Breast health

Yvonne: And the recording will be stored in the protected area on the Oscar Kilo website should anybody need to revisit it and tell colleagues and such like about it. If you don’t have an account already you might need to create one, but it’s really easy to do and there’s loads and loads of resources that are in there that you can have access to.

So this afternoon Dr Jenny Burbage and Beth Canty from the University of Portsmouth are going to talk to us in relation to breast health and bra support. They’ve been working with us on a breast health project, and the idea of this webinar really is to share some key information around breast health, bra support, and a little bit about the research project that we’ve been doing.

So we may have time at the end for questions, we’ll see how it goes, and if we do, we’ll get to as many of those questions as possible. I can put my email in the chat as well. If there’s anything that anybody wants to contact me about or chat about offline I’m quite happy to share that as well. So without further ado, Jenny, I will hand over to you.


Jenny: Excellent. Can everybody hear me OK? Yes? Fantastic. So good afternoon everybody. As Yvonne said, so my name’s Jenny and we’re here to really hopefully provide you with some useful information about the project that we’ve been conducting, and also to talk through some of the breast educational resources that have been created and are now housed on the Oscar Kilo website, and also talk about some of the rationale behind the project. And my colleague, Beth, who’s on the line, so she’s been the Research Associate on this project, and she’s been collecting some data as well to start understanding some of the implications of how different bras interact with body armour, and some of the questions. And I think we’ve come up with more questions than answers potentially but it’s a great first step in the area to really understand what’s going on.

So we’re based in – as I say, we’re a research group in breast health at the University of Portsmouth, and we investigate lots of different areas of breast health. And my interest personally has been in the occupational space and understanding the needs of women who are potentially active in their everyday roles. So how the presentation’s going to be structured today, firstly I’m going to just talk a little bit about the problem, so why are breasts a problem. And then talk about the solution, importantly, for that. Talk about some of the reasoning behind the breast and bra education side of the project, and then actually give you a bit of a flavour of some of those resources. So talk about some information about, well, what is appropriate breast support and how do you get a good bra fit.

And then Beth will pick up then and talk about the reasoning behind why we’re looking at body armour and bra interaction, what have we been finding, and where do we think this this project is going to go in the future. And as Yvonne said, very happy to answer any questions. Probably easiest to do that at the end. Feel free to put that into the chat or email Yvonne with anything.

OK, so starting off with the problem, so why is the breast the problem. Effectively it’s a very unique soft tissue for females where there’s very limited internal support. So there’s no muscles, there’s no bones, the ligaments inside the breasts aren’t true ligamentous material. So ligaments are actually very strong pieces of connective tissue that usually join bone to bones. We say that it in the breast there’s a term called the Cooper’s ligaments, but they’re really just tissue in the breast that help from a functional perspective, disperse through the breast. They attach to the muscle on the chest wall, and these Cooper’s ligaments disperse throughout the breast to separate the lobules where the milk is held as a functional aspects.

So they were never really designed to provide the breast with support, they’re there functionally to help ensure that if required then a female can provide milk. So it’s a complicated structure. This is a side-on picture that you can see, so you can see that generally the breast sits between roughly the second and sixth rib. You have got some muscles; you’ve got the pec major and minor that go where the breast sits on top, but that muscle doesn’t really provide any support to the breast. And generally we say that the skin that overlies the breast does provide most of the support.

So because of this limited natural support we end up with independent breast movement. I’m hoping you can see that video working. This is something that was taken from our laboratory. So we’re in a sports biomechanics lab where we’ve got these lovely infrared cameras where we can look at motion. And all those green dots are small reflective markers that are placed over one breast – I think that’s someone’s left breast – whilst they’re running on a treadmill, and the blue marker denotes where the nipple marker was.

And this video just helps to illustrate, well, this person is running with a poor bra, so an everyday bra, and you can really see the soft tissue deformation that occurs on heel strikes as they land on the floor that the breast really moves around, and it really hasn’t got a lot of support. So this is why we tend to then look at how we can protect and support the breasts in the best way, so this is where the bra comes in. And other problems – not to be too negative about it – but alongside obviously the anatomy of the breast there are other issues that the breast causes. So we know that around 50% of the general population do experience some breast pain. And whether that’s related to the menstrual cycle, so on a monthly basis they might have hormonal changes that lead to breast pain, but also persistent pain or intermittent pain that’s difficult to understand its source.

