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Might be a bike question....Re Knee pain

As the JOS adds longer rides I'm finding that my right knee is getting a sharp pain on the medial side of the patella.  That knee/leg is also tracking more outboard, in relation to my top tube, than my left one.  Its kind of a Chicken/Egg issue...  Is the knee pain caused by a need for a shoe adjustment to fix the tracking issue, or is the knee/leg tracking that way to compensate for a knee problem? 

Anyone have experience with this?

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