What to know about bow-shaped legs

The medical term is genu varum. When the ankles are near each other, the knees remain apart and the legs form an outward curve. Many babies have this alignment because of their position before birth, and it commonly becomes less noticeable as standing and walking mature during the toddler years.

Bowing can also reflect a difference in bone growth or healing, vitamin D or mineral problems, a previous injury, or another condition affecting the bones or joints. The pattern matters: a clinician looks at whether both legs are similar, where the curve begins, whether it is changing, and whether walking, pain, or joint movement is affected. In adults, new bowing or increasing deformity deserves assessment rather than being treated as a developmental stage.

Notice whether the curve is equal on both sides and whether there is limping, pain, swelling, stiffness, frequent tripping, or reduced activity. For a child, bring earlier photographs or growth records to an appointment if available; they can help show whether alignment is improving or progressing. Do not force the knees together or buy braces, special shoes, or supplements without an assessment, because management depends on the cause.

An examination may include watching the person stand and walk, checking hip, knee, and ankle movement, and measuring alignment. Imaging or blood tests are considered when the history or examination suggests an underlying bone or growth problem. Physiotherapy may support strength, balance, movement, and function, but exercises do not reshape every type of bony bowing. Surgery such as osteotomy is reserved for selected structural deformities after specialist evaluation.

Arrange a routine assessment if bowing is clearly uneven, continues beyond the expected early-childhood pattern, becomes more pronounced, begins later, or interferes with walking or daily activity. Persistent knee, hip, ankle, or back discomfort also warrants review.

Seek prompt care after an injury if the leg looks deformed, cannot bear weight, or has marked swelling. Urgent assessment is also appropriate for severe pain, a hot swollen joint, fever with limb symptoms, new weakness or numbness, or a foot that becomes pale, blue, or unusually cold. These features call for assessment because of the symptom itself, regardless of the degree of bowing.

Ask whether the alignment fits the expected pattern for age, whether both legs are developing similarly, and what change should trigger reassessment. You can also ask whether imaging or blood tests are needed, whether activity should be modified, what physiotherapy could realistically improve, and when an orthopaedic opinion would be useful.