What Causes Knock Knees

If your knees touch while your ankles stay apart then you have a condition known as knock knees. Learning what causes knock knees will help you be able to better correct the problem.

This is an angular deformity of the knee that causes the knee to point inward. It’s part of a child’s normal development and growth to have knock knees. In fact, all children will have knock knees to some degree for a certain amount of time.

Newborns are knocked kneed due to the folded position they maintain while inside the womb of their mother. From 3 to the age of 4 knock knees in children usually isn’t that noticeable. However, when a child reaches 4 years old their knock knees tend to be more apparent.

Some children will find that they only have one knock knee (one leg is knock). Girls are much more likely to have knock knees compared to boys.

If a child’s knock knees doesn’t improve with age or if this leg deformity begins to develop later in a person’s life like when they reach adulthood then there could be a cause for concern.

Some adults will continue to have slight knock knees that usually doesn’t cause them any problems in their day to day life. However, if an adult has a severe knock knee problem then it needs to be corrected in order for them to live a normal and productive life. Some of the common methods for correcting knock knees include braces, excercises, orthotics, and surgery.

What Causes Knock Knees

A child will usually be knock kneed all the way up until they are 8 years old. However, if knock knee correction doesn’t happen on its own by the time the child is older than 8 then there could be an underlying cause such as:

Osteomyelitis: This is a bone infection that’s usually caused by certain bacteria, fungi, or germs.

Rickets: Rickets is often the cause of knock knees in children still developing. This is a condition that occurs when a child is lacking a sufficient amount of vitamin D in their body.

Vitamin D is essential because it helps absorb phosphorus and calcium, and without it bones will weaken and result in deformities like knock knees.

Mother’s breast feeding should be-careful giving their newborn only breast milk, as this can cause vitamin D deficiency. Breast milk from the mother will only provide so much vitamin D.

Genetics can play a role in who develops rickets or not. Treatment often involves replacing calcium, vitamin D, or phosphorus with supplements.

Rheumatic Conditions: Any condition that causes joint pain is considered to be rheumatic.

Osteochondroma: This condition causes deformity in a person’s bone development. This is caused by the development of a benign bone tumor that develops around the ends of the long bones.

Rheumatoid Disease: This condition causes inflammatory changes within the joints. The cause of this chronic disease is believed to be due to autoimmune mechanisms.

Renal Osteodystrophy: Renal Osteodystrophy is a bone disease that happens when your kidneys can’t maintain the right amount of phosphorus and calcium inside the blood.

People with kidney disease are most likely to develop this bone disease. Children with renal osteodystrophy will experience slow bone development, which leads to deformities like genu valgum.

If this condition isn’t treated it will cause your bones to become weak and thin. Treating this bone disease will often involve eating a healthy diet, exercising regularly, calcium supplements, and drugs such as cinacalcet hydrochloride.

Injured Shinbone: An injury to the shin bone can cause knock knees to develop, as growth/development is part of the responsibility of the shin bone.

Obesity: Some people believe that obesity is a direct knock knee cause, but this isn’t true. Obesity merely adds to the knock knee problem (making it worse/more severe), but it doesn’t cause it. Obesity causes the knock knee problem to become worse due to the excessive amount of force being placed on the knees.

Multiple Epiphyseal Dysplasia: This is a condition that causes abnormality in the cartilage and bone development around the ends of the long bones within the arms and legs.

People with this rare genetic condition are often diagnosed with it during their childhood. However, on some rare occasions this condition might not be diagnosed until a person reaches their adult years.

Genetics: Your genes can play a role in the development of knocked knees later in childhood or cause your knock knees to not improve at the right age.

Arthritis: Both osteoarthritis and rheumatoid arthritis have been known to cause knock knees in adults.


Sometimes it will require a doctor to examine your legs to figure out what’s causing you to be knock kneed in your adolescent or adult years.

When it comes to what causes knock knees the above are some of the numerous things that could be the underlying problem.

If you’re an knock kneed adult/or a parent concerned about your child then learning what could be causing the problem is your first step. To get a full list of different knock knee causes click here.


Knock Knee Braces That Help Correct Algus Valgus Naturally

Many people with algus valgus want to know more about knock knee braces.  Knock knees are very typical among young children but if you reach your teenage years or even adulthood it can become a serious problem. Not only can this problem cause complications like arthritis in the knee but it can also cause you a great deal of embarrassment if you don’t take care of it.

