What is AWS (Cording)?
AWS, also known as “cording”, is a rope-like/ web structure that can be felt or observed under the skin, after a lymph node biopsy, or axillary lymph node dissection. Scar tissue from surgery to the chest to remove cancer cells, can also contribute to the cording. The cords generally start in the axillary region “armpit” and descend down the inner arm to elbow. Cords are possible to even travel to the palm. Cords are made up of restrictive adhesions and scar tissue.
One large, or several small cords can run down the inner arm, or into the chest wall. Physical restrictions will be very present. Pain with shoulder ROM, will be decreased arm movement above shoulder height. felt with tightness and pain. Extension of the elbow will be decreased or impossible also felt with tightness and pain.
The natural reaction to cording, is immobility. Protecting the arm by not moving the limb in painful Range of motions. This can lead to more pain, restrictions and tightness, which will eventually lead to more problems, increased adhesions and scar tissue.
1. Stretching – The first step to stretching is to seek a massage therapist or physiotherapist to show the recommended stretches and protocols. Stretching will increase the ROM, and help align scar tissue.
2. Massage Therapy- Stretching, massage techniques are used on the cord. Techniques will help reduce adhesions, align scar tissue, reduce trigger points. Pain will be decreased and Range of motion improved.
3. Moist heat- May be used, we recommend caution be used as prolonged moist heat can cause and increase in the production of lymph.
Cording usually resolves within a few treatments. Homecare and stretching is recommended to be continued.