Can Physical Characteristics and Sports Bra Use Predict Exercise-Induced Breast Pain in Elite Female Athletes?

OBJECTIVE: To evaluate whether a simple 4-factor model using self-reported data could be used to predict exercise-induced breast pain in elite female athletes. DESIGN: Survey study. SETTING: Online or hard-copy surveys completed at sporting competitions and training facilities around Australia. PARTICIPANTS: Four hundred ninety female athletes competing nationally or internationally across 49 sports. INDEPENDENT VARIABLES: A binomial logistic regression analysis was used to evaluate the strength of a predictive model that included 2 continuous independent variables (age and body mass index) and 2 binary independent variables (breast size and sports bra use). Odds ratios were also calculated to determine the likelihood of an athlete reporting exercise-induced breast pain in association with each of the 4 variables. MAIN OUTCOME MEASURES: Exercise-induced breast pain was the binary dependent variable. RESULTS: The model incorporating athlete age, breast size, body mass index, and sports bra use was found to be statistically significant, but weak, in its ability to predict exercise-induced breast pain in elite female athletes (correctly identified 66% of athletes). For every 1-year increase in age, a significant 2.6% increase in the likelihood of experiencing exercise-induced breast pain was observed. Athletes with medium-to-hypertrophic sized breasts were 5.5 times more likely to experience exercise-induced breast pain than athletes with small breasts. CONCLUSIONS: Although the current model was not sensitive enough for use by clinicians and coaches, age and breast size were both identified as critical variables in the prediction of exercise-induced breast pain. Future research is encouraged to investigate whether incorporating additional variables such body fat percentage, bra fit, and other relevant factors can add strength to the model.

Breast pain affects the performance of elite female athletes.

Although breast pain is problematic for many active women, no published research has investigated breast pain experienced by elite female athletes. This study aimed to examine the extent that mastalgia and exercise-induced breast pain affected the sporting performance of elite female athletes during training and competition. A custom-designed online survey with questions related to sport participation, as well as the frequency, severity and perceived performance effects of mastalgia and exercise-induced breast pain, was distributed to sporting organisations, coaches, medical staff and teams/clubs throughout Australia. Five hundred and forty female athletes competing nationally or internationally across 49 different sports participated in the survey. Sixty-three percent of respondents reported experiencing breast pain associated with their menstrual cycle and 33% reported that this pain worsened during activity. Forty-four percent of athletes reported experiencing exercise-induced breast pain during training or competition. Both types of breast pain were also reported to negatively affect sporting performance (20% and 32%, respectively). Mastalgia associated with the menstrual cycle and exercise-induced breast pain should be acknowledged as potential problems affecting the sporting performance of elite female athletes. Awareness around the impact of breast pain and the development and implementation of breast pain management strategies are essential for this population.

Breast and torso characteristics of female contact football players: implications for the design of sports bras and breast protection.

This study aimed to provide normative data characterising the breast size, breast position and torso size of female contact football players. 117 AFL, Rugby League, Rugby Union and Rugby 7s players attended a single testing session where a three-dimensional scan was taken of their naked breasts and torso. Dimensions relevant to the design of sports bras and breast protective equipment were then calculated from the scans. Several breast and torso characteristics of female contact football athletes differed to measurements reported for females in the general population and amongst the contact football codes. Designers and manufacturers of sports bras or breast protective equipment should consider the specific breast and torso dimensions of female contact football players to maximise the fit, comfort and efficacy of these garments. Practitioner summary: Using three-dimensional scanning, this study characterised the breast and torso size and shape of 117 female contact football players. These normative data should be used to improve the fit and comfort of sports bras and breast protective equipment for female contact football players.

The Effects of Personalized Versus Generic Scaling of Body Segment Masses on Joint Torques During Stationary Wheelchair Racing.

The anthropometries of elite wheelchair racing athletes differ from the generic, able-bodied anthropometries commonly used in computational biomechanical simulations. The impact of using able-bodied parameters on the accuracy of simulations involving wheelchair racing is currently unknown. In this study, athlete-specific mass segment inertial parameters of the head and neck, torso, upper arm, forearm, hand, thigh, shank, and feet for five elite wheelchair athletes were calculated using dual-energy X-ray absorptiometry (DXA) scans. These were compared against commonly used anthropometrics parameters of data presented in the literature. A computational biomechanical simulation of wheelchair propulsion using the upper extremity dynamic model in opensim assessed the sensitivity of athlete-specific mass parameters using Kruskal-Wallis analysis and Spearman correlations. Substantial between-athlete body mass distribution variances (thigh mass between 7.8% and 22.4% total body mass) and between-limb asymmetries (<62.4% segment mass; 3.1 kg) were observed. Compared to nonathletic able-bodied anthropometric data, wheelchair racing athletes demonstrated greater mass in the upper extremities (up to 3.8% total body mass) and less in the lower extremities (up to 9.8% total body mass). Computational simulations were sensitive to individual body mass distribution, with joint torques increasing by up to 31.5% when the scaling of segment masses (measured or generic) differed by up to 2.3% total body mass. These data suggest that nonathletic, able-bodied mass segment inertial parameters are inappropriate for analyzing elite wheelchair racing motion.

