Knock knees, medically known as genu valgum, are a common concern among parents, especially when children begin to stand and walk. However, according to Dr. Somesh Virmani, Associate Director & Head – Paediatric Orthopaedics, Sarvodaya Hospital, Sector-8, Faridabad, this condition is often a normal part of a child's growth and, in most cases, does not require any treatment.
"Parents often become anxious when they notice their child's knees touching while the feet remain apart. Many start looking for braces, special footwear, or corrective exercises. However, for most children, knock knees are simply a temporary stage of normal development," explains Dr. Virmani.
A Normal Part of Growth
Children's legs naturally undergo several alignment changes as they grow. Knock knees are commonly seen between the ages of three and four years, and in the majority of cases, the legs gradually straighten without intervention by the time the child reaches seven to eight years of age.
While this developmental phase is usually harmless, persistent or severe cases may require medical evaluation.
When Knock Knees Could Indicate an Underlying Problem
Although physiological knock knees are common, certain medical conditions can contribute to abnormal leg alignment. Dr. Virmani highlights that vitamin D deficiency leading to rickets is one of the most common underlying causes affecting healthy bone development.
Children who are overweight may also appear to have more pronounced knock knees due to increased thigh girth. In rare cases, the condition may result from injuries around the knee or certain bone disorders.
Signs Parents Should Watch For
For most children, knock knees are purely a cosmetic concern and do not interfere with daily activities. Children generally continue to walk, run, climb stairs, and play without discomfort.
However, parents should seek medical advice if they notice:
- Persistent knee pain
- Limping or difficulty walking
- Frequent stumbling or poor balance
- Reduced participation in physical activities
- One leg appearing different from the other
- Progressive worsening of the deformity
- Knock knees persisting beyond eight years of age
Treatment Depends on the Cause
Dr. Virmani emphasizes that not every child with knock knees requires treatment. In most cases, regular monitoring during growth is sufficient.
"If an underlying condition such as vitamin D deficiency is identified, treating the root cause becomes the priority," he says.
Current medical evidence suggests that braces, special shoes, or corrective exercises do not change the natural alignment of growing bones. While exercises may improve strength and balance, they do not correct the deformity itself.
Surgery is Reserved for Severe Cases
Only a small percentage of children require surgical correction. Surgery is considered when knock knees are severe, persist beyond the normal age of correction, or begin to affect walking and daily function.
Modern techniques such as guided growth surgery, a minimally invasive procedure, can gradually correct leg alignment while the child is still growing, providing excellent outcomes in appropriately selected patients.
A Message for Parents
Dr. Virmani advises parents not to panic when they first notice knock knees in their children.
"In most cases, what appears alarming is simply a normal phase of growth that resolves naturally over time. However, if the condition causes pain, affects mobility, or continues beyond the expected age, it is important to consult a paediatric orthopaedic specialist for proper evaluation."
Source: Did you know about knock knees in children? Dr Somesh Virmani shares causes, symptoms, and treatment
