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Can you comfortably stand on one leg for, say, a minute, while moving your arms around? If you cant - if you wobble or have to touch your toes to the ground to stabilise yourself, then that would suggest that you're lacking stability (usually due to a weak gmax and gmed).
Obviously, I could be mistaken (and maybe the frame is banana shaped ), but I'd look at bio-mechanics rather than bike fit first; whereas in your post you've only talked about bike fit.
In addition to the above check cleat alignment and the relative q factor (small is not always good).
"I'm not a real doctor; But I am a real worm; I am an actual worm." - TMBG
I cannot comment on your issue but perhaps I can tell you what I am doing to fix mine and you can take something from it.
I have my left inner hamstring brush the seatpost and my left knee almost brush the top tube. The right leg seems to track straight.
I also notice that during hard sustained efforts I tend to scrunch up my right shoulder and my pelvis rotates so my right hip is forward of my left.
After a couple of hours of hard riding I tend to get aching in my lower back but only on the right side (always in the exact same position) and sometimes a niggly left hamstring (right in the belly of the muscle).
So what I did was raise the saddle height a few mm to create a bit of instability to try to find out where the problem is. Turns out that after doing this, my left heel drops slight while my right foot has a very noticible pointed toe action.
So my right leg is short than my left (either via imbalance, tightness or bones - don't know which). This causes me to shift on the saddle a little toward the right and rotate my hips causing the left leg to track closer to the frame.
First thing was to get some arch support and wedges to make both legs (knees) track straight. Next I will be adding a shim to the right cleat to effectively lengthen that leg.
Sorry, all long winded but I would be looking at how your legs (knees) are tracking and paying attention to how you are seated.
mattyb wrote:First thing was to get some arch support...
that is definitely step one. collapsing arches will send your knees in. get a cycling specific arch support, ones that arent focus on the heel instead of the forefoot. wedges may help, if youre the experimenting type, get the kind that slip in under the insole, so you can try some for 20-30 min, add another, take them out if something hurts, etc.
and while doing all this, try to not think about your knees' tracking. sing some songs, tell yourself a story or something. then look down and see what youre doing. otherwise, you can consciously manipulate the outcome.
in the end, some people still just have their knees in. it's not that big a deal, as long as theyre going straight up n down. it's when they come up straight and then go down to the inside, tracing a figure 8, that is a red flag.
of course, if you have a very reputable fitter nearby, go talk to him/her too.
There is a huge difference as if the latter (a lot of people), then the collpasing arches will be altering the relationship between your knees, ankles, hips etc.
Easy way to tell is stand up naturally and have some look at your arches, then stand up whilst deliberately pointing your toes up as much as possible. How different do your arches look in the two positions?
As for cleat position, I am with you I think, however there could be an argument for wedging your feet. You are using Spec shoes, so there is some angle on the soles anyway, but often knees coming in is due to pronation of the feet.
From my experience however, the Specialised insole wedges are pretty ineffectual. Not sure why, but once read a 'learned' opinion about the neural triggers (or something) being towards the rear of the foot, so you need to change the whole shoe angle not just the front for you body to 'realise' changes have been made. Not sure about that but still... Wedges under the cleats have far more noticeable effects on pedalling dynamics.
My advise is to go see a decent bike fitter.
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