80% of women wear the wrong bra size according to most research papers.  Many women who present to their chiropractor are therefore wearing the incorrect underwear, which can ultimately lead to back pain.  Women often come to the clinic complaining of everything from persistent headaches, breathlessness, back / neck pain or shoulder tightness.  All of these things may well have a root, or be increased by poorly fitting underwear.  Most women report standing taller and feeling freer the instant they change to underwear that fits them correctly.

Bras are often viewed as an aesthetic or functional item.  This is somewhat of a fallacy as in reality a correctly fitted and supportive bra, irrespective of bust size, is as important as correctly fitting shoes.  Just as you would not wear hiking boots to your own wedding, you should also choose a bra style that is right for its use.  Using a full cup bra can reduce breast bounce in exercise by about 38%, but using a good sports bra will reduce it by about 72%.  If a sports bra fits properly, your breasts should barely move when you jump.

If you were to go to the underwear drawer of many women and see how many bras it contained, most would be shocked that there are often 10-20 plus, and when asked how many they wear, many will say that it is really only 3-5 of those and that they are often some of the oldest ones.  I have seen many women who come in complaining of mid / upper back and neck pain, who fall in to this category, and on very basic testing, and suggestion of a bra sizing trip, they return miraculously better.  There are obviously some very useful things that a chiropractor can do to help with back and shoulder problems, but it would be sensible to have done all you can to ensure you are not causing the problem with your underwear.

There are a few simple things that should be understood and can really help with these problems.  This information comes from recent research from Rigby and Peller (London).

First is the understanding that your bust is not the same when you are 50 as when you were 15, no matter how much you may wish it were.  Your bust changes size as your hormone levels change, most notably in pregnancy, or with some women when they are on the contraceptive pill, so it is sensible to have a slightly different fits for different times of the month / year.  If it’s really comfortable, it is probably fitting well.

A 34B from one retailer is not the same as a 34B from another.  You need to be careful as you select that the bra fits you well and supportively.  A 34B is often a very similar overall size to a 32C or a 36A, but is going to be quite a different shape.  We have all seen women who appear to have 4 breasts as they are wearing underwear that is far too small, though it is not always this overt.  You may well leave a good bra shop with 3 differently sized bras that all feel equally comfortable in the wearing.  80% of all support in a bra comes from the band that goes round your back, but many women seem to have this wrong and instead choose to try and lift the breasts using the shoulder straps.  All this does is cut right into the shoulder muscles, pull the back of the bra upwards and place the strains in all the wrong places.

This can equally go the other way, with women who wear bras that are too large.  If the straps are too loose and you have a fuller breast, then the underwires can be pushed up into the breast tissue, causing all manner of problems.  About 80% of bras use underwire, especially for the more voluptuous lady, but they still need to be properly fitted to prevent the wires pushing in and causing problems.  Good underwires should be really flexible and return to the normal shape easily.  If you have discomfort in the front of your chest, then often the bra band or the straps are too loose.

Padded bras do not really give lift, they add volume.

Think about the fabric of your bra.  Many bras have thin, sheer fabric on the bra band with no give.  These can often break down quickly and lead to bra integrity being lost.  A good quality bra can still look pretty with these sheer fabrics, but they are generally wider in the band.  When you feel the stretch / resistance of the fabric, it should feel firm and strong.  Try it, you will instantly spot the differences.

Almost all women have one breast larger than the other.  Often your left is larger than your right if you are right handed and vice-versa.  If your breasts are radically different in size or shape, then visiting a bra maker is a very good idea as they can build in support for one side whilst building in enhancements for the other to even out their appearance.

When it comes to telling if your bra is the right size, there are a few simple rules that can be followed.

1. You should be able to slide 2 fingers horizontally round each side of your ribs under the bra band at the same time (or the back of the band should pull about 2” off your back without massively changing the shape of your bust or the bra.
2. The bottom of the bra band, where it passes under you arm, should be easily pulled to 1” from the skin.
3. The top of the bra band, where it passes under your arm, should be easily pulled to 1.5” from the skin.
4. The shoulder straps, when viewed from the front, should not be making dents into your shoulders, and should be easily lifted to about 1” without too much movement of the bust and the back of the bra should not rise.
5. If wearing an underwire, this should lie flat against your breast bone between your breasts but it should be easy to slide 1 finger underneath it.

It is important to note that some high street retailers may simply look at you and give you bras to try or measure you with a tape and tell you your size.  This may be OK for a party occasional bra, but for frequent use, a bra should be much more fitted and so it is advisable to find a good local retailer who you feel you can trust and talk too.  Just because they are a shop, it does not mean that they are always more expensive than buying on line, you’d be surprised what some quality retailers will offer.  Fitting at least yearly, if not 6-8 monthly seems to be good practice, and a good bra worn daily and handwashed will last 6 months+, though having a few and rotating them, will likely see you through at least a few years.

