Axillary cording, or axillary web syndrome, can be a stubborn, painful, and unexpected side effect of breast cancer surgery. If you’re dealing with this, you’re not alone – and there are gentle exercises that can help.
My name is Kelly, and I am a physical therapist, a board-certified oncology clinical specialist, and certified lymphedema therapist. I specialize in working with breast cancer patients and those with lymphedema.
In this guide, I’m sharing 3 of my beginner, go-to gentle exercises to help get rid of stubborn axillary web syndrome, ease tightness, and improve mobility.
These exercises are part of my breast cancer recovery series that covers all stages of healing after breast surgery. Because everyone’s surgery and breast cancer treatment recovery is different, please make sure you’re cleared by your doctor or healthcare team before trying these.
Looking for earlier stages in recovery, or for more advanced stretches and techniques to get rid of cording? Download my free Breast Recovery Roadmap for all 8 phases.
What is Axillary Web Syndrome?
Axillary web syndrome, also known as cording, is a common side effect of breast cancer surgery, such as a mastectomy or lymph node removal. You can think of it as fibrous bands attached to scar tissue that begin in the armpit area and run down the arm. While they are invisible to the eye, someone may feel discomfort in the impacted area and experience limited mobility or range of motion.
What are Cording Symptoms?
For most people, axillary web syndrome typically presents itself 2-8 weeks after surgery; however, for some it can appear weeks or even months later.
While the cording symptoms are different for everyone, someone may experience:
- Limited range of motion
- Pain or discomfort
- Tightness
- A visible cord or band-like structure underneath the surface of the skin
How Can Someone Get Rid of Axillary Web Syndrome?
Luckily, cording doesn’t have to be a permanent condition, and with the right treatment and early intervention, there are things someone can do to mitigate symptoms and get rid of cording.
One of the main courses of treatment for axillary web syndrome is physical therapy. In addition, someone can incorporate gentle stretching exercises and arm exercises into their daily routine, which can significantly help break down scar tissue, release cords, and improve range of motion.
Exercise Guidelines
These exercises can only be done as long as someone is cleared by their doctor first for safety, as everyone has a different surgery and recovery experience.
If you would like to follow along with a video of a certified physical therapist modeling these exercises, you can watch the YouTube video linked below.
Exercise Details
As you go through these exercises, you may feel a release, hear a pop sound, or even feel a pop. There is nothing wrong; it just means that the cord is releasing. Don’t try to force a release or pop. Our goal is to keep all our exercises gentle and mild. That being said, don’t worry if you hear a pop or feel a release – it’s not harming, it’s just not necessary to force.
We’re going to go through 3 gentle exercises that focus on helping to release cording, decrease pain, and improve mobility.
Most of my patients start feeling some improvement within 2-3 weeks of doing these consistently.
These exercises are safe to do as part of a daily routine, as long as you’re cleared by your doctor first. All exercises should feel mild to moderate – stop if you feel significant pain or strain.
Equipment Required
Dycem (optional)
Sidelying Pec Stretch (With Skin Stretch)
This first exercise to help release a cord is great for mobilizing with a slight held stretch. The cord is often stuck or bound down on scar tissue, and this opening and closing motion helps with nerve movement.
- Begin in a comfortable standing position.
- Place your hand behind your head if you are able to get in that position. If you need an easier starting position, you can slightly lower your elbow.
- Slowly open up your elbow to the side, feeling gentle tension and holding for a few seconds.
- Come back to the starting position.
- Complete this motion back and forth 10 – 15 times.
Someone can add to this exercise by using Dycem to add tension to the area you want to isolate. For example, if you feel the cord is starting at the base of the armpit, you can either place your hand or Dycem on that area and gently hold the tension.
- Think about pulling the skin taut, gently towards the opposite hip.
- Hold the skin there and repeat the same motion as above, feeling more tension in that isolated area.
Nerve Glides
The nerves are different than cords, but they run through the same area. Someone can choose to add the Dycem to this exercise as well, by placing it on the isolated area and pulling the skin taut.
- Begin standing in a comfortable position.
- Extend your arm straight out to the side and then slightly behind.
- Bend your wrist backward, feeling tension all the way up your arm.
- Bring your wrist forward, releasing that tension.
- Repeat 8 to 10 times
For someone looking to add additional tension, you can incorporate a gentle head movement.
- Gently bend your ear towards your shoulder, away from that working arm, and hold in that position.
- Or, gently bend the head back and forth with your wrist movement.
Bye Bye Waves
- Begin standing in a comfortable position.
- Bring your arm out in front of you and slightly to the side at 45 degrees.
- Slowly raise your hand up and down, while you simultaneously flick your wrist up and down.
- Repeat 3-5 times, working up to 8-10 times as you become more comfortable.
You should feel tension in the wrist motion while focusing on the range of motion and putting tension on the cord.
Frequently Asked Questions
How to get rid of cording after mastectomy?
Different techniques can help you get rid of cording after a mastectomy. Gentle stretching exercises that target the chest wall and pec area can help release tightness and improve stiffness in the affected area.
For a more detailed review of getting rid of cording, you can watch this YouTube video from certified physical therapist Dr. Kelly Sturm.
How long does cording last after breast cancer?
How long cording lasts is different for everyone and depends on the severity of the cording as well as an individual’s response to treatment. For some people, cording can go away on its own, but for others it requires physical therapy and can take several weeks for symptoms to improve.
Are there different types of cording?
Yes, cording can show up in different patterns. The most common type starts in the armpit and runs down the inner arm, but it can also appear just in the armpit area, along the side of your chest, or in multiple bands that look like a web. The location depends on which lymph nodes were removed and how your body heals, but the good news is that these gentle exercises work for all types of cording.
Final Thoughts
You don’t have to live with cording forever. I’ve worked with many breast cancer patients who have successfully improved their symptoms and regained a full range of motion. Once you’ve completed treatment and have clearance from your healthcare provider, start with gentle stretching exercises or a physical therapy program.
