Fixing bow legs in adults: what to know

Bow legs, also called genu varum, describe knees that stay apart when the ankles are together. In adulthood, the shape may have remained from growth, developed after an injury, or be linked with uneven loading and arthritis around the knee. A clinician checks your walking pattern, hip and knee movement, leg length, and how the knees and feet align. Standing leg X-rays can show whether the bend comes mainly from the thigh bone, shin bone, or joint surface.

If the alignment causes no pain or loss of function, observation and strength work may be enough. Physiotherapy can improve hip, thigh, and trunk control, although exercises do not reshape a mature bone. Weight-management advice, activity changes, and treatment for knee pain may reduce strain without correcting the angle. When a marked deformity causes persistent pain, walking difficulty, or progressive joint damage, an orthopaedic surgeon may discuss an osteotomy, an operation that cuts and repositions bone to change load through the knee. Recovery and suitability depend on the exact alignment and overall health.

Arrange an assessment for new or worsening bowing, persistent knee or hip pain, swelling, locking, repeated falls, or a change in walking. Seek urgent help after a major injury if you cannot bear weight, the limb looks suddenly deformed, or the foot becomes cold, pale, or numb.

What part of my leg is creating the alignment change? Do I need standing X-rays? Could arthritis or a previous injury be contributing? What can physiotherapy improve, and would an osteotomy address my symptoms or only the shape?