My knee is sore and the exact place of the soreness is above the kneecap and outer side of it. Let me picture it for you:




But I don't feel the soreness while riding. I feel it when I touch that area. I wonder if it is a tight IT band or something worse like MCL injury. And I have to find out what is wrong with my bike fit that causes this problem. I suspect that it may be due to where I place my foot on the pedal and how I bend my legs (inward or outward). Basic bike fitting techniques tell you about horizontal and vertical placement of your foot (saddle height and fore-aft position) but I didn't see any guide for the ideal space between your two feet. Should it be shoulder wide? Should I keep the angle of my knees always at shoulder wide? I am asking this because I am using platform pedals on my touring bike and I can place my foot freely without the presence of a locking mechanism.

Not ITB. IMO not MCL either. Probably tendinitis. Go clipless, learn to pull back at the bottom and push forward at the top. Only pushing down causes this exact problem. You need to engage your VMO also, especially in the pushing-forward phase. With clipless pedals, try toeing out slightly. I tour with SPD pedals and MTB shoes. Very comfortable shoes and reasonable to walk in. For long distance walking, hiking, hoteling, etc., I bring a pair of light shoes.

Stretching will help some, but probably not enough.
https://www.bikeforums.net/road-cycli...l#post15372967

I am happy that you replied my thread. I know, you have lot of experience on this subject from my earlier posts. As you suggested, I have been diagnosed to have quadriceps tendonitis on my latest diagnosis. Actually, the pain is also presented above the kneecap area, even while I am riding (I can tell it now because I realised it just a moment ago while I was riding gently around the neighborhood). However, I had been told to have PFPS two years ago. And, in between them, I had an MRI scan and it showed that I have Grade II degeneration on medial meniscus posterior horn (is this the back of the knee? I have no pain on the back of my knee anymore). So, I can't be sure anymore. Maybe it is evolving from one issue to another. Anyway, I am not pushing and doing long rides on my touring bike anymore, just commuting. I am also doing quadriceps strengthening exercises in a daily routine and using foam roller to stretch hips, it band, quadriceps muscles. I am dealing with this issue since two years but I hope that it will go away soon. Then I can start again my longer rides with my road bike which has clipless pedals.

I think I need a electromyography check. VMO seems to misfire.

More things to try: first try ibuprofen therapy, assuming it's tendinitis. Starting today, take 600mg ibuprofen every 6 hours, all day, whether it hurts or not. Time it so you take it when you go to bed and again when you get up. 6 hours doesn't need to be all that precise. Max of 2400 mg/day. Do that for 10 days straight. That short a time won't hurt you. I know people who've done that for 6 months, no problem. If that fixes it and it stays fixed for a at least a couple days after you stop the therapy, then you know what it is, and can take ibuprofen whenever it hurts. IME it would go away gradually over a period of a few months.

If that doesn't fix it, you can try glucosamine therapy, assuming it's a meniscus problem. Take 2000-3000mg of glucosamine sulfate/day in two doses. Also take 1000mg of MSM/day. Do that for a month. Some people it fixes right up, others no effect. If no effect you can discontinue if you want.

What quad exercises are you doing and how often?

Actually I've been using Ibuprofen cream since a week or so but not so regulary. I am applying it almost every day though. I will give a try to it in pill form. I suppose it is more effective?

I have been taking glucosamine/chondrotin/msm but that was 5-6 months ago. I can't say it helped much but I wasn't resting that time. I've stopped even the very short commuting rides since 3 weeks. It helped to alleviate the pain noticeably but pain is still there especially when I touch the area.

I am doing leg lifting exercises every day in the morning and sometimes in the evenings as well. I am also doing some pillow pressing exercises. Pressing down the pillow under your knees.

...

I think I have tendinosis but that is just an end result of a patella dislocation. When I am doing that leg lifting exercises I can actually hear my kneecap rubbing. And it is kind of locking when I am walking around the house now. All I did today was few minutes of exercise. I don't know if those exercises are helping to move the kneecap to its original position. I really don't have much hope to recover nor unterstand what is going wrong with my knees.

...

Damn! I was considering to take Ibuprofen or Etodolac pills but I was wondering about that NSAID's cause heart conditions as side effect. Now I made a search and met with this warning:

https://www.nlm.nih.gov/medlineplus/d...s/a682159.html

I cannot take this risk. I'll continue with the cream and rest more.

...

I think I have a combination of IT band syndrome, quadriceps tendinosis as well as patellar maltracking and meniscus damage.