- Hi, I'm Bob Schrupp, physical therapist.
- [Brad] And I'm Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the Internet.
- [Brad] I'm right here, of course, Bob.
- I must admit, Brad, you've never looked better.
- [Brad] Thank you very much, Bob.
Now can we get on with the show?
- Yes, let's get on with the show.
Brad, quite often, we've had people
that come into the clinic, and they're really concerned
because they have a bump on the back of the leg.
- Yep, yep, and they should be, actually.
- Yeah, it's interesting, it's amazing, disproportionately,
how concerned they are, you know?
They'll be less concerned about extreme pain in their knee,
but as soon as they get that bump, they're really worried.
So what we're going to be talking about, basically,
is generally, we turn this guy around,
we look at the back of the knee, you got that ball, Brad?
- Yeah, I dropped it, Bob, hold on.
- Way to go, Brad.
Generally it's a bump that's on the inside,
more towards the inside of the knee, towards the other knee.
It's right here and it's usually the size of,
maybe a marble, it's not this big.
But it is soft like this ball. - [Brad] Sure, yeah, okay.
- [Bob] And there's fluid in it,
and people, they're thinking that actually is the problem
when actually it's the secondary part of a problem, really,
is what has happened.
So a little bump right there or right here.
- Yeah, so if we're looking at the leg, right about there.
- Why don't you stand up, Brad, for us?
So it'd be right here, right in that area,
you'd feel a bump.
Now what that's called is a Baker's cyst,
and this is after William Morant Baker,
he was a surgeon back in the 1800s,
and he's the one that first described this.
It's also called a popliteal cyst.
Popliteal, Brad, by the way, means,
you know how you got the armpit?
- Yeah. - That's the knee pit,
it's the popliteal. - Yeah, so,
the popliteal fossa in your PT scroll.
- It's, anyway, so what's the cause of this bump, Brad?
You know what, Brad, we should probably have
that knee model, tech.
- Could you toss it over there.
- We make Phil, we make him toss, we make him do everything.
Generally with a knee problem, or generally with a swelling
in the back of the knee, the problem
is actually inside the joint itself,
and so, I don't know if you can see any of this knee.
- [Brad] Yeah, the model knee, the kneecap here
has been flipped up.
- But generally, there's the cartilage here,
and that's torn or you'll have arthritis in here.
So this is causing inflammation here and fluid,
and that fluid seeps out towards the back
into that sac, and it's a one-way valve,
so it can't come back in again.
So you get that fluid here, it can't go back into the joint.
Now, the treatments for this are,
you can get a cortical steroid,
they can shoot that in there.
You can put ice, you can compress it, you know, wrap it.
What people often quite have done is they stick a needle in,
and they aspirate, and they actually pull the fluid
out of that, and they think, great, it feels better,
but the problem is it'll probably redevelop again,
unless you get what's going on inside treated.
- The cause, get to the problem.
- So the arthritis or the torn meniscus
or the torn cartilage needs to be treated
in order for that fluid not to keep being created.
So, again, this really isn't the problem,
this is just a symptom of a problem that develops.
So that's basically it, what this video's about,
and that's all we're talking about today,
is we wanted to let you know
it's not something to panic about.
Now, occasionally, rarely, those can burst,
and it can even cause a blood clot to go onto your leg,
and so you do want to be aware, this is something
you do want to check and have your doctor check out.
- Yeah, if it is a blood clot, then you need to have
some definite treatment.
- Right, right, and I don't think we got any other issues.
I think we covered everything, Brad, it's a one-way valve
and it doesn't want to come back again.
So the fluid comes in and it doesn't want to go out again.
- Right, so it's right there, right there, the model,
yep, okay.
- And for you physical therapists, we have,
we have some that watch this crap.
- Absolutely.
- It's between the semimembranosus
and the gastrocnemius muscles,
and that's a bursa, it's actually a,
I think it's the semimembranosus bursa
or the gastrocnemius bursa, there's, really,
we have all those bursas down there.
- People that just got out of school
remember those a lot better than us,
but one way or another,
I don't know why they watch this, Bob.
(laughter) - Wow, that's a great, uh ...
... tribute to us.
All right, take care.