What is Bow Legged?
Bow legs (also known as genu varum) is a condition which presents itself in the lower limb when the legs curve outwards at the knees while standing with the feet together.
This is not to be confused with knock knees (genu valgum), as that is when the knees are essentially touching (knocking) when the feet are separated.
Physiologic bowing of the child’s legs is most common in infants and toddlers, and its rarely serious and they usually grow out of it without treatment by the age of 3 to 4 years old.
Causes of Bow Legs
There are more serious medical causes and conditions of bow legs, which include rickets, Blount disease, or any other condition which can affect bone growth around the knee.
- Rickets is bone growth condition due to lack of Vitamin D or calcium. Rickets can run in families due to a genetic problem that affects how the body uses Vitamin D. This would be treated by seeing a dietician who can adjust your diet to add in Vit D and Calcium. If genetic, specialised treatment by an endocrinologist would be required.
- Blount’s disease is a growth disorder that affects the tibia (shin) bones mainly, and the growth plates around the knee. Can affect older children who are overweight, started walking at an early age, and have a family member who had the condition. Treatment may involve a knee brace or surgery depending on the severity of the deformity.
- Other conditions such as injury, infection or tumour may result in trauma to stop or hinder normal bone growth.
Podiatrists are able to complete a thorough biomechanical assessment and physical examination which will involve checking for limb length discrepancy, completing joint range of motion and muscle strength studies, visual gait assessment as well as taking a detailed medical history.
If you are concerned regarding your child’s bow legs, or they are suffering pain, limping or weakness book an appointment at Erica Dash Podiatry, where one of our podiatrists can recommend a treatment plan which may involve orthotic therapy, muscle stretching and strengthening games or offer a non invasive therapeutic solution such as shockwave therapy.
As always at Erica Dash Podiatry a referral to an orthopaedic surgeon would be the last treatment option.
Bow Legged Baby
Infants are nearly always born with bow legs because the bones had to twist when they were in the womb to fit. This is known as physiologic bow legs, which is considered a normal part of the children’s bone growth and development.
Young children who are standing or walking at a younger age, can have more noticeable bowing of the legs.
Bowed legs tends to get worse once walking begins which normally is by 18 months old, but then gets better once the child’s muscles develop and growth catches up. Usually, this happens around the age of 3 years old.
Bow Legged Toddler/Child
As the children get older, they may tend to go the opposite direction of bowed legs and start to develop knock knees, also known as Genu Valgum.
This is also a common developmental stage and seen as normal for children’s growth.
It is more common in girls, but boys can develop it also. Usually it knock knees develop as early as 2 years old, and up to 7 years old.
Outside of these parameters may require further assessment and treatment, such as stretching, exercises, orthotic therapy and potentially orthopaedic consultation.
Bow Legged Adult
If an adult has bow legs, they will not resolve without treatment. In fact, adult bow legs will worsen over time due to arthritic changes within the knee joint. Fortunately, the podiatrists at Erica Dash Podiatry are trained to offer treatment for bow legs. Successful treatments are customised orthotics to offload your knee joint, dry needling or shockwave therapy to assist with muscle imbalance and a muscle stretching and strengthening program to keep your muscles around your knee joint functioning properly.
Studies have shown that correction of bow legs prior to onset of end stage arthritis, can delay or even prevent the need for a total knee replacement. Surgery may be a treatment for some individuals for their overall health to walk and complete daily tasks pain free.
Diagnosis and assessment of bow legs are usually completed via radiographic imaging such as an x-ray while weight bearing of the long leg bones, to confirm if there is any major deformity on the knee joint of the tibia against the femur.
Bow legs may cause pain in the knees at any age, as there is a greater load and pressure on the medial (inside) compartment of the knees. As we get older, its more common to have one affected leg in genu varum due to injury.
Seeing a podiatrist or physiotherapist could help alleviate pain by means of joint and muscle manipulation and treatment which may reduce the effect of bowing on the joints.
Orthotic therapy is a great non-invasive treatment to attempt to offload the medial compartment of the knee, and can be prescribed at any age. Orthotics provide relief for children’s and adult’s feet and legs by supporting their medial arch, aligning their legs and correcting their gait.
If you, or someone you know, needs any further help, support, guidance or information, please contact Erica Dash Podiatry. See one of our six podiatrists, always ready and wanting to help.
Shockwave is a great alternative to treatments such as dry needling if you’re needle phobic and not keen on dry needling. We also have effective treatment offers for kids.