I think I some issues with my bike fit, road bike in particular. When I ride my road bike in particular I get a lot of posterior and some lateral pain behind my knee. I’ll feel it in my hamstring and calf as well. Only happens with the left leg, no problem with the right. I have the same thing when I’m on my tri bike but the pain is significantly less on the TT.
My thoughts are either the seat is too high or too far back. I have the seat all the way forward on the rails, so cant move it any further forward. I’ve thought about getting a shorter stem as i feel stretched out but to me I don’t look really stretched when I see pictures. Other thoughts are possibly moving my cleats around.
https://www.youtube.com/watch?v=phWg2dqGS0o
I think acupuncture treatment will work for you. My father was also having the similar type of problem and he had taken Chinese medicine Fairfax VA, which improved his condition a lot.
You do seem stretched out in the pic, you aren’t even on the hoods. Perhaps switch to a Zero set-back seat post and a shorter stem. Your seat height looks ok to me. What I really recommend is to book a professional bike fit from a reputable bike fitter in your area.
Here’s a link to a good article somebody once posted about knee pain that I found very helpful for this type of issue. I think the seat is too high for sure, but there might be some cleat issues too. Depends if the asymmetric pain continues after you lower the seat. I’m no fit expert so I’ll stop there, but that’s my two cents.
Look at the angle of his femur/tibia, it is FAR from fully extended. One thing I have learned from bike fitting is to throw ‘rules of thumb’ out the door as every body is different. I doubt his seat is too high but it seems also his cleats could be installd too far back. He should really go see a fit expert in person.
Just register today to reply to a month old thread to say I should go get acupuncture? Thanks for the free bump though!