When it comes to women’s health and performance, topics like pelvic health, postnatal recovery and hormonal changes are finally gaining the attention they deserve.
But there’s another key factor that’s often overlooked – one that can have a significant impact on posture, pain, confidence, and even athletic performance.
In this blog we’re talking about breast health and bra fitting.
We recently caught up with Elinor East, specialist physiotherapist from Movement Perfected, to explore why bra fitting is about far more than comfort.
With over 20 years of experience in physiotherapy and a special interest in women’s health and breast biomechanics, Elinor has seen first-hand how something as simple as the right bra can make a major difference to musculoskeletal (MSK) health, movement, and confidence.
The Hidden Link Between Bra Fit and MSK Pain
Many women experience upper body pain without realising that their bra might be part of the problem. Poor bra fit can alter posture, restrict movement, and place excess strain on the neck, shoulders, and back.
Elinor explains,
“We see women presenting with shoulder pain, neck stiffness, or mid-back tension – often desk-based or active women – and it turns out that the underlying issue isn’t just muscular or postural, it’s mechanical. The wrong bra can change how the body carries itself.”
A poorly fitted bra can pull the shoulders forward, increase upper back curvature (thoracic kyphosis), and place extra tension through the trapezius and shoulder girdle. Over time, this can contribute to pain, fatigue, and loss of mobility.
There’s also a psychological element; discomfort or self-consciousness can affect body awareness and confidence, both in daily life and in sport. For many women, addressing bra fit isn’t just about comfort; it’s about reclaiming ease and freedom in movement.
In some cases, women are referred to physiotherapy for MSK pain, only to discover that the underlying cause is related to breast support. Increasingly, referrals are being made specifically for bra fitting and posture assessment, recognising this as part of a wider, holistic approach to women’s musculoskeletal care.
Breast Biomechanics and Sports Performance
While comfort and posture are key, the implications of breast support go much further, particularly in sport.
Research from the University of Portsmouth’s Research Group in Breast Health has shown that breast movement during running can reach up to 15 centimetres vertically. Without proper support, this movement leads not only to discomfort but also to measurable changes in biomechanics and energy use.
The right sports bra has been shown to:
- Increase stride length, allowing for more efficient running mechanics
- Improve breathing capacity by reducing restrictive pressure across the rib cage
- Decrease energy expenditure, meaning less wasted effort and greater endurance
- Enhance technique and posture, particularly during repetitive or impact-heavy activities
Elinor notes,
“We’re beginning to understand that a well-fitted bra is performance equipment, just like the right shoes. It doesn’t just prevent pain, it actively helps women move more efficiently.”
These effects aren’t limited to elite athletes. Recreational exercisers and those returning to fitness after pregnancy or hormonal changes also benefit enormously from appropriate support.
For many, a properly fitted bra can be the difference between enjoying exercise and giving it up due to discomfort.
The Art and Science of Bra Fitting
Bra fitting is far more complex than simply choosing a cup and band size. Factors such as style, fabric, design, and even the time of the month can dramatically alter how a bra fits and feels.
Hormonal changes during the menstrual cycle, and even more so during peri-menopause and menopause, can affect breast size, tissue density, and sensitivity.
A bra that feels comfortable one week might be restrictive the next.
Different activities also demand different types of support. A high-impact activity like running requires a compression or encapsulation-style sports bra to limit movement, while lower-impact activities like Pilates or yoga may call for a softer, more flexible fit.
Material matters, too; breathable, moisture-wicking fabrics help manage heat and skin irritation, while structural seams and supportive straps can improve alignment and reduce load on the shoulders.
Elinor also highlights that women with larger breasts and those who spend long hours at a desk are particularly vulnerable to postural strain and bra-related discomfort. Overly tight or poorly structured bras can restrict circulation and movement, while loose-fitting options offer little mechanical support, forcing the upper body to compensate.
Beyond the physical aspects, poor bra fit can significantly impact confidence.
Many women feel self-conscious about breast movement during exercise, leading to avoidance of physical activity altogether. This creates a knock-on effect on fitness, bone health, mood, and long-term wellbeing.
“I often see women who have stopped running or training because of discomfort or embarrassment,” says Elinor. “Once they’re properly fitted and supported, their confidence, and their enjoyment, returns almost instantly.”
From Clinic to Confidence: The Role of the Physiotherapist
Physiotherapists are increasingly recognising the importance of breast health in managing musculoskeletal pain and promoting performance.
A physiotherapist can assess not only strength and mobility but also posture, bra mechanics, and how these factors interact during movement. They can provide education on appropriate support, posture correction, and exercises that strengthen the upper back, shoulders, and core to complement proper bra fitting.
For example, improving scapular stability and thoracic extension can help alleviate the strain caused by poorly fitting bras. Similarly, restoring shoulder mechanics and rib mobility can enhance comfort and performance once breast support is optimised.
This holistic, patient-centred approach empowers women to take control of their body mechanics – an important step in both preventing injury and improving overall function.
A Call for Awareness
Women’s health is a growing conversation in both sport and medicine, but it’s still largely centred around pelvic health, postnatal care, and hormonal balance.
Breast health deserves a seat at the same table.
From adolescence through to menopause, breast tissue changes constantly. Understanding how to support it correctly can prevent long-term MSK problems, improve athletic performance, and enhance quality of life.
Clinicians are now starting to see breast support as part of the wider conversation about whole-body health – not a separate issue or a matter of vanity, but a biomechanical and wellbeing factor that deserves attention.
In Summary
Breast health and bra fitting are vital yet under-discussed aspects of women’s musculoskeletal wellbeing.
The right support can:
- Prevent and manage upper body pain
- Improve posture and confidence
- Enhance breathing, stride, and efficiency in sport
- Encourage women to stay active and engaged in physical activity
Whether you’re an athlete, a physiotherapist, or simply someone wanting to move more comfortably, it’s worth taking the time to assess your bra fit — and to view breast support as an integral part of your performance toolkit.
As Elinor puts it:
“It’s not about appearance – it’s about alignment, comfort, and confidence. A well-fitted bra doesn’t just support the breasts; it supports the whole person.”
You can listen to the podcast episode with Elinor here.
If you’re experiencing upper back, neck, or shoulder discomfort, or if exercise feels harder than it should, it might be time to look beyond your muscles and assess your support.
At London Bridge Sports Medicine, our multidisciplinary team – including physiotherapists, sports doctors, and women’s health specialists – can help identify the underlying cause and guide you towards comfort, strength, and performance at every stage of life.
