Knock knees in toddlers

A person with knock knees (genu valgum) has a large gap between their feet when they’re standing with their knees together.

Many young children have knock knees, which tend to be most obvious at around age four. It’s almost always just a normal part of their development, and their legs will usually straighten by age six or seven.

Here is some information about knock knees from the United Kingdom’s National Health Service.

Should you worry?

Slight knock knees can continue into adulthood, but this isn’t usually anything to worry about unless it causes other problems.

However, knock knees can very occasionally be a sign of an underlying condition that needs treatment, especially if the condition develops in older children or adults, or doesn’t improve with age.

Symptoms of knock knees

If someone with knock knees stands with their knees together, their lower legs will be spread out so their feet and ankles are further apart than normal.

Knock knees don’t usually cause any other problems, although a few severe cases may cause knee pain, a limp or difficulty walking.

Knock knees that don’t improve on their own can also place your knees under extra pressure, which may increase your risk of developing arthritis.

When to get medical advice

Knock knees in children aren’t usually a cause for concern and should improve as your child gets older.

However, visit your doctor if:

•The gap between the ankles is greater than 8cm while standing with the knees together.

•There’s a big difference between the angle of the lower legs when standing, compared with the upper legs.

• The problem seems to be getting worse.

• A child under the age of two or over the age of seven has knock knees

•Only one leg is affected.

•There are other symptoms, such as knee pain or difficulty walking.

•You have any other concerns about the way your child stands or walks.

You may be referred to an orthopaedic surgeon (a specialist in bone and joint problems) who will arrange an X-ray of the legs and blood tests to check for underlying problems.

What causes knock knees?

Knock knees are fairly common in healthy children under the age of six or seven, and are just a normal part of growth and development.

The legs will usually gradually straighten as the child grows, although mild knock knees can last into adulthood.

Knock knees that develop later in childhood or don’t improve with age can sometimes be associated with an underlying problem, such as:

•Rickets — problems with bone development resulting from a lack of vitamin D and calcium.

•Excessive pressure on the knees — for example, as a result of obesity or loose knee ligaments (the bands of tissue around joints that connect bones to one another).

•An injury or infection affecting the knees or leg bones.

• Genetic conditions affecting the development of the bones or joints.

Treatment for knock knees

In most cases, knock knees don’t need to be treated because the problem tends to correct itself as a child grows.

Your child doesn’t need to avoid physical activity, wear supportive leg braces or shoes, or do any special exercises.

Mild knock knees that persist into adulthood don’t need to be treated unless they’re causing problems, such as knee pain.