If you have noticed a tight, string-like band pulling under your arm since your breast surgery, and it catches or stings when you reach up, you are not imagining it and you are far from alone. This is cording, and it unsettles many women because it appears without warning and can feel as though something has gone wrong. It has not. I am Fara Sonday, a specialist oncology and pelvic health physiotherapist with more than 20 years of experience, registered with the HCPC and CSP, and I assess and treat cording regularly at PhysioReform, just off Tottenham Court Road between Fitzrovia and Bloomsbury.
What is axillary web syndrome?
Axillary web syndrome, commonly called cording, is one or more tight bands of tissue that run from the armpit down the inner arm, sometimes as far as the wrist or thumb.
You can often see or feel these cords standing out under the skin when you lift your arm. Cancer Research UK describes them as feeling something like a guitar string, harmless in themselves but capable of causing pain and limiting how far you can raise the arm. The bands are thought to involve hardened lymphatic and connective tissue rather than anything sinister, which is why cording is uncomfortable and restrictive but not dangerous.
Why cording happens after breast cancer surgery
Cording tends to follow surgery that disturbs the lymph nodes under the arm, such as a sentinel lymph node biopsy or an axillary clearance.
When lymph nodes are removed or sampled, the nearby connective tissue and lymphatic channels can respond by tightening and scarring. This is why arm tightness after lymph node removal is such a common experience, and why cording often shows up in the first few weeks after an operation, although it can appear months later too. It frequently sits alongside more general shoulder stiffness after a mastectomy or lumpectomy, and the two can feed into each other, since a sore, guarded shoulder tends to move less, and a shoulder that moves less tends to stiffen further.
How do I know it is cording, and what should I check?
Cording usually looks like a visible tight band that pulls sharply when you raise your arm, but anything hot, red or rapidly swelling needs prompt review rather than stretching.
The classic sign is a cord you can feel snap or twang gently as you reach overhead, with a pulling sensation down the inner arm. What you should not ignore is spreading redness, heat, a temperature, or sudden marked swelling of the whole arm. Those signs can point to infection, lymphoedema or, rarely, a clot, and they should be checked quickly with your surgical or breast care team rather than treated as cording. If you are ever unsure which you are dealing with, it is always reasonable to ask. Reassurance is part of good care.
How does physiotherapy treat cording?
Physiotherapy for cording combines gentle stretching, hands-on soft tissue release and a graded return of shoulder movement, which eases pain and restores reach more quickly than waiting alone.
What can I safely do between appointments?
In clinic I start by confirming what is actually happening, then work through the cords with soft tissue and myofascial techniques, light scar work where relevant, and stretches you can build on safely at home. Progress is usually steady rather than instant, and most women regain comfortable movement over a number of weeks. This hands-on, individualised approach is the heart of our breast cancer rehabilitation work, and it often folds into a wider recovery plan covering shoulder range, posture and returning to the activities that matter to you. For anyone still awaiting an operation, the same principles apply beforehand through pre- and post-operative rehabilitation, which can make the early recovery period feel far more manageable. Because cording sits within women’s health as a whole, treatment sometimes overlaps with our broader women’s health physiotherapy too.
Keep the arm gently moving within a comfortable range, use warmth before you stretch, and massage the cords lightly rather than forcing them.
Small and frequent beats hard and occasional. A warm shower or compress before your exercises helps the tissue relax, and gentle daily reaching, well within the point of sharp pain, keeps the shoulder from stiffening. Light massage along the cords can soften them over time. Cording exercises should feel like a firm stretch, never a fight. If something sharply worsens or a new symptom appears, pause and check in with your team.
Common questions about cording
Does cording go away on its own?
It often settles over several weeks, but physiotherapy tends to speed recovery, reduce pain and restore movement sooner, which matters if the tightness is interfering with sleep, dressing or work.
How long does cording last?
It varies from person to person. Many cases improve within a few weeks to a couple of months with the right guidance, and some resolve and then briefly return, which is normal and not a setback.
Cording is common, treatable and, in almost all cases, temporary. You do not need to accept a stiff, painful arm as the price of recovery, whether you are in Fitzrovia, Bloomsbury or elsewhere across the West End.
Book an appointment
If cording or arm tightness is limiting you after breast surgery, you do not have to wait it out alone. Book Appointment and we will assess what is happening and start you on a clear, gentle plan to get your movement and confidence back.