Baker's Cyst

A Baker's cyst is a swelling at the back of the knee. The entire knee joint is enclosed within a capsule which is lined with a membrane and filled with synovial fluid that lubricates the joint. It is suggested that some people have a small pouch at the back of the knee with is created by extra tissue. When these people suffer a knee injury, then the body's response is to secrete more synovial fluid into the knee which tends to accumulate and fill this pouch causing the Baker's cyst.

Baker's Cyst - Symptoms
In some individuals, a Baker's cyst causes no discomfort or pain and has no obvious symptoms. When symptoms do occur then the most common ones observed are:

• A round mass or swelling behind the knee joint which may be soft or hard and is most apparent when the person is standing.
• A sense of pressure behind the knee which may go down into the calf muscle.
• Pain in the knee and a restricted range of motion.
• Persistent pain and tenderness post exercise.

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Causes for a Baker's Cyst
The most common cause of a Baker's Cyst is after an injury when damage to the knee capsule results in a build-up of synovial fluid as referred to above. The specific injury can include a torn cartilage, arthritis or even an infection in the knee joint. For those children who develop a Baker's cyst occasionally there may be no obvious reason for the cyst to have developed.

Diagnosis of a Baker's cyst
Suitably trained medical practitioners use a number of tests that are used to diagnose a Baker's cyst. These include:

• A physical examination of the knee + medical history.
• A popular easy diagnostic tool is to turn off lights and shine a flashlight through any lump. Presence of a red glow indicates that the lump contains fluid.
• Magnetic imaging resonance (MRI).
• X-rays of the knee do not show a cyst but can indicate other trauma or arthritis damage to the knee.

Treatment of a Baker's Cyst
If there is little or no pain then there may not need to be any active treatment and a doctor will just monitor the cyst over time. If treatment is indicated then the options include:

• Treatment for the underlying cause, such as medication for arthritis or surgery for torn knee cartilage.
• Avoid doing anything that can aggravate the knee joint.
• Injections of Cortisone.
• Aspirating the cyst with a needle to drain off the fluid.
• Surgery to remove the cyst entirely (extreme cases).

With any treatment plan for a Baker's cyst then rest and elevation is generally recommended to reduce the chance of the cyst returning. For children then the approach of watching and waiting is recommended as the cyst often subsides spontaneously.

Massage Therapy and Baker's Cyst
As the cysts are normally located in the popliteal region which is generally considered as an area contraindicated for most massage techniques then a massage therapist should not apply any deep pressure directly onto the cyst. The role of the massage therapist is more aimed at alleviating the underlying knee problem.

Massage to the area superior to the cyst can have therapeutic benefits i.e. balancing the muscles that influence the knee joint such as hamstrings and adductors. It is suggested that lymphatic drainage techniques may assist in reducing swelling and facilitating recovery through increasing the rate of absorption of the excessive synovial fluid.

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