So we know that there’s quite a few breast pain sufferers out there, but also exercise induced breast pain as well. So this is breast pain that is caused by effectively the breast moving in relation to the body. So we see this being reported when girls and women are exercising with very poor breast support, we then see reports of breast pain. And a way to reduce that is to enhance the bra support around the breast. We know that breast size is an issue as well. From a purely biomechanical perspective if you increase the mass then you’re increasing the forces of the loads that that breast mass has on the body so that leads to all sorts of issues in the upper body musculoskeletal system, so back pain, neck pain, shoulder pain.

Quite often we find that larger breasted women are more likely to have a poorly fitting bra, and then with that can cause quite a few issues, postural issues as well, and a lot of those are long-term implications. So having larger breasts is certainly an issue. We know that the breast is a barrier for women to exercise. We see that all the way through the ages, so from schoolgirls through to general and aging populations, where our research has shown that actually it’s quite highly rated as a reason why someone might choose not to exercise because either they can’t find the right bra, it’s too painful, they’re embarrassed by excessive breast motion. So there’s a few issues around there.

And then another element is breast ptosis or breast sag. So this is related to maybe more of this damage of the breast skin. I mentioned before that the skin is the main supporting structure of the breast, so when we – we’ve done some research to understand that, again, with not having enough breast support that the breast skin can actually damage slightly where the elastic properties of the skin get stretched too far and don’t go back into place. And unfortunately as we age, this natural process of breast ptosis is going to happen because the skin naturally loses elasticity from your mid-20s. So mid-20s onwards we’re already on a bit of a decline in terms of the breast skin properties, but not having lots of excessive breast motion can lead to the strain – this increased strain – which could lead to this breast sagging happening earlier as well.

So lots of issues surrounding the breast, but there is a solution – not to be all doom and gloom – and this is appropriate breast support. So we know through our research that appropriate breast support can reduce pain, it can reduce the risk of damage to the breast skin. We also see that it can improve performance, so this is changes in some of the ways that we’re moving when we’re running and doing different activity. By wearing a good sports bra we can actually do better which is great to hear. But also wearing a good bra can help to reduce embarrassment by excessive breast motion, improve your body image and self-esteem. So lots of good reasons to be wearing something appropriate.

But I think one of the questions that hangs over us a little bit in this context is, well, what is appropriate breast support for work, and especially for work where you may be required to be active at certain points in the day, but not necessarily active all day. So it might be that you’re sat in a car for a long period of time but then you need to suddenly go and need to run or do something physical and then come back, so what does that mean. And I think that’s the overarching question.

So I’ll talk a little bit. So this is, as I say, this presentation is almost a bit twofold. Firstly, it’s looking at the education around the breast and what we can do to improve it, and then the second part is looking at some of our research thinking about, well, actually specifically in the police and when you have to wear body armour, what happens. So I’ll talk a bit about the breast health education first. There has been some previous research that has shown effectively around 70% of police officers in the UK wear an underwired everyday tee-shirt bra whilst at work, and this is found to be unsuitable for most physical police activities leading to discomfort, pain, and rubbing and chafing issues, so some soft tissue damage there.

Also this study found that quite a high percentage of female police officers were found to wear the wrong size bra following a fitting. And this number’s very similar to what we’ve seen in many different populations as well. So when we’ve actually been able to access a population and then do some fitting we found generally the majority are perhaps wearing the wrong size. So this certainly alludes to the fact that more education is required on how to fit a bra and then what is appropriate breast support relative to breast size, to age, and to what intensity of activity is being undertaken. So certainly some good reasoning behind, well, why might we want to start providing this information.

And then elements more specific perhaps to police here is the underwire. And because we know the majority of officers are wearing an underwired bra, well do we know much about … You know, and underwire is good for – especially for larger breasted women in terms of providing additional support, but then could that be a hazard in a work environment. And I think that’s something that we need to explore a bit more, so leading again to the question well what is appropriate breast support.

So this current funded project that Yvonne mentioned at the start, we started back in March, and I think the first issue that we were interested in addressing was that there was, current at that point, no information on breasts or bras provided to any – so any female working in the police force, whether that’s police staff or police officers. So our first port of call was to find a solution, start by providing breast health educational material via a resource on the Oscar Kilo website. So that’s what we’ve done, and this is the outcome of that. So if you haven’t seen this already, so the QR code that I’ve put up – and I’ve put up on a few slides coming up – just links directly to those resources on the website.

