Tillie Doyle
Bow legs, also known as genu varum, is a condition where the knees do not touch when the feet are together. This condition is common among newborns and toddlers and usually resolves itself as the child grows. However, for some individuals, bow legs persist into adulthood and can cause knee discomfort, self-consciousness, and future arthritis. While surgery is the only way to permanently correct bow legs, exercises such as stretching and strengthening the hips and legs can help manage pain, improve balance, and protect the knees.
| Characteristics | Values |
|---|---|
| Medical term | Genu varum |
| Other names | Bow legs, bowed legs, varus knee |
| Cause | Bone misalignment, tibia rotates inward, knee rotates outward |
| Symptoms | Knees don't touch when feet are together, knees unstable, pigeon toes, tripping, clumsiness |
| Complications | Knee damage, early arthritis, knee replacement, degeneration of the inside of the knee, joint problems, osteoarthritis |
| Treatment | Surgery, exercises, stretches, physical therapy, bracing, neuromuscular training, balance exercises, BOSU ball training |
| Surgery details | Osteotomy, titanium rod inserted into tibia, screws to fix bones, X-rays before and after |
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What You'll Learn
Bow legs in children
Bowed legs, also known as genu varum, are a common condition in infants and toddlers. The condition is caused by the position of the baby in the uterus, with legs folded tightly across their bellies, resulting in a curve in the legs. Bowed legs are characterised by a distinct space between the lower legs and knees, with ankles touching but knees wide apart. While most children outgrow the condition by the age of 3, some may require further evaluation and treatment if the condition persists.
Diagnosis of bowed legs typically involves a physical examination by a doctor. In some cases, X-rays and blood tests may be necessary to rule out more serious conditions or underlying causes. Bowed legs are generally considered physiological, meaning they are a normal part of a child's growth and development. However, in rare instances, an underlying medical condition such as rickets (a vitamin D deficiency) or Blount's disease may be the cause.
If your child's bowed legs persist beyond the expected age range or show signs of worsening, it is recommended to consult a doctor. Treatment options vary depending on the underlying cause and the child's unique needs. In severe cases, surgical intervention may be considered.
It is important to note that bowed legs should not cause any pain or impair movement. If your child experiences pain or difficulty walking, it is advised to seek medical advice. Additionally, tracking the progression of bowed legs by taking photographs of your child's legs every six months can be helpful for monitoring purposes and can be shared with a healthcare professional.
In summary, bowed legs in children are typically a normal part of growth and development. Most cases resolve without treatment by the age of 3. However, if bowed legs persist or cause concern, consulting a healthcare professional is recommended to determine the most appropriate course of action.
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Bow legs in adults
Bow legs, also known as genu varum, are legs that curve outward at the knee, keeping the knees apart even when the ankles are together. This condition can occur in both children and adults, and while it often resolves as a child grows, it can persist into adulthood.
There are several causes of bow legs, including:
- Rickets, a vitamin D or calcium deficiency that leads to weak and soft bones.
- Blount's disease, a bone growth disorder that affects the shin bone's growth plate, causing excessive bowing.
- Weismann Netter Stuhl Syndrome, an extremely rare genetic skeletal disorder that results in abnormally developed bones.
- Premature birth, low birth weight, or genetic factors.
Treatment options for bow legs in adults include:
- Surgery: In severe cases of bow legs, surgery may be required to correct the alignment of the legs. One such surgical procedure is tibial osteotomy, which involves cutting and reshaping the shin bone and stabilizing it with metal plates, screws, or an external frame while it heals.
- Braces: While braces are more commonly used for children with bow legs, adults with mild cases and less than 20 degrees of angulation between their thighs may benefit from wearing leg braces or splints to correct the alignment of their legs.
- Chiropractic care: Chiropractic care and osteopathy can help treat bowed legs and alleviate associated pain.
- Physiotherapy: Physiotherapy, including specific exercises and stretches, can help improve alignment, mobility, and musculoskeletal health in individuals with bow legs.
- Natural correction methods: Some sources suggest that a 3-minute stretch performed regularly may help adults with bow legs realign their legs and alleviate pain and that certain yoga poses, such as downward dog or tree pose, can help strengthen muscles and improve posture.
It is important to note that the treatment for bow legs depends on the underlying cause, and early intervention, personalized treatment plans, and preventive measures are crucial for effective management of the condition.
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Surgery for bow legs
Bowlegs, also known as genu varum, is a condition where a person's knees stay wide apart even when their ankles are together, resulting in a bowed appearance. This occurs when the line from the hip to the ankle passes through the inside of the knee, rather than directly through its centre. While bowed legs are typically painless, they can cause discomfort in the ankles, hips, and knees in adolescents due to the pressure applied to these joints. In some cases, bowlegs can lead to knee degeneration over time, including arthritis.
