Bowlegged - When The Legs Curve Outward at The Knees
by Princeton Orthopaedic Associates
Understanding Bowlegs: Causes, Symptoms, and Treatment Options
What Are Bowlegs?
Bowlegs, medically known as genu varum, is a condition where the legs curve outward at the knees while the ankles remain together. It is common in infants due to their fetal positioning in the womb, and in most cases, the legs straighten naturally as the child grows and begins to walk. However, if the bowing persists beyond early childhood or appears later in life, it may indicate an underlying condition requiring medical attention.
Bowlegs can affect a person’s posture and how they walk (gait), potentially leading to joint misalignment and stress over time. The degree of bowing can vary from mild to severe, and its impact on daily activities depends on a person's underlying cause and individual anatomy.
What Does It Feel Like to Have Bowlegs?
Individuals may experience these bowleg symptoms:
A noticeable outward curvature of the legs when standing with feet together
Knee and hip discomfort, especially after physical activity
Instability while walking or running
Limited mobility, particularly in the hips and knees
Increased stress on the joints, which can lead to arthritis over time
Fatigue in the legs due to inefficient movement patterns
Lower back pain resulting from compensatory postural adjustments
The severity of symptoms varies, with some individuals experiencing minimal discomfort, while others may have significant pain and difficulty moving.
What Causes Bowlegs?
Several factors and conditions can contribute to bowlegs, including:
Physiological Bowing – Common in infants and young children, this naturally corrects itself by age 3 to 4.
Blount’s Disease – A growth disorder affecting the tibia (shin bone) that worsens over time, requiring medical intervention. It is more prevalent in children who begin walking at an early age.
Rickets – A vitamin D deficiency leading to weakened bones and improper growth. This condition can be prevented with proper nutrition and sun exposure.
Bone Dysplasia – Abnormal bone development due to genetic conditions, often leading to long-term mobility challenges.
Paget’s Disease – A metabolic disorder that disrupts normal bone remodeling, leading to deformities. It typically affects adults and may require lifelong management.
Poorly Healed Fractures – If a broken leg bone heals incorrectly, it may result in permanent bowing and uneven weight distribution across the joints.
Achondroplasia – A genetic disorder that leads to dwarfism and often results in bowlegs. This condition is associated with shorter limbs and joint laxity.
Lead or Fluoride Poisoning – Exposure to high levels of these substances can interfere with normal bone development, potentially leading to long-term health issues beyond bowlegs.
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While mild bowing in young children often corrects itself, medical evaluation is necessary if:
The bowing persists beyond age 3
One leg is more bowed than the other
The condition worsens over time
There is pain, instability, or difficulty walking
An underlying disease is suspected
The bowing is accompanied by other developmental delays or bone abnormalities
Early intervention is crucial in cases linked to nutritional deficiencies or growth disorders, as timely treatment can improve outcomes.
If you are an adult dealing with bowlegs, you should consider seeking treatment if you experience:
Pain or discomfort in the knees, hips, or ankles.
Difficulty walking or standing for long periods.
Worsening bowing or noticeable asymmetry.
Frequent joint stiffness or instability.
Early signs of arthritis, such as swelling or reduced mobility.
If bowleggedness is interfering with daily activities or causing joint damage, consult a doctor or orthopedic specialist for evaluation and treatment options like physical therapy, braces, or surgery if necessary.
Why Treat Bowlegs?
Untreated bowlegs can lead to complications, including:
Increased risk of arthritis, particularly in the knees and hips, due to uneven joint stress
Gait abnormalities affecting posture and movement efficiency
Lower back pain from altered spinal alignment
Joint instability, making physical activities more challenging
Increased risk of injury, particularly in athletes and active individuals
Muscle imbalances, as the body compensates for misalignment
Diminished quality of life, as chronic pain and mobility issues impact daily activities
Treatment Options for Bowlegs
The appropriate treatment for bowlegs is individual and depends on the severity and underlying cause of the condition.
Non-Surgical Treatments for Bowlegs
Bracing or Orthotics – Used in children to guide proper bone growth and support alignment correction.
Physical Therapy – Strengthening muscles, improving posture, and enhancing mobility to alleviate discomfort and prevent progression.
Nutritional Supplements – Correcting deficiencies in vitamin D or calcium for cases related to rickets, often combined with diet modifications.
Weight Management – Reducing excess body weight to minimize joint stress and prevent the worsening of the condition.
Low-Impact Exercises – Activities such as swimming or cycling can help strengthen leg muscles without excessive joint strain.
Surgical Treatment for Bowlegs
For severe cases, especially in teenagers and adults, surgery may be necessary. Osteotomy is the most common procedure, which involves:
Making an incision near the knee.
Cutting and realigning the tibia (or femur, in some cases) to correct the bowing.
Inserting bone grafts and securing the bone with plates, screws, or external fixators.
Undergoing physical therapy post-surgery to restore mobility and prevent stiffness.
Recovery from an osteotomy can take 3 to 6 months, it depends on the complexity of the procedure. Patients typically require crutches or braces initially and gradually return to normal activities.
What Type of Orthopedic Doctor to See?
If you suspect bowlegs in yourself or your child, consult a pediatric orthopedic specialist for children or an adult orthopedic surgeon for adults.
Bowlegs can be a normal part of early childhood development but may also indicate underlying health issues. Early diagnosis and appropriate treatment can prevent complications, improve mobility, and enhance overall quality of life. If you or a loved one has persistent bowlegs, consult one of our orthopedic specialists to explore the best treatment options. Understanding the causes and potential impact of bowlegs can empower you to seek timely medical advice and make informed decisions about their health.
This blog post is meant to be informative and should not act as a self-diagnosis tool. If you’d like to see one of our doctors, please contact us here.
