If you’ve recently undergone surgery involving your armpit area, you might experience a condition known as Axillary Web Syndrome (AWS). At Functional Transformation Clinic, we want to help you understand this condition and the effective treatment options available.
What is Axillary Web Syndrome?
Axillary Web Syndrome, commonly called “cording” or “tethering,” is characterized by the formation of tight, cord-like bands of tissue in the armpit (axilla). These cords can often be seen or felt under the skin of your inner arm, appearing as rope-like structures that limit movement and cause discomfort.
When Does It Typically Occur?
AWS usually develops anywhere from several days to a few weeks after surgery, though in some cases, it may appear months later. You might first notice it when attempting to raise your arm above shoulder level.
What Does Axillary Web Syndrome Look Like?
With AWS, you may experience:
- Visible or palpable cords running from the armpit down the inner arm, sometimes extending to the elbow or even to the palm
- In some cases, cords extending down the chest wall
- One large cord or several smaller ones
- Pain and tightness, particularly when lifting your arm
- Limited range of motion, making it difficult to raise your arm above shoulder height
What Causes Axillary Web Syndrome?
Axillary Web Syndrome typically develops after surgical procedures involving the lymph nodes in your armpit area. Most commonly, AWS occurs following:
- Axillary lymph node dissection (ALND)
- Sentinel lymph node biopsy (SLNB)
These procedures are often performed as part of breast cancer treatment, either during a mastectomy or lumpectomy. During these surgeries, your surgical oncologist removes lymph nodes from the underarm closest to the affected breast.
The Mechanism Behind Cording
When these surgical procedures are performed, they can:
- Damage the lymphatic vessels in your underarm
- Affect the surrounding connective tissue
In response to this damage, the connective tissue may swell and harden, forming those characteristic bands or cords of scar tissue. These are what you can see and feel beneath your skin when you have axillary web syndrome.
The cording essentially represents your body’s healing response, unfortunately, it can restrict movement and cause discomfort in the process.
Effective Treatment Options
At Functional Transformation Clinic, we offer several evidence-based approaches to treating AWS:
1. Specialized Physical Therapy
Our experienced therapists can provide:
- Gentle stretching exercises to improve your pain-free range of motion
- Manual therapy techniques to release tight cords
- Take-home exercise programs tailored to your specific needs
2. Manual Therapy
This technique involves gentle manipulation of the affected tissue:
- Your therapist will carefully work the tissue along your outstretched arm
- You are always the first priority and your therapist will keep you informed of what is happening and inquiring as to your comfort level
- The release typically brings immediate improvement in range of motion
3. Pain Management
When necessary, we may recommend:
- Appropriate pain medications
- However, we emphasize that the most effective long-term treatment is proper stretching and therapy
What to Expect During Recovery
It’s important to understand that:
- You may notice that releasing cords in one area initially increases tightness in others
- This doesn’t mean the condition is worsening—it’s part of the progressive release process
- Most people experience significant improvement after a few therapy sessions
- Complete resolution typically occurs within a few months
- AWS is usually a one-time event rather than a recurring condition
- Continuing with stretching exercises is beneficial throughout your recovery
Is There a Connection to Lymphedema?
While some experts believe AWS may indicate injury to the lymphatic system, research hasn’t conclusively established a direct link between AWS and increased lymphedema risk. However, anyone who has undergone axillary lymph node surgery should follow lymphedema risk-reduction guidelines as a precaution.
Why Choose Functional Transformation Clinic?
Our specialists are experienced in treating AWS and other post-surgical conditions. We understand the importance of proper technique, especially when applying treatments like manual therapy.
If you’re experiencing symptoms of Axillary Web Syndrome or have concerns following surgery, contact us to schedule an assessment. Our Functional Transformation team will work with you to develop a personalized treatment plan focused on restoring your comfort and mobility.
