Bowlegged or Knock-Kneed : Healthy Knee Development in Young Children

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Published On

Jun 15, 2018



If you currently have a baby or toddler, you might notice that your child’s legs aren’t straight when at rest. Some children have bowed legs, or knees that face outward instead of forward. Some children have knock knees, where the knees bend inward.

It’s normal to be concerned about whether or not your child is developing properly, and catching some skeletal and joint problems early can be a good thing for treatment in children. For this reason, parents should learn about proper knee development in children. Here’s what you need to know about young knee development and when you should be concerned.

When to Expect Straight Legs

The first thing that all parents need to realize is that babies’ bodies will not look like an adult’s body for quite some time. An infant’s bones are still quite soft at birth, and they do not have the same proportions and supporting muscle tone as older children and adults. Also, because of how growth occurs in the womb, the majority of babies are born with naturally bowed legs.

Other babies may also have knocked knees, although bowing is more common. The bowing persists as a baby learns to crawl and even walk. As a toddler, your child might continue to walk with bowed knees.

Generally, as the bones harden and as children become more adept at gross motor function, the knee eventually straightens, giving your child greater agility and speed. Your child might even go from bowed legs to straight legs to knocked legs to straight legs again. This pattern is normal.

Legs most often straighten first at around age two. Knocked knees might appear during preschool and early grade-school years. By puberty, most children will have corrected their unconventional knee positioning into a typical, straight-legged gait.

How to Encourage Strong Bone and Joint Development

Parents can encourage healthy joint development in children. As your baby moves into toddlerhood and beyond, keep the following tips in mind:

  • Provide a healthy diet. Children who have the right nutrients and calories each day are at less risk for skeletal growth problems. They also are less likely to be obese. Obesity can affect activity level and foot development, which in turn can affect the knees.
  • Encourage developmental stages. Parents should encourage crawling, walking, and other normal baby stages. Carrying the baby too much or keeping him or her in a crib or swing too long can decrease muscle development and slow musculoskeletal advances.
  • Don’t push too hard. Some parents put young children into new positions before they are ready. For example, artificially standing a child up in a play seat before they can stand with assistance can be hard on their bodies.

Even with the right care, however, some early joint problems do need intervention.

When to Be Concerned About Your Child’s Knees

Most children will grow out of early knee problems. However, in some cases, the knocking or bowing of the legs indicates an underlying condition. For example, bowed legs in a child can be a sign of rickets. Rickets occurs when a child does not have sufficient vitamin D.

Hip dysplasia can affect the alignment of the knees. Sometimes, children have joints that are too flexible, allowing them to sit in strange positions or to turn their legs at odd angles. Some children can have metabolic diseases that affect the strength and alignment of the bones.

If you notice that your child has bowing or knocking in combination with signs of pain, weakness, or an inability to learn new motor skills, it’s time to see a specialist. For more information, contact us at the Noyes Knee Institute.