How to Reduce Axillary Web Syndrome (Cording) Naturally
Following breast cancer surgery, you expect to navigate the healing of your incision and manage post-surgical fatigue. What you might not expect is to one day look at your underarm and see—and feel—a tight, painful, rope-like structure running down your arm. This unsettling discovery is often the first sign of Axillary Web Syndrome (AWS), more commonly known as cording. It can be alarming, painful, and significantly restrict your ability to lift your arm, making simple daily tasks feel monumental.
While cording can be distressing, the good news is that it is a treatable condition, and there are highly effective, natural methods to manage and resolve it. You don't have to simply endure the pain and limitation it causes. The key lies in gentle, targeted therapies that address the root cause of the problem. This comprehensive guide will explain what cording is, why it happens, and explore the natural treatments—including specialized massage and stretching—that can help you find relief and restore your range of motion. For a more holistic look at breast cancer rehabilitation, you can also read our guide to lymphatic drainage and breast cancer recovery in Torrance.
What Exactly is Axillary Web Syndrome (Cording)?
Axillary Web Syndrome is a common side effect of breast cancer surgery, particularly when lymph nodes have been removed from the axilla (underarm). It typically appears anywhere from a few weeks to several months after surgery.
Cording presents as a single or a network of visible and palpable "cords" that originate in the underarm. These cords feel like taut guitar strings just beneath the skin. They can extend down the inner arm to the elbow, and in some cases, may even run into the forearm, wrist, or to the base of the thumb.
The primary symptoms of cording include:
Pain and Tightness: A sharp, pulling pain in the underarm and along the path of the cord, especially when you try to lift your arm.
Limited Range of Motion: The most common complaint is an inability to fully raise the arm out to the side or overhead.
Visible Cords: The web of tissue is often most visible when the arm is stretched.
While the exact cause is still being studied, the leading theory is that cording is a result of inflammation and scarring of the lymphatic and venous structures in the axilla due to the surgical trauma. The surgery disrupts these delicate vessels, causing them to harden and adhere to the surrounding tissue, forming the characteristic cords. Cording after breast cancer surgery is not a sign that the cancer has returned; it is a mechanical issue related to the healing process. Learn more about healing and balance after breast cancer treatment.
Why Natural Treatment is the Preferred Approach
When faced with a painful condition like cording, it's natural to wonder about medications or more invasive procedures. However, the most effective and recommended axillary web syndrome treatment is a conservative, hands-on approach. Pain medications may mask the discomfort temporarily but do not address the underlying tissue restriction. Natural, manual therapies, on the other hand, directly target the hardened cords to release tension and restore mobility.
This approach is centered on stimulating the body's own healing mechanisms. It involves gentle stretching and specialized massage techniques performed by a qualified therapist, supplemented by a dedicated home care routine. These methods are not only effective but also empower you to take an active role in your recovery without the side effects of medication.
The Cornerstone of Treatment: Axillary Web Syndrome Massage
Specialized manual therapy is the single most important intervention for resolving cording. This is not a deep tissue massage; it is a precise and gentle technique performed by a therapist who understands the unique changes in the body after cancer treatment, such as an oncology-trained lymphedema therapist.
How Does the Massage Work?
The goal of axillary web syndrome massage is to release the adhesions and soften the hardened cord-like structures. A therapist uses specific manual techniques to gently stretch the skin and the underlying tissue perpendicular to the direction of the cord.
Assessment: The therapist will first gently palpate the area to identify the exact location and extent of the cords. They will also assess your current range of motion to establish a baseline.
Gentle Pinning and Stretching: The therapist will use their fingers to "pin" the tissue just alongside the cord and then apply a slow, sustained stretch in the opposite direction. This is done incrementally along the entire length of the cord.
Encouraging Movement: As the tissue begins to release, the therapist will guide you through gentle movements, encouraging you to stretch your arm to the point of tension, but not pain. The goal is to gradually lengthen the cord.
The "Snap": During treatment, it is not uncommon to feel or even hear a small "pop" or "snap." This can be alarming, but it is often a sign of a successful release, where a section of the adhered tissue has let go. This usually results in an immediate increase in range of motion and a decrease in pain.
This process is repeated over several sessions. Each session builds upon the last, progressively breaking down the restrictions and improving your mobility. Because of the delicate nature of the post-surgical area, it is crucial that this therapy is performed by someone with specialized training in oncology massage. For information on what to expect in a lymphatic drainage session, read here.
The Role of Oncology Lymphatic Massage
Often, an axillary web syndrome massage is integrated into a broader oncology lymphatic massage session. This is because cording is intrinsically linked to the lymphatic system. The inflammation and scarring that cause the cords also impede lymphatic drainage, potentially increasing the risk of swelling or lymphedema.
An oncology lymphatic massage therapist will not only focus on releasing the cords but also on:
Reducing Inflammation: Gentle Manual Lymphatic Drainage (MLD) techniques can help calm the inflammatory process in the axilla.
Improving Fluid Dynamics: By stimulating the lymphatic system, the therapist helps clear stagnant fluid from the area, which can reduce pressure and discomfort.
Addressing Surrounding Tissues: Cording doesn't exist in isolation. A therapist will also work on softening related scar tissue on the chest wall and releasing fascial tightness in the shoulder and back, which contributes to the overall feeling of restriction.
This holistic approach ensures that you are not just treating the cord itself, but the entire affected region, promoting deeper and more lasting healing. You can learn more about how this integrated therapy provides healing and balance by reading our dedicated blog post.