So we’ve split the resources into two sections firstly to look at, well, just understanding the challenges, some of which I’ve outlined already, and the concerns, and then looking at the breast in terms of what changes happen at different times in the lifecycle. So that might be pregnancy, that might be menopause, and how different lifestyle choices, weight gain, weight loss, how does that impact the breast, and what might we need to know about that. So there’s a few tips in there and thoughts about breast pain and breast pain management et cetera. So that’s in that first section.

And then on the second section is about well what is appropriate breast support and how do you get good bra fit as well, so delving a bit more into some of the hints and tips for being able to do that. So that’s there on the resources. And I just chose a couple of slides, or a couple of areas I guess, to talk through today because I thought that it might be a nice opportunity to talk through some of the theory behind different bras to raise that awareness, but then always channelling back to this resource that hopefully you can go back to when you want to.

So I’m going to talk about sports bras, and I think when we – that initial research that found like 70% of women were wearing underwired bras in the police, there was about 17% of women wearing a sports bra. And I think I just want to caveat to say I’m not necessarily stating that sports bras are definitely the best thing to wear for all day everyday support. And I think this is an area we want to maybe explore a bit more because sports bras themselves are generally designed for very high intensity, but quite short duration activity. So some sports bras are fine to wear for longer periods of time, all day, but they’re not always as comfortable to do that, and that’s the reports that we get.

So I think in an ideal world we would have this idea of more of an occupational bra which was better than an everyday bra because it was more comfortable but more supportive in order to be able to cope with odd bouts of activity, but isn’t necessarily like the very highest of the high support. So I’ll caveat that, but the next few slides just talk through some of the theory about what different styles of bras do, and how they affect the breast itself, so that hopefully that will be useful when coming to choose maybe products and bra products that you might want to wear for work.

So these are the three broad areas and types of bras. So you have compression sports bras, encapsulation sports bras, and then what we call combination sports bra which effectively have elements of both compression and encapsulation in them. So that’s how we would categorise different bra products. So I’ll talk through, just from a biomechanical perspective, what it is they do to the breast, and hopefully you can glean some information from that that might help with your decisions.

So the compression sports bra, to start with, is a very, very popular sports bra. Sometimes looks like a crop top effectively. Especially with younger girls we see coming, getting their first sports bras, for example, will quite often lean towards this type of product because it looks sporty. I will say that a lot of the High Street stores will sell bras that look like this, but generally they’re not particularly supportive. And I think that it’s more of a fashion piece necessarily than a great piece of kit, but they are also quite cheap which is a bonus for people that can’t afford to necessarily spend a lot of money on sports bras. So pros and cons with that.

But the idea is that this compression sports bra will effectively move the breasts and push them closer to the chest. So it compresses in using just this one piece of material. Now that is potentially a very good way of reducing breast movement and therefore hopefully reducing breast discomfort as well during exercise for women who have a more of a smaller breast mass. And I’ve put a D cup on there, as kind of less than a D cup, which I don’t … Yes, it’s not to be offensive to people in terms of saying, “Oh, you’ve got smaller breasts” or larger breasts, but from a research perspective we always have to have some cutoff just to make it easier for us to do our research. And we found that generally A and B cups, and maybe some C cups, this style can be very effective and very well received.

However, larger than that, generally this style of bra doesn’t really work very well. And the reason why is because it makes – it effectively puts both breasts into one piece of material, so they move as one unit as opposed to individually, so that doubles the mass within that bra. And it is a good – it works well because you effectively reduce the distance that the breasts are away – the furthest point they are away from you. So by moving that centre of mass of the breast closer to you then the movement reduces, and it makes things easier, which is great. But once you’ve got larger breasts that doesn’t really work particularly well.

And another issue we find with these sports bras is that they have to stretch. When you take them on and off they have to go over the widest points. They’ve still got to go over your shoulders to get on and off. So by repeatedly doing that we find that the lifespan of those bras are less because you have to constantly be pulling and pushing them on and off. So they can be good but maybe only in certain sizes and in certain situations, but generally pretty comfortable because they haven’t got any adjustability, they haven’t got any clasps, they haven’t got … You know, so putting it straight over your head then, then great.

But another thing from a fit perspective, so just taking size out of it, if you’re six foot tall versus five foot tall you might have the same breast size and effectively be wearing the same size bra, because these bras generally just come up as small, medium, or large. So the strain and the tension on the shoulder straps for someone who’s six foot compared to five is much different and it will provide different support depending on your overall body structure. So, again, sometimes not necessarily that great a fit for women as well. So that’s compression.

