Breast size, thoracic kyphosis & thoracic spine pain - association & relevance of bra fitting in post-menopausal women: a correlational study

Abstract

BackgroundMenopause would seem to exist as a period of accelerated changes for women and their upper torso mechanics. Whether these anthropometric changes reflect changes in pain states remains unclear. Plausible mechanisms of pain exist for the independent and combined effect of increasing breast size and thoracic kyphosis. Bra fit has the potential to change when the anthropometric measures (chest circumference and bust circumference) used to determine bra size change, such as postmenopausally.Identifying an association between breast size, thoracic kyphosis and thoracic spine pain in postmenopausal women and identifying the relevance of bra fit to this association may be of importance to the future management and education of post-menopausal women presenting clinically with thoracic spine pain.MethodsA cross-sectional study design. Fifty-one postmenopausal bra-wearing women were recruited. Measures included breast size (Triumph International), thoracic kyphosis (flexible curve), bra fitted (Y/N) and pain (Short Form McGill Pain Questionnaire) and tenderness on palpation (posteroanterior pressure testing). These measures were collected in one session at a physiotherapy clinic.ResultsThe majority of the women in this study were overweight or obese and wearing an incorrect sized bra. Pain was significantly related to breast size, body weight and BMI at mid thoracic levels (T7-8). In contrast self-reported thoracic pain was not correlated with age or index of kyphosis (thoracic kyphosis). Women with thoracic pain were no more likely to have their bra professionally fitted whereas women with a higher BMI and larger breasts were more likely to have their bra professionally fitted.ConclusionThe findings of this study show that larger breasts and increased BMI are associated with thoracic pain in postmenopausal women. This is unrelated to thoracic kyphosis. Increasing breast size and how a bra is worn may have biomechanical implications for the loaded thoracic spine and surrounding musculature. Post-menopause women present with a spectrum of anthropometrical changes that have the potential to contribute to altered biomechanics and affect pain states in the thoracic spine.

The Breast Size Rating Scale: Development and psychometric evaluation

“…Actual bra size. Because the majority of women wear incorrectly sized bras, correct bra size was determined for each participant using established measurement guidelines (Spencer & Briffa, 2013;Wood et al, 2008). Two female research assistants who received professional training on bra fit made all breast size measurements using under-bust and overbust circumference.…”

Bust size and pain of the musculoskeletal system – a literature review

“…A change in body posture combined with non-ergonomic work affects the emergence of pain, as evidenced by Nowotny et al [14]. The results of these studies also seem to be confirmed in three studies proving that the size of the breasts is associated with pain of the musculoskeletal system [9][10][11]. Chao et al studied the usefulness of removing breast tissue in symptomatic patients (regardless of amount of tissue removed) to improve their physical disabilities related to breast hypertrophy, and in turn, improve their quality of life.…”

“…In the reviewed studies, three studies [9][10][11] proved that the size of the breasts is associated with pain of the musculoskeletal system. The above results were explained by Schinkel-Ivy et al according to whom the torso muscles showed positive, moderately strong correlations with the size of the breast while standing and some movements of the trunk [3].…”

“…To determine the size of the breasts in Spencer et al studies. [10], and Wood et al [17], Triumph's criteria were applied [18] McGhee et al research was characterized by the most accurate method of determining the size of the breasts from the above review (each breast was scanned while the participants lay prone with their breasts freely suspended between two tables) [10]. Research by Oo et al [11] did not investigate the size of the breasts, but the size of the bra cup.…”

Determinants of breast size in Asian women

“…For example, several studies on sport and exercise participation in adolescent girls revealed large breasts to be a cause of physical strain and a major reason why they do not take part in physical activity 4 , 5 . Back problems are also more common among women who are more well-endowed 6 . In terms of breast health, breast size has been studied extensively as a risk factor of breast cancer, but the results are inconclusive 7 .…”