Your knees are like the hinges of your body, allowing you to bend, straighten and twist your legs. They’re incredibly complex joints, made up of bones, cartilage, ligaments and tendons. Your knees are essential for everyday activities, from walking and running to sitting and standing. They bear a lot of weight, especially when you’re active. Strong, healthy knees are crucial for your mobility and independence. However, sometimes, your knees can fall prey to a wide range of issues, including a Baker’s cyst.

A Baker’s cyst is a fluid-filled sac that can form on the back of the knee. This cyst occurs when there is a buildup of fluid in the knee joint. While Baker’s cysts can be a nuisance, they’re actually quite common. 

If you have a Baker’s cyst, you may notice:

• A lump behind your knee
• Swelling and stiffness in your knee
• Pain, especially when bending your knee

A Baker’s cyst itself usually doesn’t cause much pain. However, it can sometimes press on nerves or blood vessels, leading to discomfort or numbness. If you have a Baker’s cyst, there are several effective treatments available to help you manage it, including physical therapy. 

The culprits behind a Baker’s cyst

Baker’s cysts can be the result of an underlying knee problem. Culprits that can lead to the development of a Baker’s cyst include:

• Knee arthritis — Conditions like osteoarthritis and rheumatoid arthritis can cause inflammation in the knee joint, leading to excess fluid production and, ultimately, a Baker’s cyst. 
• Meniscus tears — The meniscus is a C-shaped cartilage pad that cushions your knee joints. If the meniscus tears, it can cause swelling and inflammation, which may trigger a Baker’s cyst. 
• Knee injuries — Any injury to the knee, such as a sprain or strain, can lead to an increase in fluid production and the formation of a Baker’s cyst. 

While anyone can develop a Baker’s cyst, certain factors can increase your risk:

• Age — As you get older, your joints, including your knees, can become more susceptible to wear and tear, making you more likely to develop arthritis and other conditions that can lead to Baker’s cysts. 
• Physical activity — Athletes and people who do high-impact activities are at a higher risk of knee injuries, which can trigger cyst formation. 
• Previous knee injuries — If you’ve had a knee injury in the past, you may be more likely to develop a Baker’s cyst. 

Understanding the causes and risk factors of Baker’s cysts is crucial for prevention and effective treatment. By taking steps to protect your knees and addressing underlying conditions, you can reduce your chances of experiencing this common knee problem. 

How is a Baker’s cyst diagnosed?

If you’re concerned you may have a Baker’s cyst, how does the diagnostic process go? 

• A physical exam — The first step in diagnosing a Baker’s cyst is a physical exam. Your doctor will do the following:
• Examine your knee
• Check your range of motion
• Feel for the cyst
• Imaging tests — In some cases, your doctor may order imaging tests to get a better look at your knee joint. These tests can help confirm the diagnosis and identify any underlying conditions that may be causing the cyst. Imaging tests may include:
• Ultrasound
• Magnetic resonance imaging (MRI)
• X-rays

By combining a physical exam with imaging tests, your doctor can accurately diagnose a Baker’s cyst and recommend treatment. 

Treatment options for a Baker’s cyst

The good news is that most Baker’s cysts don’t require aggressive treatment. Often, they resolve on their own over time. However, if your cyst is causing pain or limiting your activities, your doctor may recommend one of the following treatments:

• RICE method — This classic treatment approach can help reduce pain and swelling. RICE stands for:
• Rest — Avoid activities that aggravate your knee. 
• Ice — Apply ice packs to your knee for 10 to 15 minutes at a time, several times a day. Be sure to use a towel or other form of barrier between your knee and the ice pack to prevent tissue damage from the ice. 
• Compression — Wrap your knee with an elastic bandage to help reduce swelling. 
• Elevate — Elevate your leg above your heart to help reduce swelling.
• Medication — Over-the-counter pain relievers like ibuprofen or acetaminophen can help you manage pain and inflammation.
• Physical therapy — A physical therapist can teach you exercises to strengthen the muscles around your knee and improve flexibility. 
• Aspiration — If deemed necessary, your doctor may recommend an aspiration. This procedure involves your doctor inserting a needle into the cyst to drain fluid.
• Corticosteroid injection — A corticosteroid injection can provide targeted and temporary inflammation and pain reduction. 
• Surgery — In rare cases, surgery may be necessary to remove the cyst or address an underlying knee problem. 

