Siobhan O’Donovan — Busting Booby Traps — Injury Rehab Network

The June Injury Rehab Network event with BASRaT featured a presentation from Siobhan O’Donovan, aka The Booby Physio. The online event took place on the evening of Monday 10th June with 105 sports rehabilitation practitioners in attendance.

Siobhan discussed the significant impact of breast weight on the health and well-being of girls and women, & how they and their therapists can be enlightened to optimally support and manage breast weight. The recording is available to watch here.

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Siobhan O’Donovan, aka The Booby Physio, Chartered Physiotherapist, Founder PostureFitting

If you had asked Siobhán 10 years ago what she would be doing in 2024, she would not have predicted being surrounded by all things breasts and bras! But here she indeed is, on a mission to raise awareness of and demonstrate her solution for the very underestimated impact of breast weight on women and girls.

A chartered physio (MS, Dip Orth Med, BAPE (Phys Ed). MCSP, HCPC & CORU-Registered Physiotherapist) with a Master’s degree in the Prevention and Management of Sports Injury, Siobhán has always been a solution-seeker. Siobhan was on the Founding Executive Committee of BASRaT and has been a guest lecturer on Sports Rehabilitation courses in the northwest.

With over 30 years of clinical experience working with patients to prevent, treat, rehab and deter problems, she developed PostureFitting, a physiotherapy service which connects breast weight and support with posture. The resultant effects on her patients in feeling, moving, and looking better were too good to keep a secret, and she now also trains other therapists to offer the PostureFitting service. Their mutual goal is to educate, empower & enlighten in all ways so that more gals win their daily battle against gravity while busting breast & bra booby traps! 👙

Busting Booby Traps

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Siobhan summarised her career and education, which started as a PE teacher, where she became aware of biomechanics and the importance of a preventative approach to movement and activity. Siobhan then studied to become an Athletic Trainer in the USA and completed further studies/ qualifications in strength and conditioning.

In the UK, Siobhan guest lectured on the Salford (and later Bolton) Sports Rehabilitation degrees and was on the founding Executive committee of BASRaT. Siobhan is registered as a (chartered) physiotherapist with the HCPC and the CSP. Siobhan has worked in private practice and developed PostureFitting to educate and help women and their therapists to be enlightened to optimally support and manage breast weight.

PostureFitting focuses on a preventative approach, and Siobhán agrees with the belief that “your best posture is your next posture”, thereby promoting movement and minimising holding the same position for a sustained period of time. Equally, she believes that with optimal alignment, it is possible to create efficient movement with minimal energy production and maximal protection from overload.

Siobhan’s approach is to address the source of problems and to promote optimal posture through optimal/ stacked alignment. This approach promotes injury prevention and improved performance.

Posture: Evidence-Based Research

Siobhan considered the evidence base for posture, with some studies showing limited or no association between posture and back/ neck pain. However, other studies show that poor posture/ postural changes impact lung capacity, lung dysfunction and pelvic floor dysfunction. Evidence shows that a good posture results in a more positive outlook, with physical and mental health improvements noted.

Siobhán discussed that whilst postural change is common, it does not need to be accepted as normal. Many women, with their commonality being that they frequently go into or can sustain an optimally extended thoracic position, maintain a more upright posture as they age, unlike the images we have come to accept of women getting smaller as they age.

Two Elephants in the Room!

Siobhan described how torso weight is greater for women due to breasts, regardless of breast size. The biopsychosocial impact of breast weight impacts how women physically feel and move, how women feel psychologically and what they do socially.

Lifetime Breast Changes

Siobhan discussed the life stages and physical changes associated with breasts. Life stages include puberty, menstruation, menopause and ageing. Physical changes include weight loss/ gain, pregnancy, breastfeeding and illness/ injury/ surgery.

Physical and Psychological Challenges

Siobhan described some of the physical and psychological problems associated with breast weight, including:

Physical

Neck/ shoulder/ back pain
Rashes/ infections under breasts
Breathing efficiency
Pelvic floor function
Vocal cord function

Psychological

Affects mood
Lack of self-esteem/ confidence
Anxiety and depression
Social and sexual inhibition
Disappointment due to challenges associated with daily activities
Harassment due to sexualisation

Impact on Sports Performance and Participation

Siobhan described how sports performance is affected by breast weight with accelerations and bouncing during running. Women who wear sports bras perceive exercise as less difficult and take a longer stride length, saving 12 minutes over a marathon.

For sports participation, Siobhan discussed how women may be embarrassed and/ or can find exercise painful. Women may also have difficulty finding a sports bra.

Statistics show that 33% of women are not meeting physical activity guidelines, whilst 17% felt that their breasts were a barrier to activity.

Siobhan presented evidence from studies in relation to the potential performance effects of poor breast support, including increased ground reaction force, decreased breathing frequency, decreased stride length, increased perceived exertion, increased upper body muscular activity, decreased economical upper body profile and joint loading potentially increasing the risk of ACL injury.

Siobhan stated that better breast support = better running efficiency and sporting performance.

Treatment Options

Siobhan discussed the treatment options, which include breast reduction surgery and/ or education with optimal support for women. Siobhan considered the NHS required symptoms to be considered for a reduction. These symptoms are consistent with symptoms of women with large breasts wearing the wrong size bra.

Why so Many Women Hate Bras

Siobhan showed images of pain points associated with bras, particularly wired bras. Many women experience pain linked to straps and wires digging into or rubbing shoulders and breasts.

External and Internal Support: Bra-Fitting +

Siobhan described how PostureFitting offers more than just bra-fitting; it includes an optimally fitted bra. The external support of an optimally-fitted bra can change breast position on the chest wall but only has a short-term impact on posture/ alignment. Internal support promotes alignment through posture prompts and changes breast position relative to the floor, but not on the chest wall. PostureFitting is therefore the combination of both, with an optimally fitting bra (and importantly, knowledge of how to fit it) and postural engagement together.

Siobhan discussed how the aim is to uplift breast and torso weight internally and externally, as well as empower, educate, and enlighten women.

Siobhan’s GALS against GRAVITY workshop is open to healthcare and exercise professionals and provides insight into the PostureFitting approach and the ‘Why’. Practitioners may then be invited to become a PostureFitting Partner to learn how to deliver the preventative PostureFitting system.

Q&A

Siobhan kindly answered questions put forward by practitioners who attended the session. Please see the recording of the presentation for insights from Siobhan regarding the questions.

Presentation Recording

The recording of Siobhan’s presentation is available to watch here

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