Breasts Don't Have To Cause Back Pain
Saturday, October 07, 2006
Healthline
A news report in the MMD Newswire echoed a prevalent but luckily, false belief, that breasts must cause back pain. The good news is that means you do not have to be forced into back pain, and there are things that you can try quickly to relieve it yourself. You have choices.
Many of my patients who come to me with upper back pain say that their doctor or other health care practitioner told them the reason is the breasts. I show them how they can stop or reduce the pain.
One of the biggest mistakes in science is confusing correlation for cause and effect. There are so many people with back pain that it is easy to blame anything happening at the same time, like having breasts or a big belly in front, or carrying backpacks in back, or groceries on the side.
- Men have the same or higher incidence of the same upper back pain.
- Women who are smaller, or have had breast reduction and double mastectomies can have the same pain.
- If straps are binding or cutting into your neck, that can obviously be uncomfortable, so check and fix that.
- However, the specific cause is not the breasts, since men and smaller women can get the same kind of pain.
- If you round your shoulders, spend time with the upper body bent or rounded forward, or have a forward head, the shifted weight is a common contributor to upper back pain.
Look at the photo, above left. Letting your neck tilt so that your ear is forward of your shoulder, as in the photo, is called a forward head. It is not the normal tilt to the neck. It is a weak and injurious bad posture. The angle of the jaw should rest comfortably above the center-shoulder. The forward head is the source of a surprisingly large percentage of upper back and neck pain. The classic distribution of this pain is across both shoulders, up the neck, down the upper back, sometimes causing numbness or tingling down the arm. Do you have a forward head? Here is a quick test:
- Stand comfortably with your back against a wall or doorway.
- Touch your heels, your behind, and your upper back against the wall.
- Does the back of your head touch easily?
- If your head is forward of the wall, it is likely that you have a forward head.
- See if you have to crane your neck to bring your head back to the wall.
- See if you round your shoulders
- Check if you lean back to try to straighten up. Straightening should come from the upper body, not by increasing the inward curve of the lower back (hyperlordosis), which can hurt - Fixing the Commonest Source of Mystery Lower Back Pain.
Often, people who think they "stand up straight" find that they are straining their beck and shoulder back, which causes upper body pain. The problem is that they are too tight to stand with healthful position. Strained straightening and the many postures that are mistaken for straight but are not will hurt as much as slouching.
If you did the wall test, see if you are slouching forward from the forward head, or from the upper body, or both. See if you have to lean backward to straighten up. See if it is an effort to stand roughly straight, instead of normal comfortable muscle length. Those are more causes of pain, mistaken for the size of the chest. In posts to come I show two quick techniques to lengthen the front chest muscles to let you stand straight easily and comfortably. Then you will not have a forward head or rounded shoulders:
- Here is the first thing to try to restore resting muscle length to make standing straight possible and comfortable: Fixing Upper Back and Neck Pain.
- Here is the second - Nice Neck Stretch
- Try those two gently, with the aim of restoring ability to straighten out comfortably, then use the straighter position, so bent forward position does not hang on your upper back muscles, making them hurt. The stretch does not fix the pain - using them to be able to straighten out during the rest of the day is the key.
- To help unround a rounded tight upper back, gently experiment with Fast Fitness - First Morning Stretch and Quick, Feel-Good Upper Back and Chest Stretch
- Check if you spend much time rounding or bent forward - Are You Making Your Exercise Unhealthy?
- Check to see if you lean back instead of straightening - Neutral Spine or Not?
The idea is, that no matter your size, use your own muscles to prevent uncomfortable positioning. By restoring healthier upper body positioning and use, you will get built-in back muscle exercise all day. Standing straight instead of allowing your upper spine to compress under your weight will stop your pain plus give free calorie burning exercise.
If you find that lifting your chest with your hands takes the strain away, then you can do the same with your upper body muscles. It is free exercise to use your muscles to prevent your own body weight from squashing you. Pull your chin inward and shoulders back in a relaxed way by unrounding the upper back. Then weight of your head and upper body will not pull forward on your upper back muscles, making them ache.
The same applies to carrying a grocery bag, a child, or any load. Don't slouch under the load, use muscles to keep healthy comfortable position.
Fitness Fixer reader Ness left a comment on the post Fixing Upper Back and Neck Pain:
"I am very large breasted and have always been. It's a very difficult thing to find a comfortable bra. For the past few months, I've been having upper back pain. I felt like I needed to "crack." Every night I complain, and nothing works!
