When is paediatric physiotherapy recommended for bow legs?

Bow legs, also called genu varum, describe an outward curve of the legs when the feet are together. Some alignment changes occur naturally as children grow. Physiotherapy does not simply straighten a bone; it can address muscle control, coordination, walking pattern, balance, and confidence with movement. A clinician considers the child’s age, whether one or both legs are affected, symmetry, progression, and any pain before recommending a plan.

Arrange a paediatric assessment if the curve is worsening, uneven, painful, or interfering with running and play. A physiotherapist may watch walking, check joint movement and strength, and provide playful exercises for home. Supportive footwear or other treatment is considered only when clinically appropriate. Keep a record of changes in walking, pain, and activity so the team can judge progress. Learn more about [Paediatric Physiotherapy](/treatments/physiotherapy-and-rehabilitation/paediatric-physiotherapy/).

Seek prompt assessment for sudden pain, inability to walk, swelling, fever, a rapidly changing curve, or a noticeable difference between the legs. A fall or injury followed by difficulty bearing weight also needs medical review rather than home exercises alone.

Ask whether the alignment fits the child’s growth stage, whether both legs are developing similarly, and whether imaging is needed. Ask the physiotherapist which activities are suitable, how often exercises should be practised, and which changes should lead to a review.