There are two types of pain at the sides of the knees – lateral pain – pain at the outside of the knee, or medial pain – pain on the inside of the knee.

The culprit is very often cleat related. Before you do anything – check that your cleats are not worn – there is usually a wear indicator. If they’re not worn, then it’s time to look at the position.

You knee is a junction between your hips and feet – if your feet are twisting inwards or outwards, then the knee will be forced to follow, causing pain at the joint and often referring to the hips as well in time as they are forced to follow suit.

In the case of lateral pain that is on the very edge of the knee, try moving your cleat slightly closer to the inside of the shoe. If the pain is on the outside of the knee, but closer to the knee cap, your foot might be slightly internally rotated, so try adjusting the cleat slightly towards to outside of the shoe, causing your toes to point outward.

In the case of medial pain that is on the very inside of the knee, try moving the cleat slightly outwards, to adjust the angle of the knee. If the pain is on the outside, but closer to the knee cap, it is possible your toes are pointing slightly too far outward, so rotate the cleat so your toes point inward more.

The Anatomy of a Road Cycling Shoe