Knock Knees in Children: Causes, Symptoms, and Treatment Explained

You may be wondering if something is wrong if you notice your child’s knees touching each other while they are standing while the ankles stay apart. This condition medically is called Genu Valgum a.k.a. Knock Knees. It is quite common in growing children.

For parents, this condition is worrying at first glance but in most cases it is a normal part of growth and corrects on its own. In some cases though, medical evaluation is important to rule out an underlying problem.

In this blog, we’ll explain -

• What knock knees are
• Why they occur
• When they are normal
• When treatment is required

What Are Knock Knees in Children

Knock knees occur when a child stands with their knees together and feet and ankles rapart. This creates an inward angling of the legs.

This often becomes noticeable when a child starts walking. Most of the time as the child grows, it stops. The leg structure of children naturally evolves during early childhood, which is why knock knees are often temporary.

Is Knock Knees Normal During Growth

Normal Developmental Stages

In most children, knock knees are part of normal bone development. Typically:

• Babies are born with bowed legs
• Around 2–3 years, legs start to straighten
• Between 3–5 years, knock knees may appear
• By 7–8 years, leg alignment usually becomes normal

If knock knees appear symmetrically in both legs and the child has no pain or difficulty walking. it is usually not a cause for concern.

Causes of Knock Knees in Children

Physiological Knock Knees

This is the most common reason and occurs due to normal growth. It does not require treatment as it improves naturally over time.

Nutritional Deficiencies

Low levels of vitamin D or calcium in a child’s body can affect bone strength and alignment.
Vitamin D deficiency leads to a condition called Rickets which causes abnormal leg alignment.

Obesity

Excess body weight can put extra pressure on growing bones. Ultimately, increasing the inward angling of the knees.

Genetic Factors

Some children inherit this bone alignment and genetic factors are responsible for it.

Underlying Medical Conditions

In very rare cases knock knees may be linked to underlying conditions such as -

• Skeletal dysplasia
• Infections
• Injuries affecting bone growth

Signs and Symptoms to Watch For

While knock knees are often harmless for the child. A parent should observe for the following signs in the child, as they are of worry.

• Uneven leg alignment affecting only one leg
• Persistent knock knees after 7–8 years of age
• Pain in the knees, hips, or ankles
• Difficulty walking, running, or frequent falls
• Fatigue or discomfort after physical activity

In case of these symptoms being present, a medical evaluation is recommended.

How Knock Knees Are Diagnosed

Physical Examination

A doctor will assess the child’s standing posture, walking pattern, and overall leg alignment.

Measurement of Intermalleolar Distance

This involves measuring the distance between the ankles when the knees are touching to assess severity.

Imaging Tests

X-rays are rarely needed but may be recommended if the condition is severe, asymmetrical, or persistent beyond the expected age.

Treatment Options for Knock Knees in Children

Observation and Monitoring

For most children, no treatment is required. Regular follow-ups help track natural correction as the child grows.

Nutritional Correction

If deficiencies are identified, vitamin D and calcium supplementation may be advised along with dietary improvements.

Weight Management

Maintaining a healthy weight reduces stress on growing joints and supports proper alignment.

Physiotherapy and Exercises

Targeted exercises can help strengthen muscles around the hips and knees, improving balance and posture.

Bracing (Rare Cases)

Special braces may be used in select cases where alignment needs guidance during growth.

Surgical Treatment

Surgery is rarely needed and is considered only in severe cases that do not improve with growth or conservative treatment.

Can Knock Knees Cause Long-Term Problems

In most children, knock knees resolve without any long-term issues. However, untreated pathological knock knees may lead to:

• Abnormal walking patterns
• Joint stress and early wear
• Knee pain in adolescence or adulthood

Early identification and appropriate management help prevent these complications.

How Parents Can Support Healthy Bone Development

Parents can play an important role by:

• Ensuring a calcium and vitamin D rich diet
• Encouraging outdoor play and physical activity
• Monitoring posture and walking patterns
• Scheduling regular pediatric check-ups

Simple lifestyle measures often make a big difference in bone health.

When Should Parents Consult a Doctor

Parents should seek medical advice if:

• Knock knees persist beyond 7–8 years of age
• The condition appears suddenly or worsens
• The child experiences pain or difficulty walking
• Only one leg is affected

Early consultation ensures reassurance and doesn’t let the situation escalate out of hands.

Final Thoughts

Children usually develop knock knees as a common stage during their growth process. The majority of cases which appear alarming will resolve themselves throughout the passage of time. Parents need to understand normal unthreatning knock knees as it enables them to identify warning signs which help them decide when to seek medical assistance.

For expert evaluation of knock knees and other pediatric orthopedic conditions, consult Dr Ankur Singh. Dr Ankur Singh uses patient-centered treatment methods to create diagnostic procedures which lead to customized medical solutions for his young patients who experience bone and joint problems.