"Except this. haha, you have NO IDEA how pleased I am that this "fixing upper back and neck pain" stretch works.
"Now, I'm not going to pretend that I think I'm perfect now because I've been sitting straight for about 10 mins and it is starting to get a little tiring.
"But, I don't feel ANY pain.
"I'm amazed.
"Was that it?? Really my DDDs have nothing to do with it???"
See the wall test - How Doctors Use The Wall Stand.
No exercise is more important for your joint health than holding up your own body weight, no matter what or where it may be. Your size does not force you to slouch. It does not require long or repeated treatments or sessions or teams of professionals.
I run classes for motivated, bright participants who want to empower themselves - see my web page for CLASSES - www.DrBookspan.com/classes.
There is specific helpful information in my replies already here to the many reader comments below this post. Before asking more, see if your answers are already here in the comments below.
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Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail" (under trumpet) upper right.
For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify through DrBookspan.com/Academy. Learn more with Dr. Bookspan's Books.
Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail" (under trumpet) upper right.
For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal evaluation. Top students may apply to certify through DrBookspan.com/Academy. Learn more with Dr. Bookspan's Books.
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Labels: chest, fix pain, myths, neck, posture, shoulder, upper back
21 Comments:
At Wednesday, October 11, 2006 7:03:00 PM,
Anonymous said…
I have struggled with standing up straight my whole life. First it was because I was so skinny and had large breasts and as dancer I was exausted at the end of the day. Now that I am older it's because I sit at a computer all day typing like a squirrel, and in the car, and washing dishes. I don't think I will ever be able to lengthen my spine and stand straight. Help.
At Thursday, October 12, 2006 2:02:00 PM,
Ethan Hays said…
Hi, Jolie. Great post, and really caught my attention. In college, our Kinesiology class used a textbook called "Muscles: Testing and Function with Posture and Pain". I remember coming across a section about forward head, and their recommendation for treatment (if I'm remembering correctly).
It involved a set of streches, and corresponding strengthening exercises in keeping with standard treatment for "short / strong, long / weak" imbalances of anterior and posterior muscles. Basically you were told to stretch your upper trapezius (the short / strong muscles at the back of your neck), and do manual resistance exercises for your sternocleidomastiod (the long / weak muscles at the front of your neck).
Are these recommendations complementary to the upper-chest-lengthening techniques you're going to cover in an upcoming post? Or am I just mis-remembering?
At Friday, October 13, 2006 7:01:00 AM,
Healthline said…
Ethan, yes that is what they taught us in school. But as you have caught on, they do not restore resting length to the chest muscles. These shortened muscles are the main cause of the rounding that brings the upper body forward causing aching strain on the upper back, and at the same time making it uncomfortable to stand straight to avoid the pain.
Another problem with that approach is that doing stretches and strengthening exercises (manual resistance and others) do not retrain you to stop the bad habit of rounding. Plenty of stretchy and strong people slouch and move in unhealthy ways.
It also does not include the revelation that you should stop the exercises and stretches that directly promote the rounding, such as sitting and standing bent over to stretch hamstrings (see Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch and Disc Pain - Not a Mystery, Easy to Fix) and others to be covered.
I developed other methods that directly address the cause and retrain you at the same time. Then you feel better and restore healthy movement patterns right then and there, instead of spending weeks doing exercises while going back to the same bad habits that started cycle of poor ergonomics and pain. Posts coming soon. You asked just the right thing.
At Friday, October 13, 2006 8:00:00 AM,
Healthline said…
For Anonymous, Good news. Not standing straight and having upper back pain is not caused by your weight or large breasts
(see Breasts Causing Upper Back Pain is a Myth)
Next, much posture is voluntary. You can round forward and slouch, and you can pull back up to be healthier and more comfortable. Don't let your head flop forward and your chin jut forward. Is your head forward reading this right now? Without arching your lower back or tightening your neck, pull your chin inward and shoulders back in a relaxed way. Until I can post specific easy upper body techniques, try the following, with intelligent judgment and let me know:
1. Read the post Disc Pain - Not a Mystery, Easy to Fix and try the sitting suggestions. Use your own muscles to keep your shoulders beautifully straight and relaxed. As a dancer, you probably know good line and straight position when you see it.
2. In the same post, learn the change to healthy bending so that you do not practice rounding every time you reach for something.
3. Read the post Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch . Stop exercises and stretches that exacerbate the widespread problem of forward rounding the spine so much. You are already good at that.
