Genu varum, commonly known as O-shaped legs or bow legs, is a leg alignment condition where the knees remain apart even when the ankles touch.
Mild bowing in infants is normal; however, if it persists beyond early childhood or develops in adulthood, it may indicate skeletal imbalance, muscle weakness, or poor postural habits — all of which can affect joint health and walking mechanics.
Typical features include:
· A knee-to-knee gap greater than 2–3 cm when standing upright
· Lower legs curving outward, creating a “bowed” appearance
· Outer-sole shoe wear due to uneven weight distribution
· Possible knee pain or early osteoarthritis from joint stress
· Common Causes of O-Shaped Legs
1. Physiological Development in Infancy
· Babies are naturally bow-legged due to intra-uterine positioning and early standing and walking posture.
· By ages 2–3, most children’s legs straighten, and some may temporarily develop mild knock-knees.
· If curvature remains after age 6, professional assessment by a pediatric orthopaedic specialist or physiotherapist is recommended.
2. Skeletal or Medical Conditions
· Rickets (vitamin D deficiency) may soften bones during growth, leading to permanent bowing.
· Blount’s disease (tibia vara) involves abnormal growth on the inner side of the shinbone, resulting in curvature.
· Osteoarthritis in older adults can cause secondary O-shaped legs due to uneven cartilage wear.
· Health Impacts of Genu Varum
· Uneven joint loading can cause premature wear on the outer knee cartilage.
· Altered gait mechanics place extra stress on the hips, ankles, and lower back, leading to discomfort or pain.
· Postural imbalance affects appearance, walking efficiency, and long-term joint health.
How to Prevent and Correct O-Shaped Legs
1. Improve Daily Posture
· Avoid habitually leaning to one side.
· When standing, align your hips, knees, and ankles in a straight line.
2. Strengthen Key Muscles
· Gluteus medius (hip stabilizer): side-lying leg raises, clamshells
· Inner-thigh (adductors): ball-squeeze bridges, adductor squeezes
· Core stability: planks, bird-dogs, and deep abdominal activation to support posture
3. Seek Professional Physiotherapy
If the curvature is noticeable or accompanied by pain, consult a physiotherapist for a full assessment.
Professional management may include:
· Lower-limb alignment and gait analysis
· Targeted strength and flexibility programs
· Manual therapy and posture retraining
· Custom orthotic insoles to correct load distribution
· Early Intervention in Children and Teens
· Because children’s bones are still developing, persistent O-shaped legs after age 6 should be evaluated early.
· Timely intervention can help prevent permanent deformity, abnormal gait, and future joint degeneration.
Key Takeaways
· shaped legs (genu varum) are not merely a cosmetic issue — they reflect altered leg alignment that can affect knee, hip, and lower-back health.
· Most mild cases can be improved through posture correction, strength training, and physiotherapy.
· If you experience pain, stiffness, or visible curvature, early assessment is highly recommended.
· Long-term prevention depends on balanced muscle use, proper posture, and consistent exercise — not on temporary fixes.
· Maintaining good alignment keeps your legs straight, your joints healthy, and your movement efficient.
Written by the ProCare Health & Wellness Team
