Bow legs – the medical term is genu varum – is a common condition in very young children that can be problematic if it carries over into adulthood. As the term implies, it occurs when the legs are bow-shaped, with the knees wider apart while the ankles and feet are close together. In some cases, exercises may be helpful, but if not, there are other options for bow legs correction.

Bow Legs - Causes

Until they have been walking for at least a year, bow legs are normal in all children; they are less common in adults, but exact figures are not available. The muscles of the inner thighs and lower legs must be strengthened through the exercise of standing, walking and weight bearing. As these muscles become stronger, the bow-legged condition gradually corrects itself.

However, once a child reaches the age of three and is still bow-legged, other strategies may be in order. At this age, bow legs may be caused by abnormal bone development, a congenital growth disorder called Blount's disease or tibia vara, fractures that don't heal properly, lead or fluoride poisoning, and rickets – which occurs in children who have vitamin D deficiency.

Why Correct Bow Legs?

Even if your bow legs are functional and don't affect mobility, bow legs correction can be important to reduce pain and to prevent future problems. Muscles work in pairs. In conditions like bow legs, muscle strength is uneven, which can affect the hip, knee and ankle joints and cause pain. Bow legs put extra pressure on the inside of the knee and – over the long term – can increase the risk of osteoarthritis.

If you are overweight and have bow legs, that puts even more stress on the joints in the legs, which can make joint pain worse. Eventually the cartilage in the joints, especially the knees, begins to deteriorate, allowing the bones to rub together. Bow legs can also change your overall posture and may lead to back pain. Finally, it may be a cosmetic issue and affect your self-esteem.

Benefits of Exercise

Exercises for bow legs correction offer multiple benefits. Strengthening muscles promotes better posture overall and can help decrease problems like back pain. Since muscles work in pairs, what usually happens is that one set becomes weak and lengthens, while the other becomes short and tight. Flexor muscles – which bend the joint – are most likely to become tight.

Exercise focused specifically on the weak muscles in each pair brings them into balance and may help straighten the bones to which the muscles attach. Weak muscles in areas other than the legs may contribute to or make bow legs worse. For example, weak hip flexor muscles tilt the pelvis backward, rotate the femurs (long bones in the thigh) outward and separate the knees.

Exercises for Bow Leg Correction

Attempting bow legs correction with exercise takes considerable effort and dedication on your part. You should work with a physical therapist or personal trainer who has experience in this area, as the exercises must be performed correctly to be effective. These professionals can also assess which muscles are weak or overly tight and develop a program specific to your needs. Exercise may be more effective in children than adults, as the postural imbalances are “set” by adulthood. Long-standing bow legs also affect bone development, and the bones themselves cannot be changed by exercise.

The most common exercises or therapies are Pilates, yoga and exercises specifically targeted to strengthen certain muscles. One of the major benefits of massage therapy is that it relaxes tight muscles. Remember, you need to deal with muscles that are overly tight as well as muscles that need to be strengthened. Whatever other exercise you choose, it should be combined with massage therapy and stretching exercises as well as strengthening exercises.

Typical exercises include the following (all should be performed as smoothly as possible):

• Lift one leg, bend it at the knee and then gently pull it down to the chest with your arms.
• Lie flat on your back. Bend the knees and place a weight between the feet (start at 10 pounds and then increase the weight and the number of repetitions as you become stronger). Holding the weight in place by squeezing the legs together, bend the knees until your heels touch the buttocks, then extend the legs.
• Yoga helps promote overall flexibility and alignment, positions like the forward bend, Warrior poses and Cow Face are beneficial for bow leg correction. You may want to use a yoga strap to bind the legs together.
• Pilates can also help with strengthening, especially muscles that affect the pelvis and back. Ballerina Arms and Roll-Up can be beneficial. You can also lie on the back and lift both legs; keep your legs together and quickly move them up and down. Next, lift the upper torso off the ground and tighten the abdominal muscles.
• Squats and lunges are helpful for hip flexors; if necessary, use a chair or counter to help you maintain your balance.

If, despite all your efforts, your bow legs do not improve significantly, you may want to consider surgery for bow legs correction. Called an osteotomy, this is a procedure performed in the hospital, requiring a couple of nights stay after the surgery. Contact an orthopedic surgeon for an assessment and recommendations.