Breast Pain

Women have been found to experience two distinct types of breast pain during sport and exercise: cyclic mastalgia and exercise-induced breast pain. Cyclic mastalgia, or breast pain related to the menstrual cycle, affects up to 70% of women (Ader et al., 2001; Mansel et al., 2009; Goyal, 2011; Brisbine et al., 2025) and represents the most frequent breast-related symptom for which women seek medical advice (Eren et al., 2016). This pain is typically characterised as diffuse heaviness or soreness that radiates from the upper-outer quadrant of the breast towards the axillae (Goyal, 2011), and although the precise aetiology of cyclic mastalgia remains poorly understood, credible theories suggest that it may be the result of abnormally elevated oestradiol and/or depressed progesterone levels (Gong, 2006; Tejwani et al., 2011; Kataria et al., 2014; Eren et al., 2016; Hafiz, Barnes and Kirwan, 2018; Brisbine et al., 2025). 

A recent study specifically investigated this pattern in female contact Rugby League players, whereby higher levels of oestradiol and progesterone were associated with a decreased likelihood of experiencing mastalgia and elevated progesterone levels were further linked to a reduction in mastalgia severity (Brisbine et al., 2025). Indeed, current research evidence suggests that 32-60% of female athletes across sports and competition levels experience cyclic mastalgia severe enough to negatively impact their sports performance (Brown et al., 2014; Burbage and Cameron, 2017; Brooke R. Brisbine et al., 2020b; Wakefield-Scurr et al., 2024; Wakefield‐Scurr et al., 2024), making it a necessary consideration for coaching and support staff. 

Distinct from cyclic mastalgia, female athletes are also known to experience exercise-induced breast pain (EIBD), which is the direct result of breast motion during activity (Brooke R. Brisbine et al., 2020b). The total amount of breast motion experienced by a female is a factor: 

• The magnitude of breast movement how much the breasts are displaced relative to the torso, influenced by breast mass and overall body movement.
• The frequency of breast bounces total number of breast bounces, associated with intensity and duration of activity. of (Brooke R. Brisbine et al., 2020b; McGhee and Steele, 2020; Galbreath and Goswami, 2025):

Consequently, the most significant risk factors for EIBD include breast size (increasing breast motion), age (decreasing intrinsic support), poor external breast support, and participation in high intensity and/or long duration physical activity. Both the highest occurrence and greatest severity of EIBD have been reported during running and jumping (Brooke R. Brisbine et al., 2020b), with unsupported breast motion quantified up to 12cm during running (Scurr, White and Hedger, 2009) and 17.8cm during jumping (Bridgman et al., 2010). 

Nearly half of all female athletes up to the elite level report EIBD and approximately a third find that it can be severe enough to negatively impact their performance (Brooke R. Brisbine et al., 2020b). Given the dynamic nature of contact sports, which comprise a great deal of running and jumping, these athletes are believed to be particularly exposed to EIBD. Recent surveys confirm that the incidence of breast pain among female Rugby players ranged from 51–61%, despite the fact that many athletes have no strategy for pain reduction (Bibby, Comyns, et al., 2025; Wakefield-Scurr et al., 2025). This again emphasises the clinical relevance of exercise-induced breast pain within a contact sporting environment and the vital role of coaching staff in providing education and strategies for their athletes; evidence-based recommendations for managing breast pain will be presented in later sections.