I had something very similar but obviously go to your physio and see what they say.

Anyway my experience was the following.
Same pain as you describe. Got to the point that some times I was near in tears just turning the pedals over with low load. I went to the physio and they said it was knee alignment and just do squats, and then specifically do single legged squats. I tried this and it just didn't resolve it. I went about 18 months without cycling and had effectively given up on being resolved.
I then met an old friend who does sports massage. Went to him after a marathon. Got talking about my knee and he said I needed a good massage first to loosen all muscles back to neutral before doing the rehab exercises. We did that and then he gave me some glute exercises to get those firing better before I progressed to squats.
With this progression I was able to get my knee back to tracking correctly. Now, if I do too much cycling and not enough knee rehab exercises the knee pain comes back but I know how to remedy it. Basically I am quad dominant and without some regular work on my glutes, I will always default to that knee pain.

Thx! I am heading in to physio this week.

I know I wouldn't be able to actually do a squat right now, as that is exactly what seems to cause sharp pain. But maybe as you said it could be alignment issue. I have def had my fair share of glute weakness issues on that same leg, along with CAM/FAI in that hip...

If no "catching" or sharp pains, sounds like more of a tendon issue. Check to make sure your seat hasn't dropped. If not, raise it a tad and move the seat back a bit.
Both those worked for me with the exact same symptoms.

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"Good genes are not a requirement, just the obsession to beat ones brains out daily"...the Griz

I had a similar situation. One professional bike fitting later and it was improving. My saddle was in the incorrect position because I never had been correctly fitted to my bike.

Hi
I had pretty much exactly the same issue.
Right Hand knee only. Sore spot on the knee cap rather than say behind knee or on the side of the knee
Only when cycling. No issue really when running
Went to a couple of Physio's. First one no good. Second one diagnosed tight Glute
The Glute was pulling all the muscles down one side of the leg to one side and causing the kneecap to be misaligned
Stretching - like the one with one leg at 90 degrees out from core and other leg straight behind fixed it
see something like https://health.clevelandclinic.org/90-90-stretch/

+1 for kneecap alignment issues causing these symptoms. For me it was due to overly tight IT band and a strength imbalance with dominant upper quads. I had dramatically increased my activity at the time. The pain was pretty bad at one point. I guess the patella is quite sharp if it's not in the track it's supposed to be in.

For me it wasn't such an issue with running either. I think this is because when running the knee isn't usually loaded while bent at more acute angles (unless you are running up stairs or something). When the knee was loaded and more acutely bent (cycle, high steps, skiing) I had issues.

I just didn't have the problem with the glutes as much as the lower part of the quad being under developed and the IT band also needing to be stretched a lot.

Hopefully this is a patella tracking issue in your case, because it's a lot easier to deal with than any sort of tear. I had both knees taped with Kineseo tape, which brought pretty much instant relief in the short term. In the longer term, the physio gave me some exercises to balance out the strength in the right muscle groups. I now haven't had this issue in years. GL with this.

Sounds like posterior patellar issues. Relative rest, no high gears and no squats.

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Dr Jay
http://www.Tri-Pod.net

Saw physio today and that is what they are thinking, patellar tendonitis. For now I guess its strengthening exercises for the quads, etc...

Borrowing the thread. I have always had yellow SPD-SL cleats but decided to give blue a go a couple of weeks ago. Reason being I have had a bike fit both to my road and tri bike, whereby I thought it would give me a good and knee safe starting position. After three outings with the road bike and ensuing slight pain in knees and hip balls post said sessions, I cancelled it altogether and moved back to yellows.

Thing is, the slight pain is still there after a bike ride, clipped in with yellows or on platform pedals. More so for the left leg. On the front left side of the knees and around the hip ball. Any takes what it might be?

And, how should I interpret this; my knees require yellow cleats or I simply did not find the right position for the blue ones?