How Physical Therapy Helps Children with Knock Knees and Bow Legs
As a parent, noticing something unusual in the way your child walks or stands can raise many questions. Two of the most common leg alignment concerns in young children are knock knees and bow legs. While these conditions are often part of normal growth and development, there are cases when further support is needed. Understanding what is typical, what may require attention, and how pediatric physical therapy (PT) can help is an important step in supporting your child’s health and mobility.
What Are Knock Knees and Bow Legs?
Knock knees, or genu valgum, is a condition where a child’s knees touch or come close together while the ankles remain apart. This creates a noticeable inward angle when standing or walking.
Bow legs, or genu varum, is the opposite. In this case, the legs curve outward at the knees while the feet and ankles remain together. It results in a noticeable gap between the knees when standing with the feet touching.
Both of these postural patterns are common in toddlers and young children, especially as their bones and muscles grow and adapt to standing and walking. In most cases, these conditions resolve on their own as the child gets older.
When Is It Considered Normal?
It is perfectly normal for infants to have bow legs during their first year of life. This occurs due to their curled position in the womb. As they begin to stand and walk, their legs begin to straighten out naturally.
Around the ages of 2 to 4, many children then go through a knock-kneed phase. During this stage, the alignment of the knees may look exaggerated, but it is typically a part of normal growth. Most children begin to outgrow this pattern by age 6 or 7 as their muscles and bones strengthen and develop better alignment.
In most cases, no treatment is needed during these early phases. Regular check-ups with a pediatrician can help monitor the condition and reassure parents that their child is progressing as expected.
When Should Parents Be Concerned?
Although knock knees and bow legs are usually harmless, there are times when a closer look is necessary. You should consider speaking with your child’s pediatrician or a physical therapist if:
- The condition is severe or appears to be worsening over time
- There is a significant difference between the two legs
- Your child has pain in the knees, hips, or feet
- Walking looks unsteady or awkward
- The condition does not improve by age 7 or 8
- There is a family history of bone disorders or growth concerns
In rare cases, persistent or worsening leg alignment may be linked to conditions like rickets, Blount’s disease, or other orthopedic issues that affect bone development. Early evaluation and treatment can prevent complications and support healthy growth.
How Physical Therapy Can Help
Pediatric physical therapy offers a gentle and effective approach to managing knock knees or bow legs when intervention is needed. A licensed physical therapist can evaluate your child’s posture, movement patterns, strength, and flexibility. Based on the findings, they will develop a customized care plan to support alignment and function.
Here are a few ways physical therapy can make a difference:
1. Strengthening Exercises
Targeted exercises can help build strength in the hips, thighs, and core muscles. Strong muscles provide better support for the joints and promote proper alignment during movement and weight-bearing activities.
2. Stretching and Flexibility Work
If muscle tightness is contributing to poor posture or awkward gait, stretching routines can improve flexibility and reduce strain on the knees and legs.
3. Balance and Coordination Training
Therapists often incorporate fun, age-appropriate activities to help children improve balance and motor control. Better coordination reduces the risk of tripping and falling, especially if the child’s walking pattern has been affected.
4. Postural Re-education
Teaching proper standing, walking, and sitting postures can help children become more aware of their body mechanics and encourage better alignment over time.
5. Parental Guidance and Home Exercises
A big part of physical therapy for children involves educating parents. Your child’s therapist will provide guidance and home exercise plans so that therapy can continue between visits in a safe and supportive way.
Encouraging Healthy Growth
Every child develops at their own pace, and variations in bone alignment are often part of growing up. Still, as a parent, it is natural to want reassurance and answers when something seems off. Pediatric physical therapy can offer both. Whether your child simply needs monitoring or a full therapy plan, early support can go a long way in encouraging healthy movement, building confidence, and preventing discomfort down the road.
If you have concerns about your child’s leg alignment or walking pattern, consider reaching out to a physical therapy provider who specializes in pediatric care. At ProFysio Physical Therapy, our pediatric physical therapy services are tailored to meet the unique needs of growing children. We use age-appropriate techniques to support mobility, correct movement patterns, and improve strength and coordination in a supportive and engaging environment. With the right guidance and care, your child can stay active, strong, and ready for every step ahead.
Contact ProFysio Physical Therapy today at (732) 812-5200 to schedule an appointment and learn how our pediatric specialists can support your child’s healthy growth and development.