[coreJack]

I'm a 35y/o male, and have had anterior knee pain (right knee worse than left) since my late-20s from running and squatting, both of which I did sparingly. A couple of years ago, I took up cycling, and while my knees would occasionally bother me, the pain was manageable. Last winter, I rode for the first time in a couple of months and simply went too hard too quickly, and experienced a lot of pain in my right knee - even walking hurt for a couple of weeks.

Since then, I've seen an ortho who wanted me to strengthen my VMO, but that didn't seem to help at all. I've since discovered that anterior knee pain is often the result of dysfunction elsewhere. And I've noticed quite a few issues:
- quad dominance and weak posterior chain
- anterior pelvic tilt
- right hip higher than left
- feet point out (have flat feet, left is worse; orthotics for both)
- when standing with feet pointed straight ahead, my kneecaps point inward (internally rotated femurs under load)
- tight calves/soleus
- tight hip flexors
- occasional knots in my lower back


I saw a chiro who is ART trained and works with a lot of cyclists and she performed a test for chondromalacia (leg extension while she pushes on my kneecap), which produced pain in my right, but not left, knee.

For the last several months, I've been focusing on core training and posterior chain strengthening, and my knee pain is reduced, but comes back if I get on the bike, run, or squat/lunge. My right knee will even act up if I swim freestyle (flutter kick).

Here's a list of the primary exercises I perform during a week:
- dynamic warmup using lots of movements from Robertson/Cressey’s Magnificent Mobility
- anterior/posterior and side-to-side leg swings
- side, front planks
- reverse crunches
- ankle mobility movements to increase dorsiflexion
- box squats, bodyweight; notice that knee feels better when I focus on keeping the inner thighs tense at the bottom of the squat and spreading the floor with my feet
- deadlifts (limited hamstring flexibility, so I don't get low)
- pull throughs
- x-band walks

I wasn’t doing much foam rolling or stretching, but I just started on that. Also started doing pigeon pose to help improve hip flexibility; this pose is quite difficult for me - no surprise there.

Is there anything else I should be doing or should not be doing? Thanks for any feedback.