Nicola Brown

The experience of breast pain (mastalgia) in female runners of the 2012 London Marathon and its effect on exercise behaviour

Background For female marathon runners, breast pain (mastalgia) may be an important issue which has yet to be considered. This study aimed to determine the prevalence and severity of mastalgia in female marathon runners, identify factors that increase mastalgia and methods used to overcome mastalgia, and explore the impact that mastalgia may have on marathon training. Methods 1397 female marathon runners were surveyed at the 2012 London Marathon Registration. All participants who completed the four-part, 30-question survey in its entirety have been included in the analysis (n=1285). Results 32% of participants experienced mastalgia. This was significantly related to cup size and was greater during vigorous compared with moderate physical activity. Exercise-related factors were the primary factors reported to increase mastalgia participation. Seventeen per cent of symptomatic participants reported that mastalgia affected their exercise behaviour. Methods reportedly used to overcome mastalgia included pain medication and firm breast support; however, 44% of participants took no measures to relieve symptoms despite over half describing their mastalgia as discomforting. Conclusions Mastalgia was experienced by a third of marathon runners and was found to be related to breast size which has previously been unreported. The link between exercise and mastalgia has yet to be established; however, this study identified that exercise was the most prevalent factor in mastalgia occurrence which may have implications for its management. The number of participants who took no measures to relieve their mastalgia, or resorted to pain medication, highlights the importance and significance of research into exercise-related mastalgia.

The relationship between breast size and anthropometric characteristics

Current clinical selection criteria for mammaplasty use weight‐related parameters, and weight loss is recommended as a nonsurgical intervention to reduce breast size. However, research has not firmly established if breast size is related to body size and composition. This study aims to investigate anthropometric characteristics in smaller and larger breasted women and identify predictors of breast mass.

The Prevalence and Impact of Heavy Menstrual Bleeding (Menorrhagia) in Elite and Non-Elite Athletes

To identify the prevalence and impact of heavy menstrual bleeding (HMB) in exercising females where anemia may have a significant effect on training and performance a ‘Female Health Questionnaire’ was designed incorporating a validated diagnostic HMB series, demographics, exercise ability data, training status, anemia, iron supplementation and whether the menstrual cycle had affected training and performance. The survey was conducted in two stages; initially online, advertised via social media, and then repeated via face-to-face interviews with runners registered for the 2015 London Marathon. 789 participants responded to the online survey, and 1073 completed the survey at the marathon. HMB was reported by half of those online (54%), and by more than a third of the marathon runners (36%). Surprisingly, HMB was also prevalent amongst elite athletes (37%). Overall, 32% of exercising females reported a history of anemia, and 50% had previously supplemented with iron. Only a minority (22%) had sought medical advice. HMB is highly prevalent in exercising females, associated with self-reported anemia, increased use of iron supplementation and a perceived negative impact on performance. Further research is needed to investigate the impact of HMB, iron deficiency and anemia in exercising females.

An investigation into breast support and sports bra use in female runners of the 2012 London Marathon

Abstract Although it is acknowledged that appropriate breast support during exercise is important, no published literature has assessed breast support usage in a cohort of female marathon runners. This study aimed to identify sport bra use and perceived importance of sports bra use in female marathon runners. Bra satisfaction, incidence of bra related issues and factors that influence the appropriateness of sports bras were also investigated. A 4-part, 30-question survey was administered to 1397 female runners at the 2012 London marathon registration and via an online survey. In total 1285 surveys were completed. Sports bra use and its perceived importance was high, however was lower in moderate compared to vigorous activity, and lower in participants with smaller breasts. Seventy-five per cent of participants reported bra fit issues. The most common issues were chaffing and shoulder straps digging in, with a higher incidence of issues reported by participants with larger breasts. Use of professional bra fitting was low, and perceived knowledge of breast health was poor. Engagement with sports bra use is high although sports bra design could be improved to alleviate bra fit issues experienced by female runners. Educational initiatives are needed to ensure females are informed regarding the importance of breast support and appropriate bra fit during activity.

The Prevalence, Severity, and Impact of Breast Pain in the General Population

Breast pain has been investigated in clinical populations; however we have yet to understand the prevalence and severity of this condition in the general population to determine whether more should be done to minimize the impact of this condition on womens quality of life. Therefore, this study investigated the prevalence, severity, and impact of breast pain on quality of life and factors associated with breast pain in a normal population sample. 1,659 females (34.1 ± 13.2 years) completed the Breast Pain Questionnaire online, providing information on demographics, duration, frequency, and severity of breast pain, its association with the menstrual cycle, relieving, and aggravating factors and the impact on quality of life. Over half the sample (51.5%) experienced breast pain, with a severity similar to that reported in clinical populations. There was a higher prevalence of breast pain in older participants, larger breasted participants and those who were less fit and active. Of symptomatic participants, 41% and 35% reported breast pain affecting quality of life measures of sex and sleep and 10% of symptomatic participants had sufferer for over half their lives. The results of this study suggest that breast pain is a significant issue within the general population and yet this is the first study to investigate it. It is concluded that this condition warrants increased investigation, awareness, and treatment. The reported relationship between breast pain and fitness/activity levels may offer an alternative treatment in the form of exercise intervention strategies to reduce breast pain.

Do women with smaller breasts perform better in long-distance running?

