Outside Knee Pain - Cant move cleat any further

I had excactly the same issue. Everything ok up until 35-40miles then pain would arrive on outside of knee and gradualy get worse.

In the end i went to see a proper sports massage guy who informed me that my muscles on that side were all tight.

Had to take a month off the bike and a few visits to the sports massage guy to loosen it all up.

Took it easy for a few weeks building the miles back up along with stretches he gave me to do on a daily basis.

That was in April last year, 7 weeks later I done the Dragon ride (186m) with  no issues.

Hope this helps.

same problem with me,adjust to 20KM now

I went through a lot of knee pain issues in the last couple of years, with lots of red herrings along the way!

I thought it was cleat position, pronation, seat height, crank length, riding singlespeed etc.

After wasting a lot of money on other solutions, I eventually paid for a bike fit (Dougie Shaw - Edinburgh Bike Fitters). He identified that I was 'twisted' in the saddle, and showed me this using a really cool saddle pressure mapper. The twist came from my hips, tight glutes, hip flexors etc. The result was that my right foot was always overreaching, which in turn stretched my left IT more, result was (different) pains in both knees.

He showed me the stretches and strengthening I should be doing, also some tricks with a massage ball, and also general advice on how to 'hold' myself on the bike until it became natural (basically being conscious of correcting the twist).
 

Long story short, I would never have figured this out by myself, and would have continued to waste a lot of time and money fiddling with other solutions. 

The other thing I was doing wrong was just riding too much! I was training for a long distance event and was trying to keep to 10-15% extra mileage a week, but was ignoring intensity, e.g. 100km easy is very different from 100km as fast as possible. I didn't build in any recovery time either, just kept increasing distance week after week. Once I started taking every third or fourth week off, maybe getting a sports massage at the same time, I started feeling a lot better on the bike.

I think you've answered your question in that last post. You changed your shoes... I'd wager a fiver this will be the reason you are feeling pain.

As mentioned somewhere else, I'd expect your new shoes are not compensating for / working with your foot pronation.

Out of interest, which shoes did you used to have, and wht have you moved to?

The shoe change may be the reason for the start of pain, but it may not be the cause. The pain is caused because your knee isn't tracking properly. There are loads of reasons why this is. 

Also, I'm not a massive fan of diagnosed ITB problems... yes they exist, but they are often just a symptom of something else happening further up the chain.

Glute engagement, hip tracking are two big reasons why cyclist feel pain where you are highlighting.

Do some research on glute engagement exercises, do these for a couple of days, and assuming the knee symptoms have eased off the bike, go out on the bike and see if the pain returns. 

I've more or less stopped stretching over the past two years, preferring to work on muscle engagement and core strength exercises to ensure muscles are working properly. Touch wood it works for now.

I didn't ask what pedals you were using? Moving to SPD -SL pedals have helped me avoid pain. 

I had a really bad do with outer knee pain for a few months last spring - felt like someone sticking a hot screw driver into the joint and grinding it around. I eventually solved it by lowering my seat an inch or so (new bike) which helped but the thing I think really sorted it was doing some hard quad stretches - the ones where you stand on one leg and bend the other one up behind you and grab the foot and pull hard and really stretch the quad muscles. My knee's been fine since, touch wood.

If you afford it, get a bike fit. Where are you? I can recommend two in the north-west of England. 

If you can't stretch to that right now, video yourself pedalling on a turbo (from directly behind or in front), and post it on here. You'll get a bunch of good suggestions. And we'll laugh at the dodgy curtains in the background!

foot in/out isn't always the cause of lateral pains. 

foot rotation can be the cause too  ...

http://www.bikeradar.com/gear/article/take-care-of-your-knees-part-2-17445/

How is your I.T. band/flexibility?

I would see a physio first for a diagnosis and then sort out your ride position with a pro-fit.

It might be IT band syndrome. Mucking about with cleats and pedals may no longer help and it'll take something more fundamental. My own case of ITBS started out like that, pain after 30-40 miles. That number came down and down until there was pain after a few miles and for hours and even days after a bike ride.

There's loads of stuff you can google for ITBS. They all broadly recommend the same thing; activate and strengthen your glutes. Stretching your ITB is more problematic. Some say do it, others say don't bother, it's impossible.

My advice would be to keep an eye on when the pain starts. If that number of miles starts to come down see a physio, preferably one that's a cyclist. An intial appt will cost £40 but they can do all sorts of tests (Obers test, Nobles test, etc) as well as take a detailed history (crucial) to see if you have ITBS . If it's confirmed then you'll know where to go. Nothing worse than flailing about on your own trying to figure out what to do (let me tell you).

Good luck.

I have a similar problem after about 40 miles. It was pain below the knee on the outside and was diagnosed as a tight ITB. Once it progressed on a ride, my knee was collapsing inwards towards the top tube and I felt I was losing power in that leg. It was also very painful.

I completed the Etape Loch Ness a couple of weeks ago relatively pain free. I did lots of ITB stretches and I also changed my pedals from Shimano M520 SPDs to the A520 Touring SPDs which gave some lateral support and stability to my foot.

Last weekend, I went out on my cross bike, which I'd had a bike fit on and had  used for a 100Km Audax, and was in agony after about 40 miles. I hadn't continued with the streches and I'd also fitted the M520 paedals (as my wife had pinched my M424s that had previously been fitted).

So in summary, try ITB streches and more supportive (wider platform) pedals. That seemed to work for me

Ive not had it from cycling but from running I know I get pain on the outside of the knee (ITB problems) when my knee falls inwards too much. Check when you are cycling if your knee brushes along the top tube or dips in closer than the opposite knee. If so there are exercises you can do to help strengthen the muscles such as squats / one legged squats ensuring that the knee doesnt fall inwards - should stay inline with the foot or out a bit.

Not sure about spacers but a few years back I had a similar problem when coming back from injury and used inner soles cut in half to change the angle of my foot in the shoe. It seemed to help but it's difficult to tell if it was that, physio or just healing process that did it. It's not something I've ever seen recommended anywhere else so proceed with caution/advice from someone qualified