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Axillary Web Syndrome (Cording): How Cancer Rehab Physio Helps

04 August 2025•2 min read

Axillary Web Syndrome (AWS) or otherwise known as ‘Cording’ is a condition that may occur after breast cancer surgeries, chemotherapy, or radiation near your underarm.

What Is Axillary Web Syndrome

This is the presence of hardened and thickened cords in the soft tissue around the armpit which may present with pain or discomfort and can limit shoulder movement.

Cording can start to develop 2 – 9 weeks following breast cancer surgery or radiation.

It starts at the armpit and can travel down the inner arm and or onto the chest wall.

It can also occur months to years after surgery and can resolve then relapse intermittently.

Characteristics Of Axillary Web Syndrome

Tight band of tissue starting from the armpit
Can present with pain, tightness or tenderness when the cord is put under tension
Occurs in 6-86% patients
Restricted movement of the shoulder and elbow
Most commonly appears 2-9 weeks post op
Related to decrease in shoulder function and links to lymphedema

Risk Factors Of Developing AWS

Having a axillary node dissection surgery
Younger age (because you have tighter skin)
Low BMI
Increased number of lymph nodes removed
More extensive surgery
Prior chemo and or radiation

How Can Your Cancer Physio Help You With AWS

Your cancer rehab physio can help resolve cording by using techniques like

Soft tissue massage with specific techniques to massage away from the lymph nodes
Scar release techniques
Specific stretching exercises
Advice with pain management, positioning and sleeping for cording discomfort
Decreasing shoulder, neck and upper back pain related to compensatory movement patterns after surgery
Returning to work after surgery or other cancer treatments
Returning to sport or other movement goals
Increasing muscle strength, flexibility, and stability around the shoulder girdle after cancer treatments