4. Try to stretch back the other way. Start with seeing how it feels to lie flat on the floor face up without a pillow under your head. If you have medical reasons not to, address those with your health providers first. Many people are too tight to lie flat. It you are too tight to lie flat, you are too tight to stand straight. If you can get straightened from lying face up, which should feel good, practice how it feels for when you stand and sit.
Keep us posted and feel empowered to make your own changes. Maybe you can be the star of a great makeover here.
At Sunday, April 08, 2007 2:14:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
The two stretches I promised are posted:
Fixing Upper Back and Neck Pain
which stretches the tight pectoral muscles in front, (not the already overly rounded back which was the problem) and
Nice Neck Stretch.
These two stretches quickly reset resting muscle length to stop the upper body tightness that prevents standing and moving in healthy comfortable ways.
At Friday, August 22, 2008 11:53:00 AM,
Anonymous said…
I say BULLPOOP! Seriously, I'd love the author to put two 4 pound weights and tie them together and put them around her neck and wear them for about 2 weeks, than tell us how her back feels!!! If this author is right than why do many women who feel so horrible and than get breast reductions and their back pain eases or gets better? Until someone has large chest they can't even begin to understand how hard it is to carry those things on their body!
At Monday, August 25, 2008 1:43:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Dear Anonymous,
I understand your confusion. Consider what it says in the post. "Men have the same or higher incidence of the same upper back pain. Women who are smaller, or have had breast reduction and double mastectomies can have the same pain." I have seen men and women as patients of both large and small upper body size, with this kind of pain, who stop the pain quickly without changing body weight, by changing the most overlooked cause - as it says in the post " The weight that causes it is not in the chest. It is above it."
Athletes routinely use weighted vests as extra exercise. Weighted vests are sold in most exercise equipment catalogs. They vary and can be far heavier than 2 weights of 4 pounds. I use them in the form of making housecalls carrying equipment in rucksacks. How I carry them makes more difference than the location or weight, same as most other things. The weight you wonder about is less than a baby or sack of groceries and less than the weight of your head.
There are men with large shoulders and chests, and people who carry backpacks, and villagers who carry babies in back and front slings for months, with armloads of firewood and so on. One of the biggest mistakes you can make in science is confusing correlation for cause and effect.
Check the real cause - the forward head - an overlooked cause of upper back pain in men, women, large and small. This will save you time and money on extended unnecessary medical treatments and therapies, and can relieve much pain and frustration.
At Wednesday, September 17, 2008 11:44:00 PM,
Anonymous said…
I did your test for forward head and evidently do not have it. I do, however, have GG breasts and have mid-back pain every day which is killing me.
What now?
At Wednesday, September 24, 2008 12:23:00 AM,
Anonymous said…
Large breasts can most definitely cause upper back pain. I have upper back and neck pain every single day. This may be TMI, but if I physically lift my breasts up with my hands, I feel immediate relief. If I wear a bra that is not supportive enough, my back pain gets much worse. I have to wear minimizing bras with no elastic in the straps (which cut into my shoulders), or my back pain gets worse. Simply moving my head back makes no difference, and actually forces my lower back into an abnormal sway-back posture, whereas lifting my heavy breasts puts my shoulders back where they should be and straigtens my lower spine. I am not saying that your forward head thing is not true, just that you can't say that just because forward heads can cause back and shoulder pain, that heavy breasts can't also contribute to the same kind of pain.
At Thursday, September 25, 2008 11:22:00 AM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Anonymous (from Sept 17), sorry you are hurting. I numbered some things to try in the post. They give other sources of bent forward habits beside the forward head (round shoulders, habitual bad sitting and bending, tightening…) which hang upper body weight forward on the upper back, making it hurt. There are some "relief" stretches to try in #4, Read the previous comments and replies to fill in more. Feel better.
For Anonymous (bull-poop person), I have been trying your good idea since you mentioned it. I wear two old sandbag leg weights tied together. So far, I found some obvious things such as using twine to connect them over the shoulders to simulate thin straps digs, so wide straps work better, and that they can shift around, so need securing. I am getting exercise carrying the weight. When I experiment sitting and standing round-shouldered, bend wrong by leaning over, and jut the neck forward, it does draw extra on the upper back muscles than without the weights. Stopping the bad positioning relieves the strain palpably. As long as I walk and run lightly, the extra weight is nice built in exercise, not more impact. After more than two weeks with them, I experimented with positioning them. Wearing them high on the shoulder to simulate heavier shoulders made more strain during bad sitting, bending, and standing than when they were on my chest. Longer distance increases force on the fulcrum of the spine. That strain also stopped when I stopped the positional strain. See if you want to try healthier spine position as part of your arsenal to stop your own sources of pain. Thank you again for good ideas.
