful, but this wonderful patient changed my mind! She said she wanted to know because she could do something about it. She can get a more supportive, better fitting bra!

While breasts may be a taboo topic, they create a large enough physical effect that they really are worth mentioning. When young girls hit puberty, they tend to slump as they become uncomfortable with the noticeable formation that is forming there. This can cause lifelong problems with posture and spine formation. What is interesting is that most of the problems I see due to poor support actually occur in women in their middle ages. After years of poor posture and positioning from carry this weight, they develop slumped shoulders, tight pecs, and weak rhomboids (muscles in between the shoulder blades).

This tendency to slump translates into rotator cuff problems that develop over years of operating in this poor posture. I have also seen this correlate with mid-back and rib pain. A patient’s ribs will “move” in response to tight muscles pulling on them. Weakness and poor posture set up this rib pain; the intercostals (muscles in between the ribs) go into spasm just like when you pull a muscle elsewhere in your back.

If you feel that these topics might apply to you, don’t be afraid to bring it up to your therapist (or other medical professional). Addressing strength and deficits based on your personal need is what therapy is for. All women are endowed differently, and while this situation may not be applicable to some, others may experience pains and compensations that can be addressed.

An appropriately supportive and well fitting bra can be the key. So… like Oprah, I am encouraging women to go get a bra fitting, for their health and pain free function. 🙂

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