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Knee Bone or Joint Injury

Knee Pain Running | Outside Knee Pain Running

Minute Read


Posted 1 year ago


Last updated: 29/11/2022


by James McCormack

Running is an exercise that has a bad reputation when it comes to knee pain. Running is not necessarily bad for your knees like you might hear, but it is a high impact sport so it does have a toll of your body. In order to prevent injuries you need to run with good form, train appropriately with enough recovery, and have good strength and flexibility. This is where many of us fall down, if you love running you might not love doing the supplementary exercises that can keep you injury free, but these are what will keep you being able to run better and for longer.

Diagram of locations of pathologies causing outside knee pain running



Knowing a bit of anatomy of the structures in and around the knee and common symptom patterns of different injuries and knee pathologies can refine the options for what might be causing the pain on the outside of your knee. You age, health, strength and running styles are also factors that might influence the type of injuries that you might be more likely to get.



The most common causes of outer knee pain running are:

  • Lateral Meniscus Irritation or Tear
  • Lateral Collateral Ligament Strain or Tear
  • Iliotibial Band Syndrome
  • Osteoarthritis

Lateral Meniscus Irritation or Tear

A lateral meniscus tear can be caused by a sudden awkward movement such as a twist when you put your foot down badly, or by repetitive overload. This injury will usually feel like on the outside and along the joint line of the knee. It will be more painful to crouch or squat, twist the knee, and impact such as running or jumping will usually be more painful. There may be diffuse swelling which can make the knee generally look puffy rather than a specific area of swelling. In severe cases there can be locking and giving way of the knee. If you want to learn more about read our related article: Lateral Meniscus Tear: Symptoms, Causes and Diagnosis.

Lateral Collateral Ligament Strain or Tear

A lateral collateral ligament (LCL) injury can occur from trauma such as a fall or awkward twist of the knee, or less commonly by repetitive overload. An LCL tear or sprain will feel localised pain to the outside of the knee but can be slightly above and below the joint line. Swelling can occur, more swelling in acute cases, and will be more focused to the outside of the knee. It can be painful to bend and straighten the knee and in severe cases the knee might feel unstable. Read more about this injury in our related article: LCL Injury.

Iliotibial Band Syndrome

Iliotibial band (ITB) syndrome is most commonly caused by repeated overload, and with running is often linked to running mechanics and strength. ITB pain can vary from a dull ache on the outside of the knee and lower thigh, to severe sharp or burning pain. It is usually worsened when the knee is bent or the leg corses the midline, therefore walking down stairs, lunges or crossing your legs when sitting can all exacerbate the pain. Read more about this condition in our related article: Iliotibial Band Syndrome.


Osteoarthritis is an umbrella term for degenerative changes in the knee and can include wear and loss of cartilage, meniscus injury, ligament strains and growth of osteophytes. It can affect different areas of the knee joint and cause pain. Lateral knee pain from osteoarthritis will usually be felt along the joint line. It can often feel worse after too much exercise, and often the next day the knee might feel more painful and more stiff. Pain and stiffness can be most evident after periods of rest, and it can take a few minutes to “warm up the joint”. Swelling is usually not specific but the whole knee might feel and look puffy. 

Running Styles That Contribute To Outer Knee Pain

Running styles that can overload the structures of the lateral knee are those that have a very narrow gait, with their feet crossing over the midline, varus knees that bow outwards, over pronation of the foot and ankle, or landing excessively on the outside of the foot, high knee flexion in mid-stance and landing on a straight knee. If you have these elements to your running style it can be helpful to work on these to improve your running efficiency and reduce your risk of these injuries.

Pelvis Drop and Narrow Running Gait

When there is a pelvis drop the muscle around the hip are not adequately controlling the movement of the pelvis. This drop can tighten the structures at the side of the leg, including the ITB and the muscle at the top, the tensor fascia lata. Both can contribute to pain on the outside of the knee. A narrow gait where one foot lands directly in front of the other or feet cross over will have the same impact of tightening the structure on the side of the leg.

Over Pronation

The excessive inward movement at the foot and ankle when landing causes a tightening oft the structures of the outside of the knee. This can result in pain to these structures, such as the iliotibial band.

Physiotherapy with James McCormack

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.

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