pathology: Baker’s cyst

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Baker’s cyst

Definition of

Not an independent disease but secondary: reactive overproduction of synovia in knee damage, which is pressed out of the knee joint through a communication channel into a bursa that communicates with the joint space. Depending on the cross-section of the communication channel, a valve effect may occur: synovia is pressed into the bursa but does not return. The communication channels can also obliterate. The Baker’s cyst is actually the popliteal cyst that occurs in RA, but for simplicity’s sake, other causes are also referred to as Baker’s cysts. The bursa subtendinea gastrocnemii medialis and the bursa subtendinea semimembranosi are discussed as Baker’s cysts.

ICD M71

Cause

  1. Meniscus damage
  2. RA
  3. Osteoarthritis
  4. Arthritis
  5. Surgeries such as cruciate ligament reconstructions

Predisposing

  1. Activities and sports that damage or consume the meniscus
  2. Secondary for changes to the foot
  3. Age

Diagnosis

  1. Palpation (normal FC: soft to press in, valve effect: platelastic)
  2. Inspection
  3. MRI

Symptoms

  1. Pressure sensation
  2. Foreign body sensation in the hollow of the knee when the knee joint is stretched or flexed; sensation of tension when the knee joint is stretched wide
  3. Visible and palpable, possibly fluctuatingly pronounced thickening in the popliteal fossa

Complications

  1. Venous or nerve compression depending on the position
  2. In the worst case, thrombosis due to venous compression
  3. Paresthesia, sensitivity disorder due to nerve compression
  4. Bursting can cause local inflammation and compartment syndrome (indication for surgery)

Therapy

  1. Causal therapy of the knee damage
  2. Puncture
  3. Corticoids
  4. NSAIDS
  5. Physiotherapy
  6. Thermotherapy to adhere the cyst wall
  7. the communication channel can also disappear spontaneously

NHK

  1. Arnica C30

Asana practice and movement therapy

As Baker’s cysts are caused by damage to the inside of the knee, supportive postures must be based on the cause. If static errors and their effects or muscular imbalances are also the cause, asanas can be used to intervene. As the causes are varied, no standardized asanas can be given. However, stretching and strengthening the quadriceps and hamstrings are often helpful. There may be an imbalance between the inner and outer ischiocrural group, which can lead to increased rotation of the lower leg in the knee joint during movement sequences, as the inner hamstrings endorotates the lower leg and the outer group (which only consists of the biceps femoris ) exorotates it.

Then appropriate stretches should be performed that stretch more the inner or outer ischiocrural group and general strengthening training for the hamstrings should be applied, which usually reduces the discrepancy instead of just raising it to a new level. Deadlifts are ideal for this, as it is often found that the inner hamstrings is subjectively more challenged because it is weaker. In frequently repeated cyclical movements such as jogging or running, muscular imbalances in the muscles that move the ankle joint can place a strain on the knee joint, which is the cause of the Baker’s cyst.

The range of motion in the direction of supination will rarely be too small, but the tension of the supinators can be increased if the foot is placed supinated excessively (a little is physiological) and the pronation resulting from the mass inertia must be stopped. Conversely, a pronated foot can lead to over-tensioning of the pronators when the inertia-induced supination is stopped. Weakness in the abductors of the hip joint can lead to endorotation of the thigh as it moves into flexion at the hip joint for the forward step. This factor can also lead to damage to the knee joint, because the foot is placed on the ground when the leg is not moving forwards in an axially correct manner and the knee joint has to be rotated in an unphysiological manner in extensive extension in order to correct this. This is all the more likely to occur if the adductors or endorotators are under too much tension at the same time.

A hypertonic rectus femoris or vastus lateralis can impair the guidance of the patella, as can weakness of the vastus medialis, which leads to damage to the retropatellar cartilage. In principle, all intrasynovial (within the joint capsule ) disorders of the knee joint can lead to a Baker’s cyst, in practice these are damage to the meniscus or the cartilage. Extrasynovial disorders such as runner’s knee (ITBS) do not cause a Baker’s cyst. Various other disorders in the foot-leg-hip system can also lead to damage to the menisci and cartilage of the knee joint, resulting in a Baker’s cyst.

Asanas

  1. Asanas in 811: Dehnung des Quadrizeps
  2. Asanas in 812: Kräftigung des Quadrizeps
  3. Asanas in 816: Dehnung des Rectus femoris
  4. Asanas in 817: Kräftigung des Rectus femoris
  5. Asanas in 821: Dehnung der Ischiocrurale Gruppe als Exorotatoren des Kniegelenk
  6. Asanas in 822: Kräftigung der Ischiocrurale Gruppe als Exorotatoren des Kniegelenk
  7. Asanas in 826: Dehnung der Ischiocrurale Gruppe als Endorotatoren des Kniegelenk
  8. Asanas in 827: Kräftigung der Ischiocrurale Gruppe als Endorotatoren des Kniegelenk
  9. Asanas in 861: Dehnung der Supinatoren des Fußgelenks
  10. Asanas in 862: Kräftigung der Supinatoren des Fußgelenks
  11. Asanas in 861: Dehnung der Pronatoren des Fußgelenks
  12. Asanas in 862: Kräftigung der Pronatoren des Fußgelenks
  13. Asanas in 813: Kräftigung des Vastus medialis
    1. 1. Kriegerstellung
    2. 1. Hüftöffnung
    3. 2. Hüftöffnung
    4. 3. Hüftöffnung