tedlemme

Good point. And that may very well be the case. My knee pain tends toward the front-inside (anterior-medial) area of the knee. Reading on the internet suggests I might want to explore arch supports and ITS wedges for my forefoot. I know I have flat feet, so that's the next thing to look at.

I feel like my feet do track pointing straight ahead. I checked on that when I thought of fiddling with my cleat angles, but I'm not seeing an obvious problem there. I took a video this morning from dead-on and I do see that my knee cap describes an arc when pedaling: it moves inwardly on the down stroke. The patella shows a horizontal movement of probably 1-1.5" from the top to the bottom of the pedal stroke. I stuck a piece of shiny tape right on my knee cap to see it clearly.

But that gets pretty complex. Is my arch collapsing and my foot rolling from the heel or the forefoot? I know foot mechanics are really complex and it's really tough to nail that one down. I think the only way to figure that out is experiment. I'll probably go to the sporting goods store today and get some insoles (conveniently, the local store carries a brand recommended for cycling shoes on the website of a bike fitter that addresses this specific issue.)

So, you may be right. Maybe we actually do have the fit close enough, and it's time to play with the next things. The way I see it, there are three parts: bike, shoes and body. If the LBS guy is right, maybe the bike is already right. It looks a little like Frankenstein with the crazy extreme seat post and stem, but if the measurements are right, I guess that's okay. Maybe it's my body, maybe it's the shoes. I can fiddle with the shoes. As for my body, when I saw the PT (who I have no choice about, because that's the way the military medical system works), he said "if it hurts, stop doing it." (My concerns about the quality of care from military medical is a WHOLE other topic). So, unfortunately, fixing any body/strength/flexibility issues is up to me and Google.