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Medical Research

The Facts

Breast injury in female contact sports – a previously hidden/unreported injury

In a 2018 American study, 47 % of 90 female college soccer players reported sustaining a breast injury, yet only 5 % reported it to anyone. Girls may be embarrassed reporting a breast injury to a male coach, and the female breast is not included in the injury surveys administered by sporting clubs. In this study, 18 % indicated that the injury affected their participation or performance. 98% of those who experienced a breast injury were not wearing any protection other than a regular sports bra. (1)  

In a 2020 survey and assessment of 207 female Australian Football League (AFL), and Rugby players, 58% of players reported ever experiencing a contact breast injury and 48% perceived that their injury affected their football performance. In the same AFL group,  most players (87%) reported wearing a sports bra, however, only 31% perceived their bra provided any protection against contact breast injuries. (2).

Apart from the pain, and the effect on sports performance, including possibly missing games, there is substantial literature outlining the negative effects of deep bruising to the female breast tissue. It has been shown that significant impact bruising to the female breast results in the formation of hard nodules/ lumps in the breast tissue. (3)  

While not a cause of breast cancer, down the track these lumps can be difficult to differentiate from breast cancer, and several tests causing personal stress and increased medical costs may be needed before breast cancer can be ruled out. (4)

Cases of breast asymmetries have been reported developing after significant impact injury to the breast bud at an early age. Although some variation in breast size is normal and is common in most women, a large variation often disrupts a woman’s life. The authors state “Our experience suggests that these significant breast asymmetries are seen frequently in young women who have a precise history of breast trauma during the critical years of early breast development”. (5)

School Girl Breast Concerns

Exercise-induced breast pain, thought to be caused by tension on breast skin, internal ligaments and fascia during excessive breast motion during running has been reported in 44-72 % of exercising females in the UK.(6)

A survey of 2089 adolescent UK school girls showed that breast concerns were high, with 87% of schoolgirls reporting at least one breast concern, with the most common being “how to check for breast cancer” (44%) and “breast bounce when exercising”(38%).(7)  

Breast discomfort and pain can be alleviated by providing adequate support to the breasts during running and jumping activities In a 2017 UK study the greatest effect of good breast support during running was the willingness to exercise. (9)  

In 2010, 115 adolescent females from four regional NSW regional sporting academies aged 16 yr (SD 1) responded to a questionnaire about bra knowledge, including bra fit, and level of breast support. Knowledge in these adolescent female athletes was poor, with 85% of girls failing to achieve 50% for bra knowledge. However, this was shown to improve with education. (10)

Since becoming a physio, I am more aware of the impact on breasts during contact sports. We chest-mark the ball, we get bumped, kicked and shoved during play, but wearing chest protection gives me confidence to know my breasts are being protected from injury and impact, today and into the future.

Libby Birch, Melbourne AFLW Player & Qualified Physiotherapist

Trauma to the breast should be avoided, and protection in sport is recommended.”

Specialist Breast Cancer surgeon, Dr Chantel Thornton

I really want to help educate the Australian sporting bodies, coaching and sporting staff, as well as parents, on the importance of breast protection for young girls. Protecting your breasts when playing contact sport is something that isn’t talked about enough. I want to encourage and give confidence to young girls to protect their breasts from impact and injury when training and playing.

Monique Conti, Richmond AFLW Player & Professional Basketballer

Since becoming a physio, I am more aware of the impact on breasts during contact sports. We chest-mark the ball, we get bumped, kicked and shoved during play, but wearing chest protection gives me confidence to know my breasts are being protected from injury and impact, today and into the future.

Libby Birch, Melbourne AFLW Player & Qualified Physiotherapist

Trauma to the breast should be avoided, and protection in sport is recommended.”

Specialist Breast Cancer surgeon, Dr Chantel Thornton

I really want to help educate the Australian sporting bodies, coaching and sporting staff, as well as parents, on the importance of breast protection for young girls. Protecting your breasts when playing contact sport is something that isn’t talked about enough. I want to encourage and give confidence to young girls to protect their breasts from impact and injury when training and playing.

Monique Conti, Richmond AFLW Player & Professional Basketballer

References

Impact Injury in Sport

1. Smith LJ, Eichelberger TD, Kane EJ (2108) Breast Injuries in Female Collegiate Basketball, Soccer, Softball and Volleyball Athletes: Prevalence, Type and Impact on Sports Participation. Eur J Breast Health. 2018 Jan; 14(1): 46–50

2. Brisbine BR, Steele JR, Phillips EJ and McGhee DE. Breast injuries reported by female contact football players based on football code, player position and competition level. Science and Medicine in Football. 2019;4(2):1-8.

3. Kerridge WD, Kryvenko ON, Thompson A, Shah BA. Fat Necrosis of the Breast: A Pictorial Review of the Mammographic, Ultrasound, CT, and MRI Findings with Histopathologic Correlation. Radiol Res Pract. 2015.

4. Gatta G, Pinto A, Romano S, et al Clinical, mammographic and ultrasonographic features of blunt breast trauma. Eur J Radiol. 2006;59(3):327- 330

5. Jansen DA, Spencer Stoetzel R, Leveque JE. Premenarchal Athletic Injury to the Breast Bud as the Cause for Asymmetry: Prevention and Treatment. Breast Journal. 2002;8(2):108-111

School Girl Breast Concerns

6. Brown, N., Burnett, E. and Scurr, J, Is Breast Pain Greater in Active Females Compared to the General Population in the UK?. Breast J 2016, 22: 194-201

7. Brown, N., Smith, J., Brasher, A., Risius, D., Marczyk, A., & Wakefield, scurr, J. (2018). Breast education for schoolgirls; why, what, when, and how? Breast Journal, 24(3), 377–382

8. McGhee, D E, Steele, JR, Breast Elevation and Compression Decrease Exercise-Induced Breast Discomfort, Medicine & Science in Sports & Exercise: July 2010 – Volume 42 – Issue 7 – p 1333-1338

9. Risius D, Milligan A, Berns J, Brown N, Scurr J. (2017) Key performance indicators for breast support: An analysis of breast support effects on biomechanical, physiological and subjective measures during running. J Sports Sci. May;35(9):842-851.

10. McGhee, D. E., Steele, J. R., & Munro, B. J. (2010). Education improves bra knowledge and fit, and level of breast support in adolescent female athletes: a cluster-randomised trial. Journal of Physiotherapy, 56(1), 19–24.