Encapsulation is more like what we see these everyday underwired bras providing. So they effectively work by lifting and supporting the breast separately. So it is a different mode of support because compression is really trying to compress towards the chest and squeeze in, whereas the encapsulation bras are trying to lift the breast and support separately and from underneath, so it’s a different sort concept of support. Generally it’s a much sturdier construction than an everyday bra, so stiff materials. Can often include underwire, but there’s more and more on the market now that don’t include underwire but might have some other form of support.

And we’ve found through research that this style of bra is better at reducing breast movement for larger breasts, so for D and above roughly, in terms of reducing movement and discomfort. So by separating the breast with this style of bra then you’re effectively halving the mass that the bra has to be able to contain so that’s why it’s better for larger sizes.

So they’re the two key styles and ways of doing that, and then we do see quite a few of these what we call combination sports bras on the market which do incorporate elements of both. So that there will be some cup separation but then there’s also some external layering to help compress the breasts. And we’ve found some really good results with this. It can certainly reduce exercise-induced breast pain by, at the same time, elevating but also compressing the breast. But it’s quite style dependent, so I think, yes, it’s worth looking around and seeing. We generally find these are more of the higher supporting bras for the higher intensity activities, like designed for running and jumping activity for example.

And then just before I think move over, yes, to the best section, just about bra fit really. Because this is probably one of the key messages we want to get across through the resources. And, as I say, the QR code will take you over there. But we really advocate, and we have done some research to show just how inaccurate using a tape measure is. Even just as a starting point sometimes it isn’t great. It’s quite a confusing system in the UK; every manufacturer sizes differently. You could go into a particular big name store that has lots of different ranges of bras, and even within the ranges within that store you will be a different size, potentially, depending on that style.

So because of that complexity, we really try and advocate that women are taking ownership about really understanding how a bra should fit and then being able to effectively assess your own fit. So that if you buy online, for example, not all of us have time to go and have a nice fitting in a store, so can we still be able to know what’s best and where to start. So we have this five step process; it’s fairly straightforward, there’s a few extra hints and tips on online. But we always start off with the band, so the band is the first port of call. Getting the band fit right is the first thing you should be trying to do. So it should be able to come out no more than two inches if you put two fingers underneath and pulled the band.

So it is going to be fairly firm. It also needs to be level around the back as well, and I think quite often one of the biggest issues we see with poor bra fit is women may be overestimating band size, so wearing bands that are at least one, if not two, or even three sometimes, sizes too big. Because I think you put it on and go, “Oh that’s really, really comfortable,” but then quite quickly, through wash and wear, that gets even looser. And I think sometimes having to go a little bit firmer initially, and then wearing that bra in, it’s helpful. But, yes, having a look and making sure that the band’s level and firm, because that’s where in terms of the breast support itself most of the support should come from.

We shouldn’t be relying on the shoulder straps; it should be at least 80% of the support for the breast mass should be coming from underneath. So get that right, that’s a really good start. And then once you’ve got the band right, you can play around with the cup, and that will be different depending on the style of the bra. So it’s just good to understand if there’s any gaping, or if there’s any bulging, so our four boob effect. So if the bra cuts in and you can see breast tissue come above as well as below then that’s too small. If you’re seeing puckering and gaping it’s going to be too big. So finding a good cup size for you.

If it’s got underwire it’s making sure the shape of that underwire suits you and your breast root, so it’s quite important not to have that underwire resting on any breast tissue especially at the side. And it might be that some styles of bra – so I’m thinking like differences between, I don’t know, a balconette bra, or a demi bra, or a full cup bra – there are – I know for me, for example, there are some styles of bra I can’t get any of them to fit because the underwire just doesn’t actually fit me. So I think sometimes we forget that we can’t necessarily fit into everything. So having a look and checking that underwire, and making sure that that’s not encroaching on anywhere, is really important.

And then if the bra has like a centre front panel, so if it’s an encapsulating bra, checking that that is sitting flat against the chest where possible. Because if it’s too far away the likelihood is the cups are too small and the breasts are pushing that out, so having something that sits flat. And then finally to adjust the shoulder straps, and I think we’re terrible generally at remembering to do that. But they’re there for heights. The straps are there to help make sure that, yes, the product fits correctly. So make sure that they’re not too tight, that again you can pull them away but they’re not going to be slipping off your shoulder.

And then I think once you’ve had a bit more practices with that, and checking through those steps, you get more confident about what sort of styles suit you, and where you can go, and what you can do. So yes, so there’s certainly a few more hints and tips online for that, and it’s certainly an important thing to look at.

