Axillary Web Syndrome or Axillary Cording Treatment in NYC
Following breast surgery, have you noticed cord-like structures in your armpit and/or arm? If so, then you may have Axillary Web Syndrome, also commonly known as Axillary Cording or Axillary Webbing Syndrome.
Axillary Web Syndrome is a common condition that can develop after breast surgery and it is characterized by the formation of rope-like or cord-like structures in your armpit (axilla).
What is Axillary Web Syndrome?
Axillary Web Syndrome is characterized by the development of string or rope-like structures in the armpit and/or arm. It frequently presents with pain and limited shoulder movement in the arm with cording.
It is a common side effect that occurs after breast cancer surgery and the removal of axillary lymph nodes. In fact, several studies have shown that up to 86% of breast cancer patients develop axillary cording following surgery.
However, despite the high occurrence of Axillary Cording, researchers aren’t exactly sure why this cording phenomena develops. We currently believe that cording results from inflammation and damage to the local lymphatic vessels caused by surgery. This inflammation and damage cause hardening of lymphatic vessels, blood vessels, and connective tissues, leading to visible "cords".
What causes Axillary Cording?
Axillary Cording most commonly occurs after breast cancer surgeries such as a lumpectomy and mastectomy. However, Axillary Cording can also develop following a breast augmentation or breast reduction. We have seen many patients with cording after these reconstructive surgeries. Typically, Axillary Cording develops in the days, weeks and even months after surgery.
Lymph node removal also commonly causes Axillary Web Syndrome. In patients with breast cancer, lymph node removal is a common procedure to determine if the cancer has spread. There are two types of lymph node removal procedures; sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Following both of these procedures, inflammation in the area can cause cording.
Lastly, radiation therapy used in the treatment of breast cancer can also cause Axillary Webbing Syndrome. Radiation can cause damage and inflammation to the area, in addition to hardening of all the tissues in the area (a condition known as Radiation Fibrosis Syndrome). As a result, radiation can result in the development of Axillary Cording.
Regardless of the cause, it’s important to note that if you have cording, it is not because of something you did or didn’t do. It is not your fault. But rest assured, it can be successfully treated by a physical or occupational therapist specialized in Breast Cancer Rehabilitation.
Visible rope-like structures: Axillary Cording is characterized by visible rope-like structures in your armpit, that may also run down your arm into your elbow and wrist. Cording may also develop on your chest or trunk.
It is important to note that before any cords are visible, you may first experience pain in your armpit and arm as you try to lift your arm overhead.
Pain: A sensation of pulling and pain in your armpit and arm when you try to reach forward and overhead.
Tightness: Cording can cause progressive tightness, which can make it feel like you’re stretching your skin when you move your arm.
Limited shoulder movement: Due to the tightness of the cords, you may not be able to lift your arm completely overhead and/or you may not be able to fully straighten your elbow.
What are the most common symptoms of Axillary Web Syndrome?
While cording is not life threatening, it can definitely negatively affect your quality of life, surgical recovery, and daily function. Luckily, physical and occupational therapists specialized in Breast Cancer Rehabilitation can successfully treat Axillary Cording.
The physical or occupational therapist will use 4 highly effective techniques to break down your taut cords, improve your shoulder range of motion, and decrease your pain.
Soft Tissue Mobilization: Using hands-on therapy, your therapist will loosen your cords, surrounding fibrous tissues, and any adhesions, helping you achieve more mobility and function.
Scar Massage: Cording itself is considered a form of scar tissue, and scar mobilization uses manual pressure to increase the flexibility and mobility of your scar tissue.
Axillary Cord Exercises: Based on your specific stage of recovery, your therapist will recommend individualized exercises to "stretch and lengthen" your cording.
Nerve Gliding Exercises: To mobilize nerves, your therapist may also recommend nerve gliding exercises. It is not uncommon for nerves to be affected after surgery, due to inflammation and damage. So, nerve gliding exercises can definitely be a helpful treatment for Axillary Cording.
Treating Axillary Web Syndrome:
FAQs
What does Axillary Web Syndrome feel like?
Before any cords are visible, you may first experience a pulling sensation or pain in armpit and down your arm as you lift your arm overhead or forward. If you touch your armpit, you may also feel and see small structures like feel like little cords.
Does cording go away?
With specialized physical/occupational therapy and daily home stretches, 90% of cording resolves within 3-6 months of development.
Is cording or its treatment painful?
Cording itself can cause pain, as taut cords pull and tug at your skin, causing reduced mobility and range of motion.
Depending on the severity of your cording, the treatment can be somewhat uncomfortable, but your therapist will ensure that you are as comfortable as possible as they address your cording. Generally after the first appointment, you will already experience relief in your pain and more shoulder movement.
How is cording diagnosed?
Cording is diagnosed via a comprehension assessment by a physical or occupational therapist specialized in Breast Cancer Rehabilitation.
Cording typically occurs within 2-8 weeks following breast surgery. However, for some people it may only develop months later. Thus, more often than not, Axillary Cording is missed in many women. So if you are experiencing any of the above signs & symptoms, please do not hesitate to reach out to us.
How common is Axillary Web Syndrome?
Several studies have shown that up to 86% of breast cancer patients develop cording following surgery. It can also occur for melanoma and lymphoma patients.
Can cording be prevented?
Being proactive with specific post-op range of motion exercises and stretches is helpful. However, if cording still occurs, remember it’s not your fault. And we can help.
Book Appointment
If you are experiencing Axillary Web Syndrome or you suspect you may have the condition, our Breast Cancer Rehabilitation Therapist, Caitha Barr, can help!
Reach out to us to schedule an appointment with Caitha or book a FREE consultation call with Caitha today!