Sorry to hear you’ve had a setback Kefu. I’m glad you’re still searching for answers, you will figure it out, but I’m guessing it’s a combination of things like it has been for me. I feel like my movement patterns were so jacked that it will take quite a while for me to get back to normal. It seems like I’ve been compensating for injuries I’ve had over the last 3-4 years. Strengthening my posterior chain has seeemed to be a huge help.

The lateral tightness and pain hasn’t come back since I started adding adduction and modifying my pedal stroke, however the medial knee irritation I was feeling a couple years ago came back. Adduction seems to set it off, it feels like it tightens up my vmo and pulls on my medial knee. Not sure if I have an osteophyte or something but it feels like once it tightens up there is some friction right at the medial knee, I’ll feel a pin prick sensation where the vmo attaches. KT Tape seems to help it from getting too aggravated, and smashing the top of my vmo literally stops the irritation from occuring. Also stopped adducting my leg during my pedal stroke and just try to make my knee track as straight as possible throughput the pedal stroke. Frustrating since I solved one issue mostly, but this new issue popped up.

Going to do very light adduction going forward, continue my strength regimen for glutes/hams and core and make sure I’m doing mobility work to address the areas that need it.