So that’s the education bit. I will hand over to Beth in a sec to talk about the current project and what we’re doing moving this forward to now look at, well, OK, so we know education’s important, we can provide that, but what about bas and body armour, which – you know, the soft body armour that needs to be worn by the majority of officers on a daily basis. So we know that it’s essential that that body armour fits, we know that physical/psychological comfort is important, this can affect performance. However, the bra type – so the ones I’ve gone through, so whether it’s compression or encapsulation, whether it’s got underwire – can alter the shape of the breast, so the shape of that soft tissue. So that might then have this interaction effect where it could add certainly discomfort when wearing body armour.

So there’s been some research to say, well, 67% of female officers that were surveyed in this study reported that wearing body armour with a bra was either uncomfortable or very uncomfortable, and that was regardless of all bra types worn. So the recommendations are not really clear, and we don’t know what might be best for that. So yes, so this is the first issue, the second issue that we’re looking at – hopefully my – my slide’s just changed, hopefully that works.

Yes, the second issue is, OK, so there’s evidence that body armour can be uncomfortable and even painful when worn for hours, so we’re trying to investigate that interaction of the body armour and the tactical vest with different bra styles and breast sizes to see how that goes. So I’m going to hand over to Beth to take through you through just what we’ve been doing recently in that space. Beth, have you managed to take control?

Beth: [unintelligible 00:31:43] on screen, sorry.

Jenny: No, that’s absolutely fine. No worries. Carry on.

Beth: Thanks. And hi all. [unintelligible 00:31:52]. Thanks, Jen, [unintelligible 00:31:52]. Hi all, I’m Beth as both have introduced me, thank you very much, but I’m the Research Associate on the project, so I’m the one that’s been carrying out the research up in Lincoln, we’ve used a lab up there. So I’m just going to talk you through. Obviously Jen’s introduced it nicely, the rationale why it’s needed, and then moving forward how we’ve done some of the next steps following that. So as Jen’s touched on, first issue is that idea of the information that we want to look at the breast and the bras together and how they actually – sorry, there we are – then how they interact together, whether the comfort or the pain that comes from that and actually what that does to the breast once you’ve put the armour on. Because we know in a lot of the roles that armour is a necessity, so how does that actually cause any differences there.

So how we did that moving forward, so first of all, as I say we were based up in Lincoln, so we used the Lincolnshire Police Force and they kindly had 13 officers that took part, so we just used as many that were willing to take part. And within that we had individuals who were anywhere from a 32 to a 38 and then anywhere from a B to an E in cup size, and then 18 to 39 years. Obviously the caveat of that, we know that that’s not reflective of everybody, however this was a small project just to get that initial finding. So we wanted to have a look at actually what’s happening to begin with before we expand that project and hopefully look at it a bit more. And ethical approval wise you need an ECG and all of these extras, and we also had those bras sizes already which was really handy to be able to get people in for that.

And then there was a £15 incentivisation budget provided to those that took part, so not only do hopefully they get some great information to help in the future of the kit, but also they get that £15 there. And then that again comes on the back of that, that hopefully in future research we can look to widen the age range and hopefully widen that breast size, so we did expand the age range in comparison to most projects to begin with. Sometimes we only up to 35 years, but already even moving forward we know that within the force there is obviously people that are outside those age range and outside of those breast sizes, so hopefully those steps moving forward there.

Images on the screen I’ll touch on as we go through the next slide as well. But just to say that we looked at different bra types. As Jen touched on, we had a look at encapsulation, we had to look at the combination, and we had a look at an everyday underwire. We looked at different activities, so we had to think about, OK, what do individuals actually do within the role, so kind of that walking, possibly that run, and then maybe that jumping motion, jumping a fence, et cetera, if that’s ever needed, but also those different directions of movement for the breast tissue.

And then, as I say, we used both a) armour and tac vests. So if I talk about PPE, that’s what it comes down to, that idea of the armour and the vest there, those interaction of those together. So initially we wanted to have a look at breast movement, so we did carry out bra fitting for every individual before they came onto the treadmill and carried out those exercises. So as again Jen touched on, we looked to make sure we looked at the band, the cup, underwire, the front of the bra, and the shoulder straps to make sure we had the right bra size first so that wasn’t going to be any confounding factor there.

