Axillary Web Syndrome (AWS) : How Can A Cancer Rehab Physio Help AWS

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

Can I Just Leave My AWS

AWS can spontaneously heal itself with time.

Other times if untreated, it has the potential to progress into further movement pattern conditions.

These include

  • Shoulder bursitis
  • Muscle guarding
  • Pain or discomfort when sleeping
  • Pain and dysfunction with all shoulder movement
  • Dysfunction in your muscles around the shoulder blade and neck
  • Pins and needles or numbness around the underarm
  • Rotator cuff muscle weakness and degeneration

It is never too early or late to get help regarding your health after having cancer treatment.

If you or someone you know needs a check-up from a cancer rehab physiotherapist, feel free to book in with our cancer physio Zee, book online here or call us on (08) 8356 1379.

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