A multi-stage intervention assessing, advising and customising sports bras for elite female British athletes

Hidden support for the lionesses: a breast/bra intervention

Despite health and performance benefits of appropriate breast support in sport, elite women athletes' knowledge of breasts/bras is poor leading to poor bra choices, breast pain and performance decrements. This multiphase intervention assessed breast/bra issues and preferences, individually prescribed sports bras and evaluated outcomes for the England Senior Women footballers. Breast/bra workshops were delivered to England players; all 36 completed pre-intervention surveys and breast/bra assessments, before being prescribed bras six weeks before European and World Championships (2022, 2023). 24 players completed post-intervention surveys. Pre-intervention outcomes identified poor knowledge, poor bra fit, many bra issues, and cultural sensitivities. Breast pain was prevalent (61%), with 25% reporting clinically significant breast pain. Post-intervention, players reported significant improvements with prescribed sports bras. 91% reported improvements in knowledge and benefiting from the intervention. This successful intervention provided an evidence-base for ongoing breast health initiatives with England Teams, plus roll-out to all levels of women's football.

Insights into breast health issues in women's rugby

World RugbyTM supports dedicated women's welfare, injury surveillance and medical/technical interventions, yet breast health has received limited attention. This article aims to provide insights into breast health issues in rugby, including breast impacts and injuries. We discuss how breast anatomy and position may be problematic in rugby. Breast volume relates to body size, which may be increasing in women's rugby, suggesting increased breast surface area and mass, potentially increasing injury risk. Breast health issues in rugby have been reported previously, with 58% of contact footballers (including rugby) experiencing breast injuries. There are damaging effects related to these breast health issues, with breast impacts often causing pain and swelling. Breast impacts may lead to haematomas, cysts and fat necrosis which can calcify over time making them difficult to distinguish from breast carcinoma, causing further investigation and anxiety. In sport, poor bra fit and insufficient support are associated with pain, skin strain and performance decrements. This article reports the potential implications of these breast health issues on performance in rugby. Recent breast-related projects supported by rugby communities may address recommendations identified in the literature for robust breast injury classifications, updated injury surveillance systems and prospective data collection on breast injury prevalence, severity and impact in rugby. These data should inform breast injury care pathways and intervention research, including evidence-based bra design. Understanding the implications of breast impacts on tissue properties, health and wellbeing is vital. Finally, data should inform rugby-specific breast education, raising awareness of this aspect of athlete health.

A multi-phase intervention study of sports bra prescription for elite UK female athletes preparing for the Tokyo Olympics and Paralympics

Athletes report poor breast/bra knowledge, breast pain, sports bras causing lacerations and chafing, negatively affecting sports performance. No bra interventions to address these issues are reported. Working with 142 UK female athletes preparing for Tokyo Olympics/Paralympics (27 sports), this multi-phase intervention assessed breast/bra knowledge, preferences, issues via surveys and breast/bra assessments. Data were used to develop two sports bras. A total of 112 athletes were prescribed one of the new bras through individual assessments. After four weeks, wear athletes completed evaluations. Pre-intervention breast/bra knowledge was low (83% ≤average), multiple breast/bra issues were reported and most athletes wore ill-fitting, loose bras, offering limited support. Post-intervention, 63% reported improved knowledge and 97% reported their prescribed bra as better than their original bra. Eighty-seven per cent reported benefitting from this intervention, with 17% reporting improved performance. This intervention effectively assessed sports bra needs, developed and implemented solutions, which improved knowledge and potentially performance for some UK athletes.