Estimating the Maximum Isometric Force Generating Capacity of Wheelchair Racing Athletes for Simulation Purposes.

For the wheelchair racing population, it is uncertain whether musculoskeletal models using the maximum isometric force generating capacity of non-athletic, able-bodied individuals, are appropriate, as few anthropometric parameters for wheelchair athletes are reported in the literature. In this study, a sensitivity analysis was performed in OpenSim, whereby the maximum isometric force generating capacity of muscles was adjusted in 25% increments to literature defined values between scaling factors of 0.25x to 4.0x for two elite athletes, at three speeds representative of race conditions. Convergence of the solution was used to assess the results. Artificially weakening a model presented unrealistic values, and artificially strengthening a model excessively (4.0x) demonstrated physiologically invalid muscle force values. The ideal scaling factors were 1.5x and 1.75x for each of the athletes, respectively, as was assessed through convergence of the solution. This was similar to the relative difference in limb masses between dual energy X-Ray absorptiometry (DXA) data and anthropometric data in the literature (1.49x and 1.70x), suggesting that DXA may be used to estimate the required scaling factors. The reliability of simulations for elite wheelchair racing athletes can be improved by appropriately increasing the maximum isometric force generating capacity of muscles.

The Occurrence, Causes and Perceived Performance Effects of Breast Injuries in Elite Female Athletes.

Female breasts are vulnerable to direct blows or frictional injuries during sport; however, little research has investigated breast injuries experienced by female athletes. This study aimed to investigate the occurrence, causes and perceived performance effects of breast injuries in elite female athletes across a wide range of sports. A custom-designed survey was distributed to female athletes aged over 18 years who were competing nationally or internationally in their chosen sport. The survey included questions about breast injuries sustained during training and competition and any perceived performance effects of these injuries. 504 elite female athletes from 46 different sports completed the survey. 36% of participants (n = 182) reported experiencing breast injuries and 21% (n = 37) perceived that their breast injury negatively affected their performance. Contact breast injuries were reported by significantly more athletes involved in contact or combat sports and by athletes with larger breasts or a higher body mass index. Frictional breast injuries were reported by significantly more older athletes or those with larger breasts. Less than 10% of participants who experienced breast injuries reported their injury to a coach or medical professional and only half used any prevention strategies. Athletes, coaches and medical professionals associated with women's sport need to be made aware of the occurrence and potential negative effects of breast injuries. It is critical to normalise conversations around breast health so that athletes can be encouraged to report and, when necessary, receive treatment for breast injuries. Further research is also required to better understand factors that affect breast injuries in sport in order to develop evidence-based breast injury prevention strategies.

Load-Power Relationship During a Countermovement Jump: A Joint Level Analysis.

Williams, KJ, Chapman, DW, Phillips, EJ, and Ball, N. Load-power relationship during a countermovement jump: A joint level analysis. J Strength Cond Res 32(4): 955-961, 2018-This study aimed to investigate whether hip, knee, and ankle peak power is influenced by the relative load lifted, altering the joint and system load-power relationship during a countermovement jump (CMJ). Twenty-three male national representative athletes (age: 20.3 ± 3.1 years, squat 1 repetition maximum [1RM]: 133.8 ± 24.8 kg) completed 3 CMJs at relative barbell loads of 0, 10, 20, 30, and 40% of an athlete's estimated back squat 1RM. Ground reaction force and joint kinematics were captured using a 16 camera motion capture array integrated with 2 in-ground triaxial force plates. Hip ((Equation is included in full-text article.)= 20%, range 0 > 40%), knee ((Equation is included in full-text article.)= 0%, 0 > 20%), and ankle ((Equation is included in full-text article.)= 40%, 0 > 40%) peak power was maximized at different percentages of absolute strength, with an athlete-dependent variation in load-power profiles observed across all lower-body joints. A decrease in system (body + barbell mass) peak power was significantly (p ≤ 0.05, r = 0.45) correlated with a reduction in knee peak power. Timing of instantaneous system and hip peak power occurred significantly closer to toe-off as load increased. The findings highlight that the generation and translation of lower-body joint power is influenced by external load and athlete-dependent traits. This subsequently alters the load-power profile at a system level, explaining the broad spectrums of loads reported to optimize system power during a CMJ. When training, we recommend that a combination of barbell loads based on assorted percentages of the estimated 1RM be prescribed to optimize joint and system power during a CMJ.

