^

A Blog from Your Kaiser Permanente Pediatricians in Northern California

Baby legs and mom behind

Knock Knees, Bowlegs, Pigeon Toes? Usually Nothing to Worry About!

Babies have to fold into a tight little ball as they develop in their mom’s womb, right? When they come out, and stretch and move those little arms and legs, we realize what a miracle it was that they ever fit inside! Their bodies are so used to being curled up that it takes a long time until their stature or shape resembles what we expect a kid to look like.

It’s normal to watch young children transition from being bowlegged then knock-kneed on their way to standing in a straight posture. This process actually takes years.

Along the way, parents often worry and ask, “What’s normal?” Here’s the developmental path they usually take:

  • Infants and toddlers have legs that look bowlegged, toes that turn in, and feet that look flat.
  • Young kids often have in-turned or “knock” knees and out-turned feet.
  • Teens have straighter legs and feet, and visible arches in their feet. But even if their feet still look flat, it’s not usually something to worry about.

Let’s take a closer look at these stages.

Intoeing

Babies often have feet that look turned in (called intoeing). This appearance is usually normal. Remember – they were curled up in a ball inside their mother, and it takes months for their body to “straighten out.”

One form of intoeing at the front part of the foot is called metatarsus adductus and disappears by age one.

  • Gently stretching the foot can help reduce the intoeing.
  • Corrective shoes aren’t necessary.

Sometimes intoeing is caused by a slight rotation at your baby’s hip or lower leg – both of which they outgrow over time. Your pediatrician will examine your baby’s feet, knees, and hips at birth and at each checkup. Be sure to let them know if you’re concerned.

Bowlegs

Children whose legs curve outwards at the knee are said to look bow legged. This often looks worse than it is. In little kids, their diapers increase the appearance of bowing, and they tend to walk with their legs slightly bent, which makes their knees look further apart.

If you’re concerned – show your pediatrician. They’ll likely have your child lie down and stretch out their legs to confirm how straight they actually are!

Knock knees

After those bowlegs get better, kids’ legs often start to appear curved out at the knees. Just like bowlegs, knock knees are something kids usually outgrow without treatment. No special braces are needed!

As they get older, their legs will reach the shape they’ll have as adults. And while some adults do have legs that are slightly knock kneed or bow legged, it’s not to a degree that needs any treatment or is at all limiting.

When should you worry? Definitely see a pediatrician if you notice the curves in your child’s legs aren’t getting better, have gotten worse, only affect one leg, or if they have pain.

Always feel comfortable asking us to look at your child’s legs or feet if you’re concerned!

Find more resources for parents

American Academy of Pediatrics:
Bowlegs and Knock-Knees

Pediatric Orthopedic Society of North America:
Bowed Legs and Knock Knees

Disclaimer: If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.