Legs that bow inward: what to know

With bow legs, the knees stay apart when the feet and ankles are together. In young children, leg alignment can change naturally as the bones grow. In other cases, the pattern may be linked with bone development, an injury, joint loading, or a condition affecting bone strength. One leg may be more curved than the other, and the appearance can be more noticeable when walking.

A clinician looks at the child’s age, height, walking pattern, symmetry, pain, and the alignment of the hips, knees, and ankles. Imaging may be considered when the pattern is marked, uneven, painful, or not following expected growth.

Arrange a routine assessment if the bowing persists, increases, affects one side, or makes walking tiring or uncomfortable. Bring observations about when it began, whether close relatives have similar alignment, and whether the child trips or avoids activity. Do not use braces, special shoes, supplements, or exercises without advice, because the useful treatment depends on the cause and the child’s growth stage.

Paediatric physiotherapy may help with strength, balance, and movement habits when those are contributing to difficulty, but exercises do not correct every bone-alignment problem. An osteotomy is a surgical option for selected structural deformities after specialist assessment.

Seek medical advice for pain, swelling, repeated falls, a new limp, unequal leg lengths, or bowing that is clearly worsening. Prompt assessment is also sensible when only one leg is affected or the child has difficulty bearing weight. Seek urgent care after a significant injury if the leg looks newly deformed or cannot be used.

Ask whether the alignment is appropriate for the child’s age, whether both legs are affected equally, and whether an examination or X-ray is needed. Clarify which activities are suitable, what change should trigger review, and whether physiotherapy or an orthopaedic procedure has a specific role.