Concerns About My Toddler's Bow Legs: Seeking Gentle Correction Options

Pediatric Orthopedics

Hello Doctor: My daughter started pulling herself up to walk along the sofa at 8 months, and by 10 months, she was walking independently.
At 1 year old, I began to notice something odd about her walking (she has a slight bowing of the legs, and her left foot points inward, which I believe is referred to as "in-toeing." Sometimes, she trips over her own feet because of this, and people around her have commented that her left foot looks crooked and her walking seems strange).
Now, at 1 year and 2 months, I took her to see an orthopedic specialist and had X-rays done.
The doctor mentioned that my daughter has bowlegs (I forgot the exact degree, but he said it wasn't a major concern).
The main issue is the growth plates in her knees: her right leg is at 15 degrees and her left leg is at 20 degrees.
He stated that generally, both legs should be less than 15 degrees.
He advised me to return for a follow-up in three months, and if there is no improvement, my daughter may need to wear a brace on her left leg! In a worse-case scenario, surgery might be necessary for her left leg! I'm really worried since my daughter is still so young! Is this really that serious? Doctor, are there any gentler correction methods available? I'm truly concerned about missing the critical period for correction.
Thank you very much for taking the time to answer my questions.

Shu Ling, 30~39 year old female. Ask Date: 2003/07/09

Dr. Li Wenlin reply Orthopedics

Hello,
In response to your question, most children exhibit bowlegs (genu varum) when they begin to walk (typically before the age of one).
Between the ages of one and a half to three, this can gradually develop into knock-knees (genu valgum), with some angles being quite pronounced.
However, by the age of six or seven, these conditions usually improve to normal alignment.

Bowlegs often coexist with in-toeing (internal tibial torsion), which is one of the common reasons children are brought to orthopedic clinics.
In fact, the femur, tibia, and even the foot can contribute to in-toeing, with femoral internal rotation and tibial internal rotation being the most common causes.
The vast majority of children will naturally correct in-toeing as they grow, and generally, there is no need for braces or corrective shoes, with the likelihood of requiring surgery being even lower.

Regular follow-up and check-ups are crucial.
A seasoned orthopedic surgeon can differentiate whether bowlegs or in-toeing are within acceptable limits or require correction by comparing pre- and post-X-ray angles and conducting simple physical examinations.
Therefore, I recommend that you continue with regular follow-ups and not worry too much, as the probability of needing correction is quite low.
If you lack confidence in your current physician's assessment, you may seek a second opinion from another orthopedic surgeon, especially if there is a pediatric orthopedic specialist nearby.

Wishing you all the best.

Reply Date: 2003/07/09

More Info

Dear Concerned Parent,
Thank you for reaching out with your concerns about your toddler's bow legs. It's completely understandable to feel anxious when it comes to your child's health and development, especially when faced with potential treatment options that may seem invasive or severe.

From your description, it appears that your daughter has been diagnosed with bow legs, or genu varum, which is characterized by an outward curvature of the legs at the knees. This condition is relatively common in young children, especially those who are just starting to walk. In many cases, bow legs can be a normal part of development and may correct themselves as the child grows.
The measurements provided by the orthopedic doctor indicate that your daughter's right leg has a 15-degree angle and the left leg has a 20-degree angle. While the doctor mentioned that the normal range should be less than 15 degrees, it's important to note that slight variations can be typical in young children. The growth plates in the knees are still developing, and as your child grows, the alignment of her legs may improve naturally.

Regarding your concerns about the need for more aggressive treatments, such as wearing braces or even surgery, it’s essential to understand that these options are typically considered only if the condition does not improve over time or if it significantly impacts the child's mobility or quality of life. The recommendation to follow up in three months is a standard approach to monitor the situation and assess any changes in her leg alignment.

In terms of gentle correction options, there are several approaches you can consider:
1. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the knees and improve overall leg alignment. A physical therapist can provide exercises tailored to your child's needs.

2. Encouraging Proper Walking and Play: Ensure that your child has plenty of opportunities to walk and play on flat surfaces. Activities that promote balance and coordination can be beneficial.

3. Footwear: Proper footwear can also play a role in leg alignment. Ensure that your child wears shoes that provide adequate support and fit well.

4. Monitoring Growth: Keep a close eye on her growth and development. Regular check-ups with your pediatrician or orthopedic specialist will help track any changes in her leg alignment.

5. Nutrition: A balanced diet rich in calcium and vitamin D is crucial for bone health. Ensure your child is getting the necessary nutrients to support healthy bone growth.

6. Gentle Exercises: Activities like swimming or riding a tricycle can be fun ways for your child to exercise without putting too much strain on her legs.

It's essential to maintain open communication with your child's healthcare provider. If you feel uncertain about the recommended treatment plan or if you would like a second opinion, don't hesitate to seek out another orthopedic specialist. They can provide additional insights and reassurance regarding your child's condition.

Lastly, it's important to remember that many children with bow legs grow out of the condition without any need for intervention. The key is to monitor her progress and ensure that she remains active and engaged in play.
I hope this information helps alleviate some of your concerns. Your child's well-being is paramount, and with careful monitoring and gentle correction strategies, you can support her development effectively.

Best wishes for you and your daughter!

Similar Q&A

Understanding Bowed Legs in Toddlers: When to Seek Help

My daughter is 1.7 years old, and her calves are slightly bowed, resembling an O-shape. When she runs, she sways from side to side, and she enjoys walking on her tiptoes. I'm unsure if this is a normal phenomenon and whether it will have any adverse effects as she grows olde...

Dr. Li Weiqiang reply Rehabilitation
Hello: For a 1.7-year-old child, having bowed legs is generally acceptable and is considered a physiological "O" shape. If there are concerns or if the condition appears to be worsening, please consult a rehabilitation specialist or a pediatric orthopedic physician for ...

Understanding Congenital Tibial Bowing in Infants: When to Seek Further Evaluation

Hello doctor, my child is currently 9 and a half months old. An ultrasound before birth indicated that there was an issue with his foot. Since birth, the pediatric orthopedic doctor we have seen mentioned that it has become somewhat straighter and advised us to just observe witho...

Dr. Li Wenhong reply Orthopedics
Hello: If there is improvement (more upright), you can observe first without aggressive treatment. If you notice that the crawling posture seems a bit unusual, you can assist from the side. During bathing, dressing, or changing diapers, you can also perform massage on the affecte...

Can Flat Feet in Toddlers Be Corrected? Expert Insights and Solutions

A one-and-a-half-year-old child at home has flat feet. Is it possible to correct this condition? How can it be corrected? Are there specialists in large hospitals for this issue? Please recommend a physician. Thank you!

Dr. Pan Yingda reply Rehabilitation
In general, correction is not necessary. First, children's arches are not fully developed, and nine out of ten have flat feet. Second, what is so detrimental about flat feet that requires urgent correction? In my years of practice, I have yet to encounter an infant or toddle...

Can Bow Legs from Early Walking Be Corrected? Tips for Improvement

If a child develops bow legs (genu varum) due to walking too early (at 11 months), is there a chance for it to heal? Additionally, does actively tightening the leg muscles while standing help in correcting bow legs?

Dr. Shi Guozheng reply Orthopedics
Learning to walk too early does not necessarily cause bow legs. If bow legs are not severe, treatment is not required. Actively trying to tighten the legs while standing is not effective for correction.