Things to Know about Knock-Knees: Child Growth and Development


After giving birth to an infant, you might notice the somewhat twisted legs that ‘bow’ away from the body. As they grow older, the legs start to straighten. By the time they achieve 24 months, it will all be okay, but there is more ahead. Toddlers begin to walk after a year which implies that by this time, the legs still seem bow-legged. The medical professionals refer to the bowlegs as genu varum words that relate to shinbone, thighbone, or both.

As for the knock knees, it is evident when the knees seem to bend inwards, toward each other. You child reveals the signs when he or she attains three years of age, but it gradually starts to disappear after that. By the time they are reaching seven years old, they will have normal straight legs and in some cases, a slight bend that is up to 9 degrees which will be there in their lifetime. The medical term for knock knees is genu valgum which may also refer to shinbone and thighbone.

It is normal for the legs to acquire such shapes in the course of child development but severe cases need scrutiny. This article will focus on the following:

  • Observing normal growth and development in children
  • Causes, signs and symptoms of bowlegs and knock knees
  • Tips on how to treat bowlegs and knock-knees in children
  • When do you need the doctor?

Observing Normal Growth and Development in Children

Of course, it is a concern to you if you are worried the legs will never get straight. However, it is part of every child growth and progress so if it is only a slight case; then it is a good idea to give it time. Statistics show that only a few kids will need medical attention and remedy to prevent future complications. So, as a parent, you need to understand how your kid’s legs will change so that you can focus only on the necessary.

From birth to about ten years of age, most of the children usually go through a period of relative knock knee and bowleg. It is a physiological process that does not affect how a child will walk or crawl. Your toddler will still walk even with the toes pointed inwards although it will be somehow clumsy when compared to the peers with ‘better’ legs. For severe bowleg or knock-knee case, you will also see it, but the child is bound to outgrow the symptoms.

Here is a highlight of what happens as the child grows from infancy to ten years of age:

  • 0-18 months:The toddlers’ legs are bowlegged which prompt them to start walking with feet wide apart. The bowleg condition is known as varus.
  • 1 ½ – 2 ½ years:The legs are straight during this period.
  • 3-4 years:The child’s legs start moving to a knock-knee position, known as valgus.
  • 8-10 years:The legs are now in what the physicians call an adult alignment. They might be slightly kinked but still okay to walk.

Causes, Signs and Symptoms of Bowlegs And Knock Knees

Even though bent legs (inward and outward) is usual in small kids between the mentioned age brackets, there could still be a prevailing underlying condition.

If bowlegs or knock-knees didn’t develop until the child is six years of age, or they have already achieved adulthood, but the legs did not straighten in the process, know that something is lurking behind.

Signs to check include:

  • An extreme inward or outward curvature
  • The problem is still around after eight years
  • Only one side or one of the legs is affected
  • The child appears short about their age

Medical Conditions that Cause Bowlegs and Knock Knees

Some health complications are known to cause bent legs since they interfere with how the bones go about their formation. If the doctor detects either of them, then treatment has to commence for them to rectify the situation.


It is one of the leading conditions that render bowlegs and knock knees. Rickets comes as a result of vitamin D, calcium and phosphate deficiencies. It is a nutritional deficiency condition that makes the bones weak and soft.

Treating rickets needs enough of the low-volume elements absorbed by the body and basking in the sun. If your toddler has rickets, the doctor involved will conduct an x-ray to check the calcium amounts among other vital nutrients.

Blount’s disease


This is a condition that leads to lower leg bones’ abnormal growth. Biology tells us that the lower leg bone is called the shinbone or tibia.

The doctor detects the condition by taking radiographic images. After diagnosis, surgery or physical therapy is the next recommendation.


Various arthritis types can affect an individual’s knee joint which results in either bowleg or knock knee. Osteoarthritis is a common condition that leads to a curvature generation from your legs.

This form of arthritis happens when the cartilage between the leg joint in the knee become too worn out. Treating the damage involves ice, joint injections and physical therapy among others.

A severe case needs surgery where the joint will be replaced in a bid to correct the situation.


