Bowed legs in adults: what they can mean

The appearance alone does not identify the cause. A clinician considers when the bowing began, whether both legs are affected, and whether it interferes with walking or daily activity.

With bowed alignment, the knees remain farther apart when the ankles are near each other. The medical term is genu varum. Some adults have retained this shape since growth, while others develop or notice it after a fracture, a problem affecting bone strength, or wear that is greater on one side of the knee.

Assessment usually includes standing alignment, hip and knee movement, leg length, gait, and the location of tenderness. Weight-bearing imaging may be used when the result could change treatment planning.

Arrange a routine clinical assessment if the shape is new, becoming more obvious, present mainly on one side, or accompanied by knee, hip, ankle, or back discomfort. Bring details of earlier fractures, childhood bone conditions, and any change in footwear wear or walking distance.

Treatment follows the cause and the effect on function. Strength and movement work may improve comfort and control but does not straighten mature bone. Supportive footwear, activity adjustment, pain management, and, for selected severe structural problems, alignment surgery may be discussed.

Seek urgent assessment after an injury if you cannot bear weight, the leg looks newly deformed, or there is severe swelling. New numbness, a cold or pale foot, or rapidly worsening pain also needs urgent care. Without injury, book an appointment if progressive bowing comes with night pain, unexplained weakness, or declining mobility.

Ask whether the change arises from the knee or the whole leg, whether standing imaging would help, and which activities are suitable. You can also ask what physiotherapy can realistically improve, how progression will be monitored, and what findings would make an osteotomy worth considering.