Chronic right knee pain anterior and lateral

Hi,

First of all, thank you to anybody who reads this. I hope that somebody can help point me in the right direction with my problem.

My knee pain began about 6 months after I began cycling about 2 1/2 years ago, so I've had this problem for about 2 yrs. It started out as hip and knee discomfort that I could live with, so I put it off. It was a dull achy feeling at the iliosacral joint area that radiated to the right across my butt muscle. The knee pain would fluctuate from anterior, by the patella tendon, to the outside by the fibula head. The knee pain wasn't really consistent, mostly it would be when I was sitting, I never felt pain while cycling or running. So I decided to go to my doctor and he sent me to a sports medicine guy. The sports medicine doctor did a postural x-ray and determined that my hips were off 13mm and that I probably had a short leg, he had me get a heel lift, my left leg is the shorter one. He sent me to PT. I decided to get a bike fitting done around this time and that helped significantly , almost completely getting rid of the hip discomfort and knee pain. But it was still there. I did some research and determined that a heel lift wouldn't help with cycling shoes. So I needed to know exactly what my actual leg length difference was. So I went to the sports medicine guy and he did x-ray of both legs and measured the bones and it ends up I have an actual leg length difference of 7mm, my left leg. I tried a bunch of different things but ended up getting pedals that allow float so that my knees aren't locked in one position and then I adjusted the right cleat so that my right leg was a little more forward to accommodate for the extra length.

So, PT didn't really help. I decided to go to a chiropractor and they only reinforced that I should wear a heel lift all the time, so I try as much as possible to wear a heel lift. I didn't really want to invest in a chiropractor because I've heard negative things and it's expensive. At this point my hip pain was nearly completely gone but the knee pain was getting worse or more consistent. So I went to get another bike fitting and they gave me a different saddle that was thinner, the guy said I was moving around to much on the seat.

I also went back to the sports med guy and he said I have fibular head dysfunction and IT band syndrome. He sent me to PT again for IT band deep tissue massage and regular PT. The PT lady put me on a treadmill and determined that my right arch seemed to be collapsing and that I could benefit from arch supports. So I went to this specialized running shoe store and they put me on a treadmill and video taped me running and set me up with a pair of shoes that had good arch supports for me. So I tried them out for about a month and nothing really changed. I don't know if I ever had IT band syndrome because whenever I would do the IT band stretching or get massage it didn't really hurt and the guy doing the massage said it didn't feel that tight.

Right now, my knee pain is worse with sitting, I don't understand it but sitting in a computer chair right now hurts my knee, but if I adjust so that my legs are more spread out then it kind of relieves it. Only with running and cycling do I feel a dull discomfort. It was getting really bad with running where it actually was really painful, but if I stopped running it would feel better. With cycling it's just a kind of dull stinging feeling.

So I finished PT and I haven't gone back to the sports medicine guy yet but I'm leaning towards going to a podiatrist because it seems like if my right arch is collapsing then that may be causing the knee pain. But the collapsing arch may have been caused my the leg length issue. So what I've considered is that I need to raise up my left leg and fix my right arch from collapsing but I don't know the best way to do this with cycling. My issue is that if I go out and buy the things I need to do this, is it going to help me? Or is there a way I can figure out for sure what I need to do so I don't waste money on buying new cycling shoes or insoles.

I know that I may not have included all the necessary information, so if there are any questions I will respond as soon as possible. I hope that someone can help me sort out my problem and determine if I should go to a podiatrist or what I should do.

Thank you