Knock knees and the skeleton: what to know

Knock knees involve inward alignment of the lower limbs, and skeletal assessment helps separate bone shape from movement habits. The visible position can reflect the thigh bone, shin bone, joint orientation, or a combination of factors.

With genu valgum, the knees angle toward one another when a person stands with the legs straight. The hip, thigh bone, knee, shin bone, and ankle form a linked chain, so alignment at one level can affect how another level appears. A physical examination checks the relationship between these areas rather than judging the knees in isolation.

A flexible inward movement may improve when posture or muscle control changes. A fixed alignment remains present across positions and may be related to growth, an old injury, or a bone or joint condition. An X-ray may be considered when the clinician needs to view the bone axes or clarify an uneven pattern.

Record pain, stiffness, walking changes, and whether one leg looks different. Bring information about previous fractures, joint disease, or changes during growth. In the absence of symptoms, a clinician may recommend observation. When movement contributes to discomfort, rehabilitation can address strength, balance, and load management even though it cannot remodel a fixed bone.

For growing children and adolescents, [Paediatric Physiotherapy](/treatments/physiotherapy-and-rehabilitation/paediatric-physiotherapy/) may support movement and function. If a fixed skeletal angle causes substantial functional problems, an orthopaedic team may explain corrective procedures, including [Osteotomy](/treatments/reconstructive-orthopedic-surgery/osteotomy/), based on individual findings.

Arrange medical review for increasing deformity, persistent pain, swelling, stiffness, a limp, unequal leg appearance, or a decline in walking or sporting ability. Seek prompt help after trauma with severe pain or inability to bear weight. These features matter more than the visual label alone.

Ask which bone or joint contributes most to the alignment, whether the pattern is flexible or fixed, and whether growth could change the appearance. Clarify whether imaging is useful, which symptoms should be monitored, and when an orthopaedic opinion is appropriate.