Gentle Stretching: Your Daily Homework for Cording
While professional therapy is essential for releasing the more stubborn restrictions, consistent, gentle stretching at home is critical for maintaining progress and preventing recurrence. These stretches should always be done slowly and mindfully. The goal is to feel a gentle pull, not sharp pain.
Important Note: Always get clearance from your doctor or physical therapist before starting any new exercise program after surgery.
Foundational Stretches for Cording
Wall/Doorway Stretch:
Stand facing a wall or in a doorway.
Place the palm of your hand on the wall at shoulder height, with your fingers pointing toward the ceiling.
Slowly walk your fingers up the wall, as high as you can go until you feel a gentle stretch in your underarm.
Hold for 20-30 seconds, breathing deeply. Do not bounce.
Slowly walk your fingers back down. Repeat 3-5 times.
Corner Stretch:
Stand facing the corner of a room.
Place one forearm on each wall, with your elbows slightly below shoulder height.
Gently lean your body into the corner until you feel a stretch across your chest and in your underarms.
Hold for 20-30 seconds. Repeat 3-5 times.
Table Slide:
Sit at a table, facing forward.
Place a towel on the table and rest your affected arm on it.
Slowly slide your arm forward across the table, allowing your upper body to lean forward as you do.
Go until you feel a gentle stretch. Hold for 20-30 seconds.
Slowly slide your arm back. Repeat 3-5 times.
Overhead Reach with a Stick/Cane:
Lie on your back with your knees bent.
Hold a broomstick, cane, or wand with both hands, palms facing up.
Slowly raise the stick up and over your head, keeping your elbows as straight as possible. Your unaffected arm will help guide the affected arm.
Go only as far as you can without significant pain. Hold for 10-15 seconds.
Slowly return to the starting position. Repeat 5-10 times.
Consistency is key. Aim to perform these stretches multiple times a day. Listen to your body and never push into sharp pain, as this can cause the tissues to tighten up further in a protective response. For extra guidance, you can reference this resource on safe lymphatic massage for recovery.
Additional Natural Self-Care Techniques
Beyond professional massage and stretching, there are other natural strategies you can incorporate into your daily routine to help manage cording.
The Power of Moist Heat
Applying moist heat to the affected area for 10-15 minutes before you stretch can be incredibly beneficial. Heat helps to increase blood flow to the tissues and makes them more pliable and receptive to stretching. You can use a moist heating pad or a warm, damp towel. Be very careful with heat on any areas that may have numbness from surgery or radiation, as you could burn yourself without realizing it. Test the temperature on your unaffected arm first.
Mindful Movement and Posture
Be conscious of how you hold your body throughout the day. The pain from cording can cause you to slump your shoulders forward and guard your arm. This poor posture only reinforces the tightness.
Practice good posture: Gently draw your shoulder blades together and down your back.
Incorporate gentle movement: Avoid keeping your arm immobile for long periods. Perform gentle shoulder rolls and arm swings throughout the day to keep the joint mobile.
Diaphragmatic Breathing
Deep, diaphragmatic (or "belly") breathing is a powerful tool for pain management and tissue release. When you breathe deeply, you activate the parasympathetic nervous system, which is the body's "rest and digest" state. This helps to reduce muscle tension and calm pain signals. Furthermore, the deep movement of the diaphragm acts as a central pump for the lymphatic system. Before you stretch, take 5-10 deep belly breaths to relax your body and prepare the tissue for movement.
Finding the Right Professional Help
The effectiveness of your cording treatment hinges on the expertise of your therapist. It is not enough to see a general massage therapist; you need a practitioner with specific training in post-cancer care.
Look for a Certified Lymphedema Therapist (CLT) or an oncology massage therapist who lists axillary web syndrome treatment as one of their specialties. These professionals have an in-depth understanding of:
The anatomical changes after breast cancer surgery.
The delicate nature of the lymphatic system.
The contraindications and precautions for working with cancer survivors.
The specific manual techniques required to safely and effectively release cords.
When you inquire about services, ask directly about their experience and training in treating cording. A qualified therapist will be happy to discuss their credentials and approach. This is a crucial part of our comprehensive care for lymphatic drainage for breast cancer recovery in Torrance.
What to Expect in a Treatment Plan
The frequency and duration of your therapy will depend on the severity of your cording. Initially, you might benefit from 1-2 sessions per week to make significant progress in releasing the cords. As your range of motion improves and the pain subsides, your sessions may be spaced further apart, eventually transitioning to maintenance as needed.
Your therapist will work with you to create a personalized plan. They will teach you self-massage techniques and refine your stretching routine so you have the tools to manage your condition at home. We believe in transparent communication about every aspect of care, including the investment. You can review our prices for different session types here to plan for this vital component of your recovery.
You Can Find Relief from Cording
Discovering Axillary Web Syndrome can be a frustrating and painful setback in your recovery journey. But it is important to remember that it is a highly treatable condition. With the right combination of professional axillary web syndrome massage, a consistent routine of gentle stretching, and mindful self-care, you can effectively resolve the cords, eliminate the pain, and reclaim your full range of motion.
Natural, manual therapy offers a safe and empowering path to healing, allowing you to move beyond the limitations of cording and fully re-engage with your life. You do not have to accept this pain and stiffness as your new normal.
If you are struggling with cording after breast cancer surgery, we are here to help. Our team of skilled therapists specializes in oncology lymphatic massage and the treatment of Axillary Web Syndrome. Contact us today to schedule an evaluation and take the first step toward moving freely and comfortably again.