What should you know about skinny bow legs?

Bow legs, also called genu varum, occur when the knees remain apart while the ankles are together. A slim build can make the alignment easier to see, but body size does not explain every case. The curve may reflect normal development in a young child, inherited alignment, growth-related bone changes, an old injury, or another condition affecting bone strength. One leg, pain, or worsening alignment deserves closer attention.

Arrange an orthopaedic assessment if the shape is new, uneven, painful, or affecting walking. The clinician may observe gait, measure alignment, examine the hips and ankles, and request standing X-rays when needed. In children, growth and development guide decisions; [Paediatric Physiotherapy](/treatments/physiotherapy-and-rehabilitation/paediatric-physiotherapy/) may support strength, balance, and movement but cannot straighten a fixed bone angle. Severe structural alignment may be discussed with an [Osteotomy](/treatments/reconstructive-orthopedic-surgery/osteotomy/).

Seek prompt care for sudden pain, inability to bear weight, marked swelling, or a leg that changes shape after an injury. Book a non-urgent review for increasing bowing, frequent falls, limping, fatigue during walking, or pain around the knees, hips, or ankles. A visual impression alone cannot identify the cause.

Ask whether the alignment is within the expected range for age, whether both legs are affected equally, and whether examination or imaging is needed before choosing observation, therapy, or surgery.