and Correcting O-Shaped Legs: Options and Insights

I want to correct my bow legs?

Hello, Doctor.
I have O-shaped legs, but I'm not sure how severe it is.
I drew a diagram: http://imgur.com/N9BL8WS (the black represents bones, and the pink represents muscles).
It feels like my thighs are very separated from the pelvis.
My upper body is quite slim, but my lower body looks very wide! The thigh bones resemble an "X" shape at the top, and the fibula has a curvature that makes my calves appear thick laterally.
From a skeletal perspective, it doesn't look like typical O-shaped legs, but they can't come together in the middle, and the thigh muscles are increasingly expanding outward, while the calf muscles continue to grow sideways.
The muscles located in front of the tibia and fibula (the tibialis anterior) are also getting thicker, making my calves look more bowed.
When I wear pants, there is a noticeable oval gap.
(Inbody measurements show that most of my leg mass is muscle rather than fat, but I haven't been training my leg muscles; it seems to be due to the bones causing the weight to concentrate on the outside.
Sometimes when I run, I exert more force, and the outer part of my foot gets bruised.) Is there a way to correct this? I've seen many corrective exercises and leg binding methods online, but I'm unsure of their effectiveness.
Or does this degree of deformity require surgery? If surgery is necessary, could you recommend a doctor in Taipei who performs corrective surgery for O-shaped legs? Is there health insurance coverage for this? Thank you for your response!

Niming, 20~29 year old female. Ask Date: 2015/07/15

Dr. Shi Guozheng reply Orthopedics

To determine whether there is a varus or valgus deformity of the knee joint, an X-ray examination is necessary.
In a normally aligned adult, the centers of the hip, knee, and ankle joints should form a straight line.
If the center of the knee joint is deviated inward, it indicates a valgus deformity (X-shaped legs).
Conversely, if it is deviated outward, it indicates a varus deformity (O-shaped legs).
These conditions can cause pain that is difficult to manage, significant deformity, impaired walking, or unsightly appearance, which may necessitate surgical intervention.
Other treatment methods are generally considered adjunctive and may not provide substantial relief.
It is advisable to visit the orthopedic department at National Taiwan University Hospital for an evaluation and to determine whether surgery is required.

Reply Date: 2015/07/15

More Info

O-shaped legs, also known as genu varum, can be a source of concern for many individuals, particularly when it comes to aesthetics and potential discomfort. Your description suggests that you have a unique presentation of O-shaped legs, where the thigh and calf appear to be misaligned, leading to a wider appearance of the lower body. This can be attributed to various factors, including bone structure, muscle development, and alignment issues.

Diagnosis and Assessment
To determine the severity of your O-shaped legs, a thorough assessment by an orthopedic specialist is essential. They will likely perform a physical examination and may recommend imaging studies such as X-rays to evaluate the alignment of your bones and joints. The degree of curvature and any associated symptoms, such as pain or discomfort, will guide the treatment plan.

Treatment Options
1. Conservative Management:
- Physical Therapy: Engaging in targeted exercises can help strengthen the muscles around the knees and improve alignment. A physical therapist can design a program tailored to your specific needs, focusing on strengthening the quadriceps, hamstrings, and calf muscles while also improving flexibility.

- Orthotics: Custom shoe inserts may help redistribute weight and improve alignment, potentially alleviating discomfort during activities like running or walking.

2. Surgical Intervention:
- If conservative measures do not yield satisfactory results and the deformity is significant, surgical options may be considered. Procedures such as osteotomy, where the bone is cut and realigned, can correct the alignment of the legs. This is typically reserved for more severe cases where there is significant pain or functional impairment.

- The decision to proceed with surgery will depend on various factors, including your age, overall health, and the degree of deformity.
3. Alternative Treatments:
- There are numerous exercises and methods advertised online for correcting O-shaped legs, such as specific stretching routines and leg binding techniques. While some may provide temporary relief or improvement in muscle tone, it is crucial to approach these methods with caution. Consulting with a healthcare professional before starting any new regimen is advisable to ensure safety and effectiveness.

Q Angle and Its Implications
The Q angle, which is the angle formed by the quadriceps muscle and the patellar tendon, can also play a role in knee alignment and function. A normal Q angle ranges from about 14 degrees in males to 17 degrees in females. An increased Q angle can lead to additional stress on the knee joint and may contribute to pain or discomfort. If your Q angle is significantly elevated, it may be worth discussing with your orthopedic specialist, as it could influence your treatment options.

Seeking Professional Help
In terms of finding a qualified orthopedic surgeon in Taipei who specializes in correcting O-shaped legs, it is advisable to seek recommendations from your primary care physician or consult local hospitals known for their orthopedic departments. Many hospitals may offer health insurance coverage for surgical procedures, but this can vary, so it is essential to verify with your insurance provider and the hospital regarding coverage specifics.

Conclusion
In summary, while O-shaped legs can be a cosmetic concern and may lead to discomfort, there are various treatment options available. A thorough evaluation by an orthopedic specialist is crucial to determine the best course of action tailored to your specific situation. Whether through conservative management or surgical intervention, addressing the underlying issues can lead to improved function and aesthetics. Always prioritize professional guidance when considering treatment options to ensure safety and efficacy.

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