I've had knee pain off and on for the past few years and I need to fix it... It's usually in my left knee, but sometimes will show up in my right knee. It is medial knee pain directly to the side of my knee cap, not up or down. Everywhere says to adjust cleats or buy an orthotic or wedge. I ride in toe clips, so I can't adjust cleats. Does that mean I need an orthotic? What type of orthotic am I looking for?

I didn't get it this time until I recovered my saddle, but I put it back in the same position... The only other difference I've made to my routine is I've been riding harder because I've been riding solo. Milage is the same and It only hurts while pedaling seated.

Thanks for your help,
Scott

I know you said you put the saddle back exactly as before, but I'd double-check, and maybe consider adjusting it anyway. I had the same symptoms and just stony change --up I think-- made all the difference. I had simply resigned myself to aging aching knees.

thanks, I'll try that. I really need to fix this... I have to keep putting off tours because of it
I've played with saddle height, but not moving it forward or backward..

Do you pronate your feet or engage in ankleing? Probably no orthotic if your ankle is fine or foot arch doesn't collapse.

Also your saddle may not have been aligned properly such that when you sit on it your hips are not or were not during your training pointing straight forward... switching the saddle may have caused this change. This offset angle made by the hips will be "corrected" by the other joints below the hip, such as knees or ankle. So, upping the milage may have proved the tipping point for a muscular imbalance. Double check your pelvis position.

I try to keep my feet flat at all times, except when sprinting or climbing. Should I not be?
I just looked at my bike and noticed that my saddle wasn't quite straight and fixed that. Thanks for your help.

You mean keep your feet level to the ground? Or you have flat feet in general? Hopefully the saddle fixes it(the important part is keeping your pelvis straight ahead)

I mean level with the ground. I used to point my toes down, but I read somewhere that it was bad form.

You are correct. "Heels down, pedal round."