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Knock Knees


In genu valgum, often known as knock-knee, the knees touch but the ankles do not. It most typically affects young children, which might worry parents who may not be familiar with the disorder.

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What are Knock Knees?

Knock KneesKnock-knees is another name for genu valgum. When a person with genu valgum stands with their knees close together, there is a space between the ankles of at least 8 millimeters. The knees will appear to press in on one another. The most common victims are kids between the ages of 3 and 6. Most young children will have a natural correction of the issue by the time they become 7 years old. Genu valgum may, in exceptional circumstances, persist beyond adolescence. In other instances, an underlying illness or condition may cause it to manifest in older children or adults.

A person could require a doctor’s treatment if genu valgum does not go away on its own or if it manifests later in life. Genu valgum frequently cannot be prevented. There are, however, a number of therapeutic alternatives that can sometimes reduce some of the symptoms. If a doctor can locate and treat the underlying disease, the knock-knees that develop, as a result, may be prevented.


Knock knees treatment will primarily rely on the underlying cause and degree of the illness. Sometimes, knock knees that are very bad or that are worse on one side do require medical attention. Children who have knocked knees in the past could have had braces and shoe inserts. They are no longer utilized because it was determined they were useless. After age 10, doctors may recommend surgery in rare circumstances where children exhibit symptoms like discomfort or difficulty moving. Doctors often advise boosting vitamin D and calcium in the child’s diet to cure knock knees caused by rickets. Children with rickets need to consult a medical specialist. For rickets brought from a genetic condition, an endocrinologist may need to give more specialized therapy. Some examples of typical treatment choices include the following:

Medications and Supplements

In order to fix the leg alignment if an underlying illness is the cause of genu valgum, a physician must first treat the illness. As part of a therapy plan, they could take nutrients and drugs.


What causes knock knees in children?
  • Normal Development: In toddlers and young children, a slight degree of knock knees is a normal part of development, usually resolving on its own as the child grows.
  • Genetics: In some cases, genetics can play a role in the development of knock knees. If other family members have a history of knock knees, a child may be more likely to develop the condition.
  • Nutritional Deficiencies: Severe nutritional deficiencies, particularly in vitamin D or calcium, can contribute to the development of knock knees in children. This is more common in resource-poor areas.
When should parents be concerned about knock knees in their child?
  • Age and Progression: In most cases, mild knock knees in young children are not a cause for concern and often correct themselves as the child grows. However, if the condition persists beyond a certain age (e.g., by age 7-8) or worsens, it may warrant further evaluation.
  • Pain or Functional Limitations: If the child experiences pain or functional limitations due to knock knees, such as difficulty walking, running, or participating in physical activities, it’s essential to consult a healthcare provider.
  • Asymmetry: If there is a significant asymmetry between the legs or if other joint abnormalities are present, further evaluation may be necessary.
How are knock knees in children treated?
  • Observation: In many cases, especially for mild or age-appropriate knock knees, observation is the primary approach. Healthcare providers will monitor the child’s condition and growth.
  • Physical Therapy: Physical therapy may be recommended if there is an underlying muscle imbalance contributing to knock knees.
  • Orthotics: In some cases, orthotic devices or shoe inserts may be prescribed to help with alignment and gait.
  • Surgery: Surgical correction is generally considered a last resort and is only recommended in severe cases that cause pain or functional limitations and have not responded to other treatments. This is a rare approach and typically reserved for older children and adolescents.

Parents are encouraged to consult a healthcare provider if they have concerns about their child’s knock knees, especially if the condition is causing pain or functional limitations. An orthopedic specialist can provide a thorough evaluation, offer guidance on appropriate management, and address any specific concerns related to the child’s condition.





The doctors and surgeons at the Medical City Children’s Orthopedics and Spine Specialists treat children with knock knees.  We specialize in children and adolescents.

Regular Exercise for Knock Knees

According to several studies, exercise may aid patients with knock-knee posture and balance as well as develop their leg muscles. Young adults with knock-knees may also benefit from this, according to a study, although there is little evidence to support this claim for youngsters.

A person should always get medical advice before starting any workout program. Based on a person’s stride and individual symptoms, a doctor or physical therapist will be able to advise on whether exercises would be beneficial and what kinds to undertake. A person can engage in the following examples of resistance and strength training:

Side Lunges

  • Place your child’s arms in front of his or her chest while standing with their feet hip-width apart.
  • Step to the left in a sweeping motion.
  • As soon as the foot reaches the ground, bend the knee and drive the hip back.
  • While standing up, return to a neutral position.
  • Ten to twelve times, then swap legs.

Lying Abduction

  • Legs stacked one on top of the other when your child lays on the left side.
  • Right leg raised at a 45-degree angle for one second. Next, extend the leg.
  • Do this 10–12 times more, then switch to the other leg.

Wall Squat

  • Keep your child’s body a little distance from the wall as your child stands straight up against it with their feet shoulder-width apart.
  • Squat to a maximum of 90 degrees and hold the position for 5–10 seconds while maintaining abdominal contraction.
  • With additional practice, one could be able to maintain the posture for longer.
  • It could also be beneficial to perform this exercise while wearing a resistance band around the knees.

Weight loss for Knock-Knees

Genu valgum can result from an individual’s high body weight. Putting more strain on the knees and legs, and increasing weight can make knock-knees worse. In order to reduce weight, a doctor would usually advise a person who is overweight to combine nutrition and exercise.


The use of orthotics, which are shoe inserts, can assist in improving a person’s gait, or the way their foot touches the ground while they walk or run. For those with genu valgum who have one leg that is longer than the other, this may be extremely beneficial. In addition to or instead of orthotics, doctors may advise braces or splints for some youngsters. The purpose of the braces is to aid in the proper positioning of the bones as they grow.

