Knee pain Archives • Page 7 of 7 • Sports Injury

Baker’s Cyst treatment plan

We’ve detailed what a Baker’s Cyst is and how it behaves (if you missed it, click here to recap).

The next logical step is figuring out a Baker’s Cyst treatment plan to get rid of it.

Our team of Sports Physios have chipped in with their best tips for Baker’s Cyst treatment.

Anti-inflammatory meds
- Meds such as Nurofen or Voltaren can be helpful for short term (1-2 weeks) relief of swelling
- 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
- Remember that meds can minimise new swelling but they don’t get rid of swelling that’s already built up
Knee brace
- A firm compression brace can be very helpful at clearing existing levels of swelling
- It works better in conjunction with medication
- It must be quite firm to be effective

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
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 gluteals without loading the knees
- The knee doesn’t move or take bodyweight loading so it’s safe for even the most sensitive knee

Forcing the knee to fully straighten or bend
- Even though the movement is reduced, it’s limited by fluid pressure in the knee. Force it and you’ll only force fluid INTO the Baker’s Cyst
- This commonly occurs with muscle stretching such as quads or hammy stretches
Excessive twisting forces
- This tends to worsen Baker’s Cysts as most causes of swelling get aggravated by twisting forces
- 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

A Bakers Cyst is a collection of fluid in a bulge in the joint capsule. It causes a lump behind the knee, although this is typically not visible.
The average size of a Baker’s cyst varies depending on the amount of fluid and how long the knee had been swollen.
The cause of a Baker’s cyst is a separate injury in the knee which is causing fluid to accumulate inside the joint. This can include osteoarthritis, meniscal tears or cartilage defects.
How long a Baker’s cyst lasts for depends on whether the underlying injury is still producing fluid. It’s worth noting that anti inflammatory medication will stop or reduce further fluid accumulation but won’t get rid of the existing fluid.
It causes localised pain behind the knee and restriction to movement with bending and straightening. It can feel like a muscle knot behind the knee.

Baker’s cyst management involve two approaches:
- Reduce the amount of new fluid being added to the knee with ice or anti inflammatory-meds
- Use a compressive neoprene brace with adjustable pressure to speed up resolution of existing swelling
Management guidelines include avoiding exercises involving compressive or twisting positions, such as crouching or pivoting, to reduce the pain and limit new fluid accumulating
Baker’s cyst rupture causes a sudden rush of fluid into the calf along with sudden pain and tightness.
- This is often misdiagnosed as a calf tear. The ruptured cyst is usually not problematic and heals without intervention
It’s not critical to confirm a Baker’s cyst via ultrasound or MRI however it can be helpful for long term monitoring (see here for an MRI of a Baker’s cyst behind the knee)

Need to know how to fix your Baker’s Cyst?
See our self-management plan here.

A compressive knee brace is only helpful when the level of fluid bulges past the bony edges of the joint. Otherwise it only exerts pressure on the bony bumps around the knee, not on the swelling
Draining a Baker’s cyst is not painful but it’s usually ineffective as the source of fluid in the knee remains and the fluid pressure rebuilds quickly
Stretching the muscles around the knee is counterproductive as, although the knee feels tight, stretching will increase the pressure inside the knee and aggravate the cyst
- If the knee feels tight, gentle exercise like walking can help the Baker’s cyst