Measurement bias in estimates of system power during a vertical jump.

This investigation sought to quantify the level of measurement agreement in system force, velocity and power values derived across three commonly applied assessment techniques during a countermovement jump (CMJ). Twenty-five male national representative athletes completed three CMJs under unloaded (0%1RM) and loaded (40%1RM) jump conditions. Associated values of force, velocity and power were captured simultaneously from either a linear optical encoder (LOE) or force plate (FP) and then compared to the gold-standard reference values derived from a combined force plate and three-dimensional motion capture system (FPMC). The LOE significantly (p < 0.001) overestimated and failed to meet the minimum level of relatedness (<0.80) for measures of peak velocity, peak force, peak power and mean power across both conditions compared to the FPMC reference values. A reduction in measurement dispersion and bias was, however, evident during the loaded condition. The FP significantly (p < 0.05) underestimated mean and peak power across both conditions, yet measurement bias and dispersion remained consistent. These findings highlight a disparity in measurement agreement in force, velocity and power values across alternative assessment techniques and loads. Such variance in measurement agreement will uniquely alter derived force-velocity profiles, and thus the prescription of training loads to maximise system power during unrestricted CMJs.

A practical assessment of wheelchair racing performance kinetics using accelerometers.

Due to the detrimental influence of unnecessary mass on performance, racing wheelchair instrumentation used in both competition assessment and research is currently limited. Attaining key kinetic parameters of propulsion can enhance technique and provide athletes with a competitive advantage. This research examined the plausibility of inertial measurement units (IMUs) to estimate propulsion forces, during a simulated wheelchair race start and training. Start propulsion data calculated from an IMU system was compared to reference force plate data; steady state motion data was compared with existing literature. Some agreement in kinetic parameters between IMU data was observed under steady state motion, with data from athletes following a linear force-velocity relationship. In this context, it is important to identify that this cannot be directly compared to the existing literature due to the different methods of force measurement and the lack of data for similar force measurements using IMUs. IMUs were ineffective when used with wheelchairs having spoked wheels. Performance was best for measurements in the direction of motion. Although exact agreement was not observed, the IMU can provide an effective tool in the in-field assessment of propulsion kinetics.

Placement effects of inertial measurement units on contact identification in wheelchair racing.

Inertial measurement units (IMUs) provide a practical solution for attaining key performance data for wheelchair sports. The effects of IMU placement position on the identification of propulsion characteristics are unknown. The aim of this study was to determine the variability in the reliability of cycle time measurements (time between hand contacts) across IMU locations on the chair frame (axle housings), and wheels (axle, push rim, outer rim), on both the left and right sides (n = 8). Contacts were defined by spikes in the resultant acceleration data, corresponding to impact between the hands and push rim, and verified against motion capture. Five elite wheelchair racing athletes propelled at racing speeds on a treadmill. Excellent inter-rater Intraclass Correlation Coefficient values indicated high reliability and repeatability for both motion capture and IMU signal analysis approaches (R = 0.997, p < 0.001 and R = 0.990, p < 0.001, respectively). The best results were (as determined by the best between method agreement) were observed for IMUs located on the frame. Detection reliability was positively associated with signal-to-noise ratio of the acceleration data. The IMU assessment approach facilitates an automated processing capability, which is an improvement to the currently used video analysis.

Use and perception of breast protective equipment by female contact football players.

OBJECTIVES: Female contact football players sustain contact breast injuries that can negatively affect their sporting performance. This study investigated what female contact football players wear on their breasts during training and competition, and their perceptions on the protection provided by these garments against contact breast injury. DESIGN: A custom-designed survey about breast injuries and prevention strategies was distributed via an online link to coaches and team staff of contact football teams throughout Australia. The fit and features of breast support and/or protection that players wore during training and competition were also directly assessed. METHODS: 207 female Australian Football League (AFL), Rugby League, Rugby Union (XVs) and Rugby 7s players completed the survey. The breast support of 112 of these players was also assessed. RESULTS: Only 17% (n=35) of players reported using breast protective equipment, of which 66% (n=23) perceived it provided protection against contact breast injuries. Reasons reported for not using protective equipment included not knowing it existed (n=79, 53%), it was too uncomfortable/hot (n=50, 24%) and that it did not fit or was restrictive (n=33, 22%). Although most players (n=97, 87%) reported to wear a sports bra, 52% (n=58) wore an ill-fitted bra and only 31% (n=63) perceived it provided any protection against contact breast injuries. CONCLUSIONS: Breast protective equipment is not commonly worn by female contact football players reportedly due to a lack of awareness of its existence, discomfort or poor fit. Although most female contact football players usually wore a sports bra, most players perceived these bras did not provide breast protection.

