What is Bow Legs?

Bowlegs, also known as genu varum, is a common condition in infants and toddlers where the legs appear to curve outwards, creating a distinct gap between the knees, while the ankles remain in close proximity to each other.

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Bow legs are a common condition observed in babies, which often occurs due to the limited space within the womb, leading to the compression of the tibia bones. While some medical professionals may initially suggest massage as a solution, casting should be considered for more severe cases. Its effectiveness is notably higher when the child receives the appropriate care before they start walking.

Should parents be concerned?

Once your child reaches the age of 2 and begins walking, any concerns regarding the shape of the hips, knees, or feet should prompt a visit to a podiatrist for a comprehensive lower limb assessment.

Key Considerations:

  • Observe if the legs are naturally straightening
  • Check for asymmetrical bowing, where one leg may be more bower than the other
  • Look out for signs of pain, limping, weakness, or difficulties in running/jumping.

The podiatrist may recommend for an x-ray of the hips, knees or feet in specific cases to rule out Blount’s disease. Blood tests may also be suggested to eliminate conditions such as rickets if it has not been done.

Addressing persistent bowlegs:

If a child is showing signs of bow leg past the physiological time frame, our podiatrists must ascertain whether the bow leg is caused by bone growth problems such as Rickets or Blount’s disease. Most infants and toddlers have at least some physiologic bowing of their legs, which parents may become concerned; other family members may have such knee shapes that did not resolve during childhood growth and development.

Severe bowlegs in older children could indicate Blount’s disease especially if the child is overweight, started walking early or has a family history of the condition.

Typical complaints associated with bowlegs include:

  • In-toeing (pigeon toe walking)
  • Tripping and stumbling often
  • Clumsy walking pattern
  • Foot, ankle, or knee pain
  • Difficulty running and participating in sports
  • Foot alignment – typically flatfoot condition

Unaddressed bow-legged conditions increases the risk of developing knee joint problems later in life.

Managing Bowlegs

The management of bowlegs often involves close monitoring of the child and may include:

  • Lower limb braces, ankle-foot orthotics or customised orthotic devices
  • Footwear modifications
  • Physical therapy

If the condition is severe and persists into adolescence, surgical intervention may be necessary to correct abnormal bone alignment. It is crucial to address bow-legged conditions promptly to reduce the risk of developing knee joint problems later in life. Follow ups with a podiatrist and appropriate interventions contribute to effective management and positive outcomes.

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Common Symptoms

Having trouble running/jumping

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A lower limb specialist, such as a podiatrist, will be able to perform a thorough foot assessment using diagnostic tools, such as a musculoskeletal diagnostic ultrasound to determine the source of your foot pain. If surgery is required, your podiatrist will refer you to a trusted foot and ankle doctor for surgical solutions.

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