Baker’s cyst is a stretching of the fibrous capsule and the synovial membrane of the popliteal region. So in a nutshell explains one of the common problems of the knee joint. I will try to explain the essence of this disease in more detail. First, let’s remember the features of the structure of the knee joint.
The capsule and the synovial membrane are the peripheral protective system of the knee joint, which includes three main components:
• tibial collateral ligament, which, according to F. Bonnel (F. Bonnel), can withstand a force of up to 115 kilograms per square centimeter and stretch to 12.5 % of its length before rupture;
• the fibular collateral ligament, which is able to withstand a force of 276 kilograms per square centimeter and stretch to 19 % of its length, that is, unexpectedly more resistant to rupture and more elastic than the tibial ligament;
• posterior capsule-fibrous complex consisting of a number of interconnected connective tissue components.
There are also other additional fibrous-tendon elements of different strength and importance.
The synovial membrane is the inner layer of the capsule (bag) and contains a viscous synovial fluid that lubricates the joint surfaces and helps them slip. When this shell breaks, the liquid can be felt under the skin on the back of the knee joint in the form of a kind of fluctuation, so Baker’s cyst is also called a fluctuating stretching.
In addition to the ligaments, the peripheral protection of the knee joint is provided by the periarticular muscles. In order not to complicate the text, I will say that there are only 12. Thus, the rupture of the capsule and the synovial membrane of the popliteal region reduces the spring function of the knee joint. In a person with such an injury, the ability to move remains, but there is a persistent chronic pain when walking, and eventually limp. In my head different thoughts about the treatment to surgeons, and these confirm the need for surgery, although the recovery guarantees do not give. Statistics show that surgical actions such as “stitch stretching(!)” are ineffective. In addition, after some time after surgery, fluctuation (painful swelling in the popliteal region) occurs again, and pain when walking back…
Personally, I in this case look at the treatment of this disease from the standpoint of “stretching”, which is pointless to operate. Therefore, I want to explain some features of the connective tissue that forms the joint capsule.
What is connective tissue?
Connective tissue is a dense collagen fibers, oriented, in connection with the linear arrangement of fibroblasts, on long-term loads acting in one direction (!) and therefore very resistant to tension forces. Connective tissue forms tendons, ligaments, fascia, aponeurosis, and hence capsules.
(Let me remind you that collagen is the most common protein in the human body, it accounts for 30 % of the dry weight of a person: skin, tendons, bones, muscles, blood vessels and other parts. Fibroblasts are the principal specialized cells of the connective tissue that create the tissue architecture of the system.)
Thus, the stretching of the capsule is a weakening of connective tissue, in its structure consisting of parallel lying and tightly Packed collagen fibers (with a small amount of intercellular substance).
Surgical “suturing” Baker’s cyst in any case is a violation of longitudinally (that is, in parallel) lying collagen fibers. The result is a kind of patch that eventually transforms into a keloid scar, making this popliteal area even more prone to injury even under simpler loads. (Keloid is a local tissue thickening caused by abnormally high amounts of collagen that forms in skin scars. The removal of such scars is almost always accompanied by a relapse of the disease). This is exactly what happens…
The cause of stretching the popliteal region (that is, the formation of Baker’s cyst) are:
- Weakening (hypotrophy) of the muscular-ligamentous apparatus of the knee joint (peripheral protective system), as a result of which any careless movement associated with a sharp straightening of the leg in the knee joint can lead to such a stretching;
2) Sudden load on the rear surface of the femur to which muscles and ligaments the back of the thigh was not ready.
Athletes have such a thing: a bad “heated”. That was in my case. So what to do? How to get rid of pain in the popliteal region, avoid surgery and reliably restore the peripheral protection of the knee joint?
My answer can also help with other sprains and even, for example, with the usual dislocation of the shoulder. In this case, the exercises will of course be different, but the principle one. This answer lies in the solution of the structure of the capsule of the joint, tendon and ligaments, namely in their longitudinal, linear structure! The fibers broke, stretched! What to do? To sew? What’s the point? Isn’t it easier to strengthen them?!
I propose to “collect” the stretched connective-woven fibers of the capsule by force exercises acting along these fibers. But! With minimal impact! Importantly, understand, that any the joint has 4 the surface — front, the back and two lateral, and this means, that and exercise should be not less four — on each of these surfaces.
When Baker’s cyst “collect” stretched connective tissue fibers capsules can be strength exercises, acting along these fibers. Perform such exercises should be with minimal impact, while the exercise should be at least four — on each of the articular surfaces.