Updated: Mar 1
Musculoskeletal Series Part 1: Bowleggedness
Have you (or grandma) ever looked at your child's legs and thought they might be "bowlegged"? This is a common concern for parents as they watch their child grow. So let's discuss in detail what bowleggedness is and if or when you need to be concerned.
What is bowleggedness?
Bowlegs, or genu varum, is when a child's legs curve outward when standing. When a child with bowlegs stands with their toes pointing forward, their ankles may touch, but their knees remain apart.
However, bowlegs are generally NORMAL. Being bowlegged is a normal part of growth in babies and toddlers.
Furthermore, normal bowleggedness:
Is not painful or uncomfortable
Will not interfere with your child's ability to walk, run, or play like a typical child
Corrects itself over time
Does NOT require surgery or intervention (braces, special shoes, etc)
Why is my child bowlegged?
All babies are born bowlegged because of their position in the womb. As they grow and the amount of space in the womb decreases, a baby's arms and legs default to bent positioning, which results in a slight curve in their legs below the knee. However, parents typically don't really notice bowleggedness until your child begins to stand and walk.
As your child continues to bear weight, walk, run, and become more coordinated with movement in general, their body will eventually correct itself to handle the changes in body positioning. However, this process takes several months to years, just as it took several months for your child's bowlegs to develop in the womb.
By age 3, most children no longer appear bowlegged. By age 7 or 8, most childrens' walking patterns have become normal or near-normal.
How do I know if my child's bowleggedness is normal?
Most bowleggedness in children is completely normal. Here are some clues to know if your child's bowlegs are normal:
Your child's bowlegs are symmetric (it looks the same on both sides)
Your child is otherwise developmentally normal
Your child eats well and is gaining normal amounts of weight
Your child does not seem in any pain or bothered by their bowlegs
Even if your child seems to walk awkwardly or trips and falls often, this is typically normal as well. That's why we call them "toddlers".
If in doubt, ask your child's pediatrician at your child's next well visit.
When should I be concerned about my child's bowleggedness?
There are a few rare conditions that can lead to bowleggedness in children, such as rickets and Blount disease.
In Blount disease, the shinbone (tibia) in one or both legs grows abnormally, causing a significant bowleg curve below the knees. Unlike normal bowlegs, Blount’s disease gets worse over time, not better.
In rickets, severe vitamin D deficiency, either dietary or due to an underlying metabolic condition, causes weak bones, leading to bowlegs.
Signs to be more concerned about your child's bowlegs include:
Your child's bowlegs seem to be getting worse, not better, after the age of 2
Your child's bowlegs look asymmetric (do not look the same on both sides)
Your child limps when walking as if in pain
Your child complains of knee or hip pain
Your child is shorter than normal
If your child has any of these symptoms, talk to your child's pediatrician right away.
Continue reading the Musculoskeletal series for other related topics such as:
When Should My Child Crawl and Walk? (coming soon)
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Carpenter TO, Shaw NJ, Portale AA, Ward LM, Abrams SA, Pettifor JM. "Rickets'. Nat Rev Dis Prim. 2017 Dec; 17101.
Wilkins KE. "Bowlegs". Pediatr Clin North Am. 1986 Dec; 33(6): 1429-38.
Sabharwal S. "Blount Disease". J Bon Joint Surg. 2009 Jul; 91(7): 1758-76.
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