Baker´s Cyst

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What is Baker’s cyst?

Baker’s cyst is a liquid-filled swelling that can cause a bulge and a feeling of tightness in the back of the knee. Baker’s cyst is related to chronic knee inflammation, which can have different underlying causes: from simple overuse problems to severe lesions of the cartilage or meniscus, and all kinds of systemic chronic inflammation.

How can it occur?

The cause of Baker’s cyst is usually found inside the knee. It occurs when the joint produces excessive amounts of liquid due to chronic inflammation. The trigger for this inflammation can be a cartilage or a meniscus issue, but it does not necessarily imply a severe structural problem. Poor stabilization of the knee can also cause inflammation due to the increased mechanical stress on the joint in periods of particularly intense training.
As pressure builds up inside the knee from the high levels of liquid, this will gradually extend the joint capsule in the back of the knee and may form a liquid-filled cyst. The amount of liquid inside the cyst, and therefore its size, will depend on the severity of the inflammation. Especially when training impact is high, Baker’s cysts can swell up to the size of a plum, or even bigger, causing a lot of pain and limiting the range of movement of the knee.

What are the typical symptoms of a Baker’s cyst?

You may feel a tension or pain in the back of your knee. If the Baker’s cyst is big enough, you will be able to feel a bulge that can vary in size.

How can a Baker´s cyst be diagnosed?

Your doctor will examine your knee and may find a bulge in the back of your knee. Ultrasound is an easy way to identify a Baker’s cyst, however, an MRI scan will often be needed to identify cartilage or meniscus problems as the cause of the cyst.
If no structural damage is found in the MRI, an exact analysis of the factors that can cause overuse in the knee will have to be performed. Setting a correct diagnosis of this issue demands a thorough functional clinical examination, including specific tests to identify joint and muscle dysfunction. Finding out the exact causes of Baker’s cyst is often challenging and your doctor may ask a specialist in manual medicine for his opinion.

bakerscyst

This MRI scan shows a little Baker’s cyst in the back of the knee. Fluids appear white in this picture. You can easily spot the Baker’s cyst as it is filled up with liquid.

What treatment options are there?

As pointed out above, there is usually another problem behind the cyst that has to be addressed. Once this problem is solved the cyst will usually disappear by itself. Wearing a brace around your knee may release discomfort caused by a Baker’s cyst.
In order to handle a given overuse situation in the course of rehabilitation, its underlying causes – namely muscle dysfunction and muscle dysbalance – have to be addressed specifically. Muscle dysfunction can appear as muscle tightness (contraction) or weakness (inhibition) and the muscles affected have to be treated accordingly in the rehabilitation process. Some muscles will have to be stretched whereas others will rather have to be strengthened. A well-suited training program including corrective exercises as well as a general strengthening and endurance routine is the most effective way to deal with most overuse situations.
Manual medicine and especially deep myofascial release treatment is recommended to address present joint and myofascial dysfunction. Restriction of the fascia plays a key role in all overuse issues and can be addressed effectively with manual medicine. Ensure that you follow your specific training routine after the rehabilitation is finished. Myofascial rollers (Blackroll, Triggerpoint Roll, etc.) as well as Lacrosse balls and resistance bands are easy to use in the studio and will help you remain balanced in the long run.

Next steps

Do you think that you might have a Baker’s cyst and want to have it sorted out? These are the next steps:

  • See a doctor

Dancers seek help from various different kinds of therapists, many of whom may employ treatments that are outside of mainstream medicine. Before considering the use of such alternative medicine, you should see a doctor for an evaluation and diagnosis.
Finding a doctor who is familiar with the specific medical issues faced by dancers is often challenging and you may need to see several different specialists in order to get a full picture of your diagnosis. A good place to start is to ask your friends and fellow dancers for the names of their favorite doctors.

  • Find a specialist in manual medicine

Doctors who specialize in manual medicine practice a whole-body approach. They will try to identify and specifically treat the underlying causes of your problem, rather than just the localized symptoms. This approach is important in addressing all aspects of the often very complex overuse problems that dancers experience. A specialist in manual medicine will perform a functional examination on every part of your body and will treat you according to these thorough findings.
To find a physician who specializes in this field, search for “Manual Medicine”, “Osteopathic Manipulative Medicine” or “Osteopathic Physician” on the internet.

  • Start working on your problem

There is a lot that you can do to work on your problem after a proper diagnosis has been set. Ultimately, it often comes down to addressing the same fundamental issues. Here are some useful exercises that I recommend to my patients:

Flexibility trainingITB release, Rectus femoris release, Hamstrings release, Adduktor release, Psoas stretch, Lumbar spine releasePiriformis release,

Strength training: Core training – resistance band workout, Core training – Abs crunches, “The clamshell” – Piriformis training, “The monster walk” – Piriformis training

Please refer to your doctor to confirm that the exercises you choose to do are suited to your individual problem, and obtain supervision from a professional trainer to ensure that you are performing them correctly.

  • Talk to your ballet master or dance teacher

Technical issues and faulty dance technique are important predisposing factors of overuse and injury in dancers. Amending dance techniques often plays a crucial role in the treatment and prevention of overuse and injury and you should not hesitate to address any issues, if necessary.


 

 


Medical Disclaimer