Cording, also known as Axillary Web Syndrom
Cording is a tightening of tissues in the armpit (axilla) resulting from treatment for breast cancer and can be present in both women and men. Treatment for cording is available from our skilled physiotherapist.
Cording may occur following minor or major surgery in the breast or axillary regions as well as following chemotherapy and may take weeks or many months to develop.
Cording presents as thin ‘cords’ or ‘strings’ and can be seen or felt under the skin in the axilla or upper arms. It is likely to be more visible in the axilla.
The patient may notice and of the following:
pain in the shoulder and upper arm regions
tightness in the armpit (axilla)
limited shoulder movement, especially when lifting the arm above the head or when reaching out to the side. This limitation could be due to pain or tightness in the axilla or along the arm.
Photos provided by a generous patient of ours, thank you.
How is cording caused?
Surgical procedures such as removal of a lymph node, lumpectomy or mastectomy, and/ or chemotherapy for breast cancer may cause unavoidable micro-trauma of blood and lymph vessels. This leads to inflammation and over time can cause scarring or hardening of these vessels. The hardened vessels feel like cords, string, or rope lying under the surface of the skin and are not flexible and so are tight when stretched such as lifting the arm up. They may even be visible just under the skin especially in the axilla but tightness or pain may be felt from anywhere from the front of the chest down to the elbow or forearm.
Physiotherapy Treatment for cording:
Cording can be treated by our skilled physiotherapist using specific stretching and mobilizing techniques. Physiotherapy treatment is gentle, which is particularly important as the skin can be extremely tender and fragile in the area. Some of our patients chose to attend physiotherapy for a few sessions initially and our physiotherapist can also teach the patient, or a family member or carer, how to perform treatment techniques at home. Performing treatment on a daily or alternate day basis provides optimum results.
As treatment progresses the hardened or scarred vessels stretch and in some cases break, which is a good thing and not painful or harmful in any way. The stretching reduces, and usually resolves, the tightness and the pain in the axilla and arm resulting in immediate improvement in movement of the arm and return to normal use of the arm. Physiotherapy can also provide specific exercises for the shoulder and arm strengthening appropriate to the patient’s needs ensuring excellent recovery.
See our Physiotherapist Deborah Farr for further information and treatment.