Look after your investments!  Good bras often start around £60+ mark and it is really worth looking after them properly.  They say “handwash” for a reason, if gentle cycle was ok, they’d say “wash on gentle cycle”.  The motion of a washing machine can massively damage both the underwire and the fabric around the wires, leading to rapid deterioration of the bra and even protrusion of the wires.  Put your bra in a sink of tepid water with your detergent, gently agitate it and leave it for about an hour.  Take it, rinse it and then allow it to air dry naturally (not on a radiator, that is cheating and may lead to deterioration).  If you really can’t face that, then buy a bra bag (they are very cheap from good lingerie shops).  Fold your bra gently into it and put it on gentle cycle with a towel to stop them banging around, and again, leave it to air dry naturally.

Extra information if you are pregnant;

• Breasts can change massively with pregnancy, though most of the increase in size happens in the early part of the pregnancy.  The first trimester can see breast cup size increase from a D to an E/F relatively easily and there can be a further ½ cup size increase in each 8-10 week period until birth and the first 2 weeks of lactating can see the breasts enlarge by another 1-2 cup sizes.  About 2 weeks later, when milk supply is firmly established, the breasts will begin to lower in size again.
• Until recently, underwire was considered a no-go area as it was felt that it could damage the milk ducts.  There are now some underwired nursing bras available, though these have to be fitted properly to prevent the possible rupture of your milk ducts.  Women with larger breasts (generally DD+) are possibly better suited to wearing underwires owing to the support and the shape they give.  Whilst pregnant, underwires are generally not suggested, especially from 7months gestation onwards.  Some women’s breasts do not change shape that much during pregnancy, so they may be able to stay in properly fitted underwired bras.
• Bras should be assessed every 2-3 months whilst pregnant as the breasts can change shape so quickly during this time.  After birth, women should be checked at about 2 month intervals so the decrease in breast volume can be correctly managed.  Many women just assume they can use the underwear from their first pregnancy for any subsequent children.  The problem with this is that breasts may not be as firm in a second pregnancy, they may enlarge more, or any other conceivable change.  This means that they are wearing unsupportive underwear and they come in with all manner of neck / back problems.
• Even if you have unfortunately miscarried, your breasts will still go through many of the same changes and it is equally important to keep your checks up to date.
  

Extra information for mastectomy / prosthesis wearers;

• Just because you have had a mastectomy, you do not have to settle for second best, and feeling feminine and sexy is just as important as it was before your surgery.  There are many prosthesis available to help you in this, including specialist lightweight ones.  Companies like Rigby and Peller sell off the shelf prosthesis as well as custom made items.  Also look out for Pink Rooms, where women who have had such procedures can meet, talk through their experiences and share tips.  Most good shops will sell pocketed bras that allow your prosthesis(es) to simply slot it.  You can also buy swimwear designed to take them.
• Hospitals will often ask you for your bra size and give you a prosthesis based on this, but some good lingerie shops will more accurately assess how your body is and have tailored prosthesis made specifically for you.  If you have had a radical (double) mastectomy, then the world is literally your oyster.
• If you have had lymph nodes removed, then it is generally not advised to use an underwire as it can compress and aggravate scar tissue.  Some women also get pain and swelling in their arms after surgery.
• This may be helped by gentle massage of the arm and by treatment of specific muscles in the arm, shoulder and or trunk.  This can get irritated and inflamed by surgery and treating these can, in some circumstances, radically reduce the discomfort that is felt.

General point on pain / discomfort

When your breasts increase in size and weight, this adds extra pressure on your back and shoulders.  If not supported, this can lead to pain and generalised aching.  As the breast increases in weight, it pulls on various muscles in the shoulders and chest.  Many women with poor bras are very tender when examined around the top of the breast and the collar bone.  This muscle holds a lot of the weight of the breast tissue, and if not supported, effectively gets strained.  In doing so it can drag the shoulders forward and put extra strain on the neck muscles.  If your bra does not fit properly around the back, the danger is to use the shoulder straps tighter to help, but this gives the characteristic dents in the shoulders.  Unfortunately, this crosses one of the main muscles of the upper back and neck and simply pressing it when it is in this tender state can give everything from nausea to headaches and neck pain.  Ultimately, getting the bra band fitting correctly may reduce the tension on the chest muscles, thus releasing the neck muscles, improving posture and easing aches and pains.

Ultimately, your bra is a very important bit of kit and you should not treat it simply as a fashion item, they can really affect your body in both good and bad ways.  A good bra will make you feel taller, straighter, more uplifted and much more comfortable.  They will not, however, necessarily solve all your problems.  Your chiropractor may well be able to help you with any of the joint, spinal, postural and/or muscle problems that can come from years of misuse of our bodies.

We’d love you to give us a ring at Luck’s Yard Clinic to see if we can help you in any way, from a quick check to ensure that your posture is good and how you move, to a full treatment session.  Please do not hesitate to contact me if you want to know more, or need a consultation.

Nic Langlois, MChiro, BSc.