What adjustments do I need to make it go away!

I am a noobie so take this advise with a grain of salt. I experienced pain in the inside of the knee and made it go away by adjusting the cleats on the bottom of my shoes (clipless pedals). I found that the cleats were forcing my toes inward and they were positioning my foot too far forward of the pedal axis. To correct this I adjusted the cleats toward the toe of the shoe (pedal axis under the balls of my feet) and adjusted the angle so that my toes point straight forward.

bbcngineer

when do u get the pain?

i used to get some pain on my inner knee, on the upper part of the knee. it only developed a few times while i was on the bike and usually about 12 or so miles into a ride. i realized i wasnt warming up properly and i was just going full out from the start of my rides. stretching when it occured usually helped, going easy at the start and spinning fixed the problem.

I just posted this in another thread, but it might help you so here goes...

I was having pain in my right knee on the inside anytime I rode 40 miles or longer. Had a prefessional bike fit done, he made some major adjustments and put some shims under my cleat to compensate for my over-pronation. Pain was still there. Did some research and found out inside knee pain is caused by your toes being pointed out or your feet too far away from the bottom bracket. Messed with my right cleat a bit, it got better but still there. I was baffled. I have never had any knee problems before, even when I was jogging 40 miles/week. I was getting pretty disappointed since I never had this problem on my mountain bike and 5 weeks and 1000 miles on the new road bike and I was hurtin'.

The other day my bike developed a strange clicking noise in the bottom bracket, so I pulled the crank off and re-tightened/lubed everything. I noticed my crank was not pushed all the way in (it is one of those 2-piece hollowtech Ultegra cranks), so it was sticking out about 2mm farther than it should have been on the right side. Did a 50 mile ride on Sat. and an 80 miler on Sun. No pain at all. The clicking BB went away too ;)

Bottom line, as others here have already said, a small mis-aligment in fit can cause big trouble.

Chris Carmichael, in his book The Ultimate Ride, says that medial knee pain (inside) is usually caused by:

1) weak lateral hip muscles;
- or -
2) poor cleat alignment - toes point out;
- or -
3) excessive stance - width on pedals.

The recommended correction for cleat alignment is define and align cleat to neutral.

Outside knee pain is the opposite, toes point out. Same correction, bring cleat to neutral.

According to this, moving the pedal to neutral and getting the balls of your foot over the pedal axis may have been the adjustment that corrected your problem. You may want to move the cleat so that the toe is pointing more inward again and see if this feels even better.