Jicafold

Exactly. VMO strengthening is the mainstay of most physical therapy exercises for patellofemoral syndrome. As most patellar tracking issues involve lateral tracking of the patella, the VMO helps pull things back into place into proper anatomic alignment. I know you said your radiographs were normal however the radiologist may have only been looking for obvious abnormalities and may not appreciate any lateral tracking or may not have performed the sunrise view.

matimeo

At your age, I experienced the exact same thing you're describing. As in, I could have written your post. My issue turned out to be tight hamstrings and glutes, resolved by stretching. For some reason, doing more hiking/walking also helped. I also got a bike fitting, but he didn't change much, so I suspect the tightness was the issue. I think I was also more tight in one side, creating some imbalance.

Drew Eckhardt 

Yes. I didn't notice my position moving down with seatpost changes which led to knee pain.

A professional fit with video fixed it. Good position on left, bad on right.

redmandarin

Not sure I understand what makes the position on the right bad - is the knee too high?

Rowdy

I had the same pain and switched to Speedplay pedals.

drlogik 

I'm not a doctor either but previous posts are on the money, pedals with more float, especially if you walk with a supination or pronation. I second getting the bike properly fit for you (saddle height, length, cleat toe in/out, handlebar height, stem length and reach, etc). That can make or break a ride and the knees.

Drew Eckhardt 

Seat too low, knee joint angle too acute.

wilson_smyth

OP, Everyone will tell you what specifically worked for them, but you have your body with its own nuances.
Go see a specialist to figure out what the remedy is for you.

Otherwise you will end up with new shoes, pedal extenders, pedal wedges, etc, all costing a fair bit of wedge in total, with little chance of your specific issue being resolved.

70sSanO

OP made one post back in April 2019. But there are good suggestions here that can help a lot of other people, so this thread is beneficial.

John

Cyclcist11023131

I find my legs going thru stages of growth. Muscles get stronger, run out of air. Build up your air and now your knees hurt. Ligaments seem to take the longest to strengthen. Knees get stronger and you run out of air and so on. Meanwhile many pain adverse riders search for a cure. It is important to be fit to your bike but a lot of the rest is more about your own mechanics. We all get to the point where you change your attitude, sit perfect and pedal correctly as you fly into the wind. With those perfect mechanics, you run out of air, your knees hurt, and you are really tired and sore after a ride. As it should be.

CharlesClark

It is obvious that during cycling there is a strong load on the knee. I would advise you to buy a knee brace. You just need to make sure you get the best knee braces. The best ones are the ones for hiking. There are more of them, and they are available for low prices on websites like Amazon. I got mine for only 30 bucks, and my knee feels much better when I wear it. The craziest thing is that now I feel more confident. I can put more load on it now, and I could never do it without the right knee brace. It's worth checking them out, you might have great results with one.