You may have noticed. Swimming, football, running, basketball, volleyball, weightlifting, or any other sports discipline… the breasts of women who engage in sports are generally quite small, and in some athletes, almost non-existent. Whether small breasts result from sports, or if women with small breasts are successful in sports, or if women with large breasts avoid sports, is a cyclic question. Two reasons explaining this phenomenon have been put forward.
The first reason: breast tissue consists of connective tissue, lymph nodes, lobes, lobules, milk ducts, and fatty tissues. Between 7-56% of a breast’s volume consists of fatty tissue, ranging from 3.6-37.6% in mass. A significant part of it is composed of fatty tissue.
During sports, when there is not enough glucose in the body, fats, usually acting as a reserve energy source, are utilized. This results in the reduction of fatty tissue in the breasts, causing a decrease in volume and weight. When the fatty tissue within breasts, comprising more than half of their volume, decreases to around 6-7%, the breast will reduce by half. If this occurs later in life, and the skin surrounding the breast doesn’t shrink sufficiently, ptosis (sagging) occurs.
The second, more indirect reason is akin to the relationship between height and basketball. Scientifically, there is no direct correlation between playing basketball and an increase in height. However, basketball players are generally tall because being taller is often an advantage in basketball, leading to greater success and recognition. Hence, famous basketball players are usually selected from taller individuals, not because they became tall due to playing basketball. It’s a kind of natural selection: if children start engaging in sports during their growth period, it might be assumed that their increased height is due to playing basketball.
In conclusion, in physically demanding sports like gymnastics, football, basketball, and volleyball, women with smaller breasts may have an advantage. The additional weight and volume created by large breasts can hinder success in sports due to factors such as increased breast displacement (resulting in more pain), exposure to greater impacts on the breasts, and posture distortion. Therefore, women with smaller breasts tend to be more successful in athletic activities. Consequently, women with smaller breasts will be chosen more frequently by professional institutions, and the breasts of prominent female athletes will tend to be smaller.
Sports-related Breast Pain
The breast is a partially mobile organ located on the chest wall. It is positioned within the deep and superficial fascia of the breast and is enveloped by the skin externally. The presence of loose areolar tissue beneath these structures allows easy movement of the breast. Although there is Cooper’s ligament within the breast itself, this ligament restricts movement to some extent.
Some studies have stated that 56% of women participating in sports experience breast pain. This pain arises from the vertical movement of the breast during exercise. This movement in the vertical plane can range from 8-18 cm up and down. When the body jumps upward, the breast moves rapidly in the same direction at a speed of approximately 0.9 m/s, and when the body stops moving upward, the breast suddenly comes to a halt, causing pain in the breast and chest wall.
Excessive load on the skin during exercise causes these structures to stretch, leading to prolonged breast pain and sagging over time. This pain is likely to be more pronounced in cup sizes C and D.
Water Sports
The general belief is that women with larger breasts find it easier to engage in sports in water. This is partly true. In water, the vertical movement range during jumping exercises is greater than on land (due to the buoyancy of water), but the speed is slower. Therefore, although water sports may be more tiring, breast pain is less likely.
Sports-related Breast Trauma
A study showed that 47.9% of female athletes experienced breast damage during sports participation. Approximately one-third of female athletes reporting breast damage mentioned bruising or discoloration. This injury was likened to seatbelt injuries. Often, in the months or years following the injury, nodules develop due to lip cysts or fat necrosis.
Breast trauma can lead to the development of breast cancer, breast deformities, and chest asymmetries. The injury typically starts as lipid cysts and calcifies over time, making it challenging to distinguish from breast carcinoma.
2.1% of sports-related breast traumas required treatment due to breast injury. Bruising, hematoma, swelling, and pain were common outcomes.
In the past, a sports participant should mention a history of breast injury during routine breast examinations and mammograms. This would assist the doctor in interpreting mammograms.
Effect of Breast Size on Posture
Large breast size is prevalent in society and most significantly affects the musculoskeletal system by disrupting spinal functions. The problems created by large breasts are mainly poor posture, shoulder, and neck pain. The presence of a significant weight in front of the body causes thoracic kyphosis and lumbar lordosis. Another important change is the psychological distress caused by large breasts, leading to body image issues and sexual disorders. After breast reduction surgery, most of these symptoms improve or decrease. Therefore, breast reduction surgery is considered a functional rather than an aesthetic operation. Fındıkçıoğlu and colleagues organized a poster on posture correction in large-breasted patients.
MMotivation for Participation in Sports with Large Breasts
There are many negative factors in large-breasted women. One of them is the reduced participation in sports activities. Suppressed sports activity forms a vicious cycle, reducing energy expenditure, leading to breast enlargement and an increase in BMI. The upward movement of the breasts during the downward movement of the body, followed by a sudden stop, causes pain in the breasts during jumping and running sports activities. This becomes a significant obstacle to engaging in sports. Proper bra usage partly limits this. In a study by Celeste and colleagues, there was no significant difference between small and large breasts in simple exercises, but in intense movements, there was a half-performance deficiency in large breasts compared to small ones.
Breast Reduction and Sports Performance
Despite the use of medication, physical therapy (posture study), and proper bras for large breasts, improvement is not observed. According to the American Society of Plastic Surgery reports, in 2015, 46,988 breast reduction surgeries were performed, and it was stated that these were more for medical necessity than aesthetics. Findings showed increased self-confidence, decreased use of painkillers, and increased postoperative activity. In the U.S. military, physical activity levels, including snow, shooting, and a 2 km run, are periodically tested. Female soldiers underwent the same tests after breast reduction surgery. After surgery, running speed increased by an average of 30 seconds, and sit-ups increased by 3. These improvements were attributed to the reduction of breast weight, decrease in breast pain, posture correction, and improvement in lung function.
Breast Cancer and Sports;
Generally, sports activities reduce the likelihood of developing breast cancer. 10% of breast cancers are associated with inactive adult lifestyles. Sports activities can reduce the risk of breast cancer through various mechanisms, such as altering the menstrual cycle, increasing insulin sensitivity, and reducing fat mass, inflammation, and the production of sex hormones.
Adolescents are more sensitive to breast cancer because their breast tissue is newly developed. Especially in girls who engage in sports between the ages of 12-24, the average age of first menstruation being delayed by about 3 years is considered protective against breast cancer. The incidence of premenopausal breast cancer has been reduced by up to 25%. However, there is no observed effect on postmenopausal breast cancer development.
Breast Enlargement and Sports
The question of what happens if breast enlargement is performed in small-breasted athletes has been scientifically reported in only one case. A 46-year-old swimmer and sports instructor underwent breast augmentation with a 225 cc implant. Subsequently, she completed the 2000-yard freestyle swim 40 seconds later. This increased breast weight was attributed to the resistance of weight and water.