We had a look at the breast movement, so you might hopefully be able to see on that video there’s wires there, so they’re just electromagnetic sensors, so they helped us have a look at that movement. So first of all how much they’re moving and how quickly that’s moving, so displacement, velocity, and those accelerations, and they will be quantified using those sensors. And then they were placed on the middle of the thorax so we could quantify that in regards to the actual individual, but also on all different boundaries of the breast. So you can see on the nipple, and then outer, inner, and – outer, inner, and upper boundary of the breast there, so we had to look at all directions of that bra.

We then – oops, it’s not moving for me. There we go. So the video’s moving in the bottom, you should be able to see that hopefully. So that was our lab setup, so you could see the cameras on the wall, that was helping us detect the motion of the individual as well. So that’s our motion capture system so it’s helping us to quantify the actual individual as well, so joint angles, et cetera, and then velocities as well of that individual. So you can see hopefully on the next picture there’s all the markers there of all the landmarks that we managed to quantify that individual. So then, as we’re moving forward for that analysis, we’re quantifying those together, so how the individual is moving and how the breast is moving.

We later added on the PPE as well, so we had trials with and without the equipment. So you can see on the individual – I know it’s going back and forth through the video, sorry – you will be able to see on the individual that she’s wearing that PPE there as well, so we had that interaction both with and without, so you’d be able to tell the difference. And then at every stage of the testing we had a questionnaire. So you’ll be able to see a little example on the screen there, but that was a case of asking the individual their perceptions of that bra. So not only were we analysing through the quantify- – the biomechanical quantifications, but having a look at actually how did that individual feel. So that’s a lot of comfort, pain variables, suitability, support, and we had a look at that across each exercise. So as I say we did a walk, a run, and a jump, and that’s both with and without that PPE.

So we asked that at every point there so we can really assess and understand how that individual felt in different bra types and across different exercises. So we had essentially six exercises for each bra, so we had three bras, so your everyday underwire, your compression, and your combination, and then the three exercises of each with and without equipment. So thanks to the participants that came in for a long period of time there, that managed allowed us to get a lot of data. So we are still in a little bit of analysis here, but moving forward to actually what we’ve found so far.

So you’ll be able to see, 62% of the participants that we had normally wore an underwired tee-shirt bra every day, so that’s aligning a little bit with the findings that we knew before. But actually within the Lincolnshire Police Force, of those participants that took part, 62% of those did wear the underwired tee-shirt. And then 23% of those wore a non-wired tee-shirt bra as well, so we know that already the majority aren’t wearing that sports bra, but 15% did wear that sports bra on shift.

Eighty-five per cent of participants reported breast or bra issues on shift. So again, a really large percentage there that weren’t happy with their bra support, or had uncomfortability from some aspect of the bra. Thirty-nine per cent reported under bands or the shoulder straps were digging in, and that was again a discomfort, but that was particularly with PPE. So they noticed that as they added that PPE on – which they had to wear on shift, there was no choice in that matter – that that did increase their discomfort of those shoulder straps. And then the underwired bra was the most painful, the least supportive, the least comfortable, and the most unsuitable. So not much going for the underwire bra in regards to people’s perceptions on that there.

So those were some of the initial findings, and then just to put this into a graphical aspect for you for some of the other questions that we asked, we asked which aspects of the bra were least supportive, and across all the different conditions. So that’s all the bra types with and without that personal protective equipment, the underwire with the PPE was found to be the least supportive which correlates with the idea that the majority of individuals were wearing an underwear bra under their PPE. So that’s the least supportive there, and out of all of that the cups were the least supportive aspect. And then for the combi bra the lateral aspect of that bra was the least supportive there.

So then we again moved on to some more variables, and we had the pain scale here. So underwire again came up as the cause – the underwire bra, sorry, was causing the most pain, and that was running – specifically running within that underwire was the component that caused the most pain. And then you can see that the combi was the most supportive here. But if you actually look overall the whole figure you can notice how most conditions were in that lower half. So if we are on that scale from unsupportive to supportive, it’s suggesting that actually a lot of those bras, apart from that combi towards the end, they were finding unsupportive. So whether that’s similar or dissimilar, but overall they were quite unsupportive there, so they weren’t particularly happy with that.

And then we moved on to comfort and suitability, so again we had that broadscale from uncomfortable to comfortable and unsuitable to suitable. And we noticed that as comfort increases, support increased. So as participants felt that the bra was more comfortable they also found that it was more supportive. So we were looking at those higher support bras, so we were looking at the combi, and that was more comfortable. And then as the suitability increased, also the support increased. So again, we were comparing that combi bra compared to the compression and the underwired, it did seem to be more suitable for those.