Surgery for Knock Knees

Surgery is not the first option for knock-knee patients. Doctors only perform surgery if pain-relieving measures, including stretching, exercise, and weight loss, are ineffective. Medical professionals perform guided growth surgery on kids by inserting a tiny metal component into the knee. This metal plate aids in the proper direction of bone growth. The metal plate is removed after another surgery when the bone is properly positioned. Osteotomies can be performed on adults and older adolescents. Osteotomy is a surgical procedure in which a tiny metal plate is inserted into the knee, much like guided growth surgery.

To maintain the knee’s proper alignment, the plate is employed as a permanent brace. A doctor could recommend a knee replacement under unusual circumstances. In this instance, the genu valgum will be fixed with a properly positioned mechanical knee. Any surgical operation can have a wide range in price depending on the surgery, the patient’s insurance status, and the kind of insurance. The intensity of the patient’s symptoms may also play a role.


Although there are several potential causes for genu valgum, including genetic and metabolic bone disorders, there may not always be a definitive reason. However, genu valgum is frequently a minor issue. Genu valgum risk factors include the following:

  • The knee may bend inward as a result of a healed fracture in the growing region of one of the surrounding bones.
  • A deficiency of calcium or vitamin D can cause rickets, an issue with bone growth. Today, this occurs considerably less frequently than in the past. Calcium and vitamin D pills are effective treatments for it.
  • Some children are born with a disease called dysplasia, which can affect how bones grow.
  • Obesity can influence how bones develop.
  • The knee may bend inward due to malignancy in a leg bone.
  • Damage to or disease of the knee or leg.
  • Dysplasia of the bones.
  • Illnesses associated with lysosomal storage, such as Morquio syndrome.
  • Rickets is a vitamin D-deficient disease.
  • Arthritis especially in the knee
  • Lack of calcium.


Distinctly visible separation of the ankles, while the knees are together is one sign of genu valgum. In order to make up for the absence of a distance between their knees, a person’s gait may be impacted. This will manifest as limp and balance issues while walking. Usually, a person won’t have any symptoms, although they could feel hip, ankle, knee, or foot discomfort on occasion.


A physical examination, during which the patient is examined and a thorough medical history is obtained, usually precedes the diagnosis. For children, the doctor will examine the development pattern of the patient’s legs. A doctor would probably ask the patient to explain the location, intensity, and frequency of any pain they are experiencing. The doctor will also consider:

  • Standing with proper knee alignment.
  • The gait of a person.
  • If the legs are different lengths.

A doctor may also examine a patient’s shoe bottoms for signs of uneven wear. To analyze the bone structure, a doctor may occasionally request an MRI or X-ray. The doctor must also decide if there is an underlying cause. The doctor would often advise waiting to see whether the problem gets better on its own if there is none.

When to get Medical Advice

Children’s knock knees often don’t require any attention and should grow better as they age. Visit our doctors if:

  • The angle of the lower legs when standing compared to the upper legs is significantly different, with the space between the ankles being larger than 8 cm.
  • The issue appears to be escalating.
  • Knock knees can occur in children as young as 2 or as old as 7.
  • Just one leg is impacted.
  • Additional signs of discomfort or pain such as hurting knees or trouble walking.
  • Your child’s posture or gait does not appear correct.
  • In maturity, your child gets knocked knees.

Genu Valgum vs. Bowlegs

The Latin term for bow-leggedness is genu varum, which is akin to knock-knees. Early childhood is when they both appear most frequently. Bowlegs are knees that bend outward, leaving less room between the ankles. Knock-knees, which curl inward and widen the gap between the ankles, are the reverse of bowlegs. While knock-knees most frequently affect kids between the ages of three and six, bowlegs seldom last past two years old. Both of these disorders may have both organic and pathological origins.

Outlook for Knock Knees

In nearly every instance of genu valgum, the ailment will go away before a child enters puberty. Stretches and exercises to realign the knees and ease discomfort are likely to be the most common kind of treatment for older children and adults. With orthotics or braces, some people may get alleviation. Surgery is occasionally required in really severe instances; however, this is rarely the first line of treatment for genu valgum because most other approaches work well. Adults and older kids who have Genu Valgum need to be treated. Osteoporosis and other conditions that affect the muscles and joints, such as genu valgum, may arise if the condition is not addressed.

So, What Should Moms and Dads Do?

The following reasons provide sound advice to parents who seek care for their children.  We strongly suggest seeing the experts who specialize in children — like the Medical City Children’s Orthopedics and Spine Specialists.  The following further describes our medical practice:

  • Expertise in Pediatric Orthopedics: We specialize in pediatric orthopedic practices that have specific expertise in treating musculoskeletal conditions in children. This includes a thorough understanding of developmental issues, growth-related concerns, and the unique needs of pediatric patients.
  • Experience with Knock Knees: Our doctors, surgeons, nurses, and staff diagnose and manage conditions like Knock Knees in children. They provide comprehensive evaluations, monitor growth and development, and recommend appropriate treatments based on the child’s age and the severity of the condition.
  • Child-Focused Environment: Our pediatric orthopedic practice creates a child-friendly and comfortable environment. This can help reduce anxiety and ensure that children receive care tailored to their specific needs.
  • Access to Specialized Services: Our Specialized pediatric orthopedic practices have access to advanced diagnostic tools, such as pediatric imaging equipment, and can offer a range of treatments and therapies specifically designed for children.
  • Collaboration and Multidisciplinary Care: We collaborate with other pediatric specialists, such as physical therapists, pediatric rheumatologists, and nutritionists, to provide holistic care for children with complex musculoskeletal conditions.



HealthyChildren.org: Bow Legs and Knock Knees

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