For the Health of It: Cording Web Syndrome Treatments

Tyler Ryan and Hima Dalal discuss shoulder issues that can arise from breast cancer surgery

Cording / Axillary Web Syndrome -Breast Cancer &
Integrative Rehab

● Definition: Cording, also known as Axillary Web Syndrome (AWS), is a complication
that can occur after breast cancer surgery, especially when lymph nodes in the
underarm (axilla) are removed.
● Cause: Removing or damaging lymph vessels and connective tissues during surgery
causes these structures to form cord‑like bands of scar tissue or hardened lymphatic
vessels. These cords run from under the arm, often down the inner arm, chest, even to
wrist or forearm. Inflammation, scarring, lymphatic damage, and connective tissue
changes contribute.

Symptoms of Cording
Some of the common symptoms include:
● Feeling of tightness, pulling, or tight band under the skin, especially when raising the
arm, reaching overhead, or stretching.
● Visible or palpable cords under the skin, in the armpit, inner arm, or along the chest.
● Pain, burning, or sharp discomfort when stretching, raising the arm, or during certain
movements.
● Restricted range of motion of shoulder and/or elbow: difficulty lifting the arm, extending
the elbow, or doing overhead activities.
● Tenderness, sometimes other sensations like tingling or numbness.
● Timing: Symptoms often begin a few days to several weeks post‑surgery but may also
show up months or even years later.

Why Integrative Rehabilitation Helps
Integrative rehab combines conventional physical/occupational therapy with complementary
approaches (holistic/manual/energy‑based) and addresses not only the physical but also
emotional, energetic, and connective tissue health. Here’s how:
1. Manual physical therapies

○ Soft tissue mobilization, massage, myofascial release etc., help loosen the tight
scar tissue and cords, allowing better mobility. These techniques help to stretch,
soften, break adhesions.
○ Gentle stretching, range‑of‑motion exercises help maintain or restore
shoulder/elbow flexibility. Consistency matters.
2. Lymphatic health & lymphedema prevention
○ When lymph nodes are removed, there's risk both of lymphedema and scar
formation. Therapy that addresses lymph flow (manual lymph drainage, edema
control) can help reduce swelling that exacerbates tissue tension.

3. Scar mobilization
○ Scar tissue (from surgery, mastectomy, node removal) often tethers the skin,
fascia, and underlying tissues. Mobilizing scars (through massage, manual
therapy) helps reduce restrictions.
4. Functional training and movement re‑education
○ Teaching proper posture, alignment, careful movement, avoiding compensatory
movement. Ensuring patients gradually regain function with guidance so that pain
or fear doesn’t lead to disuse, which otherwise can worsen stiffness or even lead
to frozen shoulder.

5. Holistic / energy / emotional dimensions
○ Often physical scarring and tissue damage carries emotional trauma; pain, fear
of movement, anxiety over cancer recurrence etc. Integrative therapies address
those, which helps reduce secondary tension, stress‑induced muscle guarding,
and improves overall healing environment.

6. Early intervention
○ The earlier therapy is started, the better the outcomes, less long‑term
impairment.

Hima Dalal’s Role & Crystal Myofascial Release (C‑MFR)
Hima Dalal – Credentials & Experience
● She is an Integrative Occupational Therapist with 43 years of experience.
● She is a Cancer Rehabilitation Specialist and Lymphedema Rehab Specialist.
● She has training in myofascial release, scar tissue management, craniosacral therapy,
energy medicine, wellness practice, etc.
So she is a well‑established authority in integrative breast cancer rehab, particularly for
managing scarring, cords, lymphedema.

Crystal Myofascial Release (C‑MFR) — What It Is & Why It May Be
Particularly Helpful
From what Hima Dalal describes, Crystal Myofascial Release (C‑MFR) is her invented/hybrid
technique that blends elements of traditional myofascial release with crystals, energy work,
acupressure/acupuncture point knowledge, and manual therapy.
Some features & advantages:
● Use of crystals: The crystals are used to assist in the release of fascia, which may help
emotionally and physically. They are said to store “universal life‑force energy” and help
in releasing emotional trauma held in muscles via muscle memory.
● Less invasive / less painful: Compared to some tools (like plastic/metal scraping tools)
or aggressive manipulation, using crystals might provide a gentler method, reducing
discomfort or risk of over‑trauma.
● Targeted for fascia, scars, soft tissue restrictions: Especially helpful when typical
therapy hasn’t fully resolved restrictions. Scars after mastectomy or node removal are
amenable to this approach.
● Holistic dimension: It combines physical release with energetic/emotional release,
which may help patients who feel pain or restriction isn’t just physical but also tied to the
surgery, to stress, fear, or trauma.
● For Any questions contact
● www.himadalalintegrativehealth.com