In this video is for people who have a baker cyst on the back of their knee that has burst. I'm
going to tell you about why this happens and what to do next. My name is Dr. David Middaugh, and I'm
a specialist physical therapist at El Paso Manual Physical Therapy. And this channel is dedicated to
helping people stay healthy, active and mobile while avoiding unnecessary surgery, injections
and pain medications. Please consider subscribing to our channel so that you don't miss out on any
of the helpful videos we post every single week. So let's answer the question. What's a baker cyst
for those of you that don't know, a baker cyst is excessive fluid development in the knee joint that
has become a pouch or assist on the backside of the knee. Here's the front of the knee,
there's a kneecap and that's where the knee bends right there. And the joint capsule the container
that holds all the stuff inside the joint the fluid inside of the joint, it's finished
on the back and it starts to expand on the back. I go into lots of detail in another video called
What is a baker cyst, which I've linked in the description below. That's all I'm going to say
for now in this video because I want to talk about the other stuff but if you needed learn
about how Baker cysts develop, then go check that video out in the description below.
Now to get to the topic for this video today, why did your baker cyst rupture or burst or pop
the reason for this is that excessive fluid development has reached its limit the joint
capsule are the ligaments that hold the joint together and hold that fluid inside that have
stretched out in the backside and created that little bubble back here where the knee bends.
It has reached this limit and that capsule bursts the joint capsule bursa ligaments burst
and all the fluid that was being held inside by that joint capsule starts to drain downwards into
the calf muscles and into the ankle and foot even now it is possible to get that
Baker cyst drained or aspirated is what the doctors will call it, they'll stick a needle
in it and draw the extra fluid out. And that helps to reduce the pressure inside there.
So that might help you avoid rupturing your Baker's cyst if you don't have one that's
ruptured yet, or in the rare case that you had one that ruptured and it's reformed again,
you might have this aspirated so that it doesn't rupture again, because it can be quite painful.
The real root question here is how do we get that extra fluid? Or set differently?
How do you quit making extra fluid inside your knee joint so that it doesn't keep draining out
into your lower leg? Or does it make the Baker's this problem worse of yours has not popped yet.
And the answer to this is we need to depressurize the knee joint that extra fluid development
is the body's response and these response to extra pressure going through the knee joints.
And it's cushioning itself that extra fluid helps to separate the thigh bone from the knee bone so
that it can form a bit of a cushion. It also is helping to heal
the cartilage and meniscus ligaments within the joint because they may be injured as well.
And the reason for the excessive pressure in the knee joint. Because you might ask yourself, well,
my other knees okay, then develop a baker cyst. And I use both legs about the same amount. So
why does only one you have a Baker says why I'm only making extra pressure in that knee.
Now this comes down to a muscle imbalance that is a root problem of many issues, including chronic
knee problems like knee arthritis, bone on bone knee joint situations, cartilage damage, meniscus
tears, and other ligament injuries as well. Everybody responds differently to the excessive
knee pressure set up by the muscle imbalance. It's just a matter of what's going to affect you
first, are you predisposed to getting the arthritis because of your family history.
Do you tend to put your body in a position where the meniscus is getting pinched? And you have
other issues that could be feeding into this as well there's a variety of problems to look at.
What is in your control right now is you got to fix that muscle imbalance
in order to take the pressure off the knee so that you're not making extra fluid inside your
knee joint feeding that Baker cyst and the fluid that is now running down the leg because it popped
but more on the muscle imbalance in a second. What do you do right now your leg is probably swollen,
maybe even your ankle and foot is swollen? How do you get that swelling to go down because
of the baker cyst? Well, often your doctor will tell you that your body's just going to reabsorb
it and that actually is what happens. But how do you make it go faster than just waiting around to
potentially just taking pain medication this whole time. Here are some exercises that you
can start to do right now to get your body to pump that fluid back up into your circulation.
I've got two for you. One is going to be heel raises and the other one is going to be toe curls
and extensions. from a seated position. Get your feet flat on the floor and all you're going to do
is real gently raise your heels and come right back down. Easiest pie you can do
this anywhere you are you can do this sitting down at home sitting down at a restaurant.
Sitting in the vehicle you ideally have to be Sitting, you can technically do this standing
as well, you might just lean away from the leg that has the Baker's this problem and put more
pressure on the leg that isn't bothering you. And also lean up against a wall or something
sturdy that you can hold on to for balance. And I would do this all day long, make sure that you're
moving through a comfortable range of motion and that it's not making a baker cyst problem,
any worse or any swelling in the Foot Ankle any worse, you can do one side at a time if
you prefer. And the speed isn't a big deal, what you need to know about this exercise.
And the reason why it's helpful for swelling from the fluid from a baker cyst is that fluid has to
travel through something called the lymph system. On the back of the calf right in the middle is
a big pump for the lymph system. And so when you contract the muscles, when you tighten these calf
muscles by elevating your heel, it helps to push the fluid up into the rest of the body. Now you
also have to move through the rest of your legs. So walking and other exercises are okay to do as
long as they're not making any worse. But this is especially important for getting the fluid to
leave your foot and ankle and lower leg. Now, in addition to the second exercise
that you want to do our toe curls and toe extensions, and these look just like this,
you're just going to curl your toes, and then pick them up. Just like that all the
way down as much as you comfortably can go. And then all the way up as much as you can
comfortably go. Now it doesn't matter if your toes are together, or apart. You know,
if you're spreading them out or not, it really isn't super important. Just go as high as you can
and as low as you can. And it's okay to pump your ankles up and down with this as
well you can kind of combine the two movements. Now once you get a little tired, take a break,
the fatigue should go away within minutes, you know, maybe an hour or two at most.
And then you need to get back on doing this exercise over and over again. And I would be
obsessed with doing this exercise until that swelling goes down so that your legs back to
normal compared to the other side. And those two exercises are key right after your baker cyst has
burst, you need to get that swelling down so that it doesn't cause other problems.
Oftentimes, people start to walk differently. They're limping because of the pain. And the
swelling just feels odd and strange as they move their leg. So a lot of times people
just avoid activity and avoid exercise. And they're left with not really knowing what to
do. Doctors don't typically share exercises for this type of condition with patients.
They literally just tell patients just wait at home, it'll get better, it'll go away on its own,
take pain medication in the meantime, and they leave it at that some people will start
to cycle like using an indoor a stationary bicycle or even an outdoor bicycle. And that
can be beneficial since the movement of the bicycle does activate some of the same muscles.
But I would still recommend doing the exercises that I showed you just a second ago
here on this video. It's more precise, and you can get a lot more control over the actual area
that's been affected by the swelling. And you can do them virtually anywhere that you can sit down,
you can even do some of them standing. And all you need to do is kick off your shoes,
you can even do them with your shoes on if you're talking about doing the heel raises.
Now the toe curls and extensions might be a little bit more difficult because your shoe might just
block you from going the full range of motion, but you could still try to wiggle around a little
bit inside your shoe. Now these are the short term exercises I would do. The longer term fix is going
to involve addressing your glute strength so that you can deep pressurize your knee to decrease the
amount of fluid coming through your knee joints. And to do that there's tons of good exercises out
there. I've linked a video with the best exercises to start with for your glutes down in the
description below. So go check that out once your knees feeling better and you're less swollen. Hey,
thanks so much for watching this friends. Please share this with somebody that you know has a
Baker's cyst. Ideally, they can catch it before bursts, maybe even get it drained or aspirated
that might be beneficial. But most importantly, I would love for them
to start fixing that muscle imbalance as soon as possible. We'll catch you in the next video. Bye