Cording is a common side-effect that develops after surgery for breast cancer.

It feels like a tight, painful cord or web of ligatures that run from the mastectomy wound or drain wounds via the armpit and upper arm to the hand. Cording can also run across your chest. It develops right after surgery or even weeks or months afterwards.

Cording is also known as axillary web syndrome or AWS. It is thought to be caused by inflammation and scarring of the tissues surrounding the lymph vessels, blood vessels, and nerves.

Though most women experience cording after breast surgery – there is more focus on the prevention and treatment of lymphedema, causing many women to search for help very late for cording. The longer cording is left untreated, the tighter it becomes, and the longer it takes to break down the cords.

Cording is a severe side-effect that restricts the movement of your upper limbs.

It can affect your ability to do many daily activities, such as hanging washing, reaching into top cupboards, or turning to wipe your bottom.

When cording snaps – if you stretch -it can feel like an electric shock.

Treatment of cording

Exercise: Just after your operation, do your stretch exercises as prescribed at least twice every day

Get help early – Drains are usually removed by week 2 or 3. Ask your doctor to refer you after the removal to a therapist who works with breast cancer patients’ rehabilitation – a physiotherapist or an occupational therapist.

Manual therapy done by a physiotherapist or occupational therapist effectively breaks down cords. Your therapist may gently pull on the tissue in your arm, starting in the upper arm and working toward your wrist. It may cause a cord to snap with a popping sound. It doesn’t usually hurt if this happens, and it might help you move your arm more freely. Although manual therapy is often uncomfortable, you will feel better after every session. Don’t stop sessions too soon – cords can form again.

Swimming laps is the best exercise for lymph drainage, and it helps regain your arms’ full mobility.

Massage—Softly massage your wounds and areas where cording has formed twice daily between your therapy sessions or when you feel a burning sensation in the specific locations.

Keep doing exercises to keep your arms supple, prevent cording permanently, and keep your arms in good condition. 

Laser therapy uses a small device that breaks down cords by sending low-level beams to the ligatures. It helps break down scar tissue.

Therapists:

Maretha Logie- Traut: Breast cancer rehabilitation / Lymphoedema Therapy  OT ZONE 

Reference: 

After surgery | Breast Cancer Now. https://breastcancernow.org/information-support/facing-breast-cancer/living-beyond-breast-cancer/after-surgery