For most people with large breasts, the relationship between cup size, back pain, and posture problems is unsurprising. You might often have neck and shoulder aches to prove it. However, it might be validating to know you’re not alone (because you’re totally not).

A 2020 study published in Women’s Health London surveyed 269 women with varying bra band and cup sizes. They found that participants were more likely to report breast-related back pain with every increased cup size. This means that as they climbed from A to B to DD and beyond, respondents were 13 percent more likely to experience pain.

This is because larger breasts can shift your center of gravity forward, leading to a more slouched posture and placing more stress on the neck and upper back, Jessica McManus, PT, FAAOMPT, physical therapist, functional medicine health coach, owner of Full Circle Wellness PT says.

This then has a domino effect on the back muscles. These rhomboid and middle trapezius muscles stabilize the shoulder blades against the thoracic spine. “With the increased strain on the middle of the spine (thoracic), increased tension travels up to the neck (cervical spine), causing tight and fatigued upper trapezius muscles,” says Kristen Gasnick, PT, DPT, board-certified doctor of physical therapy at Holy Name Medical Center.

All of this helps explain why your large breasts cause back pain and why you might experience aches and pains in your shoulders, neck, and even the lower back. To ease these pain symptoms, there are a handful of strategies to incorporate into your daily life.

1. Make sure you’re wearing the right bra for your body

Wearing the right bra is super important when it comes to reducing breast-related back pain, according to McManus. Some general tips include getting measured and fitted for your size by a professional once every year or every two years, as breast size frequently changes. Additionally, you shouldn’t have red marks on your skin from your straps digging in your shoulders, which means that the bra is too tight and pulls down on your breasts, McManus adds. You should be able to easily fit a finger under the straps and they shouldn’t slip off your shoulders, says Heather Jeffcoat, DPT, doctor of physical therapy and pelvic floor therapist and founder of Femina PT. Bands on your bras should have at least three hooks in the back, as this is a huge factor in their level of support, she adds.

If your large breasts cause back pain during exercise, the most important thing you should do is have a supportive sports bra, Gasnick says. She recommends having one that has enough compression to support the breasts’ weight and two separate adjustable straps that allow the bra to elevate the breasts without pulling down on the upper back and neck too much. Racerback bras concentrate a lot of weight along the spine and on the inner shoulders near the neck, which causes more pain.

Depending on the type of workout you are doing, it is also important for a sports bra to hold your breast-high and close to your body, according to McManus. This becomes more important for high-impact workouts like running than something like yoga.

Unfortunately, the popular, stylish sports bras with thin straps won’t do, according to Dr. Jeffcoat. Brands should consider offering more modern styles of supportive sports bras, but for now, high-impact, wide-strapped, thick-banded sports bras with cups that encapsulate your whole breast are the best way to go.

2. Tweak your work setup to make it posture friendly

If you work at a computer, ensuring that you have a good ergonomic set-up can help prevent this forward slouched posture. If your large breasts cause back pain and your desk setup causes you to lean forward, that strain can really add up for your back. The best way to maintain a good working posture is to push your buttock into the back of the chair and to lean your back against the chair back for support, says McManus. Additionally, make sure the chair stays upright when you do this, instead of leaning back in a reclined position.

3. Take breaks if you sit a lot

Be sure to get up every 30 min and mix deep breaths into your lower rib cage, McManus adds. This can help your body loosen up after being in a sitting position for a while. The deep breaths help your chest open up and improve blood flow to your muscles as well, she adds. Shallow breaths, McManus explains, can often put a strain on upper chest muscles like the squalene muscles, which can sometimes already be fatigued from the weight of your chest.

4. Try strength exercises

When it comes to pain, strengthening the back and shoulder muscles is a good idea (when you’re not actively injured). For example, Gasnick says strengthening the back muscles can increase their tolerance for the force that your chest puts on them. Useful exercises include anything that brings the scapulae into retraction, Gasnicks adds, which happens when you squeeze the shoulder blades together. Common examples of these exercises are lateral pulls, rowing exercises, and overhead presses.

5. Stretch the affected areas

Since having larger breasts can often pull your posture forward, exercises that open up the front of the chest can help correct your posture, says McManus. These can look like a chest opening exercise called, “Open Book,” where you lay on your side on the floor and extend your arm out, up, and over following with your head. This can encourage the muscles in your chest to open.

Additionally, she recommends stretches that promote extension or straightening of the mid back are very helpful. This can be done by rolling on the foam roller in ways that feel good. Another example would be standing in your door frame and placing one arm on the wall, extending your arm up straight. Then taking a step forward in order to feel a stretch in your pectoral muscles, according to Dr. Jeffcoat.

Ultimately, finding solutions when your large breasts cause back pain can be so frustrating. Finding the right bra is challenging (and expensive), and improving posture is not always as simple as it sounds. It’s not your fault that your breasts are fatiguing your muscles! Hopefully, breaking down these strategies makes them a little more accessible and gives your neck and back the break they whole-heartedly deserve.

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