Knee pain on the outside


External / lateral knee joint pain refers to pain that is mainly (not always exclusively) concentrated on the external part of the knee joint. This includes pain in the area of ​​the outer thigh and lower leg, the outer ligament, the surrounding soft tissues, the outer knee joint gap and the head of the fibula (caput fibulae).

External knee joint pain can be caused by direct damage to the anatomical structures involved, or it can arise as a relayed pain in the case of damage to an anatomically distant location. An example of a cause is outer ligament stretch.

Causes of knee pain on the outside

Knee pain when jogging can have very different causes. A common cause is excessive strain or improper strain on the knee. Especially beginners or those returning to the sport choose the training load to be too high. If training is stopped, the pain will go away on its own within a few hours or until the next day.In this case, the training plan should be reduced and the training intensity increased more slowly.

Another source of pain when jogging is incorrect running technique with a sharply bent knee or worn running shoes. A consultation in a specialist shop with treadmill analysis can provide information here.

Read more on this topic at: Treadmill analysis

One of the physical causes is a muscular imbalance, especially in the thigh muscles. The stability of the hip joint and ankle joint also plays a crucial role in ensuring painless, undisturbed movement. An unevenly developed thigh muscles create different strengths of tension, which means that the kneecap deviates to the side and can cause pain. In addition, the muscular tension is perceived as painful.
If the foot muscles or the hip muscles are only weakly developed, the leg axis twists. This twist again results in an incorrect load on the knee joint, which is painful. If such a muscular problem is underlying, targeted exercises of the weak muscle groups can lead to a significant improvement.

A more difficult problem is permanent deviation of the leg axis. Especially with the knock knees, the area of ​​the outer knee joint is more stressed. Sports like jogging worsen the problem due to the additional shock load. In this case, you can try to counteract the leg misalignment with adapted running shoes. Under no circumstances should the training be continued if there is pain, as long-term damage such as osteoarthritis of the knee joint threatens.

The runner's knee (iliotibial ligament syndrome, ITBS, tract chafing) occurs more often in a bow leg position, which causes the iliotibial ligament to rub against the outer bones of the knee joint and irritate it. In addition to inflammation of the ligamentous system and the periosteum, bursa in the area can also become inflamed. The problem improves with training breaks until pain relief and anti-inflammatory ointments.

Finally, an injury to the knee structure must be considered. External meniscus injuries or ligament injuries can also lead to considerable pain when exposed to stress and should be ruled out by a doctor.

Possible diseases

  • O- or knock-knees
  • External meniscus tear
  • Ligament injury
  • Iliotibial band syndrome
  • Osteoarthritis of the knee

These diseases are described in more detail below

If one

In contrast to the knock-knees, the knee joints on the bowleg are shifted outwards in the axis. Affected people can put their ankles together with their legs straight, but the knee joints do not touch. This axial shift results in greater stress on the inner (= medial) knee joint in the bowleg. There, the meniscus or the cartilage layer can be damaged, so that after a long period of exercise, pain occurs, especially in the inner knee joint.

Read more on this topic at: If one

Knock knees

With the knock knees, the leg axis is typically not perfectly straight. Instead, the knee joints are shifted slightly inward compared to the hips. You can test this by trying to stand with your legs straight. If the knees touch but you can't bring your ankles together, you probably have knock knees. The shifted leg axis increases the load on the outer (= lateral) knee joint. Symptoms usually only appear after many years of exposure. The cause can be meniscus or cartilage damage, and osteoarthritis can develop after a long period of time.

Read more on this topic at: Knee legs

Pain when walking and jogging

Knee pain can be triggered by various mechanisms when hiking and jogging. If someone is not used to the strain, a brief overload is usually the cause of the pain on the outside of the knee. For example, muscles can be hardened or tense. If you hike for several days, sore muscles on the outside of the thighs can also be the cause. Those who hike and run a lot, on the other hand, have to think of chronic damage to the structures in the knee joint. If there is external knee pain, the external meniscus can be affected. Cartilage damage is also a possible cause.

Iliotibial Band Syndrome (ITBS)

In iliotibial band syndrome (ITBS) is a widespread pain syndrome of the knee joint that occurs after or during exercise. Due to the increased occurrence in runners, this clinical picture is also called Runner's knees designated.

The iliotibial band, from which the name ilio-tibial ligament syndrome (ITBS) is a strip of connective tissue that surrounds the outer muscles of the thigh. It pulls from the pelvic muscles over the knee joint and a protruding bone on the knee joint to the shin. It is used to stabilize the thigh bone under load. In the ilio-tibial band syndrome (ITBS) there is a rubbing of the connective tissue strip (Iliotibial band) on the protruding bone of the knee joint.

