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Knock Knees & Bow Legs in Children: What’s Normal, What’s Not & When to See a Specialist
It’s not uncommon for parents to notice their child’s legs looking slightly curved—either bending inward or outward—and wonder:
“Is this normal, or should I be concerned?”
In many cases, these leg shapes are just part of normal growth. But sometimes, they may indicate an underlying orthopedic issue. In this blog, we’ll explore how to tell the difference and when to seek expert evaluation.
What Are Knock Knees and Bow Legs?
Bow Legs (Genu Varum)
In this condition, the child’s legs curve outward at the knees when standing with their feet together, creating a gap between the knees. Bow legs are often most noticeable when toddlers begin walking.
Knock Knees (Genu Valgum)
Here, the knees touch or angle inward while the ankles remain apart. Knock knees typically become more visible between ages 3 to 5.
Both conditions affect lower limb alignment and are commonly seen during normal early childhood development.
What’s Considered Normal?
- Bow Legs are common in infants and toddlers (ages 12–24 months) and often correct naturally by age 2 or 3.
- Knock Knees usually appear between ages 3 and 6 and often resolve by age 7 or 8 without any treatment.
These variations are part of how children’s bones and muscles adapt to upright walking and weight-bearing as they grow.
When Should You Worry?
While many cases resolve on their own, some signs require medical attention:
Consult a Pediatric Orthopedic Specialist If:
- The condition persists beyond age 7
- The curvature is severe or worsening
- Your child experiences pain in the knees, hips, or ankles
- There is difficulty walking, running, or frequent tripping
- One leg is more curved than the other
- Your child has short stature or delayed growth
- The child has a family history of bone or growth conditions
These could be signs of underlying conditions such as rickets, bone infections, or genetic disorders affecting bone development.
Diagnosis at Child OrthoCare
Our evaluation process includes:
- A detailed physical examination
- Review of medical and family history
- Measurement of limb angles and alignment
- X-rays (if needed) to assess bone structure and growth patterns
The goal is to differentiate between self-correcting developmental changes and structural problems that require intervention.
Treatment Options
Treatment depends on your child’s age, severity of the condition, and underlying cause.
If It’s Part of Normal Development:
- No treatment needed
- Routine monitoring every 6–12 months
- Nutritional guidance for healthy bone growth
If Treatment Is Required:
- Physical therapy to improve muscle strength and alignment
- Orthotic supports or night braces
- Nutritional correction, especially for vitamin D or calcium deficiency
- Surgical intervention (e.g., guided growth surgery or osteotomy) in rare, severe, or non-improving cases
How to Support Your Child at Home
- Provide a balanced diet rich in calcium and vitamin D
- Encourage outdoor play and physical activity
- Use well-fitted footwear—avoid high arches or heavy shoes
- Discourage sitting in a W-position for long periods
- Follow up with your orthopedic specialist as recommended
Final Thoughts
Knock knees and bow legs are usually just part of normal childhood development. But in some cases, they may signal a condition that needs medical care. Knowing when to act can make a big difference in your child’s long-term bone health.
With early diagnosis and proper treatment, most children grow out of these conditions and go on to walk, run, and play without limitations.
Concerned About Your Child’s Leg Shape or Gait?
Let Dr. Nargesh Agrawal, Pediatric Orthopedic Specialist at Child OrthoCare, evaluate your child with care and clarity.
We offer advanced diagnostics, personalized treatment plans, and compassionate support to ensure your child’s healthy development.
Book an Appointment Today
Visit: www.childorthocare.online/contact
Or call us to schedule your child’s consultation.
Let’s support your child’s growth—one strong step at a time.
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