Back of knee pain:Runner with painful Baker's Cyst

Patient

Q: I have been running for over twenty years and up until about a year ago I was pain free. I started getting pain behind the left knee. I had an MRI performed and it came back that I had a Bakers cyst. I quit running for about 6 months and it got better. I would try to run but it would always flair back up. I am now running very slowly and only 3 days a week. It is sore the day after the run but better the second day. I now notice that I have trouble raising my left heel. Is it due to the Bakers cyst or something worse?

Doctor

A:   The most common mass in the popliteal fossa (the region behind the knee) is the Baker’s cyst, also called popliteal cyst, it results from build up or fluid distention of the calf muscles bursa. It usually communicates with the knee joint by way of a slit like opening at the posterior and inner aspect of the knee capsule just superior to the joint line. A Baker’s cyst may serve as a protective mechanism for the knee, when certain disorders cause joint effusion; this liquid is displaced into the Baker’s cyst, thus reducing potentially destructive pressure in the joint space. Arthritis is the most common condition associated with Baker‘s cysts, with osteoarthritis probably being the most frequent cause. The treatment of Baker cysts is conservative and includes the use of no steroidal anti-inflammatory medications, ice, and assisted weight bearing, in addition to the correction of underlying intra-articular disorders. Internal derangements of the knee can be treated with therapeutic arthroscopy.

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