So that’s kind of the findings we’ve got so far. Obviously a lot of that was from the questionnaire that we had for each step, so a lot of the information, a lot of data came from that. But those next steps and hopefully some more findings that we can bring to you at a later date, but we’re still looking to analyse that biomechanical data, so again coming back to those displacements, the velocities, and the accelerations of both the individual’s trunk and also the breast motion in having a look at the interaction of those with the equipment.

How we look at that comfort perception, so how that perception actually aligned with what the biomechanical data is telling us, having a look at those motion of the body and breast again, so just looking at those individual, and having a look at how that varies, so whether that’s across exercises or across bras, or both. Because we want to see – obviously we know that individuals might not necessarily – depending on job roles they might not have to carry out all exercises, they might not be jumping, they might not be running, so maybe having a look at that. And then obviously different bra types, what’s suitable for there, so that’s where those conditions and comparisons come on.

Then hopefully, after we’ve gathered all that information, we can have a look at future recommendations there. So whether that is recommending those different bra types, but again that comes down to the idea that we know there’s personal preferences to begin with, and that preferences might be based on that occupational role. So depending on the individual’s role they might be used to having a set bra already, and people might tend to stick with what they know, and that’s what they enjoy. But then having a look at, OK, could we try something else and how does that differ with your job role. And then obviously depending on the amount of physical activity, whether that’s someone’s age, breast size, or the intensity of that activity, that all depends on there.

So that’s summarising what we’ve done, and hopefully what’s to show next. And that’s a bit of a whirlwind tour, so if anyone’s got any more – obviously more questions as we come onto that, but that’s what we’ve done so far. And then I’ll just hand back to Jen just to follow up. Obviously carrying all of that out as we went through, that did come up with a lot of questions, and thankfully we did have a lot of interest from individuals, but some of those might have been individuals that, as I say, might not have matched that criteria, so it allowed us to really have a look and dig into what is the need and what is the want out there for future research. So I’ll pass that back over, thank you very much.

Jenny: Perfect. Thanks, Beth. Yes, just this last slide really, just some of our thoughts about, I guess, research in this area, and coming from the research and the people that we tested, and what we’ve seen. So understanding more about what – well, what are female police officers’ satisfaction with their body armour fit and function, so looking at their interaction with bras that we’re wearing. We haven’t really got that information from a UK policing population. What I think certainly has come out, there’s a few concerns, has been the impact of larger breasts, so what does breast size, and how does that fit in with the body armour fit and function piece. So certainly some ideas around how we might look into that.

And then the impact of body armour on mobility and performance during physically demanding tasks. That’s, again, linked in with how that is interacting with various breast support as well. Is underwire safe to wear on duty, there has been some work started on this in Australia, but it’s been just very much at the beginning, so I think there’s certainly scope to look a bit more into the underwire piece especially because we know through this study and previous research that this is still the most popular type of bra being worn, so it’ll be good to understand that a bit more and whether we can make any clear recommendations on that.

Question about if our current bras on the market are really fit for occupational use, and if they’re not, then is this scope for work with bra manufacturers to maybe be looking to develop new products. That might help to balance between the comfort and support element if that type of product isn’t already on the market. So that’s related to various recommendations. In terms of – and this is quite a broad point, whether the police need to be investing in bra fit and issue service. It might not be something they need to do in its entirety, but is there some help or a step further that’s needed to help females make sure that they are kitted out appropriately.
And I’m doing some work with the Army currently where we have introduced a bra fit and issue service, and that’s certainly not perfect, but we’ve certainly got some great recommendations from that. And there’s certainly been a need for that identified, and now all female recruits in the UK – Army recruits – are being issued with sports bras. So is this the type of area that we’re looking at in the future for the police as well. So, yes, so just a few thoughts on where this area of research might go next, but that’s it from us. And as I say, very happy if anyone’s got any questions we’re happy to answer them, so thank you very much.
Yvonne: Thanks both. Really, really, really useful points there, and good I think for everybody to get a little bit of an insight into the research that’s been ongoing. Lots of links there to the information on the website, so feel free to visit that and have a look and see what’s going on there as well which will just cover more of the information that Jen’s provided for us. So happy for any questions. We do have some time for questions if there’s anything that anybody wants to ask.

[00:45:54 - 00:46:04 - Audio gap]

Jenny: [unintelligible 00:46:04] everybody.

Yvonne: Yes, there’s nothing in the chat in terms of questions. Oh, Kate’s got her hand up. Go ahead Kate.

