Breast augmentation and back pain

Over the years, I've worked with many women who have had breast implants. Almost all of the women I've worked with who have had breast implants have complained about back pain and almost impossible-to-stop shoulder slouching.

Now, I know that most of the people who come to see me are coming because of pain, so this is probably not an issue that happens to every woman with breast implants, but it's something I've seen enough times to think it's maybe not a great idea to do (certainly not for myself!).

Sometimes it is possible to get relief from the tightness in the chest that keeps pulling the shoulders forward. Several times I've seen instances where constant soft-tissue work just became a daily necessity (in some ways it's a necessity for everyone!). With back pain, sometimes the implants have had to come out for relief.

I don't know how much information is out there on this, so I'd like to throw a couple questions out to the internet...

Do you or someone you know have implants with no problems? Or are constant exercises, stretches, and soft-tissue work necessary to stay out of pain? Did anyone advise you of the possibility of this kind of development of pain?

Feel free to share your experiences in the comment section below.


It's been many years since this post originally went up on the internet. There are a lot of women who have gotten breast implants and then developed shoulder, neck, and back issues. But does that mean getting implants automatically results in having those problems? I don't think so. Some women get implants and have no problems with their shoulders, neck, or back, so there must be I think there's something else going on.

If you've made it here, you've probably been told some frustrating things like "it's all in your head, maybe implants just aren't for you, there's nothing wrong with your body, etc." In some sense, these things are partially true. Be glad there's nothing in the X-rays and MRIs, since another surgery would likely not be that helpful anyway. But just because medical professionals can't find something OBVIOUSLY wrong with a bone or a tendon or a tumor, doesn't mean there is nothing to be done.

For any woman who's frustrated with these problems, I think it's important to realize that these same problems are also extremely common for women who DO NOT have implants. The problem can be present for ALL women, and it can be made worse by a variety of factors (e.g. size of implant, duration of having had implants, specific exercises, lack of exercise, etc.). I think the most productive and practical way to think of the problem is to focus attention on the muscles that may be contributing to your issues.

To help you understand, let's look at how something else can land you in the same painful situation.

How yoga (and other popular women's fitness regimens) can lead to shoulder, back, and neck issues).

The first thing you need to recognize is that the problem is not just with implants. The problem has to do with how the muscles of your body work together or don't work together to keep your shoulders, back, and neck happy. To clarify this, let's look at how many women - without implants - often end up with the same issues you have.

Yoga is hugely popular among women. For many, it's viewed as a perfect exercise regimen. Many have the best of intentions while doing yoga, believing that the increased flexibility will naturally lead to more comfort, but the reality is that there is no such thing as a perfect exercise regimen, and yoga can and does cause pain.

The most common yoga issue I've seen in female clients is pain in the thoracic spine, along the neck, and/or around the shoulder. In this video I explain some of the shortcomings of yoga that setup this problem.

The quick summary is this: yoga only very minimally trains the muscles of your body that are responsible for holding your shoulders back. The majority of poses and movements train the shoulders into a protracted position. This strengthens the muscles of the chest and front of the shoulder while allowing the muscles of the back of the shoulder and around the shoulder blade to get relatively weaker.

This is not a balanced situation for your body, and shoulder and neck issues are the result.

Yoga is not the only culprit here. Any exercise regimen that does not very specifically target the muscles responsible for good shoulder position will eventually train the shoulders into pain. Boot camps and group workouts, no matter what brand they may fall under, more often than not have the same shortcomings. It's much easier (in terms of equipment setup and coaching) to have people do exercises like planks, mountain climbers, pushups, and dips. None of these exercises require equipment of any kind, after all.

But all of those exercises will eventually train poor shoulder positioning unless exercises involving pulling/rowing are used to train the opposing muscles (examples: dumbbell rows, inverted rows, rear delt flyes). All those exercises require equipment, are harder to coach, and require much more attention to form and appropriate weight selection - which can be impossible to deal with in a group situation!

Even if you weren't doing yoga or any type of boot camp/group fitness class, modern life does nothing to train the posterior shoulder muscles or the muscles that stabilize the shoulder blade. So many people who are sedentary at desk jobs all day can end up with the same kind of gnawing pain and tension along the mid back, neck, and shoulder.

