Wednesday, November 14, 2012

Knock Knees and Bow Legs in Children



As we discussed last time, parents understandably seem to very sensitive to any apparent deformity or perceived imperfection in their children as they develop.  Another common concern for parents is if their children walk with their knees touching or with their legs bowed.  Let’s discuss some of the important points regarding this subject.

Some of the principles we discussed in the toe walking post also apply to this discussion.  Abrupt changes or a sudden deviation from the normal over a short period of time are the best indicator of an underlying problem.  When children are learning to walk, they will find the easiest, most comfortable way to get around.  This tends to not be the most normal looking gait cycle.  Unless they were walking in one way and abruptly change, variations from “normal” should not be alarming.

As a child matures, their bones go through an unwinding process.  This process is called torsion.  As the bones unwind, a child’s gait will slightly alter until the maturation process is a finished.  Depending on the age of the child, their legs will vary from being slightly bow legged to slightly knocked kneed and somewhere in between.    This evolution of the legs tends to resolve at about the age of fourteen, with the legs being straight or very close to it.

Parents should seek medical attention if the deformities are severely exaggerated in either direction.  Most often, severe walking deformities can be expected with some childhood neurological disorders and are often caught close to the birth of the child.  However, they can develop later unexpectedly due to an underlying bone disorder or malnutrition due to malabsorption of a certain nutrient.  These are less common but do happen.

We’ll talk about another pediatric condition in our next post that if treated immediately can be completely reversed without any residual effects.