If you’ve had breast surgery—especially surgery that involved lymph node removal—and you suddenly feel a tight, pulling “string” in your armpit or down your inner arm, you’re not imagining it. Axillary Web Syndrome (AWS), often called cording, is a real (and surprisingly common) post-surgical issue that can make simple movements—like reaching for a shelf or washing your hair—feel uncomfortable and restricted.
The good news: AWS is usually treatable, and most people improve with the right combination of gentle movement and targeted breast cancer rehab support.
Quick note: This article is educational and not a substitute for medical care. If you’re unsure what you’re feeling—or symptoms are severe—reach out to your surgeon/oncology team or a rehab clinician.
What is Axillary Web Syndrome (AWS)?
Axillary Web Syndrome is a condition that can happen after breast cancer surgery, most often when axillary (underarm) lymph nodes are removed or sampled. The hallmark feature is one or more tight, rope-like cords that can be felt (and sometimes seen) under the skin in the armpit and along the inside of the arm. These cords can be painful and can limit shoulder and arm movement.
When Does Cording Show Up?
Many people notice AWS within 2–8 weeks after surgery, but it can also develop later or recur months (even years) afterward.
What Cording Feels Like (Symptom Clarity)
People describe cording in a few very recognizable ways:
- A tight band or “guitar string” in the armpit
- Pulling pain when you lift your arm, reach overhead, or stretch outward
- A visible line or webbing under the skin (sometimes more obvious when the arm is raised)
- Reduced range of motion in the shoulder/arm
- Tenderness along the cord pathway
Sometimes the sensation is more “tight and weird” than sharply painful—but either way, it can make normal daily movement feel guarded.
Why Does Axillary Web Syndrome Happen?
Experts don’t all describe the cords exactly the same way, but AWS is widely considered a post-surgical complication related to tissue healing and changes after lymph node procedures (like sentinel lymph node biopsy or axillary lymph node dissection) and/or breast/chest surgery scarring.
There’s nothing you did “wrong” to cause it—and feeling it doesn’t mean your recovery is failing. It’s a known part of the healing landscape for many breast cancer survivors.
AWS vs. Lymphedema: Are They Connected?
It’s smart to ask, because AWS and lymphedema both involve the lymphatic system and can show up after lymph node surgery.
- AWS (cording) = tight cord(s), pulling, movement restriction
- Lymphedema = swelling (often with heaviness, tight rings/jewelry, skin changes, or pitting)
Some clinicians note that people with AWS may be at increased risk of lymphedema because they share risk factors (like lymph node removal), while research findings on a direct link are mixed.
Practical takeaway: If you have cording, keep an eye on swelling or heaviness in the arm/hand/chest wall and bring changes to your care team early.
What Helps: Gentle Next Steps That Are Commonly Recommended
1) Early, Targeted Rehab Works
The most consistent message across reputable resources and research is that physical therapy-focused rehab helps—especially approaches built around gentle stretching and exercise to restore motion and reduce pain.
A large review of AWS literature also concludes that exercise and stretching are key tools used in physiotherapy management.
2) Keep Movement Gentle (Not Aggressive)
Many clinical handouts stress daily stretching to tolerance—meaning you should feel a mild pull, not sharp pain—and to keep at it until function normalizes.
If you’re noticing yourself “freezing up” and avoiding any arm motion, that’s often when a rehab referral becomes extra helpful.
3) Don’t White-knuckle It Alone If It’s Limiting You
If cording is preventing you from lifting your arm comfortably, sleeping well, or returning to activity, you deserve support. This is where breast cancer rehab professionals shine.
When to Refer (CLT / OT / PT): A Simple Decision Guide
Consider asking for a referral to a rehab professional if:
- You can’t raise your arm normally, or daily tasks are hard
- Pain is significant or not improving
- You’re unsure whether what you feel is cording vs. something else
- You notice new swelling, heaviness, tightness of the hand/arm, or skin changes (possible lymphedema signs)
- Symptoms persist despite gentle stretching efforts (some guidance suggests seeking help if it’s not resolving over time)
Who can help:
- PT or OT specializing in breast cancer rehab
- Certified Lymphedema Therapist (CLT) (often also a PT/OT)
If you’re ever unsure, call your surgeon/oncology team and ask, “Can you refer me to a PT/OT who specializes in breast cancer rehabilitation or a certified lymphedema therapist?”. You can also use Norton School’s Therapist Referral Form to find a CLT near you!
Comfort Product Categories (Supportive Options You Can Discuss With Your Clinician)
Products don’t “cure” axillary web syndrome on their own—but the right tools can make movement more comfortable, support sensitive tissues, and help if swelling is part of your picture. Here are common categories people explore with clinician guidance:
1) Compression Sleeves + Gauntlets/Gloves (When Recommended)
Some individuals in rehab are advised to wear a compression sleeve and gauntlet—particularly if there’s swelling risk, heaviness, or symptom flare-ups with activity.
Why it can help (for the right person): provides supportive compression during daily activity or exercise, and is commonly used in lymphedema management.
2) Compression Bras / Breast & Chest Compression Wear
If your discomfort includes chest wall tenderness, post-surgical swelling, or you’re navigating breast/chest lymphedema concerns, supportive compression bras and compression shirts/vests may be part of your comfort strategy.
3) Swell Spots and Padding for Sensitive Areas
Soft padding products (often used under bras or compression garments) are commonly used to support areas affected by post-surgical swelling, scarring, or fibrosis—and some are designed specifically to reduce pressure or “bra cutting” near the underarm/side chest.
These can be especially relevant if your cording is accompanied by tightness and tenderness in the lateral chest/underarm region.
4) Skin-Comfort Basics (Because Sensitive Skin is Common Post-Treatment)
If you’re wearing compression or padding, keeping skin comfortable matters. Think gentle cleansing, fragrance-free moisturizers, and watching for irritation—especially in the underarm fold.
FAQs
Is axillary web syndrome dangerous?
It’s typically a benign post-surgical complication, but it can be painful and limiting—so it’s worth treating.
How long does cording last?
Many people improve with time and rehab, but the course varies. It can also recur later.
Does cording mean I have lymphedema?
Not necessarily. They’re different conditions. Still, because they share risk factors, it’s wise to monitor for swelling and get early support.
What’s the most helpful first step?
If you suspect AWS, contact your care team and ask about referral to breast cancer rehab (PT/OT) or a Certified Lymphedema Therapist (CLT)—especially if motion is limited.
Bottom Line
Axillary web syndrome (cording) can feel alarming, but it’s a known post-surgical issue that often responds well to the right rehab approach. If it’s limiting your life, you don’t have to push through: a CLT/OT/PT with breast cancer rehab experience can guide safe, effective recovery—and the right comfort products (compression, supportive bras/chest wear, and targeted padding) can make the process easier.
