So over the past 4 years I have been to 3 different bike fit guys. Seen each of them 2 times. I have always had knee problems but it never started until I started riding a time trial bike. I had raced mountain bikes for 4 years and then got into tris. Knee problems started then. Thought it might be running but it didn't seem to be. Ended up having knee surgery to help relieve pressure under knee cap. Still a year later suffered through knee pain every time I rode.

So I was reading this article in triathlete mag (I think) and this coach was talking about Q factor. So I went and measured my mountain bike from pedal to pedal and came up with a number. Measured rode and TT bike and came up with a smaller number. Did a search for pedal extenders and bought a pair of 20mm ones. Put them on by TT bike and rode 3 different times of 1 hour each and no pain!!!!

Can't believe after 4 years, knee surgery and 3 bike fitters that never even addressed shoes or Q factor that this little extenders help the problem.

Hopefully this is the long term solution and not just a temporary fix.