Breast injuries sustained from exercise are becoming more and more common, especially with the growing representation of women and girls in traditionally male-dominated sports.

Female athletes serve as inspiring role models, encouraging greater community participation. For instance, since the Australian Football League Women’s (AFLW) launched in 2017, the number of clubs offering women’s or girls’ teams has doubled between 2016 and 2018. This surge in participation, coupled with the increased professionalism in women’s sports, has also introduced unique injury risks for female athletes. One notable example is the heightened risk of breast injuries, which can occur in both contact and non-contact sports.

Female athletes most often report two kinds of breast injuries:

1. Direct contact injuries

These happen when the breast is struck directly, which could be caused by another player, the ground, or sports equipment.A large survey of 297 female contact football players in Australia revealed that 58% reported experiencing a contact breast injury during training or matches. These were primarily due to contact with another player (49%), followed by contact with the ball (20%) and contact with the ground (16%).

Breast contact injuries can range in severity from localised hematomas to hemorrhagic shock, but concerningly, 90% of those who sustained an injury did not report them to any coaching or medical staff. Despite the high prevalence, long term health impacts and implications are not yet entirely clear.

2. Frictional skin injuries:

These occur when the skin on the torso, breast, and shoulder experiences abrasions, rubbing, or chafing due to friction from bras, uniforms, or other equipment.These injuries are more problematic in those exercising for longer periods of time (e.g. endurance runners), in older athletes, and in those with larger breasts. In elite female athletes, 20% have reported frictional issues, with almost half of them having no prevention or management strategies in place.

Although we don’t know the statistics in recreational exercisers, there are some simple steps you can take to prevent frictional skin injuries:

• Ensure your sports bra fits correctly. There are great resources available to help you choose the right sports bra type and fit for your needs, such as this Sports Bra tool.
• Choose a sports bra that has soft smooth fabric on the inside of the band, has no seams, hooks or zippers in contact with your skin and is made of moisture-wicking material.
• Apply an anti-chafing product to the skin under your bra.

What to do if you sustain a breast injury

If you sustain a breast injury, see your doctor and have the injury assessed and treated if necessary.

Although there is no evidence linking contact breast injuries with breast cancer, there is evidence of long-term changes to breast tissue after a contact injury.

Prevention of an injury is better than treatement

Better understanding breast injury rates in sport helps shape prevention strategies and policies, aiming to keep women and girls safe while playing.

Breast protective equipment is commercially available and can assist with preventing contact-related injuries. However, only 50% of female contact sport athletes report knowing that this equipment was available.

Within a survey of 207 female contact sport athletes, only 17% reported using breast protective equipment and of those who used the garments, 25% reported that the garments were uncomfortable, did not fit appropriately and/or that they were too restrictive. Within the same survey, 87% of athletes wore a sports bra but only a third believed that it would provide any protection against contact injuries. The authors reported that the extensive range of breast and torso shapes and sizes amongst female contact sport athletes may contribute to reduced perceptions of comfort and fit of breast protective devices.

Therefore, if breast contact or collision are likely in your sport, consider a protective garment to minimise the force/impact and prevent potential injury, and try it out in training before competition to assess comfort and fit.

Currently in Australia, there are several breast protective options on the market, including mouldable breast guards, protective inserts, and a foam protective vest covering the upper torso including the breasts and ribs.

Previous unpublished research by Deakin’s Centre for Sport Research showed a 75% reduction in impact with the use of the Zena Sport’s protective vest during simulation trials. However, it’s not clear yet how well the vest works in real-life sports situations, especially with different movements and types of contact.

Exercising right with breast injuries

If you have sustained a breast injury, after consulting your doctor to have the injury assessed, it can be beneficial to work with an Accredited Exercise Physiologist, Accredited Exercise Scientist or Accredited Sports Scientist to help with your performance, rehabilitation and injury prevention in the future.

Find your local exercise professional today.

Contribute to breast protection research

If you are a female contact-sport athlete, or a coach of female contact-sport athletes and you live in Victoria, please get in touch to see if you or the athletes you work with might be eligible to participate in a research study by emailing s.hoffmann@deakin.edu.au

Written by Dr. Samantha Hoffman, AES, ASpS2, PhD. Sam is an academic at Deakin University with research expertise in female athlete health and performance.