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What to do if my child has bow legs?

Physio&SoleClinic Bow Legs, Physiotherapy November 11 2022

(Photo credit: https://www.pobar.org/bowlegs-and-knock-knees)

What are bow legs?

Bow legs (or genu varum) is when the legs curve outward at the knees. This creates a wider space than normal between the knees and lower legs. When your child stands with his or her feet and ankles together, the knees stay wide apart. Infants and toddlers often have bow legs. It’s rarely serious and usually goes away without treatment, often by the time a child is 3 years old. 

What causes bowed legs in babies? 

Bow legs develop for a number of different reasons. The most common cause of bow legs is a condition called physiologic genu varum – meaning that bowlegs can often develop in the child’s first year as part of natural growth for no known cause. Babies can also be born with bowlegs because of their folded position in the womb. Bow legs don’t usually bother young children because the condition doesn’t cause pain or discomfort. Parents might worry about the appearance of their child’s legs, or an awkward walking pattern but bow legs doesn’t affect a child’s ability to crawl, walk, or run. Children with physiologic bow legs need not limit their activities. 

Certain conditions, such as Blount’s disease, metabolic disorders, and bone malformations, may also cause a child’s legs to bow.

  • Blount’s disease: Blount’s disease is a condition found in children that affects the growth plates around the knee. The disease causes the growth plate near the inside of the knee to either slow down or stop making new bone. Meanwhile, the growth plate near the outside of the knee continues to grow normally. The result is a bowlegged appearance in one or both legs.
  • Rickets: Rickets is the softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency. Rare inherited problems also can cause rickets. 

When should parents be worried? 

If your baby or child has bowlegs with any of these symptoms, they may have a more serious condition

  • Bowing that continues to get worse after 2 years old
  • Bowing past the age of 3 years old 
  • Knee or hip pain 
  • Limping when walking
  • Short stature (below 5th percentile) 
  • Asymmetrical bowing (bowing on one side) 

If any of these symptoms are present, please consult with your child’s pediatrician. 

How do children’s legs generally develop? 

  • Infants: Infants may be born with bow legs 

When babies start pulling to stand, the alignment of their hips is still slightly bent with their legs bowed. Their feet are placed far apart from one another to increase their base of support to help with balance while standing. They are also flat footed during the initial years. 

Once your baby walks without support, they will continue to have feet far apart to increase their base of support and their hips wide and rotated outwards with their arms out to the side. They keep their hips and knees slightly bent when walking. 

By around 18 months, the knees start to become straighter and less bowed. 

  • Toddlers: 

Around 2 to 3 years of age, you may again see your children’s alignment change to appear more knock-kneed. They may also present with some intoeing. 

  • Young Children: 

Between 4 to 6 years of age, your child’s knees will usually start to straighten out with some possible out-toeing present. 

By 7 years of age, alignment will have normalized to appear more like an adult alignment.

Diagram

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When is treatment required and how are bowlegs in children treated? 

Generally, physiologic bowed legs do not require any special shoes or braces or treatment. The bowing should improve as the child grows, typically from 18 months until about 3 years of age. 

If your child has a specific diagnosis such as Blount’s disease or Rickets, your doctor will recommend the appropriate treatment for that condition. Treatment that may be required in such cases could be bracing, surgery or medication. 

If you have any more questions regarding this condition or any paediatric physiotherapy related questions, feel free to contact our paediatric physiotherapist at our Ask A Physiotherapist platform at +65 9899 7967 or contact our branch to arrange an appointment!

Physio & Sole Clinic

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