By rubbing the strip of connective tissue (Iliotibial band) on the protruding bone of the knee joint, there is stabbing pain on the outside of the knee joint. At first, the pain only occurs under increased stress, for example during or after jogging. Later on, the pain can become noticeable when climbing stairs and even simply walking. The pain can become so severe that further movement of the leg is impossible, and this can lead to severe physical limitations for the person affected.

The cause of the development of ITBS lies in irritation of the sensitive periosteum that surrounds the knee joint and the protruding bone on the knee joint. Frequent bending and stretching of the knee joint, such as when jogging or climbing stairs, leads to rubbing of the connective tissue strip (Iliotibial band) on the protruding bone of the knee joint and thus irritation of the periosteum with the characteristic pain.
Various anatomical changes, such as misalignment of the feet or weakness of the pelvic muscles, can lead to the development of the ilio-tibial ligament syndrome (ITBS) favor.

Acute onset pain should be treated with cold, for example in the form of ice packs and cooling, anti-inflammatory ointments. In addition, the stress that leads to the discomfort (for example jogging) should be stopped.
If the above measures fail, there is also the possibility of surgery. Here the connective tissue strip (Iliotibial band) cut in a z-shape. This lengthens it, relieving the strain on the knee joint.

Further information is available under our topic: iliotibial band syndrome (ITBS)

Patellar lateralization / lateral retropatellar arthrosis

With patellar lateralization, the kneecap (= patella) shifts outwards (= lateral). As a result, the kneecap is no longer completely in its normal plain bearing. Usually the reason for this is a weakness in the supporting structures of the kneecap, including the collateral ligaments and the thigh muscles. When the knee joint moves, the kneecap not only glides over the thighbone with its cartilaginously protected part, but instead the thighbone rubs against the bone of the kneecap or it destroys the protective cartilage. In the long run, this leads to what is known as lateral retropatellar arthrosis. The outer (= lateral) part of the cartilage behind the kneecap (= retropatellar) is worn out. The delicate bone of the kneecap is not adequately protected, so bending the knee causes pain on the outside.

Read more on this topic at:

  • Retropatella osteoarthritis
  • Patellar lateralization

Condition after dislocated kneecap

With a dislocated kneecap, the kneecap jumps out of its normal sliding bearing on the knee. At first glance, this is characterized by sudden and severe pain. In most cases, various other structures of the knee joint are also affected. This can lead to cartilage damage to the kneecap, thigh or lower leg bones. Vessels or ligaments in the knee joint can also be affected. This can sometimes cause long-lasting pain, especially when moving, and surgery on the affected structures may also be necessary. Immediately after the kneecap pops out, a bruise often forms, which causes severe mobility restrictions and pain.

External meniscus tear

The pain is here at the outer knee joint space.
  • Synonyms:
    External meniscus rupture, external meniscus lesion, external meniscus degeneration, external meniscus damage, external meniscus disease
  • Place of greatest pain:
    In the area of ​​the outer knee joint gap.
  • Pathology / cause:
    Accident-related or wear-related (degenerative) tear of the external meniscus or external meniscus ganglion.
  • Age:
    can occur at any age
  • Accident:
    Twisting trauma (accident) of the knee joint during exercise. With degenerative cracks, there is usually no memory trauma.
  • Type of pain:
    Stinging, light to dull, drawing. Possibly. limited, partially blocked mobility of the knee joints. Incoming stabbing pain after turning the leg.
  • Pain development:
    After a trauma (accident) suddenly, otherwise slowly increasing or recurring with breaks.
  • Pain occurrence:
    V.a. during exercise, in a crouching position or after unfavorable rotational movements of the knee joint. If the meniscus becomes trapped in the knee joint, the knee can no longer be fully extended and constant pain can result.
  • External aspects:
    In the case of acute injury, swelling usually increases. In the case of degenerative cracks, there is less swelling depending on the load, sometimes none.

Read more on this topic at:

  • External meniscus lesion
  • External meniscus tear
  • Meniscal tear

Lateral (external) knee arthrosis

Even with lateral knee osteoarthritis, the pain is located at the outer knee joint gap.
  • Synonyms:
    Arthrosis of the outer compartment, lateral gonarthrosis
  • Place of greatest pain:
    In the area of ​​the lateral / external knee joint gap.
  • Pathology / cause:
    Wear-related cartilage damage to the knee with inflammation of the mucous membrane with main damage in the area of ​​the outer knee joint.
  • Age:
    Older age (> 50 years). In over 80% of those over 60 years of age, wear-related changes can be detected in the x-ray of the knee joint.
  • Type of pain:
    Stinging, light to dull, drawing. Stiffness of the knee joint. Possibly. limited mobility of the knee.
  • Pain development:
    Slowly increasing, sometimes stabbing, sometimes pulling depending on the stage of osteoarthritis.
  • Pain occurrence:
    Morning start-up pain. Increase in pain under exertion (with increasing walking distance).
  • External aspects:
    Swelling, possible overheating. Often knock knees (genu valgum).

