Breasts Causing Upper Back Pain is a Myth
Saturday, October 07, 2006
Healthline
A recent news report echoed a prevalent but false belief that breasts cause back pain. The MMD Newswire report quoted the fit expert at Maidenform as saying, "The fact is, bras don't cause pain - really it's the weight of the breasts that cause it." Many of my patients who come to me with upper back pain say that even their doctor told them the reason is their breasts, which weigh them down in front. They find they can stop the pain by checking and correcting several other factors.
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. 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, it is not the weight of breasts, by itself, since men and smaller women get this same kind of pain. The weight that causes it is not in the chest. It is above it. If you round your shoulders, spend time with the upper body bent forward, or have a forward head, the forward tilt 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.
People are told all the time to "stand up straight." The problem is that many can't. They are too tight. Trying to force straightening 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. That is another cause of pain. 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?
By restoring straighter upper body positioning, you will get built-in back muscle exercise all day, and the weight of your head and upper body will not pull forward on your upper back muscles, making them ache. Keep your chin inward and shoulders back in a relaxed way by unrounding the upper back. The idea is, that no matter your size, or what loads you carry, you can be free of pain and free of myths about upper back pain. Have fun.
Labels: chest, fix pain, myths, neck, posture, shoulder, upper back
11 Comments:
At Wednesday, October 11, 2006 4:03:00 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 11:02:00 AM,
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 4:01:00 AM,
Jolie Bookspan, M.Ed, PhD 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 5:00:00 AM,
Jolie Bookspan, M.Ed, PhD 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 11:14:00 AM,
Jolie Bookspan, M.Ed, PhD 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 8:53:00 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 10:43:00 AM,
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 8:44:00 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 Tuesday, September 23, 2008 9:23:00 PM,
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 8:22:00 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 4:06:00 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.
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