Understanding Bowlegs: Causes, Symptoms, and Treatment Options

Being bowlegged, or bow-legged (genu varum), means that when you stand with your feet and ankles together, your knees stay apart and the legs curve outward. In babies and toddlers this bowing of the legs is usually normal and straightens on its own as they grow. When bowed legs last past early childhood, get worse, affect one leg more than the other, or show up in an adult with knee pain, it is worth having the legs looked at by your doctor or by one of us at POA.

What Are Bowlegs?

Bowlegs, known medically as genu varum, is a condition where the legs curve outward at the knees while the ankles stay together. It's common in infants because of how they were positioned in the womb, and in most cases the legs straighten naturally as the child grows and begins to walk. If the bowing lasts beyond early childhood or shows up later in life, it may point to an underlying condition that needs medical attention.

Bowlegs can affect posture and the way a person walks (gait), and over time that can mean joint misalignment and added stress. The degree of bowing ranges from mild to severe, and how much it affects daily activities depends on the underlying cause and on a person's 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:

When to Seek Treatment for Bowlegs

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 matters in cases linked to nutritional deficiencies or growth disorders, because timely treatment can improve outcomes. If any of the above sounds like your child, have them seen by your pediatrician or contact us at POA.

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 getting in the way of daily activities or causing joint damage, see a doctor or an orthopaedic specialist for an evaluation and a look at options such as physical therapy, braces, or surgery if it comes to that.

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

How Are Bowed Legs Diagnosed?

A visit usually starts with a conversation about when the bowing was first noticed, whether it is changing, and what activities bring on pain. We then watch how you or your child stands and walks, look at the gap between the knees with the ankles together, and compare one leg to the other.

Imaging fills in the rest. A standing X-ray that takes in the hip, knee and ankle shows how the leg lines up and where the bowing is coming from, the thigh bone (femur) or the shin bone (tibia). If a nutritional or metabolic cause such as rickets is suspected, blood work may be ordered as well.

Knowing the cause and the exact location of the bowing is what shapes the plan, whether that is watchful waiting in a young child, therapy and activity changes in an adult, or surgery. If you would like your legs or your child's legs assessed, talk to your doctor or contact us at POA.

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:

1. Making an incision near the knee.
2. Cutting and realigning the tibia (or femur, in some cases) to correct the bowing.
3. Inserting bone grafts and securing the bone with plates, screws, or external fixators.
4. Undergoing physical therapy post-surgery to restore mobility and prevent stiffness.

Recovery from an osteotomy can take 3 to 6 months, depending on the complexity of the procedure. Patients typically use crutches or a brace at first and return to normal activities gradually.

Common Questions About Bow Legs

At what age do bow legs straighten on their own?

Physiological bowing, the common kind seen in babies and toddlers, usually improves once a child has been walking for a while and settles by about age 3 to 4. If the bowing is still obvious after that, is getting worse, or affects one leg more than the other, have your child seen by your pediatrician or contact us at POA.

Can bowed legs be corrected in adults?

Bracing works by guiding growing bone, so it is used in children rather than adults. In adults, care usually starts with the conservative options above, physical therapy, weight management and low-impact activity, and osteotomy surgery is considered when the bowing is severe or the knee is wearing unevenly. Which path makes sense for you is a conversation to have with your doctor or with us at POA.

Do exercises or stretches fix bowlegs?

Exercise does not change the shape of a bone. It can still help, by strengthening the hip, thigh and core muscles that support the knee and by improving balance and walking mechanics, which often takes some of the strain off a sore joint. Our physical therapists can build a program around your particular alignment, so ask your doctor or contact us at POA.

What Type of Orthopaedic Doctor to See?

If you suspect bowlegs in yourself or your child, see a pediatric orthopaedic specialist for children or an adult orthopaedic surgeon for adults.

Bowlegs can be a normal part of early childhood development, and they can also be a sign of an underlying health issue. Early diagnosis and the right treatment can prevent complications, improve mobility and make daily life easier. If you or a loved one has persistent bowlegs, request an appointment with one of our orthopaedic specialists to go over the options that fit your situation.

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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.