Treating Axillary Web Syndrome with Sports Medicine Acupuncture

Patient MG is a healthy and active 59 year old female who was originally coming in for knee pain and sciatica. At the end of her 3rd treatment she mentioned that she recently started experiencing some discomfort in her armpit, primarily a sensation of tightness and a stinging sensation, and when she looked at it in the mirror she noticed a cord-like structure running across her armpit to the medial arm that she had never noticed before. We did a shoulder assessment, but her range of motion was normal and all of the surrounding muscles of the shoulder joint seemed to be firing correctly and without pain. I had never seen or heard of any conditions that matched this presentation.

After researching it on her own, the patient sent me several articles about a condition called Axillary Web Syndrome (AWS). Axillary Web Syndrome is poorly understood in the medical literature. It is occasionally seen in women who have recently had surgery performed on their axillary lymph nodes for breast cancer. Some argue that the tight, cord-like tissue is part of the lymphatic system while others believe it to be tight fascial tissue. There is also a subset of patients who develop this condition idiopathically, meaning without any known cause. How or why this happens is not understood.

At her next treatment, MG and I decided to focus on treating the Axillary Web Syndrome to see how well Sports Medicine Acupuncture® might work to reduce her symptoms and return her shoulder to normal, healthy function. 

I decided to start first by treating the posterior rotator cuff muscles and the periscapular muscles (the muscles on and around the back of the shoulder). Even though the cord is on the front/inside of the shoulder, oftentimes an imbalance on one side of the body will be mirrored by a corresponding imbalance on the other side of the body. For instance, tight, shortened quadriceps muscles typically coexist with weak, lengthened hamstring muscles. On the front of the shoulder we treated the pecs and delts and the subscapularis. The subscapularis is the only muscle that can be accessed deep within the armpit, which is where the cord appears to originate. After acupuncture we did a myofascial technique to release the subscapularis muscle and surrounding fascial tissues.

This next picture was sent the day after our first AWS treatment. The cording appears to be almost completely gone and the patient reports that she feels significantly better, although there is still some mild tightness and stinging at the end range of motion.

By the next treatment the residual symptoms from AWS had completely disappeared and we were back to focusing on her original chief complaints of knee pain and sciatica.