I can only speak from personal experience but I had similar knee pain and symptoms for years. Tried just about everything mentioned in this thread, they only ever provided temporary relief. Unrelated to my knees I decided one day to start lifting more and devoted 5 solid months to getting a lot stronger one summer/fall. When I got my squat up to 1.5xBW and my deadlift to 2xBW my knee pain disappeared and hasn't returned since. A strong joint is a healthy, stable, happy joint and the "strength" you have from mtn biking is not the type of strength you need for a strong stable joint. If anything the quad-centric activities like mtn biking and downhill skiing are probably creating bigger muscle imbalances that are exacerbating your knee pain. I'm 30lbs heavier than when I started lifting and can still pound bumps all day without any of the knee pain or soreness that I had when I was skinnier and weaker. As always though, YMMV
"They don't think it be like it is, but it do."
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