A Baker's cyst is a general term used to describe most synovial herniations around the knee. A herniation occurs when the supportive structures of your joint, in this case the synovium, begins to stick out of the joint capsule. It can also be used to describe bursitis, or inflammation of the bursa, occurring in the back of the knee joint. While most Baker's cysts are not a serious problem and may even go away on their own, obtaining full range of motion of the knee joint can be painful. Treatment including physical therapy may be prescribed in order to improve your condition.
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Signs and Symptoms
You may have a Baker's cyst if you feel pain and there is noticeable swelling in or around the knee. Pain or swelling in the top of bottom portions of your knee can indicate bursitis in the top or bottom articulations of your knee. If there is pain and swelling on the medial, or inside of your knee, you may be experiencing bursitis of the collateral ligament located on the tibial bone side of your knee joint.
To control inflammation and reduce pain and swelling from the bursitis, your doctor may first offer a quick fix. Draining the bursa can reduce swelling and a corticosteroid injection may reduce pain. However, these strategies cannot be administered for the long term. This is especially true for a steroid injection as the medication can degrade other tendons and ligaments.
If physical therapy is prescribed for your condition, you will meet with a physical therapist who will work to reduce pain and swelling. Treatment may include ice and compression therapy to reduce inflammation. You may also be asked to do range of motion exercises. They increase the motion of the joint as well as increase flexibility. As your condition improves, the physical therapist may suggest ways to strengthen the muscles around the knee. The stronger your muscles are, the lighter the load on the knee.
Range of Motion Exercises
To increase the pain-free range of motion for your knee joint and leg, you may have to do flexibility and range exercises. These may include a quadriceps stretch, hamstring stretch, heel slides, wall slides and prone leg hangs. A quadriceps stretch increases the flexibility of your quadriceps muscles located in the front of your legs while a hamstring stretch increases the flexibility of the muscles in the back of your legs. A heel slide also increases range of motion. Sitting with your knees bent, slowly slide your heel back and forth on the ground slowly increasing the range. A wall slide is similar to a heel slide, only you are lying on your back and sliding your foot up and down a wall. A prone leg hang involves lying on your stomach and hanging your injured leg, slowly increasing the amount it can be straightened.
The quadriceps and hamstring muscles control the motion of the knees. During physical therapy, a goal may be to increase the strength of these muscles. Exercises such as knee extensions, hamstring curls, lunges and squats may be prescribed. A knee extension involves extending your knees against weight. Hamstring curls involve flexing your knees against weight. To perform a lunge, step forward with one leg, keeping your back leg straight, dip down by bending your knee of the front leg. To do a squat, stand with your feet hip-width distance apart with your back straight and your glutes out. Lower yourself down by bending both knees. Your knees should not go over your toes. Strengthening exercises may begin at a light intensity and will increase to one to three sets of 10 to 15 repetitions.