At Monday, September 29, 2008 7:06:00 AM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
To Anonymous (Sept 23), good that you found three things - rounding your upper body forward hurts, that when you can straighten to "where it should be" the pain lifts too, and that swaying your lower back hurts.
You mention you can already straighten your upper back using your hands o help lift. Try the same without hands. Then the anterior (front) weight will be free weightlifting exercise that strengthens your upper back. A chief factor in everyone's health is being able to support your own body weight - high or low - without unhealthful slouching.
Rounded shoulders and bent forward upper body (with or without a forward head) increases the pull on the upper back structures, and can make them ache. You have found that unrounding is key. Check if you spend time bent forward - standing, sitting, bending. Ideas are in
Are You Making Your Exercise Unhealthy? and Sitting Badly Isn't Magically Healthy by Calling It a Hamstring Stretch and Common Exercises Teach Bad Bending.
Keeping your shoulders "back where they should be" will give good exercise. Straightening from the upper back without leaning backward from the lower back is key. Several posts already on this site explain in detail. One to start with is Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain. It has several links to other posts for more understanding and things to try.
I went back to the post and put some "relief" stretches to try in #4. Also look over previous comments and replies to this post to see if anything there helps. Feel better.
At Friday, November 21, 2008 2:55:00 PM,
Jolie Bookspan, M.Ed, PhD, FAWM said…
Readers, Click the post Fixing Upper Back and Neck Pain and scroll to the October 2 2008 comment to see the reply from Ness, who wrote about success stopping the pain with this technique.
At Thursday, January 29, 2009 2:01:00 AM,
Anonymous said…
I have to say that I agree that my back,neck and shoulder pain is due to my large breasts. If I lift my breasts up with my hands pulling them upward, I can feel the relieve on the back of my neck and shoulders. I mean these boobs are evidently heavy ! I don't understand how any woman could ever want to have large breasts implants. If they only knew the pain and agnony they would have to endure they would be doing a double take.
At Monday, March 02, 2009 10:48:00 AM,
Anonymous said…
I agree somewhat. I have large breasts, much larger since the birth of my daughter. I have felt significantly more pain since they have gotten bigger. However, I will agree that my posture could have something to do with it. It feels a lot more difficult to balance my weight properly and have correct posture since having the extra weight in front. I am going to try to rearrange my posture and also try to keep my head straight and not forward as much and see if it helps. So, I do think that it may be that posture is more difficult with large breasts which is why we girls might have some more problems with the pain. Thanks for the suggestions!
At Tuesday, March 31, 2009 5:12:00 PM,
Anonymous said…
I passed both of your tests. I have H cup breasts and not only do I have upper back pain from them, I also have ligament issues on my front chest from them.
My breast surgeon (lumps on the ligaments from the heavy breasts stretching and causing adhesions), my chiropractor, my massage therapist and my trainer all are in agreement that my breasts are not only large, but heavy and this is causing my upper back pain. I am in pain every day. I do round my shoulders, but as I said this is CAUSED by the large heavy breasts. I am working with a team (seriously) to fix this for good. I don't want a reduction because of what they do to the nipples.
At Thursday, April 09, 2009 9:25:00 AM,
Anonymous said…
I wear a 32G Cup and am in great physical shape. I wear excellent bras and have since jr high school because I have always had large breast. I do yoga and stretching. I stand as straight as I can and sit straight, and at the end of the day my back, neck and shoulders are killing me.
When I lift my breast up I also feel relief (as many other mentioned). I do not doubt that stretching/posture help, but unless YOU have large breast and deal with all the issues that come with them there is NO way you will ever understand us large breasted women. Sometimes I feel like a prisoner in my own body because of these things. I also happen to have a consult with a plastic surgeon tomorrow for a breast reduction.
