What is bowleg?
Bowleg is a term used to describe outward curving of the legs that occurs in almost all children. Also known as genu varum, this is part of normal development. It is actually abnormal for children less than 18 months of age not to be bowleg.
Bowlegs, Knock Knees and the Normal Growth Process
Because of their folded position in the uterus, normal children are born bowlegged. This actually increases until the age of 18 months, and then the legs straighten on their own.
By the time a child reaches age three or four, they develop a knock-kneed configuration, in which their legs angle inwards.
This knock-kneed configuration straightens by about age six, leaving the normal slightly knock-kneed adult alignment. All of this is part of normal development in children, and if your child is on this schedule he/she requires no treatment. We do not use surgery, braces, therapy or special shoes as long as your child is within this normal range
When is Alignment not Normal?
Very occasionally, children can have other problems that result in an abnormal alignment. Some of these problems relate to serious injuries, problems with metabolism or nutrition, or other orthopaedic problems such as Rickets or Blounts disease.
If the child maintains bowlegs after 24 months of age, if the bowlegs are severe or much worse on one side or if other problems are present, we will recommend you see a podiatrist for further evaluation.
How is bowleg diagnosed?
In order to diagnose bowleg the podiatrist must examine the legs and knees. A person with bowleg will have legs that appear farther apart than normal. The distance between the knees while the child is lying on his or her back is a clinical measurement of genu varum. An instrument called a goniometer can be used to determine if the angle of one or both knees is abnormal, and the condition can be confirmed by joint x-rays, although they may not be necessary. Internal tibial torsion can complicate the bowleg diagnosis. Internal tibial torsion, also known as medial tibial torsion, is an inward twist of the tibia bone (shin bone at the front of the lower leg). This condition can make bowleggedness appear worse than it really
How is bowleg treated?
Again, the huge majority of children with bowlegs are absolutely normal and require no treatment. In unusual circumstances, however, we may diagnose your child with a different problem and recommend orthotic braces, special shoes, casts, or surgery if their conditions worsen. If bowleg is left untreated, it can cause osteoarthritis or trouble walking as the child ages.