Breast injuries in female runners

What does the breast consist of?
The breasts are composed of mainly fatty tissue, mammary glands and muscle. The muscle is deep, so cannot provide much help in supporting the breast.

Coopers ligaments help hold the breasts up. These are thin bands interwoven into the breast and are not very strong. If the breasts are not supported properly with a good sports bra then repetitive bouncing from running can stretch the Coopers ligaments permanently.

The main injuries affecting breasts are nipple problems (jogger’s nipple or friction injury), a direct blow to the breast, causing a contusion, and repetitive trauma caused by constant movement and bouncing whilst running.

Repetitive trauma injury in runners
Continuous running causes the breasts to move up and down and side to side. This not only causes pain resulting from the trauma of excessive movement but will result in permanent stretching of the Coopers ligaments resulting in drooping breasts.

Women can suffer breast pain when running whatever their size, but breasts that are not properly supported can lead to tension and strain in the upper back and neck, particularly in the larger breasted woman. Excess weight at the front can mean the back muscles have to work harder to keep the shoulders in the correct position. These muscles will eventually become weak and stretched leading to back and neck pain.

What can runners do about repetitive trauma injury?

• Wear the correct sports bra. This should give support and prevent vertical movement as well as side to side movement.
• 'Breast droop' is irreversible, so prevention is better than cure.
  
  
• For back pain, try to maintain correct posture with shoulders back. Also a regular sports massage is a great way of reducing the tension in the muscles.

Running injuries resulting from direct trauma
Direct trauma can occur from being hit by a ball, a racket or even an opponent when running or playing a sport. A contusion (bleeding within the muscle or breast) may occur.

What can you do about it?

• Apply ice and support the area.
• Occasionally, if the injury is bad, you may need to see a doctor who will aspirate the injury (drain off the fluid with a needle).
• Wearing the correct sports bra.
• In some sports such as martial arts, a plastic cupped bra can be worn over the top. 

Jogger’s nipple
This is a painful condition more common in men than women. It is in effect a friction burn caused by constant rubbing of a t-shirt on the nipple. It is more likely to develop in cold and wet weather.

What can you do about it?

• Protect the injury from further trauma and allow it to heal. This should not take long.
• Again, prevention is better than cure. The correct sports bra can help, as can applying petroleum jelly to the nipples or covering them with zinc oxide tape before running.

A good sports bra should have complete cups to prevent movement of the breasts in all directions. It should also have wide, non elastic straps. Any fasteners should be covered to prevent rubbing against the body.