Bow Legs (Genu Varum)

What are bow legs?

Bow legs — medically called genu varum — describes a leg shape where the knees stay apart when the ankles are together, producing an outward-curving appearance.

Some degree of bowing is entirely normal in young toddlers and typically corrects naturally as the child grows. By around the age of 2, most children's legs have straightened out, going through a brief knock-kneed phase before settling into adult alignment.

Persistent or progressive bowing beyond the typical age, or bowing on one side only, may reflect an underlying cause that warrants assessment. The vast majority of cases are physiological — but the small minority that aren't benefit from being identified.

What does it feel like?

Bow legs themselves don't usually cause pain or functional problems in young children. The presentation is typically about appearance:

• Visible gap between the knees when standing

• An outward curve to the lower legs

• Sometimes an awkward-looking gait

• Often picked up by parents or relatives during normal development

• In persistent cases, sometimes asymmetry between the two legs

If pain or functional difficulty is part of the picture, that often suggests a cause beyond simple physiological bowing.

How is it diagnosed?

Examination establishes the degree and pattern of bowing, looks for asymmetry, and checks for other features that might point to an underlying cause.

X-rays aren't routinely needed for typical physiological bow legs in young toddlers. They become useful when the bowing is asymmetric, marked, persistent beyond the typical age, or accompanied by other concerning features.

Sometimes blood tests are arranged to look for nutritional or metabolic causes of bone deformity if the picture suggests these.

What are the treatment options?

Most physiological bow legs need no treatment — they correct on their own with growth. Reassurance and observation are usually enough.

When there's an underlying cause — for example, a nutritional issue, a growth plate problem, or particular conditions affecting bone development — treatment is directed at that cause. Surgery is occasionally needed for significant or progressive deformities. Nev will work through what's right for your child at your consultation.

When should you get it checked?

Seek a specialist assessment if:

• Bowing is marked or seems to be getting worse

• Only one leg is bowed, or one leg is more affected than the other

• Bowing has persisted past around age 2-3

• Your child has pain, a limp or other symptoms alongside

• You'd like reassurance or a clearer plan

Most children with bow legs have nothing to worry about — but a clear assessment gives families confidence and identifies the small minority that need further attention.