Bow Legs

Quick answer: Bow legs (genu varum) is when the knees stay apart while the feet and ankles touch, so the legs curve outward like a bow. In babies and toddlers it’s a normal stage of growth that usually straightens out on its own. In adults it can be structural, from bone shape or knee arthritis, or postural, where the way the thighs rotate and the knees lock makes the legs look bowed.

Maybe you’ve always had a gap between your knees when your feet are together, or you’ve noticed it more in recent photos. Maybe you’re a parent watching your toddler walk and wondering whether those curved legs are normal. Either way, the useful question is what’s creating the curve.

What Are Bow Legs?

Stand with your feet together. If your knees stay apart, with a visible gap between them, your legs are bowed. The medical term is genu varum, and you’ll also hear bowlegged or bowed legs. Bow legs are the opposite of knock knees (genu valgum), where the knees come together and the ankles stay apart.

Structural vs. Postural Bow Legs

This is the most important distinction for adults:

• Structural bow legs come from the shape of the bones or the knee joint. The shin or thigh bone curves, or wear on the inner side of the knee (osteoarthritis) gradually angles the leg outward. The curve looks much the same however you stand.
• Postural (functional) bow legs come from how the legs are positioned. When the thighs rotate inward and the knees lock back into hyperextension, often with arches that roll in, the legs can look bowed even though the bones are straight. This kind tends to change when you unlock your knees or turn your kneecaps to face forward.

Do I Have Bow Legs? A Simple Self-Test

1. Feet-together test. Stand barefoot in front of a mirror with your feet and ankles touching. Is there a gap between your knees? How many fingers’ width?
2. Kneecap check. In the same position, look at your kneecaps. Do they face straight ahead, or point slightly inward toward each other?
3. Unlock test. Soften your knees slightly and turn your thighs so your kneecaps face straight ahead. If the gap between your knees shrinks noticeably, the bowing is likely at least partly postural.

Are Bow Legs Normal in Children?

Yes, in babies and toddlers. Babies are born with curved legs from their position in the womb, and according to KidsHealth from Nemours, bow legs usually correct on their own by about age 3 or 4. Many children then go through a knock-kneed stage before their legs straighten around age 7 or 8.

Talk to your child’s pediatrician if the bowing continues past age 2 or gets worse, affects only one leg, is severe, or comes with pain or a limp. Bowing past age 2 or in one leg can point to Blount disease or rickets, which need medical treatment.

What Causes Bow Legs in Adults?

• Thigh rotation and locked knees. The most common postural pattern: thighs turned inward, knees pushed back, and weight resting on the outer edges of the feet or on rolled-in arches (overpronation).
• Hip and pelvis position. How the pelvis sits, including an anterior pelvic tilt, changes how the thighs hang and rotate.
• Knee osteoarthritis. Wear on the inner side of the knee can gradually angle the leg outward.
• Childhood causes. Bowing that didn’t fully straighten, Blount disease, rickets, or a past growth plate injury.
• Bone rotation. A twist in the shin bone (tibial torsion) can make the legs look bowed.

What Are the Symptoms of Bow Legs?

Many people with bow legs have no symptoms. When there are symptoms, people commonly describe:

• Aching on the inside of the knee
• Outer hip or thigh tightness
• Ankle or foot discomfort, especially on the outer edge
• Feeling less stable on uneven ground

None of these proves bow legs are the cause. See a doctor if you have knee swelling, locking, giving way, or pain that doesn’t settle.

How Do You Fix Bow Legs?

Many people assume bow legs are simply “how their legs are made,” and for structural bowing that’s partly true. But if the unlock test changed how your legs looked, a good part of what you see is positional, and position is something the body can relearn.

For postural bow legs, what tends to help is restoring even rotation at the hips, unlocking the knees, and improving how the feet and ankles carry weight. How much the gap changes varies from person to person. Structural bowing from bone shape or arthritis won’t change the same way; severe or painful cases are managed by an orthopedic specialist, sometimes with bracing or surgery.

Exercises for Bow Legs

Three starting points. Move slowly, and stop anything that causes pain.

1. Sitting Femur Rotations

Sit tall on the floor with your legs straight and about 2 feet apart, using your hands behind you for support. Pull your toes back toward you and keep your knees straight. Roll your hips forward so your lower back gently arches. Slowly rotate your legs in and out from the hips, finding the end of the range in both directions. Repeat 10 to 20 times, then widen your legs and repeat, for three sets.

2. Static Wall

Lie on your back with your legs straight up a wall, hip-width apart, and your arms relaxed out to the sides, palms up. Keep the back of your pelvis on the floor; if your lower back lifts, scoot away from the wall. Tighten your thighs, point your kneecaps straight toward the ceiling, and pull your feet down toward you so they’re parallel. Hold for 3 to 4 minutes.

3. Airbench

Stand with your back against a wall and walk your feet forward until you can slide down into a sitting position, knees bent to about 90 degrees and heels under or slightly in front of your knees. Keep your feet and knees hip-width apart and pointing straight ahead, with your weight in your heels. Hold for 1 to 2 minutes, and sit higher on the wall if your knees feel strained. It teaches your knees to work bent and aligned, instead of locked.

Choosing Your Next Step

There’s no single right path. It depends on how you like to work:

• You’d like to start on your own. The self-tests and exercises above are a sensible place to begin.
• You’d like someone to find what’s driving it. A free 30-minute consultation includes a postural assessment of how you stand and walk. We have clinics in Newton, Gloucester, Santa Monica, Beverly Grove and Middletown, RI.
• You’re not near a clinic. Virtual posture therapy brings the same assessment approach to you.

Frequently Asked Questions About Bow Legs

Is it okay to have bow legs?

Often, yes. Bow legs are normal in toddlers, and many adults have a small gap between their knees without any problems. It’s worth looking into if it’s getting worse, is on one side only, or comes with knee, hip or ankle discomfort.

Can bow legs be corrected in adults?

Postural bow legs, from how the thighs rotate and the knees lock, often change with consistent, targeted work. Structural bowing from bone shape or arthritis won’t change shape, though better alignment and muscle control can still help how the legs handle load. The unlock test above is a good first clue to which you have.

Are bow legs genetic?

Leg shape can run in families, and some conditions that cause bowing, such as certain forms of rickets, are inherited. But many adults with bowed-looking legs have a postural pattern rather than an inherited bone shape.

Is surgery the only treatment for bow legs?

No. Most children need no treatment at all, and many adults with postural bowing never need surgery. Surgery is usually reserved for severe structural cases, some cases of Blount disease, or painful knee arthritis. That decision belongs with an orthopedic surgeon.

This article is general education, not medical advice. If you have knee pain, swelling or instability, or bowing that is worsening or one-sided, see a physician or orthopedist first. For children, start with their pediatrician. Posture therapy works alongside medical care, never instead of it.

Related reading: Leg and Knee Alignment: the complete guide.