Comparing inertial measurement units and marker-based biomechanical models during dynamic rotation of the torso.

Inertial measurement units (IMUs) enable human movements to be captured in the field and are being used increasingly in high performance sport. One key metric that can be derived from IMUs are relative angles of body segments which are important for monitoring form in many sports. The purpose of this study was to (a) examine the validity of relative angles derived from IMUs placed on the torso and pelvis; and (b) determine optimal positioning for torso mounted sensors such that the IMU relative angles match closely with gold standard torso-pelvis and thorax-pelvis relative angle data derived from an optoelectronic camera system. Seventeen adult participants undertook a variety of motion tasks. Four IMUs were positioned on the torso and one was positioned on the pelvis between the posterior superior iliac spines. Reflective markers were positioned around each IMU and over torso and pelvis landmarks. Results showed that the IMUs are valid with the root mean square errors expressed as a percentage of the angle range (RMSE%) ranging between 1% and 7%. Comparison between the IMU relative angles and the torso-pelvis and thorax-pelvis relative angles showed there were moderate to large differences with RMSE% values ranging between 4% and 57%. IMUs are highly accurate at measuring orientation data; however, further work is needed to optimise positioning and modelling approaches so IMU relative angles align more closely with relative angles derived using traditional motion capture methods.

Compression Garments Reduce Muscle Movement and Activation during Submaximal Running.

PURPOSE: The purpose of this study was to investigate the effectiveness of sports compression tights in reducing muscle movement and activation during running. METHODS: A total of 27 recreationally active males were recruited across two separate studies. For study 1, 13 participants (mean ± SD = 84.1 ± 9.4 kg, 22 ± 3 yr) completed two 4-min treadmill running bouts (2 min at 12 and 15 km·h) under two conditions: a no-compression control (CON1) and compression (COMP). For study 2, 14 participants (77.8 ± 8.4 kg, 27 ± 5 yr) completed four 9-min treadmill running bouts (3 min at 8, 10, and 12 km·h) under four conditions: a no-compression control (CON2) and three different commercially available compression tights (2XU, Nike, and Under Armor). Using Vicon 3D motion capture technology, lower limb muscle displacement was investigated in both study 1 (thigh and calf) and study 2 (vastus lateralis + medialis [VAS]; lateral + medial gastrocnemius [GAS]). In addition, study 2 investigated the effects of compression on soft tissue vibrations (root-mean-square of resultant acceleration, RMS Ar), muscle activation (iEMG), and running economy (oxygen consumption, V˙O2) during treadmill running. RESULTS: Wearing compression during treadmill running reduced thigh and calf muscle displacement as compared with no compression (both studies), which was evident across all running speeds. Compression also reduced RMS Ar and iEMG during treadmill running, but it had no effect on running economy (study 2). CONCLUSION: Lower limb compression garments are effective in reducing muscle displacement, soft tissue vibrations, and muscle activation associated with the impact forces experienced during running.

Effects of Athlete-Dependent Traits on Joint and System Countermovement-Jump Power.

PURPOSE: To establish the influence of athlete-dependent characteristics on the generation and timing of system and individual joint powers during a countermovement jump (CMJ). METHODS: Male national representative athletes from volleyball (n = 7), basketball (n = 6), and rugby (n = 7) performed a set of 3 CMJs at relative barbell loads of 0%, 10%, 20%, 30%, and 40% of absolute back-squat strength. Ground-reaction forces and joint kinematics were captured using a 16-camera motion-capture system integrated with 2 in-ground force plates. Limb lengths and cross-sectional areas were defined using 3-dimensional photonic scans. A repeated-measures analysis of variance determined the interaction between system and joint load-power profiles, whereas a multiregression analysis defined the explained variance of athlete-dependent characteristics on the load that maximized system power. RESULTS: System and isolated hip, knee, and ankle peak powers were maximized across a spectrum of loads between and within sports; power values were not significantly different across loads. A positive shift in the timing of hip and ankle peak powers corresponded to a significant (P < .05) positive shift in the timing of system peak power to occur closer to toe-off. An optimal 3-input combination of athlete-dependent characteristics accounted for 68% (P < .001) of the explained variance in the load that maximized system peak power. CONCLUSION: The load maximizing system power is athlete-dependent, with a mixture of training and heredity-related characteristics influencing CMJ load-power profiles. The authors recommend that a combination of relative loads be individually prescribed to maximize the generation and translation of system CMJ power.