Read more on this topic at: Osteoarthritis knee

Ligament injury

The pain is here in the course of the outer ligament, i.e. also on the outside of the knee joint.
  • Synonyms:
    External ligament tear, external ligament injury, damage to the lateral collateral ligament
  • Place of greatest pain:
    In the course or beginning / origin of the outer band.
  • Pathology / cause:
    Overstretching or tearing of the outer ligament.
  • Age:
    Mostly young, physically active people.
  • Accident:
    Yes. Usually it is a so-called varus trauma. This means that the knee joint is being forcibly pushed into a bow leg position. If the stretch reserve of the outer ligament (ligamentum collaterale laterale) is exceeded, the ligament will tear or tear.
  • Type of pain:
    pungent, bright, on the outside
  • Pain development:
    Suddenly. Often in the context of football injuries.
  • Pain occurrence:
    In connection with the injury. Pain when checking the lateral ligament stability. Possibly. Outward instability of the knee joint.
  • External aspects:
    Lateral, possibly general knee swelling.

Read more on this topic at: Outer ligament tear

Lateral chafing syndrome

Lateral chafing syndrome causes pain in the area of ​​the lateral thigh roll.
  • Synonyms:
    Inflammation of the iliotibial band (ITBS = iliotibial ligament syndrome or chafing of the tract).
  • Place of greatest pain:
    On the side of the thigh roll.
  • Pathology / cause:
    Rubbing the iliotibial band (tendon-like sheath of the thigh) on the thigh.
  • Age:
    Mostly young, physically active people.
  • Type of pain:
  • Pain development:
  • Pain occurrence:
    Load-dependent. Often when jogging.
  • External aspects:
    Preferred occurrence with bow legs. The knee misalignment causes the outer knee joint to protrude, which promotes chafing of the tract.

Read more on this topic at: Runner's knees


The first thing you should do if you have knee pain after jogging is to stop exercising immediately. The knee should be cooled and elevated. Anti-inflammatory ointments with a cooling effect also help with relief. Further therapy is initiated in consultation with the doctor depending on the cause of the pain. Targeted muscle training or a running shoe that is adapted to the needs of the knee is often sufficient. In some cases, if there is an injury to the meniscus, an endoscopy may be necessary. If the symptoms persist, the runner's knee can also be treated with a small operation.

Read more on this topic at:

  • Muscle training
  • Knee arthroscopy

Can a bandage help with external knee pain?

A bandage on the knee joint can primarily stabilize it and thus help with muscular weakness or structural damage in the knee. If the knee pain is due to an injury to the outer ligament, for example, the bandage stabilizes the knee joint so that it cannot buckle outwards. People who have dislocated their kneecap or who do so frequently can also benefit from a bandage that stabilizes the kneecap.

Read more on this topic at:

  • Knee brace
  • Knee support for sport

Kinesio taping

Kinesio taping is primarily used to support the muscles. The elastic kinesio tape is applied to the skin over a muscle in such a way that it supports the muscle when it is tensed in its pulling direction. In the case of knee pain caused by a muscular imbalance, the kinesio tape can therefore alleviate the discomfort, especially during exercise. The kinesiotape is less suitable for large structural damage to the knee that requires stabilization.

Read more on this topic at: Kinesio tape


In most cases, good development can be expected in the further course. Exceptions are causes of the pain such as leg misalignment or excessive wear and tear of the knee joint. In this case, you should consider changing the sport to activities that are easy on the knees, such as swimming or cycling.

Diagnosis of external knee problems

Basically, if knee pain occurs again and again after exercise, it should be clarified by a specialist. In addition to an external examination of the joint, other examinations such as an X-ray or MRI of the knee can be ordered to rule out a serious injury to the knee.
In some cases, a treadmill analysis is carried out by sports doctors in order to identify errors in the movement sequence.

Read more on this topic at:

  • MRI of the knee


The best measures to avoid knee pain while jogging, in addition to carefully choosing your running shoe, are to wear realistic training goals and the conscientious stretch of the muscles.

Anatomy of the knee joint

Anatomy of the knee joint
  1. Thigh bone (femur)
  2. Medial meniscus
  3. External meniscus
  4. Fibula
  5. Shinbone (tibia)

Figure knee pain outside

A - Right knee joint from the front

  1. External hamstring muscle -
    Vastus lateralis muscle
  2. Femur -
  3. Kneecap -
  4. Outer meniscus -
    Lateral meniscus
  5. Outer band -
    Ligamentum collaterale fibulare
  6. Fibula -
  7. Shin -
  8. External calf muscle
    Gastrocnemius muscle,
    Caput laterale

    a - Ligament injury
    (Outer ligament tear)
    b - External meniscus tear
    c - Lateral
    (external) knee arthrosis

You can find an overview of all Dr-Gumpert images at: medical illustrations