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I had patella-femoral dysfunction for a while, which sounds similar. Basically the muscles pulled the kneecap out of line, so it didn't slide smoothly over the joint.
This was a while ago now, but I went to a GP, who gave me a referral to a physio. They gave me a load of exercises to do and those sorted it out.
Death_at_Altitude
gooner47
ThomasdeGlynt
Sorry for late reply, haven't had a chance to get on until now.
I'm running 48/17. I've commuted on a fixed gear before, but that was an old second hand Langster with spds and cleats. Haven't ridden a freewheel in a long time.
I've recently built my own bike and this is the first time I'm putting any decent mileage on it, so that's why I feel like it may not be properly set up for me. I really want to keep the flat pedals and straps if possible, because I like to just be able to hop on and off the bike with "normal" shoes on.
I have a front brake which I use, but sometimes I will just opt for leg braking, but not from any huge speeds.
I track stand, which I thought might not be helping so I've since stopped that.
"Pain beneath kneecaps" - hard to tell exactly, but when I'm sitting it feels like it is lower on my leg just below the kneecap (not beneath - poor word choice). So on the top front of my leg as you look at me head on.
I'm spinning, don't tend to get up to crazy speeds or get very aggressive with acceleration.
Saddle height - I will check this.
Skidding - no, I don't skid.