Axillary Web Syndrome and Physical Therapy
Axillary web syndrome is described as a palpable cording from the armpit down the medial part of the arm as a complication after breast cancer surgery. It usually appears two to eight weeks after surgery.How common is axillary web syndrome?
According to a recent report 86% of patients who undergo breast cancer surgery with the removal of the lymph nodes from the armpit develop axillary web syndrome.What causes axillary web syndrome?
The scar tissue formed after removing lymph nodes leads to the formation of a fibrous banding or axillary web syndrome. The restriction of the lymph flow may contribute to axillary web syndrome.Other names:
- Cording
- Fibrous banding
- Lymphatic cording.
Risk factors
- Prophylactic mastectomy
- Lower body mass index
- Chemotherapy or radiotherapy
- Lymph node removal
Sign and symptoms:
- One or multiple cords in the armpit.
- Arm pain that radiates down the arm, elbow, forearm, and wrist.
- Tightness in the armpit with lifting arm up to shoulder level or overhead with the elbow fully extended.
- Difficulty with straightening the elbow.
- Tingling or numbness from the shoulder to the arm.
- Pulling sensation in the arm.
- Swelling into the affected arm.
- Heaviness sensation in the arm that gets worse at the end of the day.
- Tight cord in the armpit that goes into the inside of the upper arm, elbow, forearm, wrist, and thumb.
- Tight cord under the breast that goes toward the abdomen.
- A visible cord crossing the armpit.
- Tightness on shoulder and chest area.
Physical Therapy techniques used to treat axillary web syndrome:
- Myofascial release
- Soft tissue mobilization
- Functional manual therapy
- Proprioceptive neuromuscular facilitation
- Cord manipulation
- Scar release mobilization
- Joint mobilization
Exercise routine to improve axillary web syndrome
Start with a warm up:
This warm up strengthens your shoulders and relieves muscle tension.-
Shoulder circles
Bring your shoulder up, roll them backward, downward making a circle. Repeat 10 times -
Shoulder retractions
Pinch shoulder blades together for 10 times -
Body twist
Put arms across chest, turn the body to the left then to the right keeping the head forward. Repeat 10 times
Cooldown Exercise
a. Gentle chest and arm stretch
- Place a bolster or a pillow lengthwise behind the back .
- Roll a blanket and place it on the end of the bolster.
- Lye down with the back resting on the bolster and the head on the rolled-up blanket.
- Bend the hips and knees.
- Slowly bring knees apart keeping feet together.
- Relax shoulders and arms with palms up.
- Close the eyes and breath deep and slow.
- Deep breathing calms the mind and relieves muscle tension.
b. Child’s pose
c. Corner wall stretch
- Stand up two steps far from the wall.
- Rest your forearm in a corner wall.
- Bring one foot forward and slowly lean the whole body forward toward the wall.
- Feel the stretch across the chest and armpit.
- Hold this position for 5 long breath.
- Try again this time with arms a little bit higher to target different tight areas.