Kate: Yes, that was fascinating, and so much I didn’t know that I should have known. First of all, are you happy for – I’m Chair of the Women’s Network for Cambridgeshire, are you happy with me to share this recording? I’m assuming that it’s going to be shared. Or is this too early in the stage of your research to do that?

Jenny: Is that for you, Yvonne, to answer, because …

Yvonne: Well, yes, I mean it will be put onto the protected area of the Oscar Kilo website, and that’s simply for it to be protected for policing. But yes, for you to use it in Cambridgeshire however you see fit, then I can’t see a problem with that as long as Jenny and Beth you’re happy with that?

Jenny: Yes, absolutely.

Beth: Yes.

Jenny: We did a talk for Lincolnshire Women’s Network, didn’t we, the other day. So yes, this is a nice piece I think for those groups. So yes, always very happy to disseminate that information. So yes, and as I say, we’re a work in progress with some of the lab testing, but from an education side certainly there’s data you can share now. And then we can hopefully update if we – well, once we’ve finished the project, and there’ll be outcomes from that. So, yes.

Kate: And the other thing is, I’ll be rea- – I know somebody’s put it in the chat, I’ll be really interested in your work with the military, because obviously in policing we’re on tight budgets, wellbeing is really heavy on the agenda, but it is trying to obviously do everything we should/could for people who work for us, but it comes at a cost sometimes. So how you persuaded them to get involved with that, and the costs involved in the service would be really gratefully received too.

Jenny: Yes, no, so I’m very happy to, yes, chat about that. I mean I think that we did some – yes, initial work with the military where we really identified a need. There was a lot of bra issues going on; girls turning up for training not wearing appropriate kit, and yes, it was great to be able to get a foot in the door there and then still – she’s still on a funded project with them to evaluate their sports bra fitting and issue service, and that’s an enduring contract now. It’s just been renewed for another three or four years. So I think that’s a great model for women in occupational roles, but that’s almost like the most. Like there’s other things you could do that aren’t necessarily as full scale and as costly, so things like having bra fitting available, even money towards bra products, even if they’re not fully issued. There’s different levels and different layers to that that all link in obviously to overall wellbeing. So yes, I’m always very happy to chat about that in that area.

Kate: Thank you.

Yvonne: The last slide, Jen, the one before. Deb, do you want to come on and just mention your comment in the chat in terms of the points, the bullet points?

Jenny: Hi, Debbie.

Debbie: Hmm. Am I on mute? I’m back. Hello.

Yvonne: You’re there. You’re there.

Debbie: Hi, I’m so sorry. Hello. Yes I’m currently on Mat Leave so I’m probably quite a – almost a full year out of date on this, so … But, yes, within DSTL, the Defence Science and Tech Lab, we have a couple of different projects and programmes. Obviously since the Women On The Ground Close Combat Review where every single role in the military was opened up to every female, body armour fit, breast support, and generally female PPE has become forefront of everybody’s minds. So yes, we’ve got a few programmes and projects running on this, some of which I know we can share, and some of which for obvious reasons we can’t at the moment. I’m not sure what’s been released at the moment, so I shan’t say too much. Again, I am about 10 months out of date at the moment, but back in February.

Yes, so I know that we’ve got a Crime and Policing programme running at DSTL, and obviously plenty on PPE and female fit in general, so very keen to get in touch with everybody when I’m back in Feb. And if you ping me an email I will read them occasionally and forward onto the appropriate people if you need a response before February, so thank you.

Jenny: Thanks, Debbie. It’s great to [cross-talk - 00:50:53].

Yvonne: That’s great, thank you.

Jenny: Yes, so Debbie and I were PhD students together a very long time ago.

Debbie: Ah, so long ago. Oh my goodness.

Jenny: Yes, a very long time ago. But, yes, no, Debbie, I’ve been chatting to Nicky Armstrong at DSTL about potential opportunities. So yes, we’d love to keep you in a loop with that. I’ll send you an email as well.

Debbie: Thank you.

Yvonne: Fab. Great. Any final points or questions from anyone then before we wrap up?

[00:51:24 - 00:51:32 - Audio gap]

Yvonne: No? If not, then we’ll finish there, and I’ll just say thank you to everyone for joining us this afternoon. Thank you so much, Jen and Beth, really informative session for everybody, and some – yes, some great information there to share. So do visit the Oscar Kilo website, there’s lots of other stuff on there that I’m sure will be of interest as well in force. So thank you again, and we’ll catch you on another webinar, I’m sure, in the future. Thanks everyone.

Jenny: Thank you.

Beth: Thanks all.