Knock Knees (Genu Valgum)

What are knock knees?

Knock knees — medically called genu valgum — describes a leg shape where the knees touch but the ankles stay apart. It's the opposite shape to bow legs.

A degree of knock knees is entirely normal in children between roughly 3 and 7. Most children pass through a knock-kneed phase as their legs reshape from the bowed appearance of toddlerhood into adult alignment.

Knock knees that are very marked, asymmetric, or persisting beyond the typical age range may need assessment to make sure there's no underlying cause and to plan management if needed.

What does it feel like?

Most children with knock knees have no symptoms. The presentation is typically about appearance:

• Knees touching when standing while ankles stay apart

• An awkward or wide-stanced gait

• Sometimes complaints of tiredness in the legs after long activity

• In some cases, knee pain or discomfort with prolonged activity

• Occasionally, asymmetry between the two legs

Persistent or marked knock knees can sometimes be associated with knee discomfort, particularly in older children and adolescents.

How is it diagnosed?

Examination assesses the degree of knock knees, looks for asymmetry and checks for other features that might suggest an underlying cause.

Standing X-rays of the legs are useful when the knock knees are marked, asymmetric, persistent or associated with symptoms. They allow precise measurement and assessment of the growth plates.

In some cases, additional tests are arranged to look for nutritional, metabolic or other underlying contributors.

What are the treatment options?

Most physiological knock knees need no treatment beyond reassurance and observation. They typically correct on their own as growth progresses.

Where the deformity is marked, asymmetric or progressive — particularly in older children with growth plates still active — there are sometimes options to gently guide growth back towards normal alignment. Surgery is occasionally needed for significant or persistent deformities. Nev will work through what's right for your child's situation at your consultation.

When should you get it checked?

Seek a specialist assessment if:

• Knock knees are marked or worsening

• Only one leg is affected or one is much worse than the other

• The pattern has persisted into older childhood or adolescence

• Your child has knee pain or functional difficulties

• You'd like reassurance or to discuss what to expect going forward

Most knock knees resolve naturally — but a clear assessment helps identify the cases that benefit from active management and gives families confidence about what they're seeing.