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@MechaMorgan
"I've been getting agonising knee pain on my road bike on anything over 60km. After going to Nic at VeloPhysio, we worked out that my left quads were so tight that my knee was being pulled outwards a little at the top of my pedal-stroke, misaligning my leg in action."
Was my initial problem - although I've got horribly tight hamstrings, psoas and muscles which contribute to (thankfully decreasing) back pain.
Happy to let you know what I'm up to, but I explicitly DO NOT RECOMMEND doing these exercises without the prior advice of a certified medical professional. What has fixed my problem might exacerbate yours, and I wouldn't wish that on anyone.
In combination with hamstring stretches*, psoas stretches**, and ITB foam roller work, I've been using a foam roller on my quads, rolling right from the ditch of the hip down to my knee, along the outside front of my leg, so to speak. It's awkward and painful but its definitely, definitely helped.
I've also been doing 2 different kinds of squats to improve my knee strength and break bad habits. The first is a classic squat but thrusting your butt out so you end in a more sitting / bike riding position, and then pushing back up through the heels so your hamstrings pull. 20 times, focusing on clean form with a straight back.
The other is a one footed squat, while leaning in to a cycling position and extending the raised leg out behind you, almost like a superman pose. The important thing is to make sure both hips are perpendicular to the floor, which tends to need a mirror and a bit of weird shimmying around. Then bend your knee until you feel all the muscles in your knees engaged. Hold for 8-10 seconds and repeat 5 times on each foot.
** Kneel with one leg up, ensure your hips are tucked straight so your spine isn't curving and then raise your arm up and over your head on the same side as the knee on the floor. You should feel your hips and quads on the knee-down-side go taught as you stretch your psoas. This is VERY useful for loosening up your back, I'm told.