This article makes a good counter to the stretching/posture "cure".
http://www.healthcentral.com/chronic-pain/c/23153/41581/breasts-neck
At Sunday, May 03, 2009 10:45:00 PM,
Anonymous said…
I very much DO believe that large breasts can cause back pain, and I know because I'm one of them. Now, it might not be the 'direct' cause but none the less, it would help many women not to hurt if they had smaller breasts. Reason is, many with large breasts don't want to have them sticking out all the time and that be the main thing about them that people notice, therefore, they hunch forward to help hide themsleves. Also, many large breasted women don't want them hanging to the ground so they look like 'tug boat Annie' so they wear bras that are as tight on the shoulders as they can get them to hold up their breasts. I wear bras with extra large straps that are padded and they still dig into my shoulders. In fact, what muscle I used to have, if any, on top of my shoulders is no longer there. I have an indent no matter if I gain or lose weight and I'm only about ten lbs over right now because of wintering indoors. Trying to hold up my breasts to a decent hight so that even an old shirt doesn't look awful on me is a hard task. It means checking all day long to make sure my straps are as tight as they can be, which really hurts bad by the end of each day. I don't dress in style because those clothes don't fit me around my breasts though they do everywhere else and I haven't the money to buy speacial clothing to fit just that area. My neck, my upper back, my shoulders and my head hurt on a daily basis. Trust me, if you had something sticking out of you so much so that it was the first thing other people looked at, most all the time, you'd be doing whatever you could to make it look smaller. I'm guessing you have no idea what it's like to feel as I and many others do. Maybe porn stars, movie stars, rock stars like to show theirs off but most every day people do not. I just want to be known and liked for who I am inside but in the meantime, those who don't know me, look and I don't want them looking where they're looking. I'm hurting more than you know both inside and out and I'd give anything to have at least my physical hurting gone. I'll bet that would even help me emotionally as well, and no, I'm not messed up in my head. I'm a wife, mother of five grown children and grandmother of going on 13. I've spent all my life trying to downplay this one thing about myself and I wish was different and in doing so, I really do hurt. When I take off my bra at night, it pulls at my chest muscles and then they also begin to hurt. You need to talk with more women like me and I think you'll change your mind about what causes pain and what doesn't. It's not as easy as standing up straight with your head held back and just fixing a bad bra problem. There's a whole lot more going on than that!
At Sunday, May 03, 2009 10:56:00 PM,
Anonymous said…
I should add here that self confidence makes a large difference in how someone holds themselves. Wearing 'pretend' large breasts for a couple of weeks isn't going to let you in on how it feels to grow up and walk around daily with large breasts. It's not going to tell you how it feels when others make awful jokes and comments about how you look and it's not going to cause you to lean forward to hide yourself so you don't look so large. You know what you've put on isn't real so you have no emotional issues about it. Of course you're going to sit and stand straight while testing how it is to have large breasts. But those of us who really DO have large breasts are doing all we can to not make them the center of attention. Life with large breasts just can't be compared to a two week study! Mine Hurt me all the time! And if men and smaller women hurt, well then they have no excuse not to stand or sit straight since there's nothing sticking out to China when they do. We can all hurt, no matter our size because of bad posture, but...large breasted women have an extra load to haul while doing it, both physical and emotional.
At Monday, June 08, 2009 8:00:00 PM,
Anonymous said…
Okay whoever wrote this really needs to shut up. You walk aroud with 10 pound weights on your chest and see how easy it is to stand up straight. I honestly want to know what and obvious man who wrote this would say. This is ridiculous. Large breasts cause you to slouch because your back muscles arent ment to support that much weight causing back problems, and guess what if it was easy to stand up straight don't you think women would big breasts would I can't believe the ignorant idiot who wrote this.
At Saturday, June 27, 2009 9:15:00 AM,
MegaMom said…
I actualy tried what the Good Doctor wrote and it reduces this pain I had for so long. Doctors and chiropracors and everyone else I spent money on said it cause I am big. I already feel better a big thank you for caring and helping us! signed MegaMom
At Wednesday, February 17, 2010 12:18:00 AM,
Anonymous said…
This is absolutely ridiculous to think that large breasts aren't contributing to back pain. Let's get real. Yes, a million people have desk jobs and sit with forward shoulders and heads and very poor posture, but even if are to correct this (and correct their lower back increased lumbar lordosis) as well as give them midback strengthening, any woman with big boobs is fighting a losing battle in either posture to hold your boobs up in full thoracic extension- not good either- or having the neck muscles do excessive work leading to other problems like thoracic outlet syndrome. The people that wrote this/researched this obviously do not have large breasts and it's embarrassing to think they might even be covering for the plastic surgeons because they wouldn't want to let the entire public know that you could damage your body by getting breast enlargements now would they...
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