I get front inside pain on my right knee. My right foot is quite duck footed. Left is slightly ducked but I dont get knee pain.

This happens on both my road bike (Look Keo pedals - 3 bolts) and my mountain bike (Time atac pedals - 2 bolts).

I've tried accommodating my right foot's duck stance by rotating the cleat on my road bike. It started hurting even more so I reverted back to straight. Perhaps the rotation was too much and I need to revisit rotation and make a smaller change.

I started reading up on q-factor of the pedals. Perhaps I need a wider stance on my right pedal to accommodate my duck stance?

I've read the following on Velofit. While the pain location is consistent with my own, my knees track inward toward the centerline of the bike (top tube). So this leaves me somewhat confused.

"Medial Knee Pain

Pain on the inside of (usually both) the knees, can often be due to insufficient stance width. This is often accompanied with knees that track outwards (away from the centreline of the bike) over the top of the pedal stroke."


Any recommendations on how I can fix this issue?
Thanks.

The main reason I use pinned flat pedals is that I can adjust my foot position to alleviate knee pain.

On a bike, my knees seem naturally to find spacing that's wider than normal pedal width, so I use pedal extenders - the wider separation allows my knees to go straight up and down more naturally. If you go for an extender, my reco is to get something cheap to test but to switch to one(s) that do(es)n't rust if you like the effect.

Frankly, I am not a big fan of professional bike fitting for recreational riders, except when knee pain is a problem. A good fitter may solve the problem for you or allow you to avoid painful trial and error.

What you are experiencing is very common. There's even a name for it: chondromalacia patellae. I rotate my cleats until my foot angle is parallel to the center line of my bike. You might need clips with a smaller possible angle of rotation. Fix it before it gets worse.

I walk like a duck too; my crankarm spider is always marred by my shoe rubbing against it.

Do you clipless pedals have float? I've always used pedals with some float.