Baker’s Cyst Knee Physiotherapy

Baker’s cyst is called baker’s cyst not because bread/cake-baking bakers get it, but because it was discovered in the 19th century by Dr William Baker. It’s an inflammation of a bursa behind the knee, but it’s more accurate to say its a semimembranosus bursitis or a popliteal cyst.

It’s one of the most common causes of behind-the-knee

  • knee swelling
  • knee pain
  • knee stiffness

So you must know behind our knees there is this structure called the popliteal bursa, it’s a pretty small fluid-filled pocket that is located between the hamstring muscle tendon and knee bone, and it’s #1 job is to reduce friction.

These popliteal cysts tends to affect patients who are over 40 and affect women more than men.

Does something specific causes baker’s cyst?

It typically develops when there’s excess fluid in the knee joint and because of that, there are so many factors that can cause swelling in and behind the knee.

The most common cause of it is knee osteoarthritis, which is a condition where the knee joint wears out due to normal wear and tear. This can lead to swelling in the knee joint. That’s why, 1 in 2 patients who suffers of knee osteoarthritis tends to develop baker’s cyst at some point in their lives.

Other things that can cause and contribute to it are

  • gouty knees
  • knee injuries that causes swelling such as anteriour cruciate ligament injuries, knee cartilage injuries or patellar injuries

The excess synovial fluid can seep out of the joint and into the semimembranosus bursa, casuing swelling resulting in knee bursitis.

What are the symptoms of bakers cyst

The average size of a Baker’s cyst is about 3 cm.

The first symptom patients tend to experience is the awareness of a bulge behind their knee, it’s an unusual experience for people as it feels like an internal

  • small water balloon
  • squash fruit

Some people dont even notice it because it can be so small and minor swelling…but in some cases, it can get pretty large.

These kinds can cause pain behind the knee, tightness in the knee as well as knee stiffness – especially when you bend and straighten the knee. Knee pains that are related with these kinds of popliteal cysts tends to get worse / aggravated with

  • activities
  • when standing for long periods

Resting always help bring down the pain and inflammation.

Diagnosing bakers cyst

Diagnosing a popliteal cyst is usually done by your doctor (can be a family doctor, or orthopedic surgeon) based on what you share with them; following by a manual assessment where they will see and palpate to confirm.

In some cases, they may call for an imaging test (typically MRI) to confirm the diagnose of a baker’s knee cyst.

The symptoms of a ruptured popliteal cyst can be similar to those of a DVT (a blood clot in the leg) so if you experience pain in your calf accompanied by any swelling, redness or heat, see your doctor immediately.

Baker cyst treatment options

There are a number of things that can help to treat a bakers cyst including:

  1. Cold therapy can help reduce the swelling in the knee and the bursa, which in turn will help to reduce the pain.
  2. Medication such as non-steroidal anti-inflammatory Drugs (NSAIDs) e.g. ibuprofen can help to reduce pain and swelling with popliteal bursitis, but they should only ever be taken on advice of the doctor due to the potential side effects.
  3. Gentle stretching can help with tightness in the muscles around the knee. Tightness can aggravate a popliteal cyst by squashing it which can lead to further inflammation. That’s why specific knee stretches can be very effective.
  4. Aspiration If a bakers cyst is too large and causes a lot of discomfort and pain behind the knee, then the excess fluid can be drained with a needle by your orthopedic doctor or GP. It is a fairly straight forward and simple procedure and usually provides instant relief. That being said…it is very common for the fluid to re-accumulate in the bursa if the underlying cause of the bursitis is not addressed
  5. Injections Knee bursitis can respond well to cortisone injections. This is where your doctor injects a mixture of steroid and local anaesthetic into the knee which works to reduce the swelling and reduce the pain behind the knee. Again, the benefits are usually fairly instant but are often short lived as the swelling behind the knee will return after some time.
  6. Surgery Whilst not usually necessary, in a small number of cases, surgery may be recommended. This is usually the case if the popliteal cyst is a result of long-term damage in the knee e.g. cartilage tear or arthritis

Golden question: how to prevent baker’s cyst from coming back

The unfortunate problem is that baker’s cysts tends to come back, especially for people who has knee arthritis or knee osteoarthritis.

What physiotherapy can do is to help provide graded specific knee strengthening and stretches physiotherapy. Strengthening the muscles help to offload and absorb the forces that go through the knee joint, protecting it and decreasing chances of knee swelling that may lead to knee cyst.

This is especially the case when the popliteal cyst has developed due to arthritis.

Is there any possible complications?

Yes…sometimes a bakers knee cyst can burst.

If that should ever happen…then the fluid from inside the cyst (bursa) will be released localled where it was, and it will be slowly absorbed back into the leg and then body. Sometimes this can cause swelling and pain in the calf muscles and knee.

It’s take about 10-20 days thereabouts.

Baker’s cyst knee pain physiotherapy

Physiotherapist can help provide to ease the pain and accelerate soft tissue healing and knee strength and range of motion:

  • cold therapy
  • moist heat paraffin wax therapy
  • radio-frequency Indiba physiotherapy to accelerate soft tissue healing
  • joint mobilization
  • stretching exercises
  • strengthening exercises
  • scar management
  • hands on manipulation and mobilization (manual therapy)
  • computerized spinal decompression traction
  • soft tissue management
  • heat therapy and heat treatment and heat pack to relief tight muscles and joints
  • ultrasound therapy to accelerate soft tissue healing
  • exercise therapy
  • acupuncture and/or dry needling
  • deep tissue release
  • and more

Where To Next?

Leave a Comment