Last year I didn't have any major knee pain issues when I got my trike.

This year when I started out, my knee was hurting above my knee cap. It felt like a muscle related issue and I assumed it was conditioning related.

Then I got clipless shoes, and the knee pain has moved to below the knee cap, on the front of the leg.

Not sure where to start with adjustments. The cleats are currently all the way back, but I'm not sure if it's cleat position or maybe I need to adjust my boom length due to the new shoes. My leg extension feels pretty good, but maybe I need to move a small direction in one way or the other.

Thoughts?