It is caused by vitamin C deficiency and contracting this complication can cause bending of knees. Vitamin C is crucial in generating collagen and producing the connective tissue. Treating this condition requires an increase in vitamin C intake through the diet and supplements.


Some genetic variations can cause bowlegs and knock-knees such as the Cohen syndrome. It is inherited and can affect different body parts apart from the legs. Metaphyseal dysplasia is another genetic complication that can lead to deformed legs. The common term for it is Pyle’s disease.

Injuries or infection

Some infections and injuries can lead to change in curvature of a child’s legs. One of them is known as osteomyelitis. It is an infection that occurs in the body through the bloodstream all the way to the bone. If your child has an injury on one of their legs or both, regardless of how they got it, it might expose the germs to the bone and go on to develop there.

The most effective method of treating this infection is through surgery. Since it makes certain bone areas dead, going under the knife involves removing the dead parts. Injury in most cases happens on one leg so treatment in such a scenario will only be for the victimized leg.


It increases the overall body weight in your child. So, if he or she is obese, the knee ligaments might loosen due to excess pressure in the knee area. It will lead to outward or inward bending of the legs which later leads to walking problems.

[Related: Childhood Obesity]

Tips on How to Treat Bowlegs and Knock-Knees in Children

After getting familiar with bowlegs and knock knees, here are some tips for parents who are worried about their child’s legs shape and overall physical wellbeing.


Watch and wait

You might wonder how this will cure your bowlegged or knock-kneed kid but yes, you need to remain calm as you watch. Like we said earlier, young children mainly under the age of three will have bowlegs that are in the process of fixing. Monitor your child’s growth to see if the bow is fading. If you notice that he or she has trouble when walking, engage your pediatrician to see the way forward.

What you need to note is having an eye on the toddler is essential towards prohibiting an extended case of bend knees. Consider having regular visits to the doctor so that the appropriate intervention can be determined if the problem persists.

② Monitor the vitamin D and calcium levels

A deficiency in vitamin D and calcium leads to rickets. The disease renders the bones weak, soft and vulnerable to bend. Increasing the vitamin’s intake among other necessary elements can help prevent rickets and maybe correct the abnormal situation if it is already there.

What you need to know is that rickets cause bowleg or knock-knee and not vitamin D and calcium deficiency unless proving has it that their low levels should be considered after testing. On the other hand, if the tests show that they are lower than the acceptable range, make sure your child receives the right dosage through diet and supplements.

③ Using medical braces and other solutions


Leg braces, casts or shoes can be used to can be used to correct the legs’ curvatures in children. If the bowleg or knock-knee does not disappear on its own, then your child will need some mechanical assistance. Also, if there he or she is suffering from another disease, you can use them to help remedy the legs since the body has much to fight with at such a point.

This style of knee correction is only used in severe scenarios. The doctor can also recommend further treatment such as surgery if it is evident that the casts or braces cannot help.

  • Braces:They help realign the legs by pulling the knee towards the right position. It is advisable to wear them at night. The orthopedic involved will instruct you on which one is right for your young one.
  • Medial heel wedge:It refers to a wedge that can be inserted in the shoe to aid in raising up the child’s heel interior and not the outside as it seems. They range from ¼-3/8 inches, and they help in correcting the mechanical axis by pulling it outwards for the knock knees. If there is another condition affecting the lower body part, wedges may not be that useful.

There Are Consequences Later in Life if The Legs Are not Corrected

If you don’t take care of your child’s legs while they are young, it will pose a challenge once they enter adolescence. With angled legs, there is more strain on the ankles, knees and hips which makes them find it difficult to do too much physical exercise. Also, they are prone to contracting arthritis when they grow older due to worn out joints.

Watch the following video to see what exercises you can engage your young toddler in to reduce the risk of severe bowlegs and knock knees. And the below video show the exercises for toddler.

Prevention of Knock-Knees in Children

The leg deformation we just discussed is part of any child’s growth so you cannot prevent it. You can only watch and correct it if it becomes too much for the kid.

Read More:

Birthmarks & Hemangiomas in Children

Smart Guidelines to Help Prevent Allergies in Kids


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