The best treatment for your Baker’s cyst will depend on the severity of your symptoms and the underlying cause. It’s essential to consult with your doctor to determine the most appropriate treatment plan. 

Physical therapy techniques that can help a Baker’s cyst

Physical therapy can be a powerful tool to help you manage a Baker’s cyst. Some techniques your physical therapist may use in your customized treatment plan may include:

• Therapeutic exercises — Therapeutic exercises are exercises designed to help target specific areas of concern. For a Baker’s cyst, your physical therapist may choose exercises such as:
• Range-of-motion exercises — These exercises can help improve the flexibility of your knee joint. Your physical therapist may guide you through gentle bends, stretches and rotations. Heel slides are a simple exercise for restoring flexibility in your knee. While lying on your back, slide your heel toward your glutes, bending your knee as much as is comfortable, and then gently straighten it out again. 
• Strengthening exercises — Building strength in the muscles surrounding your knee, particularly the quadriceps and hamstrings, can help stabilize your joint and reduce stress on it. A standing calf stretch can help alleviate tension in the back of the knee. Stand facing a wall, place one leg back, and keep it straight as you bend your front knee. Lean forward gently to stretch the calf of the straight leg. 
• Manual therapy — Manual therapy techniques encompass a wide range of hands-on techniques including:
• Soft tissue manipulation — Your physical therapist may use their hands or special tools to apply gentle pressure to soft tissue like muscles and tendons to help relieve tension and boost blood flow. Techniques may include kneading and stroking motions to loosen tight areas and relieve pressure on the cyst. Manipulating around the hamstrings and calves can ease tension in the back of the knee and help reduce discomfort from the cyst. 
• Joint mobilization — Your physical therapist may guide your knee through gentle movements to help improve its range of motion and reduce stiffness. Gentle mobilization of your knee can help improve synovial fluid movement, potentially decreasing fluid buildup in the back of the knee. 
• Electrical stimulation — Your physical therapist may place electrodes around the affected knee. These electrodes deliver low-level electrical currents to stimulate nerves and muscles, reducing pain and promoting healing. 
• Aquatic therapy — The buoyancy of water reduces impact on the knee while providing natural resistance. Your physical therapist may guide you through exercises such as water walking, leg raises and knee bends to improve joint function in a low-stress environment. 

By incorporating these techniques, physical therapy can provide a comprehensive approach to managing a Baker’s cyst, helping to reduce pain, improve mobility and enhance overall knee function. 

The risks of ignoring a Baker’s cyst

While Baker’s cysts often resolve on their own, leaving them untreated can sometimes lead to complications, such as:

• Rupture — One of the most common complications is a ruptured cyst. When this happens, fluid from the cyst leaks into the calf muscle, causing sudden, sharp pain, swelling, and sometimes a feeling of water running down your leg. This can be mistaken for a blood clot, so it’s important to seek medical attention. 
• Limited mobility — Persistent swelling and pain from a Baker’s cyst can restrict your range of motion and make it hard to do daily activities.
• Nerve compression — In rare cases, a large Baker’s cyst can press on nerves in the leg, causing numbness, tingling or weakness. 

To help minimize your risk of complications, it’s best to consult with a health care provider if you suspect you have a Baker’s cyst. They can assess your symptoms, diagnose your condition and recommend appropriate treatment. 

Recover with confidence at Lattimore Physical Therapy

At Lattimore Physical Therapy, we understand that every patient’s journey with a Baker’s cyst is unique. Our team is dedicated to providing personalized care to help you achieve optimal results and regain comfortable mobility. Through individualized treatment plans, we use effective techniques to address your specific needs and ease the discomfort of a Baker’s cyst. Let us partner with you on your path to relief with compassionate support and specialized expertise. Trust our team at Lattimore PT to help you live your best, active life. 

Contact our team today for more information or to schedule an initial appointment.