This knee pain flared up 8 months ago after I got a new road bike. I bought the bike to train for racing my single speed mountain bike. I know it was partly training error that caused this as I hadn't been riding all that much before I went on a hard ride. I also believe it has something to do with the bike fit and bio-mechanics, I'm currently sorting that out. Riding my mountain bike is virtually pain free, while riding my road bike and ski touring flare it up. The road bike has a narrower q-factor or stance and I'm a bit more bow-legged on my left side. I know there is probably an underlying cause for the pain, so I'm trying to exhaust all my options before I even think about surgery. My patella on my left leg tracks a bit laterally, so I am working on balancing all the muscles in my leg. But I'm not sure that's causing the irritation I am feeling.
This medial knee irritation is very hard to pinpoint. It feels like it's coming from the area with the black sharpie mark in the picture below. When the irritation started it was bi-lateral at first, but has only been present in my left knee the last couple months. It's a nagging irritation that I don't want to push too far and be back at step one with it really flared up. At first I was thinking it might be plica, but doesn't plica run higher up near the medial side of the knee cap? I've gone to a couple sports medicine docs and orthopedic surgeons, they don't really have any ideas. They said it's not plica, but who really knows. Is the Pes Anserine Bursa located near that black mark in the pic? I think I might go to a podiatrist to have my gait checked out as well. Any other advice?