Bow Legged

Being bow legged is when one or both of your child’s legs curve out, away from the center of their body at the knees. “Genu varum” is the medical term for bow legs.

Being bow legged creates extra space between your child’s knees and lower legs. Their knees will be noticeably farther apart than usual when they stand straight with their ankles together. It’s the opposite of being knock kneed. That’s a similar issue that creates a gap between your child’s knees instead of their ankles.

Bow legs are common in infants and toddlers. It’s rarely serious. Babies born with genu varum usually grow out of it naturally within two years. Untreated bow legs that don’t go away on their own can last into adulthood.

A healthcare provider will tell you if your child will need any treatments and what to look out for.

Symptoms of bow legs

The physical shape of your child’s legs is the main symptom of being bow legged. You’ll be able to see that their knees don’t touch when they stand with their feet and ankles together.

The bowing is usually more noticeable when they’re walking. Some children with bow legs might walk with their toes pointed in. This is known as having pigeon toes (intoeing).

Being bow legged usually isn’t painful. And it won’t affect your child’s ability to crawl, walk or run.

Bow leg causes

Lots of issues can cause bow legs. The most common cause is a condition called physiologic genu varum. This happens if a fetus develops in a cramped position in the uterus. The pressure from the unusual position makes bones develop more rotated than usual. Then, after your baby is born, that extra rotation leads to bow legs.

Physiologic genu varum will likely correct itself as your child’s bones grow and develop. If their legs haven’t straightened by the time they turn 2, there may be another reason. These include:

• Blount’s disease
• Rickets
• Skeletal dysplasia, including dwarfism
• Broken bones that don’t heal correctly
• Fluoride or lead poisoning

Complications of this condition

Being born bow legged rarely causes complications. Most children grow out of it naturally. But untreated bowed legs that don’t get better on their own may increase your child’s risk of bone and joint issues. The unusual shape to their legs can put extra pressure on their hips, knees and ankles.

If a health condition causes persistent bow legs, your child may be at risk for other complications. These are usually more from the condition that causes bow legs than the change to their bones themselves. Your healthcare provider will help you understand what you should expect.

How doctors diagnose this condition

Your child’s healthcare provider will do a physical exam and ask about your child’s medical history. If your child is under 2 years old, they might not need any other tests. Your provider will check your child’s legs regularly to make sure they’re growing out of bow legs.

If your child is older than 2, your provider may measure their legs and watch them walk. Your child may need X-rays to take pictures of their leg bones. Your provider might order blood tests to check for conditions like rickets.

Your child might need to visit an orthopaedist. This is a healthcare provider who specializes in caring for bones, joints and muscles.

Treatments for bow legs

If your child is under 2, they probably won’t need any special treatment. Children usually grow out of being bow legged on their own. Your healthcare provider will monitor changes in your child’s legs as they develop. They’ll make sure it’s getting better on its own as your child grows.

If your child is older than 2, or if their bow legs are severe, your provider can recommend treatments. They’ll suggest ways to support and straighten your child’s leg bones. Common treatments include:

• Braces, splints or casts: These gently hold your child’s bones in the correct position so they grow straighter. Just like braces on your teeth can realign your smile, these treatments help reshape your child’s leg bones.
• Special shoes: Your provider or a podiatrist can suggest shoes that help your child hold their legs in a more natural position. They might need these shoes along with a brace or splint
• Treatments for specific causes: Your child might need treatments for a condition that causes bow legs. For example, they’ll need vitamin D and calcium supplements to treat rickets.
• Surgery: It’s rare to need surgery for bow legs. But your provider will suggest it if your child’s legs are bowed enough that it affects their ability to move and other treatments haven’t worked. A surgeon will reshape your child’s bones or implant metal plates to act like a brace on the inside of their body.

How to correct bow legs in adults

Untreated bow legs that don’t naturally straighten on their own can last into adulthood. Most of the time, this won’t cause pain or other issues. But if it does, surgery is the only treatment for adults with bow legs.

That’s because your bones won’t respond to treatments like braces or splints once you’re an adult. Children’s bones are much softer and more flexible than adult bone tissue. Once you finish developing, your bones harden and won’t change shape without surgery.

Talk to a healthcare provider if you have bow legs that cause any pain or discomfort. They’ll let you know if surgery is a good option for you.

When should I see my healthcare provider?

Visit a healthcare provider if your child has bow legs and they don’t improve by age 2. Your provider will keep an eye on your child’s legs. They’ll let you know if or when your baby will need treatment.

Ask your provider how often your child will need follow-up exams. Most of the time, you can follow the typical schedule for check-ups and well-child visits.

What can I expect if my child has bow legs?

Your child’s legs should straighten out as they start walking. Every baby is different, but this is usually between 11 and 18 months. In most cases, being bow legged won’t cause any long-term issues. Even if your child needs surgery, they should have no lasting effects once they heal.