A Baker’s cyst—also known as a popliteal cyst—is a fluid-filled swelling that develops behind the knee and can cause pain, stiffness, and limited mobility. While the cyst itself is not usually dangerous, it is often a sign of an underlying knee condition that needs proper treatment.
At Cawley Physical Therapy & Rehabilitation, we regularly treat patients with Baker’s cysts at our clinics in Scranton, Wilkes-Barre, Trucksville, Pittston, Kingston, Nanticoke, Mountain Top, Factoryville, and Carbondale, PA. This guide explains what a Baker’s cyst is, why it develops, and how physical therapy can relieve symptoms and address the root cause.
Understanding Baker’s Cyst
A Baker’s cyst forms when excess synovial fluid builds up in the knee joint and pushes into the space behind the knee. This usually occurs as a response to irritation or inflammation inside the knee joint.
The cyst itself is not the primary problem—it is a secondary condition caused by something else stressing the knee.
Common Symptoms of a Baker’s Cyst
Symptoms vary depending on cyst size and underlying knee health, but commonly include:
- Swelling or fullness behind the knee
- Tightness when straightening or bending the knee
- Knee stiffness or reduced range of motion
- Aching pain behind the knee or calf
- Discomfort during walking, squatting, or stairs
- Pain that worsens with prolonged standing
In some cases, a cyst may rupture and cause calf swelling that mimics a blood clot, requiring immediate medical evaluation.
What Causes a Baker’s Cyst?
A Baker’s cyst almost always develops due to another knee condition, such as:
- Osteoarthritis
- Meniscus tears
- Rheumatoid arthritis
- Cartilage degeneration
- Knee inflammation or synovitis
- Overuse injuries
Because the cyst is a result of joint irritation, treating the underlying problem is essential for long-term relief.
How Is a Baker’s Cyst Diagnosed?
Diagnosis typically includes:
- Physical examination
- Medical history review
- Ultrasound or MRI imaging (if needed)
- Ruling out blood clots or other conditions
A physical therapist focuses on identifying movement restrictions, muscle imbalances, and joint stress contributing to fluid buildup.
Why Physical Therapy Is Effective for Baker’s Cyst
Physical therapy does not “drain” the cyst directly. Instead, it reduces joint irritation, improves knee mechanics, and decreases fluid production—allowing the cyst to gradually shrink.
Physical therapy helps by:
- Reducing knee inflammation
- Improving joint mobility
- Strengthening muscles that support the knee
- Correcting movement patterns
- Reducing pressure within the joint
In many cases, symptoms improve without injections or surgery.
Safety Guidelines Before Starting Exercises
- Avoid aggressive stretching behind the knee
- Do not force full knee extension if painful
- Stop exercises that increase swelling
- Expect gentle stretching, not sharp pain
- Progress gradually
A physical therapist can modify exercises based on cyst size and symptoms.
Exercises Commonly Used in Physical Therapy for Baker’s Cyst
The following exercises are frequently prescribed to reduce knee stress and improve mobility.
Heel Slides
How to Perform
Lie on your back with legs straight. Slowly slide the affected heel toward your buttocks, bending the knee as far as comfortable. Hold briefly, then slide back to the starting position. Repeat 10–15 times.
Why It Helps
Improves knee range of motion without placing excessive pressure behind the knee.
Quadriceps Sets
How to Perform
Sit or lie with your leg straight. Tighten the muscles on the front of your thigh by pushing the knee down toward the surface. Hold for 5 seconds. Repeat 10–15 times.
Why It Helps
Strengthens the quadriceps, which help stabilize the knee and reduce joint stress.
Straight Leg Raises
How to Perform
Lie on your back with one knee bent and the affected leg straight. Tighten your thigh and lift the straight leg about 12 inches off the ground. Hold briefly, then lower slowly. Perform 10–12 repetitions.
Why It Helps
Builds strength without excessive knee bending.
Hamstring Stretch (Gentle)
How to Perform
Lie on your back and gently lift the leg upward while keeping the knee slightly bent. Hold for 20–30 seconds without forcing full extension.
Why It Helps
Reduces posterior knee tightness while avoiding excessive pressure on the cyst.
Calf Stretch
How to Perform
Stand facing a wall with the affected leg behind you. Keep the heel down and gently lean forward. Hold for 20–30 seconds and repeat.
Why It Helps
Improves lower-leg flexibility and reduces strain through the knee joint.
Hip Strengthening Exercises
Weak hips increase knee stress. Common PT exercises include:
- Side-lying leg raises
- Glute bridges
- Standing hip abduction
Strengthening the hips helps improve lower-body alignment and reduces joint irritation.
Treatments Used Alongside Exercise
Physical therapy may also include:
Manual Therapy
- Soft tissue mobilization
- Joint mobilizations
- Swelling management techniques
Activity Modification
- Reducing aggravating movements
- Adjusting walking or exercise habits
Modalities
- Ice or compression for swelling
- Electrical stimulation if appropriate
What to Avoid with a Baker’s Cyst
- Deep squatting
- Kneeling for prolonged periods
- High-impact activities during flare-ups
- Aggressive stretching behind the knee
Avoiding these activities prevents increased fluid buildup.
When to See a Physical Therapist
You should seek care if:
- Knee swelling persists more than 1–2 weeks
- Pain limits walking or daily activities
- Swelling continues to return
- You feel tightness behind the knee when straightening
- Home exercises are not helping
Early treatment often prevents worsening symptoms and recurrence.
How Long Does It Take to Heal a Baker’s Cyst?
Recovery varies depending on the underlying cause. Many patients experience symptom relief within 4–8 weeks of consistent physical therapy. Chronic arthritis-related cases may require longer-term management.
Get Expert Care for Baker’s Cyst at Cawley PT
If swelling or pain behind your knee is limiting your mobility, professional guidance can make a significant difference. Treating the underlying cause—not just the cyst—is key to lasting relief.
Schedule your FREE consultation with Cawley Physical Therapy & Rehabilitation today.
Frequently Asked Questions (FAQ)
Is a Baker’s cyst serious?
A Baker’s cyst is usually not dangerous, but it often signals an underlying knee problem such as arthritis or a meniscus tear. Without treatment, symptoms may persist or worsen, making physical therapy an important step in recovery.
Can physical therapy make a Baker’s cyst go away?
Physical therapy cannot directly remove the cyst, but it can reduce joint irritation and fluid production. As knee mechanics improve and inflammation decreases, many cysts shrink and symptoms resolve naturally.
Should I exercise with a Baker’s cyst?
Yes, but exercises must be gentle and targeted. Physical therapy focuses on strengthening and mobility that reduce stress on the knee while avoiding movements that increase swelling or pain.
How is a Baker’s cyst different from a blood clot?
A Baker’s cyst causes swelling behind the knee, while a blood clot often causes calf pain, warmth, and redness. Because symptoms can overlap, medical evaluation is important if sudden swelling or severe pain occurs.
Will a Baker’s cyst come back after treatment?
Recurrence depends on managing the underlying knee condition. Physical therapy reduces recurrence risk by improving strength, mobility, and joint mechanics, but ongoing maintenance may be needed for arthritis-related cases.