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If you’re searching for a Baker’s Cyst treatment plan, you’ve most likely already been diagnosed with a Baker’s Cyst.
If not, the quick definition of a Baker’s Cyst is a pocket of fluid, big or small, behind the knee (see here for more information on why Baker’s Cysts happen).
It’s an “overflow” pocket from excessive or prolonged knee swelling.
It’s *not* a cyst like you’d classically imagine, a fluid-filled growth from an infection or disease.
We’ve gone into more detail on what a Baker’s Cyst is and how it behaves, so you can click here to recap.
After a diagnosis, the next logical step is figuring out a Baker’s Cyst treatment plan to get rid of it.
Most Baker’s Cyst treatment plans involve a combination of meds, braces, diet and Baker’s Cyst exercises.
Our team of Sports Physios have chipped in with their best tips and exercises for Baker’s Cyst treatment.
What can you do about knee swelling with a Baker’s Cyst?
Anti-inflammatory meds
(Warning: before starting any course of meds, you should speak to your Pharmacist about whether it’s appropriate for you).
The first step in Baker’s Cyst treatment is to reduce the size of the lump behind your knee.
Meds such as Advil, Nurofen or Voltaren can be helpful for very short term (1-2 weeks) relief of swelling.
They’re fast acting but come with a fair range of side effects, which get worse with prolonged use.
After 2 weeks, meds such as Mobic or Celebrex (which require a doctor’s prescription in most countries) are more appropriate for longer term use.
They’re slower acting but have less side effects, so they can be taken for months if needed.
Remember that meds can minimise new or additional swelling but they don’t get rid of swelling that’s already built up.
They work by reducing new swelling while the body absorbs the existing swelling, so they need to be used in conjunction with Baker’s Cyst exercises.
Reduced body weight
It might sound surprising but reducing your bodyweight by 5kg can reduce the loading on the knee by up to 40kg!
The difficulty here is that to reduce body weight, most people would exercise a little more but too much exercise will only worsen your Baker’s cyst.
So the best approach here is to use an effective diet that gets fast but sustainable results – no fad diets or crash diets.
Better shoes
Wearing more supportive footwear will reduce the abnormal (usually twisting) forces on the knee that cause irritation and swelling.
They do this by reducing the movement of the arch as you load the foot/leg – the arch dropping also causes an inwards twist of the leg.
While the arch movement (known as pronation) is necessary for normal function, excessive or uncontrolled pronation will overload the knee.
Running shoes and hiking shoes/boots are often better designed for cushioning and support.
Suffering from knee pain and need the right shoes?
Our Physio experts have listed the key features to look for in running shoes to help manage knee pain.
They also name their 8 most recommended running shoe models for knee pain.
Knee brace
Almost a mandatory addition to any Baker’s Cyst treatment plan, a firm compression brace can be very helpful in speeding up with absorption of existing swelling.
To understand how it works, we need to briefly go over how swelling inside the knee disappears.
Any fluid in the knee is constantly turned over/replaced by being absorbed through the knee cartilage and into the bone.
The cartilage also adds good quality, nutrient rich fluid to the knee.
So the two ways we can resolve the fluid overload is to reduce the new fluid added to the knee (anti-inflammatory meds, avoiding irritating movements) and speed up fluid absorption (braces, exercises).
The fluid pressure in the knee can be increased to help “push” the fluid into the cartilage.
A firm, and it has to be firm, brace will add a continuous increase in pressure.
Exercise can also add more pressure, but more on that below.
It’s worth noting that too much pressure, like crouching to squeeze the knee, adds further irritation to the cartilage and makes it leak fluid at a faster rate.
It also risks rupturing your Baker’s Cyst, which you can read more about here.
Knee braces work better/faster in conjunction with medication and Baker’s Cyst exercises as it tackles the problem from both ends of the fluid in/out cycle.
What are the best exercises to include in a Baker’s Cyst treatment plan?
Remember that the focus of exercises is to build strength around the hip and knee, but it’s also to increase pressure on the cartilage to help it absorb fluid quicker.
From that point of view, the humble, wonderfully simple “walk around the block” should be part of your exercises.
It’s gentle and adds the right amount of pressure to the knee in most cases.
If the knee is too painful or too swollen, your Baker’s Cyst treatment plan might replace walking with more volume of home exercises.
Whatever you do, just avoid “recovering” by laying on the couch and Netflixing your life away.
The home exercise program for Baker’s Cyst treatment:
- Squats
- The good ol’ Squat is still one of the best options because of its simplicity and effectiveness
- Only lower to half depth (knee bend at 90 degrees) or less if that causes discomfort
- Only squat on two legs
- Avoid single leg squats due to the additional twisting force at the knee
- Wall sit
- A squat variation, this involves sitting against a flat wall with feet shoulder width apart and shins vertical
- It’s safe as there is no movement at the knee and the loading can be controlled based on how far down the wall you sit
- It can be progressed to single leg if required – just make sure you move your foot to the middle of your body before lifting the other leg up
- Hip bridges
- This exercise involves laying on your back, knees bent and feet on floor., then push through feet to lift your hips off the floor
- It builds strength in hamstrings and gluteal muscles without loading the knees
- The knee doesn’t move or take bodyweight loading so it’s safe for even the most sensitive knee
- To increase the challenge, you can add a weight or move to single leg, as shown here
What exercises and activities should you avoid during a Baker’s Cyst treatment plan?
- Forcing the knee to fully straighten or bend
- Even though the movement is reduced, it’s limited by fluid pressure in the knee (like an overinflated balloon). Force it and you’ll only force fluid INTO the Baker’s Cyst and aggravate the cartilage to produce further swelling.
- This commonly occurs with muscle stretching such as quads or hammy stretches, which are unnecessary as part of a Baker’s Cyst treatment plan.
- Excessive twisting forces
- This tends to worsen Baker’s Cysts as most causes of knee swelling hate twisting forces and will react with more fluid produced
- For example, walking on rocky or sandy ground or some gardening tasks
- Alcohol
- Yep, unfortunately your evening routine may be making the swelling worse
- Alcohol will increase swelling reactions and produces more fluid in the knee
- We often get asked how much alcohol can be consumed before it affects swelling
- There’s no magic number, it’s a continuum from your first glass
- So no alcohol is best but, if you must, one glass is better than three.
Disclaimer for Baker’s Cyst Treatment Plan
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