A Baker’s Cyst (also called a popliteal cyst) is a fluid-filled sac that develops behind the knee. It occurs when excess joint fluid (synovial fluid) seeps out into the space behind the knee joint. A Baker’s Cyst is often a symptom of underlying conditions such as osteoarthritis or knee injury. 

A Baker’s Cyst will appear as a protruding area of swelling localized to the back of the knee. It will feel taut and sensitive to the touch. The swelling at times may extend up or below the knee. The knee will feel stiff, tight and have increased pressure/pain when bending or straightening the knee. Numbness behind the knee can occur with excess swelling occluding the nerves behind the knee. Pain may be felt with going up/downstairs, bending/squatting activities and fully straightening the knee (ex. kicking). 

A Baker’s Cyst can be caused by injuries or degenerative changes within the knee joint. Tears of the cartilage (meniscus) and osteoarthritis can cause inflammation/swelling within the knee joint space. Repetitive activities of fitness or weight-training can cause stress to the knee joint. These activities can include squats, lunges and jumping activities. 

R.I.C.E

There are treatment options available to address a Baker’s Cyst depending upon its severity. The most conservative approach is to rest, ice, compress and elevate the knee for 3-7 days following an injury. Ice can be applied for 10-15 minutes 3-4x/day with the leg elevated above the heart. To control the swelling, compression can be applied to the knee using an ace wrap or knee compression sleeve. Over the counter anti-inflammatory medication (Ibuprofen, Naproxen) can be taken to control inflammation/swelling of the knee. 

Orthopedic Knee Specialist

If swelling of the Baker’s Cyst persists, it is best to see an orthopedic knee specialist to assess the knee and provide possible treatment. An X-ray will be taken to assess the integrity of the knee joint. A cortisone injection may be given into the knee joint space to reduce inflammation. In severe cases, the orthopedic specialist may elect to aspirate (drain) the knee to relieve pressure. Surgical intervention may be indicated to address or correct the underlying issue that is creating the Baker’s Cyst. Common conditions leading to joint inflammation can be meniscus tears or osteoarthritis. Arthroscopic knee surgery will be needed to repair the meniscus and a total knee replacement indicated with moderate to severe cases of osteoarthritis.

Physical Therapy

Physical Therapy can begin once the underlying issues causing the Baker’s Cyst are resolved. This can include non-operative or postoperative intervention to improve knee joint function, strength, flexibility, and mobility. The patient will be evaluated by a Physical Therapist and a plan care will be administered. Therapy sessions most likely will include manual treatment to the knee, specific strengthening exercises, stretching of the muscles that connect to the knee, gait and stair climbing training.

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