Fibular head pain

Being injured is such torture. Even more so when you don't really no what the cause is.

This sounds like it could be tendinitis of the biceps femoris or
popliteus, from looking through Andy Pruitt's e-book.  He describes:

SYMPTOMS
Pain on the outer side of the knee about one inch below the middle of
the joint and slightly above the bony protuberance.

CAUSES
* A too-high saddle or riding a fixed-gear (track) bike.

* Bow-legged people often suffer from this problem.

* Pedals with excessive float make the problem worse because the
biceps femoris and popliteal tendons have to work hard to stabilize
the resulting excessive tibial rotation.

TREATMENT
* Apply ice as many as three times a day for 15-20 minutes each time.

* Take a non-steroidal anti-inflammatory drug (NSAID) with food.

*  Lower the saddle about 3 mm.

* Switch to a pedal system with limited or no float.

Kelby Bethards Replies

Anthony,

What you are describing does sound accurate for your problem. I experienced the same thing at one point, never required surgery but the pain and feel of the "need" to rotate my heel back inward was significant and turned out to be what I needed to change.

You have done the trouble shooting this far in stating the differences betwixt the different bikes, so that needs to be rectified.

The bike fit panelists will have a better (than my simple monkey brained approach) answer for the specifics of how to adjust your cleats and so on, but I once read/heard something long long (15 yrs) ago that made sense to me. Sit on a ledge of some sort (small retainer wall, counter top, etc) with your feet dangling. Now let them "hang loose" - how they want to hang, and look at how they are positioned. This is somewhat how they want to be on the bike too. (For example, mine hang toes out a bit and toes down a bit, and this is incidentally how my feet are when I ride) So, if your feet hang so that the toes point out, if you will, that is probably how they will feel best on the bike.

The problem with a lack of rotation in the pedals, as you have noted, is excessive rotational forces inward on the lower leg, this stretches the biceps femoris tendon too much causing tendonitis and tenosynovitis and so on. Not to mention excess wear and tear on the menisci in the knee joint.

So, in my personal experience, the egg beaters do have more rotational options and float abilility...too much for some and too loose for others but they may be the right idea for you. This assumes that the rest of your positioning is good.