Walking With Knock Knees: What to Know

Knock knees, also called genu valgum, describe knees that angle inward when the legs are straight. The effect varies with age, the amount of alignment difference, muscle control and whether one or both legs are involved. Some people have no symptoms. Others may notice the knees touching, feet positioned differently, tiring during longer walks, or pain around the knee, hip or foot.

In children, leg alignment changes as they grow, so age and development matter. In an adult, a new or progressively changing alignment deserves assessment because joint wear, a previous injury or another bone problem may contribute.

Choose comfortable, supportive footwear and avoid activities that repeatedly cause pain until you have advice. Do not force the knees apart while walking. A physiotherapist can assess hip and leg strength, foot position, balance and movement patterns; [Paediatric Physiotherapy](/treatments/physiotherapy-and-rehabilitation/paediatric-physiotherapy/) may be suitable for a child. Keep a note of pain, limping, falls and whether one side is changing.

Treatment is guided by symptoms and growth or skeletal maturity. If a substantial bony alignment problem causes ongoing functional difficulty, an orthopaedic specialist may discuss an [Osteotomy](/treatments/reconstructive-orthopedic-surgery/osteotomy/), which reshapes or repositions bone to improve alignment. It is not needed for every person with knock knees.

Arrange assessment for persistent pain, a new limp, frequent falls, unequal leg appearance, difficulty keeping up with usual activities or alignment that is worsening. Seek prompt care after an injury if weight bearing is very painful or the knee looks deformed. Sudden weakness, numbness or inability to walk needs urgent medical attention.

Ask whether the alignment is appropriate for age, whether both legs are affected, which examination or imaging is useful, and whether exercises or footwear changes could improve function. Ask what changes should lead to a review.