I just started getting back into biking a few months ago. I have been experiencing knee pain in my left knee due to the alignment of my feet/hips. My feet point out at about 20 deg for my left and 10 deg for my right during a normal walk and to help with this I changed from eggbeaters to speedplay pedals for the free float. This seems to have helped quite a bit with my left knee, but then my right knee started to hurt, probably just a delayed reaction. I have not cut the relief into my right shoe yet to allow the proper angle for my foot, but I can tell you straight away the pain is drastically increased if I put any twisting force onto my leg.
The pain centers around the, well lets try to describe this non medically. Extend your leg fully and grab your right kneecap. Move down and right about 2" and there should be a bone there, then a gap with some muscle, and a smaller bone. In that gap, and maybe slightly above is where I feel pain. I believe this describes ITB syndrome but I am not an expert. I am also having some shin pain, but I think thats just shin splints or something like it as I get used to
Here is the odd thing, on yesterdays ride about 5 miles in, my right knee started to hurt. This time pretty bad, I had to stop pedaling it was so bad. Considering I still had to ride back 5 miles, I wasnt sure what to do so I tried pushing my foot forward, and it seemed to help. Eventually I put my heel on the pedal and started to pump. Absolutely no pain. Pull my foot back and by the time the pedal was in the middle, pain was back. It was completely back if I put locked in with the clipless.
I am going to cut the relief later today, but wanted to get some opinions on what you think might be wrong. My distance from the pedals seems to be correct. Using one idea I should just barely be able to stretch my leg so my heel rests on the pedal vs the ball of my foot during a normal pedal stroke. My hips do not move while pedalling normally. My back is comfortable and I can sit up without touching the handlebar no problem so there is plenty of balance there. My feet cleats are pretty much as far back as possible on the shoes (or my feet are as far forward as possible depending on how you are looking at it).
My left knee did not bother my at all during this experience, even doing double duty coming all the way back, so I would say getting that foot pointing outwards really helped. I am considering getting extenders so I can point my foot out another couple degrees as I am able to touch the crank now on my left, and we will see about the right. I will get another 3-4 deg with the relief, along with the crank being a bit more flat against the shoe.
As soon as I get a chance, I will be going to see a doctor, but I want to have your general feedback/ideas so I can bounce them off of him/her. Doctors are great people but they are not magic workers. More information might allow me to describe the issue better and get results that work for me.