What should you know about slight bow leg?

Bow legs, or genu varum, describe an outward curve of the legs that leaves the knees apart when the ankles are together. Alignment differs with age, growth, body structure, and previous injury. A mild, symmetrical appearance without pain may need observation rather than treatment. Concern increases when one leg looks different, the curve is progressing, the child tires or limps, or an adult develops new knee pain. The appearance alone does not show how much load reaches each part of the knee.

Notice whether the alignment is symmetrical and whether it changes with growth, walking, running, or fatigue. Choose activities that remain comfortable and avoid trying to force the knees straight with braces or exercises without guidance. In children, paediatric physiotherapy can assess movement, muscle control, and functional development while the clinician monitors growth. For adults with persistent pain or significant mechanical imbalance, an orthopaedic review may discuss options such as osteotomy. Treatment depends on the cause, age, symptoms, and joint loading.

Arrange an assessment if bowing is newly noticed, worsening, clearly one-sided, associated with limp or pain, or interfering with play, sport, or daily walking. Seek prompt care after an injury with inability to bear weight, severe pain, or visible deformity. A clinician may examine the hips, knees, ankles, walking pattern, and growth history before deciding whether imaging is useful.

Is the alignment appropriate for my age? Is it symmetrical and changing? Could it be affecting knee loading? Should we monitor it, use paediatric physiotherapy, or consider an orthopaedic procedure?