Getting a bit of pain on the inside (medial?) of my left knee from road cycling. Using stiff carbon soled Sidi’s with Specialized blue (medium support) BG foot beds as recommended by bike fit a few months ago. Took a look at my Speedplay cleats and pedals today and there’s signs of wear to the inside of the left cleat that it’s actually touching the pedal axle. Any ideas which shim will counter the pressure or over rotation on the inside of the foot?

This is a great little guide to work through:

http://www.bikeradar.com/gear/article/take-care-of-your-knees-part-2-17445/

Medial/inside knee pain would suggest a lateral (outside, or right hand side of right foot/left hand side of left foot) wedge. However, work through the guide, it could also be cleat positioning…

Wedge with the thick side so it’s nearest the crank; never wedge the other way.
The wedge should go under your cleat, or under your heel.

Cheers Shermer, bike fit adjusted my cleat position, rotated cleats so toes are pointing more inwards. As a kid my shoes always showed wear on the inside of the heel. So possibly 1.5mm wedge support to the outside of the forefoot might help?

Wear on the outside of the heel is normal for most people I’d have thought; that’s where you foot strikes first, and then it rolls inwards.

Do you have high arches and bowed legs?