ok, I think I have narrowed it down my right knee issue(s) to my commuting mtb, after riding it my left knee (and only my left knee, right is fine) experiences soreness on the medial/lower area, basically between the kneecap and the bone ‘spur’ in terms of location: do you think this is related to the saddle being too low/high/forward/back? This is driving me crazy and I would appreciate some help in figuring this out… it being a mtb I can’t replicate exactly my road position, and the clipless are also different (shimano vs look, a lot more float), this has definitely been nagging me…
Not really enough info to go by, but a very general rule of thumb is that anterior knee pain tends to be from a saddle too LOW.
not sure how I can provide more info, save taking a pic or something, but I have tried to set things up the same way as on my road/tri bike in terms of height (at least ballpark). The pain is not really in the knee proper, but as I was saying between the kneecap and the bone spur (where the fibula attaches),
Sounds like a cleat positioning issue.
You could try to move the cleat slightly (3-4 mm) out laterally if the pain is medial.
I guess this would bring your foot closer to the crank (I suspect your foot now is too far away from it)
It sounds like your knee is not tracking in a straight line like a piston.
Cheers
Like rroof said, general rule is pain in front of knee = lower saddle, pain behind knee = lower saddle; also moving saddle forward effectively lowers it relative to BB, moving it back effactively raises it. Other than that, you’ll just have to tweak around a bit. Other variables could be different crank lengths, different shoe/pedal combos (different thickness from sole to cleat), etc.
Sounds like a cleat positioning issue.
You could try to move the cleat slightly (3-4 mm) out laterally if the pain is medial.
I guess this would bring your foot closer to the crank (I suspect your foot now is too far away from it)
It sounds like your knee is not tracking in a straight line like a piston.
Cheers
thanks for the tip, obviously the Q factor on my mtb cranks is a lot wider also, maybe that’s causing issues too, I will try and move the cleat and see what happens
I was getting what sounds like the same pain on my road bike. I went from 175mm cranks to 170’s and the pain went away literally overnight.
Most MTB’s run 180mm cranks, so there is something to think about.
Yes, and by going to shorter cranks you effectively raised your seat … 
I cant tell if you are being sarcastic or not, but I actually raised my seat after I installed the shorter cranks.
My problem was excessive ROM with the longer cranks (seeing as how Im a short arse at 5’7")
Correct A69, shorter cranks = bottom of pedal stroke is raised closer to the BB, so the rider position would be higher relative to the seat if you don’t raise the saddle accordingly.
Dude!
I’ve had the same issue… I don’t know that I ever narrowed it down, but there are numerous variables at play.
However, my issue began when I changed road bikes.
Often, when you change setups, the tendons/ligaments and muscles go through an adaptation phase and that can cause the nagging ache that you are likely sensing.
Good luck!—FT
I generally try to raise or lower my seat at the onset of pain
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What you describe (medial knee pain below the knee cap on the inside) is exactly what I have been re-habbing for a while. Started with some aggressive low RPM stuff on the trainer. Became more aggravated with running. Friend/cyclist suggested I roll my IT band with the foam roller - he thought with all the running it could be a tight ITB causing an imbalance. Bingo! 2-3 days of rolling 3 X per day and stretching the ITB and my knee is feeling near 100%. I also adjusted the float on my Speedplay cleats to allow a little more range of motion when I ride.
That kind of quick fix to an injury never happens to me. Knock on wood.