Abstract Literature has established that a range of physiological, biomechanical, and training variables influence marathon performance. The influence of anthropometric characteristics has also received attention. However, despite major marathons exceeding 40,000 participants and approximately a third of these runners being female, no data exist on the influence of the breast on running performance. This cross-sectional study aimed to explore the impact of breast mass on marathon finish time. One hundred and sixty-eight of 321 female marathon runners contacted completed an on-line survey focusing on marathon performance during the 2012 London marathon. Participants were categorised as smaller (<500 g, 54%) or larger breasted (>500 g, 46%). Regression analysis identified that 24% of marathon performance variance could be explained by body mass index (BMI), but breast mass improved the model to explain 28% of performance variation. The model determined that for women with 32/34 or 36/38 underband each increase in cup size equates to a performance decrement of 4.6 min or 8.6 min, equivalent to 34.4 min difference between a woman with 36A compared to 36DD breast size. Larger breasted runners had greater BMIs, completed less marathons and had slower marathon finish times (316 ± 48 min) compared to smaller breasted runners (281 ± 51 min). Twenty-five per cent less larger breasted women finished in the fastest quartile. These results suggest that differences in breast mass are an important factor for female athletes and should be considered in future research in this area.

The prevalence and impact of heavy menstrual bleeding among athletes and mass start runners of the 2015 London Marathon

The single most common cause of iron deficiency anaemia in the developed world in premenopausal females is the menstrual cycle.1 It is well recognised and reported that amenorrhoea and oligomenorrhoea are common in elite athletes typically as a result of relative energy deficiency;2 however, little is known about the prevalence of other menstrual abnormalities. Heavy menstrual bleeding (HMB or menorrhagia ) affects a quarter of the general population,3 yet no data exist for athletes or exercising women. It is possible that HMB might impact significantly on womens participation in sport. HMB can lead to fatigue, anxiety, reduced mood and energy levels with a negative impact on quality of life and productivity.4 Furthermore, iron turnover in exercising females …

Understanding key performance indicators for breast support: An analysis of breast support effects on biomechanical, physiological and subjective measures during running

ABSTRACT To assess the effectiveness of breast support previous studies monitored breast kinematics and kinetics, subjective feedback, muscle activity (EMG), ground reaction forces (GRFs) and physiological measures in isolation. Comparing these variables within one study will establish the key performance variables that distinguish between breast supports during activities such as running. This study investigates the effects of changes in breast support on biomechanical, physiological and subjective measures during running. Ten females (34D) ran for 10 min in high and low breast supports, and for 2 min bare breasted (2.8 m·s−1). Breast and body kinematics, EMG, expired air and heart rate were recorded. GRFs were recorded during 10 m overground runs (2.8 m·s−1) and subjective feedback obtained after each condition. Of the 62 variables measured, 22 kinematic and subjective variables were influenced by changes in breast support. Willingness to exercise, time lag and superio-inferior breast velocity were most affected. GRFs, EMG and physiological variables were unaffected by breast support changes during running. Breast displacement reduction, although previously advocated, was not the most sensitive variable to breast support changes during running. Instead breast support products should be assessed using a battery of performance indicators, including the key kinematic and subjective variables identified here.

The impact of badminton on health markers in untrained females

ABSTRACT The purpose of the study was to examine the health effects of 8 weeks of recreational badminton in untrained women. Participants were matched for maximal oxygen uptake (V̇O2max) and body fat percentage and assigned to either a badminton (n = 14), running (n = 14) or control group (n = 8). Assessments were conducted pre- and post-intervention with physiological, anthropometric, motivation to exercise and physical self-esteem data collected. Post-intervention, V̇O2max increased (P < 0.05) by 16% and 14% in the badminton and running groups, respectively, and time to exhaustion increased (P < 0.05) by 19% for both interventions. Maximal power output was increased (P < 0.05) by 13% in the badminton group only. Blood pressure, resting heart rate and heart rate during submaximal running were lower (P < 0.05) in both interventions. Perceptions of physical conditioning increased (P < 0.05) in both interventions. There were increases (P < 0.05) in enjoyment and ill health motives in the running group only, whilst affiliation motives were higher (P < 0.05) for the badminton group only. Findings suggest that badminton should be considered a strategy to improving the health and well-being of untrained females who are currently not meeting physical activity guidelines.

Is Breast Pain Greater in Active Females Compared to the General Population in the UK

Cyclic and noncyclic breast pain effect up to 60% of women, decreasing the quality of life. In addition, exercise‐induced breast pain (thought to be caused by tension on breast skin and fascia during breast motion) is reported in up to 72% of exercising females. These forms of breast pain may be experienced concurrently; therefore, it is hypothesized that this compound effect may cause higher breast pain prevalence and severity in active populations. This study investigated the prevalence and severity of breast pain in an active cohort, compared to a random cohort. A random sample of 234 UK females completed a self‐administered survey reporting physical activity history, prevalence, severity and frequency of breast pain, breast support habits, bra satisfaction, occurrence of bra‐related issues, and demographics. This sample was age‐matched to a sample of active females (n = 234) from a cross‐sectional survey of 1,285 female marathon runners who completed a similar survey. Breast pain prevalence was significantly lower in the active cohort (32.1%) compared to the random cohort (43.6%), however, the severity and frequency of breast pain was similar in both cohorts. Females in the active cohort undertook significantly more physical activity, were lighter, had greater nulliparous rates, greater adherence to sports bra use, but less adherence to professional bra fitting. With lower breast pain rates in the active cohort the hypothesis of a compound effect of multiple forms of breast pain causing an increase in prevalence and severity is rejected. The lower prevalence may be related to increased physical activity, reduced body mass, and increased sports bra use. Sports bra use is already recommended in the literature for symptomatic women, however, this is the first study to report that increased physical activity and weight loss may be an appropriate life style choice to reduce the prevalence of breast pain.