I have one of those impossible to answer, "Go see your fitter" *questions. but what is the fun of that? I'm asking anyway.*

I have been experiencing the classic knee pain symptoms on the front of my knee cap. My seat doesn't feel to be too high, and I'm not rocking in the saddle or anything goofy there. My fitter adjusted my cleats for me so they haven't been way out of whack.*

I removed my cleats and pushed them as far back toward the heal as they will adjust. The pain does seem to have stopped, at least for the moment.*

A little additional info:

I have fairly flat, size 47 long narrow feet.*

I have relatively long legs. I'm 6'3" and a fairly light build...no track quads here.*

I'm 43 years old and have been riding again for 10 months after a hiatus of 8 years...work, wife, kids....

I'm on a new 2 month old bike (A HA!) with new Speedplay pedals adjusted for about 10 degrees of float. I never seem to be bottoming out in either direction of rotation on the float during my pedal rotation.*

Am I creating a worse problem that will pop up later by having the cleats at the rearward position? I will ride and see, but knees worry me. I'm just curious if I am creating a bear trap that will sneak up and cause a bigger problem.*

I recently had knee problems on my left leg, where my right is dominant.

It was just under the knee cap, more the patella area. Since it is the left leg, it would also hurt more when strained when getting in and out of a car (or lower than SUV vehicle)

What I discovered is that my cleats were positioned where my toe would be pointed too much inward. Where I thought this was better to keep them knees against the top tube, turns out, it made for poor knee/toe alignment. Even when facing a mirror on the spin bike, my knee appeared straight, and aligned, but it was actually just toeing in that caused a flare up.. It would be worse after working on climbs or out of saddle drills.

I also have really flat feet and pedalling hard for a few years only seemed to flatten out my arches even more so. Keep your toes pointed more forward and see what happens.

I was getting this on my track bike with SPD's and they have quite a bit of float and I thought that would have negated any need to adjust, but afterwards, my knee problems subsided.
g;luck

So do you still have pain then? I just had a similar issue of knee pain on my left side. Turns out it was cleat position as i felt my saddle height was ok. Had my cleats too far back actually. Took quite a bit of fine tuning over several rides but finally got it figured out. Remember, millimeters are miles with this!!

I'll find out this afternoon. Yesterday was good, but I need a longer ride. 20 miles doesn't really tell me anything. I think I will see how it is, and then start creaping the cleats forward a mm at a time toward the center point.

The highlight above is another clue whereas simply focusing on "positioning" of bike touch points may mask in the short term but not solve the underlying problem.

Your body is very clever with compensating or offloading work to more efficient otherwise dominant skeletal/muscular areas when in stress (for that matter, your entire neurosystem).

Coming back for 10 mos after an 8 year hiatus can be quite a shock to your skeletal and muscular chain initially, going unnoticed by you, but if your body is weak in an area or even slightly imbalanced, there will be a cumulative cost that eventually calls out as particular aches and pains at a unilateral site, then often without correction, becomes a chronic issue.

For cyclists just returning and even for seasoned pros, periodic checking as well as incorporated weekly training of your individual leg strength and nervous system firing through any number of drills found online (includes stress, plyometric, balance and stretching/yoga) goes a long way toward improved healthful performance on the bike.

I underscored "individual" above as with cycling the power-stroke is primarily a single leg activity. For example, while squats and deadlifts are tremendous whole body exercises, for cycling, mimic those as well as other exercises on a single leg.

Of course all of what I've written is a large assumption of your specific situation and maybe already completely obvious to you. But I thought worth mentioning.

I hope it is solved soon for you.