I need help figuring this one out. Rider is experiencing pain on the outside part of her knee. She has quite a bit of inward knee movement throughout her pedal stroke. She pronates moderately. We has shimmed with varus wedge and used superfeet orthotics to stabilize the arch. Knee tracking is visually improved with still some inward movement with 3 varus wedges. We have moved up and down the saddle height range from 145 to 153 degrees without much change or reduction in knee pain. Cleat width seems to be correct. The only 'fix' to her knee discomfort seems to be her pointing her toe downward throughout the pedal stroke. I can't really think of what this is doing aside from effectively lowering her saddle height on the left side. Specifically her discomfort seems to be lateral of her patella tendon on the bottom of her kneecap.
Thoughts on what is causing the issue? BTW, she is using a pair of Look Keo with 4.5 degree float cleat. We have checked cleat rotation and she seems to be comfortably within the float range without any noticeable outward or inward patellar rotation throughout the pedal stroke.
Thoughts on what is causing the issue? BTW, she is using a pair of Look Keo with 4.5 degree float cleat. We have checked cleat rotation and she seems to be comfortably within the float range without any noticeable outward or inward patellar rotation throughout the pedal stroke.