Bow legs – another, more old-fashioned term was bandy-legged – is a condition that is normal in an infant but can cause problems with age. Untreated, bow legs can create gait problems, cause knee pain and back pain and increase the risk of arthritis and joint damage later in life. The risks of bow legs can range from minor to severe, depending on the degree of deformity.
Bow Legs – From Normal to A Problem
In the womb, babies develop bow legs due to the position of the body. After birth, the bow-legged condition is normal. Once a child begins to walk, the muscles and other supporting structures in the legs gradually develop and the legs straighten. By the age of two, most children have straight legs. However, disease and injury can affect bone growth and development, leaving the child with bows in one or both legs. If caught early, the condition may be improved with braces, physical therapy or medications. If not, the structural imbalances caused by bow-leggedness create many problems.
Conditions that Cause Bow Legs
In addition to the structural risks of bow legs, it is important to consider the reason why the condition occurred in the first place. Blount's disease tends to occur more often in African American children and is often associated with obesity and/or walking at a very young age. Normal bone remodels - breaks down and rebuilds - in a continuous cycle. In Paget's disease, the bone rebuilds more quickly, resulting in soft, weaker bones throughout the body. Rickets results from vitamin D deficiency – it also affects the whole body. Dwarfism can be a genetic disorder or result from inadequate production of growth hormone.
Proper body alignment and posture are impossible with one or both legs bowed. Since the skeleton is connected by muscles, ligaments and tendons, a misalignment in the legs results in gait and postural changes. The misalignment causes muscles to become shorter or uneven (muscles work in pairs) which further affects posture and gait. As a result, patients can develop pain in the ankles, knees, hips or back. Since most people compensate for pain by further adjusting their posture or gait, secondary problems often develop as a result of these changes.
Bow legs place an abnormal amount of stress and pressure on the inside of the knee joint. The knee is a highly complex structure that includes bones, muscles, ligaments, tendons and cartilage. Any of these can be stressed by bow-leggedness. Cartilage is what covers and protects the bones from rubbing together. Over time, the cartilage becomes worn, frayed and deteriorates. This can lead to a condition called bone-on-bone in which the bones actually rub together. This causes significant, permanent damage to the bone surface. In addition, a chronic inflammatory process develops, which leads to pain, stiffness and disability.
Bow legs can be corrected with surgery. If you suffer from bow legs, you should contact an orthopedic surgeon for an assessment. Early treatment is always desirable.