In the first months and years of your child’s life, you may notice their knees and legs look a bit strange. Do they look like a cowboy as they waddle along, or maybe you notice their knees “knock” when they walk?
Concerns about your child’s gait (how they walk) and leg alignment are common, but they can be a bit alarming, especially if this is your first go as a parent.
Most often, these are connected to two bone-related conditions in young children called bowlegs and knock knees. Bowlegs and knock knees usually require no treatment, but here’s what you should know about them.
What are bowlegs?
Bowlegs (or genu varum) are when legs curve outward at the knees while the feet and ankles touch.
“Almost all babies are born bowlegged,” said Ryan Miller, MD, a pediatric orthopedic specialist with Banner Children's. “It is a well-documented part of normal development.”
Infants are born bowlegged because of the folded (or fetal) position they have in the mother’s womb. Imagine being cramped up in a tight space for nine months—it’s bound to do a number on your body!
Things like excessive weight, early walking and a family history of the condition can also be contributing factors to bowleggedness. “Chubby babies may get excessively bowlegged around the time they start walking,” Dr. Miller said. “The excess weight may exaggerate whatever alignment they have at that time. As well, walking early can put pressure on growth plates and accentuate bowleggedness.”
The good news is that children’s legs straighten out as they start to walk and bear weight, “somewhere around 16 to 18 months,” Dr. Miller noted. “By age 3, most children no longer appear bowlegged.”
What are knock knees?
Knock knees are when knees touch but the ankles are far apart. This may cause an awkward appearance in your child’s gait, with their knees “knocking” or hitting each other when they walk and run.
“This is most notable at about 3 years old, and then it starts to get better with normal development—usually by age 7,” Dr. Miller said.
What should I do if my child has bowlegs or knock knees?
In most cases, your child will outgrow both conditions without needing any special treatment, but it’s important that you keep up with your child’s regular well-check visits so they can be regularly monitored.
Things like braces, corrective shoes and exercise are rarely helpful and may hinder your child’s physical development or cause unnecessary emotional stress.
“For the vast majority of children, treatment only involves observation—watching the alignment as the child grows and develops,” Dr. Miller said. “If the health care provider does have concerns about the severity of either condition, a referral to a pediatric orthopedic surgeon may be recommended.”
Referrals are typically given in the following circumstances:
- One leg is worse than the other leg.
- It occurs later in childhood.
- The condition worsens.
- Your child is in pain, limping or has weakness or trouble running.
- Your child has a short stature, a metabolic bone disease or a family history of arthritis.
If you are worried your child may need help, see your child’s health care provider for advice.
Bowlegs, where the ankles touch and the knees don’t, and knock knees, where the knees touch and the ankles don’t, are normal during early childhood and most often require no treatment.
If you have concerns about your child’s growth and development, contact their health care provider.