Shoulder Kinematics of Axillary Web Syndrome in Women Treated for Breast Cancer

Renata Braudy, Brittany Atoms, Jenna Coghlan, Meaghan Staples, David Moga, Ryan Tollefsrud, Rebekah L. Lawrence, Paula Ludewig, Linda Koehler

Research output: Contribution to journalArticlepeer-review


Objective: To better understand how the shoulder moves in breast cancer survivors with axillary web syndrome (AWS), we compared 3-dimensional (3D) shoulder kinematics during shoulder elevation among breast cancer survivors with and without AWS 5 years postoperatively. Although research consistently shows decreased shoulder range of motion with AWS, we do not understand the underlying biomechanics. Design: Nested case control study. Setting: University Academic Breast Center. Participants: Twenty-five women who had surgery 5 years previously for unilateral breast cancer with the removal of at least 1 lymph node participated in this study (N=25). Twelve participants had AWS; 13 women did not have AWS. Interventions: Not applicable. Main Outcome Measures: Three-dimensional shoulder kinematic data during shoulder forward flexion, scapular plane abduction, and coronal plane abduction were collected using 3D electromagnetic motion tracking. Kinematic data were extracted at 30°, 60°, 90°, and 120° of arm elevation for scapular upward rotation, internal rotation, and posterior tilt as well as for glenohumeral external rotation. Results: Women with AWS demonstrated 15.2° less scapular upward rotation at 120° humerothoracic elevation (95% confidence interval [-25.2, -5.2], P=.005), regardless of plane. No significant between-group differences were found for any other angle of scapular upward rotation, nor for scapular internal rotation, scapular posterior tilt, or glenohumeral axial rotation at any angle. Conclusions: Five years after surgery for breast cancer, women diagnosed with AWS have altered scapulohumeral kinematics that may place them at an increased risk of shoulder pain based on existing kinematic literature in healthy cohorts. This information can help guide rehabilitation programs for breast cancer survivors to facilitate pain-free upper extremity function after treatment.

Original languageEnglish (US)
Pages (from-to)403-409
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Issue number3
StatePublished - Mar 2023

Bibliographical note

Funding Information:
Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number K12HD055887, the Powell Center Fund for Women's Health Advancement endowment at the University of Minnesota, administered by the University of Minnesota Women's Health Research Program, and in part by shared resources via NIH P30 CA77598, utilizing Masonic Cancer Center's shared resources, and NCATS CTSA UL1TR002494, University of Minnesota. The funding sources played no role in the design, conduct, or reporting of this study.

Publisher Copyright:
© 2022


  • Axillary Web Syndrome
  • Breast Neoplasms
  • Cording
  • Kinematics
  • Lymph Nodes
  • Rehabilitation
  • Scapula
  • Shoulder

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


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