Bow legs in teens: when alignment needs checking

The evaluation looks at growth, leg symmetry, walking and joint symptoms. Management is individual because the options can differ depending on whether growth plates remain open and where the alignment change originates.

Genu varum means the knees remain apart when the ankles meet. In a teenager, visible bowing may reflect the shape of the thigh bone or shin bone, a difference between limbs, or an issue affecting growth. A physical examination is needed to distinguish structural alignment from a stance or movement pattern.

A clinician may ask when the curve first appeared, whether it is changing and whether relatives have similar alignment. They can observe standing and walking, measure limb alignment, examine the hips, knees and ankles, and request standing imaging when the findings warrant it.

Start with a paediatric orthopaedic or musculoskeletal assessment rather than relying on online exercise plans. Bring older photographs if they clearly show how alignment has changed, and note any pain, tripping, sports limitation or footwear wear pattern.

Physiotherapy may address strength, balance, flexibility and movement habits when those contribute to symptoms. It cannot reliably straighten a structural bone curve. If guided growth or bone realignment is being considered, the specialist will explain how remaining growth, severity and joint loading affect timing and choice.

Make an appointment if bowing becomes more obvious, affects only one side, or comes with knee, hip or ankle pain. A limp, repeated tripping, reduced participation in usual activities, apparent limb-length difference or difficulty fully moving a joint also merits review.

After an injury, seek urgent assessment for inability to stand on the leg, obvious new deformity, severe swelling, or loss of feeling or movement in the foot. A hot swollen joint with fever or marked illness also requires prompt medical attention.

Ask whether growth plates are still open, which bone contributes to the curve, and whether both legs are affected equally. Families can also ask how follow-up will track change, what physiotherapy is intended to achieve, and whether waiting could narrow future treatment choices.