It was a physical therapist in Illinois by the name of Colleen, who first taught me the importance of correlating the pain women have in the middle of their back and top of their shoulders with the proper fitting of their bra.

As a man, it wasn’t intuitive to think about the fact that women start wearing bras in their adolescence and continue until they are in their golden years. Add up all the body changes that take place during that time—development, pregnancy, child birth, menopause, weight loss and weight gain.  In most cases, women take it upon their selves to figure out what bra size they should be wearing.

Bras were created to support a woman’s breasts while also being comfortable both on the top of the shoulders (along the Trapezius muscles) and along the middle of the back, especially where the clasps attach.  With some women, breast size creates musculoskeletal issues. Breasts will continue to pull women forward with the upper spine having to contribute in stabilizing the spine or counter balancing. In order to properly stabilize or counter balance, the muscles between the shoulder blades need to be firing or contracting. These muscles include the Rhomboid group and the inferior 1/3 of the Trapezius. Instead, typically what happens is the hyperactivity of the upper Trapezius muscle (a shoulder shrugging effect), Pectoralis muscle groups shorten (the chest muscle), Scapular protraction (shoulder blade move up and away from the spine), and the compression of the middle Thoracic Spine where the bra’s clasp are usually located.

Chiropractors often treat women for frequent stiffness and pain in the middle back. I personally have patients that have such extreme tenderness and pain in their middle backs, that I can’t just perform a Chiropractic adjustment to them with my usual manual adjusting techniques. I have found myself using adjusting tools or devices like the Impulse Adjustor (an electric adjusting tool) or the Rapid Release (a $1000 massager the mimics electricity but through vibration frequency) or even changing my adjusting technique or force to accommodate for their discomfort. This chronic pain finding has been termed by some as T6 Syndrome. The rough area where the bra’s clasp connects is the T6 spinal vertebra. When having a constant force pressing or squeezing a spinal segment(s), it can have an effect. I have seen this more times than I would like. A matter of fact, I have been involved in approximately half a dozen breast reduction cases where my treatment documentation was needed to prove to an insurance company the legitimacy of the need for surgical breast reduction.

Humans have a tough enough time getting around Upper Cross Syndrome (where the shoulders roll forward and up due to the anatomic changes described above and in blog posts or podcasts also found on my website), but women continue to suffer with the fact that they have this constant pressure in the middle of the upper Trapezius muscle and the squeezing of the middle Thoracic Spine. So, you may ask what solutions are available other than having to depend on your Chiropractor to provide relief?

I recommend women get their bras professionally sized at least every two years and especially if there has been any body shape or composition changes. Examples of these professional locations include but are not limited to: Victoria’s Secret, Macy’s, JC Penny’s. Now, it isn’t a guarantee since you could walk into a Victoria Secret and be met with a teenager that has just started there and doesn’t have the experience to help properly. Don’t feel shy to request someone else. Although uncomfortable, this is your body and how you will feel as a result of your experience.

Flexibility of the upper Trapezius and the Pectoralis group of muscles is very helpful, although temporary. The more permanent or long-lasting affects come from the strengthening of the Rhomboid muscle group and the bottom 1/3 of the Trapezius muscle. This is what will reverse the Upper Cross Syndrome mentioned earlier. As you draw your Scapulas (shoulder blades) back and down, those muscles are activated or facilitated. Once you have them in the correct position, then you can start to strengthen the accessory muscles that are needed which are the Anterior, Lateral, Posterior Deltoids, the Triceps, and Serratus Posterior (to name a few).

Chiropractors are a great place to start with diagnosing and creating the initial pain relief and flexibility needed to start the recovery process. But it is also important to have the home exercise plan or gym workout to support your body against the fight with gravity and the natural progression of the human body as it ages. I personally work with each of my patients to give them that home exercise plan or I do refer them to a trusted Physical Therapist.

Just know that you don’t have to deal with what you have. Find someone who can help you process what you need and help you achieve that need – someone to support you well.

I hope you learned something today.  Thanks for reading – and stay well.  Dr SJ