With women's football in the spotlight as the 2023 FIFA Women's World Cup kicks off, a leading Wollongong health researcher wants to make people more aware of the injuries sport can cause to women's breasts.
Associate Professor Deirdre McGhee said despite the attention women's sport has gained in recent years, coaches, medical staff, sporting organisations and even athletes still do not know enough about this "silent", female-specific issue.
"It's a really great opportunity to think about what the issues are for female athletes," the University of Wollongong researcher said.
"These women are pioneers and they're leading the way for women in sport and promoting women in sport, which is fantastic, but at the same time we need to make sure we maximize the health of our female players.
"Female players have worked hard and long to have the opportunity and skills to be involved in football at the World Cup level.
"But their bodies are not exactly the same as men's and we need to pay attention to the differences."
Prof McGhee said improving breast health - which includes making sure women have access to well-fitted sports bras - and better treating breast injuries to prevent long-term scarring or deformities would also help to improve more women's participation in sport.
She said while the sporting world was "only just working out" specific issues facing female athletes, research showed around half had experienced breast injury.
However, she said only one in 10 athletes reported breast injuries to coaches or medical staff.
"I want to raise awareness that injuries occur, I want athletes to report them so we can treat them, and that will maximise female participation, performance and breast health," she said.
"To start, better awareness will encourage athletes to report them, because currently the research that's been done in every single sport, not just soccer, is that 90% of injuries or more were not reported."
She said many factors were behind this, including that the body charts traditionally used to identify sports injuries were male - which means they don't have breasts.
Likewise, the type of injuries clinicians record, like muscle strain or ligament sprain, don't capture harm to the glandular tissue of breasts.
"The alarming thing is that most women who have a breast injury continue to play with their injury," Prof McGhee said.
"And sometimes some injury surveillance systems in sports only count a "missed time injury", so it only counts when it causes you to miss a training session or miss a game.
"But even though women continue to play, they tell us that it's really painful to run or painful to throw their arms, or they say 'I'm reluctant to tackle because I'm fearful I'm going to get another injury', so they're not playing as well as they could.
"These women are warriors, going out with an injury, it's starting to swell and bruise and it's really painful but they keep playing - it's pretty remarkable."
She said if women were better able to speak up about breast injuries, physios and other clinicians would be able to treat swelling or bruising on the field to make sure they were not in as much pain while they kept playing.
Prof McGhee said another barrier to reporting injuries was that athletes did not want to talk about their breasts with a majority male coaching or medical staff.
"We all need to change our attitude to so that this is something that's open for men and women to discuss," she said.
"I say to male coaches and physios, 'look, you need to bring up sports bras as sporting equipment, you need to bring up breast injuries as a sporting injury'.
"But I also I think when you're looking at assessing breast support and bras, or directly treating injuries and examining their breasts, it's going to be better if it's female led - and that means there's opportunity for women in this field too."