Orthopedics Leg, Foot & Ankle Bowed Legs in Children and Adults By Jonathan Cluett, MD Jonathan Cluett, MD LinkedIn Twitter Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. Learn about our editorial process Updated on April 18, 2022 Medically reviewed by Stuart Hershman, MD Medically reviewed by Stuart Hershman, MD LinkedIn Stuart Hershman, MD, is a board-certified spine surgeon. He specializes in spinal deformity and complex spinal reconstruction. Learn about our Medical Expert Board Print Bowed legs can occur in all age groups and has several distinct causes. In some people bow legs are a problem that requires treatment, in others, it may be a normal part of development. Christine Schneider / Getty Images Causes of Bowed Legs There are a number of different causes of bowed legs. Normal Development As a child develops, different parts of the body grow at a different rate. As a result, skeletal alignment can change causing some unusual appearance of the extremities at specific ages. The most common cause of bowed legs in the toddler age range is simply normal development. Generally, under the age of 2 years, bowed legs are considered a normal process of the developing skeleton. The angle of the bow tends to peak around the age of 18 months, and then gradually resolve within the following year. Most often, children this age are simply observed to ensure their skeletal alignment returns to normal as they continue to grow. Blount's Disease Blount's disease is a condition that can occur in childhood and adolescence. The problem in these children is an abnormal growth plate at the top of the shin bone (tibia). In very young children, it can be difficult to differentiate Blount's disease from normal developmental bowing, however kids with Blount's disease will not gradually improve, and the X-ray appearance of their growth plate will show characteristic abnormalities. Bowed Legs in Children and Adults Rickets Rickets has become a very rare condition in the developed world, although it is still common in developing parts of the world. The most common cause of rickets is a nutritional deficiency of calcium or vitamin D, which are important nutrients for good bone health. Fortunately, with the advent of fortified foods, nutritional rickets has become very uncommon in the developed world. What Is Rickets? Osteoarthritis In adults, bowing of the legs can be the result of osteoarthritis or wear-and-tear arthritis of the knees. This condition can wear away the cartilage and surrounding bone of the knee joint. If the wear is more on the inner side of the knee joint, a bow-legged deformity may develop. In some cases, the degree of bowing of the legs can correspond to the severity of arthritis along the inner side of the knee joint. Wear and Tear Arthritis Treatment Options Treatment of bow legs depends entirely on the cause of the condition. In order to determine the cause of a bow-legged problem, you should be evaluated by a healthcare provider. After being examined, your healthcare provider may order tests such as X-rays which can provide more information about bone alignment and possible abnormalities. Children In young children under the age of 2 years old, bow legs are typically observed to see if, with continued growth and development, the condition will spontaneously resolve. Kids with Blount's disease may require surgical treatment to alter the growth of the tibia bone or to realign the bones, depending on the severity of the condition and the growth remaining. Adults Adults with severe arthritis most often consider knee replacement surgery. However, if the adult is younger, for example in their 20s, 30s, or 40s, they may consider a surgical procedure to realign the bone. By performing this procedure, called an osteotomy, the forces acting on the knee joint can often be shifted from the unhealthy part of the joint to the healthy part of the joint and correct the alignment of the knee. Frequently Asked Questions What causes bowed legs in adults? Osteoarthritis is a potential cause of bowed legs in adults. It is a common form of arthritis that also causes joint pain, stiffness, limited range of motion, joint enlargement, and swelling. Do bowed legs get worse with age? Bowed legs usually only get worse with age if they are caused by an underlying disease or condition. For example, Paget's disease of the bone is a rare disorder that typically affects an older population. One sign of the disease is the enlargement of bones, which can result in bowed legs. Are there leg braces for toddlers with bowed legs? Leg braces can be used for toddlers with bowed legs caused by Blount's disease. As a child grows, the bracing guides their legs into a straighter position to prevent bowed legs. Improvement is often seen within the first 12 months of this treatment. If a child's legs still aren't improved by age 4, surgery may be required. What is the medical term for bowlegs? Genu varum and varus deformity are medical terms used to describe bowed legs. It indicates that the knee joint is bowed or bent outward. Exercising When You Have Bow Legs 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Espandar R, Mortazavi SM, Baghdadi T. Angular deformities of the lower limb in children. Asian J Sports Med. 2010;1(1):46-53. doi:10.5812/asjsm.34871 Taksande A, Kumar A, Vilhekar K, Chaurasiya S. Infantile blount disease: a case report. Malays Fam Physician. 2009;4(1):30-2. Uday S, Högler W. Nutritional rickets and osteomalacia in the Twenty-first Century: Revised concepts, public health, and prevention strategies. Curr Osteoporos Rep. 2017;15(4):293-302. doi:10.1007/s11914-017-0383-y Hunter DJ, Mcdougall JJ, Keefe FJ. The symptoms of osteoarthritis and the genesis of pain. Rheum Dis Clin North Am. 2008;34(3):623-43. doi:10.1016/j.rdc.2008.05.004 American College of Rheumatology. Paget's disease of bone. Johns Hopkins Medicine. Blount's disease. By Jonathan Cluett, MD Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. 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