Are my cleats causing running pain?

As above. I am fine on the bike, no problems. However when I run (especially in the 3/4 triathlons I’ve done) I get excruciating pain on the outside of my knee. I’ve been diagnosed with itb issues by a physio, and seen many people regarding treatment but I’m wondering about the causes.
Since riding my race bike, I’ve noticed my heel strikes the chain stays so my foot isn’t angled outwards quite as much as I’d like. When I’m riding 3-4 sessions a week, will this be causing undue stress on my joint that I’m only noticing when I go for a run? To add more complications, the pain comes on at random points. More recently I’ve been doing slow 10k runs with no problem once a week and yet last Sunday it blew up at 8k.
Could all be speculation but interested in your thoughts

Yes, switch to running shoes. Trying to run in your cleats will cause all sorts of problems.

Ok, seriously, have your physio watch you run. I battled knee pain for many years and it got pretty bad as I ramped up my training distance. Turns out that I have somewhat high arches but they “collapse” when running, transferring all of the impact to the knee, which led to knee pain, tight ITBs, and weak hip flexors and abductors. Custom inserts solved many of the problems, along with ITB massage and rescuing my running mileage.

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Unfortunately with covid my appointments for inserts have been pushed back, but an interesting take, thanks.

In the meantime, I’m waiting on some pedal extensions to arrive, hopefully allowing me to turn my feet out a bit more naturally

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