If left untreated, bowlegs can cause pain, increased deformity, knee instability, and progressive knee degeneration. Surgery is one option to correct bowlegs and prevent further complications. The decision to undergo surgery depends on the severity of the condition and the patient's preferences. It is important to note that there are different surgical techniques available, and the most suitable approach will be tailored to the patient's specific needs.
One surgical option is osteotomy, which involves cutting the bone to change its alignment. This procedure is typically performed on the tibia (shinbone) but can also be done on the femur or both bones in more severe cases. In moderate cases, internal fixation is used, where a plate or rod is inserted into the leg to stabilize the osteotomy. For more severe malalignments, gradual realignment of the limb is achieved through external fixation, with pins inserted into the bone and attached to an external stabilizing structure.
Another surgical method is using circular frames or rings, which are powerful tools for deformity correction. These frames can simultaneously address multiple deformities, such as severe bowing in the tibia, tibial torsion, loss of knee extension, or leg length discrepancy. Patients can walk and adjust the frame immediately after surgery, and the gradual straightening of the bone promotes healing. Once the correction is achieved, the external fixation is removed.
In growing children, guided-growth, minimal-incision surgery may be used to encourage the limb to gradually grow straight. This approach is less invasive and aims to guide the natural growth of the limb. However, it is important to carefully monitor the condition and consider non-surgical treatments before opting for surgery. Physiologic bowed legs in young children often correct themselves by the age of 3 to 4, and even up to 5 years old in some cases.
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Exercises to correct bow legs
It is important to note that exercise cannot permanently fix bow legs as it does not change the shape of the bone. However, exercises can help straighten your legs and protect your knees. Here are some exercises that can help:
Glute Stretch
Lie on your side with your legs stacked on top of each other and your knees bent at a 90-degree angle. Keep your knees together and raise your top foot off your bottom foot while rotating your top leg in. You can add a miniature resistance band for extra resistance. Repeat this 10 times on each leg. This exercise helps relax the powerful hip muscles, allowing your knees to move inwards and reducing bow-leggedness.
Thigh and Hip Muscle Stretches
Place a foam roller or rolled-up towel between your knees. Stand with your feet a few inches apart and squeeze the foam roller between your legs. Keep your knees straight and bend forward to touch your toes, then return to the starting position and raise your arms overhead. Repeat this 10 times. This exercise helps strengthen the muscles that pull your knees back towards the centre.
Toe Raises with Soft Knees
Hold onto a bar or a wall for balance and soften your knees, bringing the tibia forward over the ankle joint. Do 10 toe raises, ensuring that your knees go forward as your toes rise up. Then, try 10 single-leg toe raises on each side. This exercise helps bring awareness to the proper alignment of the lower limb over the ankle.
Hamstring and Adductor Stretches or Resistance Band Exercises
These exercises can help bring your knees closer together (adduction) and rotate your knees back in (internal rotation).
It is recommended to consult a healthcare professional or a physiotherapist for a comprehensive assessment and guidance on the most suitable exercises for your specific needs.
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Causes of bow legs
Bow legs, also known as bowleg syndrome, genu varum, or tibia vara, is a condition in which a person's legs curve outward at the knees, even when the ankles are together. While it is a normal part of growth and development for infants and toddlers, if the condition persists beyond the age of two, there may be an underlying cause.
One of the most common causes of bow legs in children is Blount's disease, a growth disorder where the growth plates around one or both knees develop abnormally. It is characterised by a sharp curve in the shinbone (tibia) below the knees. The condition worsens over time and can lead to knee joint problems. Treatment typically involves wearing a brace or surgery.
Rickets is another cause of bow legs. It is caused by a prolonged deficiency of vitamin D and calcium, which are essential for healthy bone growth and development. The lack of these nutrients weakens the bones, causing them to bow. Rickets can also be caused by a genetic abnormality that prevents the absorption of vitamin D. Treatment for rickets typically involves adding vitamin D and calcium to the diet.
Other causes of bow legs include Paget's disease, a metabolic disorder common in older people that affects bone breakdown and rebuilding, resulting in weaker bones. Bone dysplasia, a general term for conditions affecting bone and cartilage growth, can also lead to bow legs. Dwarfism, specifically the most common form caused by achondroplasia, a bone growth disorder, can also result in bow legs.
In some cases, bow legs can be caused by abnormal bone development due to improperly healed fractures, early walking (before 11 months), childhood obesity, or genetic factors.
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Frequently asked questions
Bow legs, also known as genu varum, is a condition where the knees don't touch when the feet are together. It is caused by a bone misalignment where the tibia rotates inward, and the knee rotates outward.
For children, bow legs usually resolve without treatment as they grow. If bow legs persist into the toddler years, they can be treated with bracing, physical therapy, or, in rare cases, surgery. For adults, surgery is the only way to correct bow legs, although exercises and stretching can help straighten the legs and protect the knees.
Some exercises that may help with bow legs include abductor/external rotator exercises with a resistance band, kick-backs with a resistance band, and hamstring and adductor stretches. Balance exercises, such as BOSU ball training, can also help improve function in daily activities and prevent falls.