Why would implants matter then? 

I think of implants as the straw that breaks the camel's back (or strains the woman's back, in this case). The extra weight is borne by the pectoral muscles (chest muscles), which exerts a pull on the shoulders into the forward position. For some women who have stronger posterior shoulder and shoulder blade muscles in the back, this may pose no issue whatsoever.

For women who do not have strong enough posterior shoulder and shoulder blade muscles to handle this added weight, the result can be a gnawing feeling of strain and tension that no amount of massaging relieves. This is simply an issue of having the strength to handle the new challenge.

If, for example, I had you hold a 5 pound dumbbell in your hand, you might be able to do it for 15 minutes without any problem. If I made it 10 pounds, you still might be able to do it for 15 minutes without cramping or complaining from the muscles of your fingers and forearms. But if I increased that weight to 15 pounds, you would very likely find your forearm and finger muscles screaming well before 15 minutes were up.

Does that mean 15 pounds is the maximum weight a female hand can hold for 15 minutes? No! It means your hand, given its current training and strength levels, cannot handle more than that - for now. With training, your hand could certainly do it, but it needs practice before it will be able to do it. It's important to also point out that, in this situation, no amount of massage or chiropractic adjustments would make this task less painful. This is a problem of training. If your muscles aren't strong enough, they simply aren't strong enough. The pain is a signal of struggle due to weakness. 

This is the same situation as with implants and the muscles of the back and shoulder. If the muscles are not trained to handle the added weight of the implants, the implants may seem to be the problem. But implants are only side of the equation.  The other side is the strength of the opposing muscles! 

So what are your options?

From this perspective, you have two choices: strengthen the muscles necessary to keep your body comfortable OR remove the implants. I'm a man who has never had and (I believe I can safely predict) never will have breast implants, so I can't fully put myself in your shoes, but I can tell you this: if I imagine myself in a similar situation, I would most definitely attempt to address the musculature gradually and precisely. You probably chose to have the implants for a reason, and those reasons are likely still there for you. Also, even if you remove the implants, if the shoulder and back muscles are weak and never get trained up, you may still end up with back and shoulder pain even if you do remove the implants. I would choose to try to exercise my way out of the problem first before getting the implants removed. 

If you want to keep the implants, the challenge will be to build the strength to keep them. And you'll just need to recognize that you'll need to keep doing exercise throughout your life to feel comfortable and pain free. In some that may inspire some dread..."I'll have to exercise forever to stay comfortable?!" The reality is that everyone needs to exercise and move their bodies to stay comfortable. The only difference for you is that you'll have bigger boobs while you exercise. 

How can you start retraining your body?

  1. Use these exercises as a starting point. They're simple. They're easy. They are NOT the end-all, be-all. They will help you get control over the right muscles to start. You'll need to increase the difficulty within two weeks.
  2. Watch our YouTube videos related to the shoulders.
  3. Find a trainer near you to help you. It would not be a good idea to start doing a boot camp or group class (for the reasons given above). Find someone you feel comfortable with and who understands that you need to learn perfect form rather than just get a sweat on. You can increase the intensity once you have learned to coordinate your shoulder and back muscles better. If you can't find someone near you, Skype can work.
  4. Check out the Shoulder Fix. This is a do it yourself program packed with written instructions and videos to help you carefully retrain your shoulders. It's a program designed to help you understand good shoulder and spine function and then safely and gradually retrain it. We made it because our schedules at Upright Health are too full to help everyone we want to help, not everyone can afford to train with us for months, and there are millions of people who need this safe, intelligent approach. So we filmed a ton of videos and put it all together online so you can start it instantly at less than the cost of a session with us. You check it out here.

Want shoulders that feel good and move well?

In closing

Hopefully you find this theory and perspective helpful. Know that you're not alone, and that if you take proactive steps to retrain your body, you can get a whole heck of a lot more comfortable!


About the Author

Matt Hsu is a trainer and orthopedic massage therapist. He fought a long battle with chronic pain all over his body and won. He blends the principles he learned in his journey, empirical observations with clients, and relevant research to help others get their lives back.

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