When axillary web syndrome (cording) and/or lymphedema persists after surgery, even up to 2 years after surgery, here are some considerations...
In this video I discuss 2 cases about cording: the anonymous one below, and my own.
The reason I discuss my own is because it’s super relevant to answering this question about what to do with cording (axillary web syndrome) after lumpectomy or mastectomy. You don't also have to have lymphedema too (like me), but regardless, this video will help you understand more about cording and options for management.
Cording requires a multi-modal approach, and I am adamant that therapy includes multiple disciplines as well as Functional, Integrative, and Lifestyle Medicine.
The case:
Anonymous case study (real person that is remaining anonymous, but this could describe SO many women) -
My client is 4 months post-op bilateral mastectomy, w/ lymph node removal on the left.
The visible cording is in the left axilla into the distal into the mid humerus, I'm sure it is much more extensive though.
She has a complicated medical history (EDS, MCAS, CCI, POTS..the fun collection of dx) but is rocking this beating cancer thing like a champ having just finished chemo last week. She does not have any lymphedema and does not have any restrictions. She has (normal range of motion) AROM WFL in the shoulder and spine w/ c/o tightness in the cording. She is walking and is doing light weights and I will be working with her online for exercise & conditioning. She has done some gentle cupping but is a bit nervous to mess with it too much as no one seems to be able to give her advice with any confidence.
Any thoughts or techniques you found helpful?
My response is included in this video, and this short response below:
My cording was pretty extensive back in 2021, and I worked on it a LONG time to get to a maintenance point.
The secret was combined lymphatic work and ultimately - aggressive manual therapy for the cording.
I had vascular and neural lymphedema (neural after the first surgery and then the second surgery fixed the neural cording and lymphedema but led to vascular lymphedema).
After I took care of the vascular lymphatic issue with insurance finally agreeing to a pump, I could really attend to the cording.
Keep in mind that joint hypermobility also plays a role in this - and other risk factors include being female and being on the thinner side, for some strange reason. So the complicating diagnoses of POTS, EDS, CC, and MCAS really feed right into the risk of cording.
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Disclaimer: This and any other videos by Dr. Ginger Garner and the Living Well team do not constitute a patient-provider relationship nor are they a substitute for medical care or physical therapy. By participating in these videos user assumes all risk. Before starting this or any other exercise regimen you should seek the advice and/or clearance of your physician, nurse practitioner, and/or physical therapist.
22 янв 2024