The Cause

In order to really treat this lower leg deformity you have to know what’s causing the problem this late in your life. By the time you reach eight years old you are supposed to outgrow this problem and it’s supposed to correct itself on its own. If this doesn’t happen then there is usually an underlying problem that is causing it to persist past the age it’s supposed to correct itself.

There are various causes of knock knees but the most common causes are other medical conditions like scurvy or Blount’s disease. These underlying conditions cause knock knees as a result of them not being treated properly.

Once again the problem with knock knees isn’t just the potential problems it can cause in a person, but also the embarrassment of the physical appearance of it. What’s worse, the longer a knock kneed adult takes to treat their problem it will only get worse be harder to correct properly.

Most people that contact us here are hoping that there is another option besides expensive and drastic surgical procedures that may not even correct the problem. One of these alternative options for treating bow legs and knock knees without surgery involves wearing knee braces.

Knock Knee Braces

knock knee braces

Knock knee braces can help but usually they won’t fully correct knock knees if the person is already at a certain age where their bones stop developing and growing.

The first thing you should do if you’re interested in knee braces for knock knees is to get consultation from a certified orthopedic surgeon or sports medicine doctor. If an orthopedic believes that braces will help your knock knee problem then they will suggest that you wear the braces at night while you’re sleeping to help realign you knees and lower leg properly.

The knee braces will help realign your knees into its proper position by pulling the knee upwards. The average knock knee brace will have to get attached to the shoes of the patient in order to help pull the knee upwards into its proper position.

Types of Knee Braces

The most popular kind of knee brace for knock knees are unloader braces. These knee braces unloads the stress that is being directed to the joint being affected.

The unloader knee brace will either be designed to unload the medial or lateral area of the knee. The medial being inner and the lateral being the exterior part of your knee.

It’s important to know that these type of knee braces can cost a lot of money, but some insurance companies will cover the cost so make sure you check with your health insurance company.

Most of the time these unloader braces will be used congruently with various exercises and other alternative methods to help make them more effective at knock knee correction.

Since there are various types of unloader braces out there you should always consult your doctor about which option will be the best for your specific condition.

How Does It Work

These knock knee braces will apply a degree of force in order to lessen the amount of pressure on the area of the knee that’s being affected, which will lead to less pain and gradually a more normal knee function.

There are some companies who produce these unloader knee braces that will allow you to give their braces a trial and if you don’t like it within a certain amount of time you won’t have to pay a dime. One of these companies offering a free trial on their knee braces can be found here.

What Knee Brace is Good for You?

The type of knee brace your doctor recommends that you wear will depend on the problem you’re dealing with. Unloader knee braces will be used to help with knock knee or bow legged deformities.

The main goal of these unloader or offloader braces is to decrease the uneven loading in the knee. Another type of braces often used to help correct knee problems are functional knee braces, which aim to help your knee stay stable after an injury.

Patellofemoral knee braces will help provide a smooth kneecap motion in patients suffering from knock knee deformity due to complications in the femur of the knee.

Check out this site for different braces that could help.

How to Use a Knee Brace Correctly

Always follow the directions provided by your health care provider in regards to your knee braces. Wear the brace at the times recommended (usually at night while you sleep), and make sure you clean it routinely with soap and water.

Always make sure you check your brace, especially if you’ve been wearing it for a while. You need to make sure there isn’t any severe wear and tear on the braces you’re using so they can be at their most effective potential.

The healthcare provider who recommended the braces for you to use will give you instructions on how to take care of your braces so that they remain in good condition and continue to provide you the best treatment for knock knees.

Potential Complications

There are definitely some adverse effects that come along with wearing knock knee braces. These braces aren’t for everyone so you have to keep an eye on how they make you feel when you first start wearing them.

From our experience some of the most common adverse effects of knee braces for knock knees and bow legs include:

  • Swelling or Pain in the Knee
  • Inflammation in the Knee
  • The knock knee or bow leg deformity seems to be getting worse instead of better


Knock knee braces are definitely a great investment for some people, but they don’t help every knock knee or bow legged patient.

Sometimes the leg deformity is so severe that knee braces won’t help much, but will help with providing a certain amount of relief from the pain and discomfort algus valgus and genu varum can cause.

Knock Knee Surgery and Bow Leg Surgery

Believe it or not knock knees are a common problem that many people experience in their lifetime. I know me personally used to be so self conscious about my knocked knee problem that it would make me not want to be around other people. Knock knee surgery is an option but it should be your last option when nothing else will work.

A lot of people don’t even realize they have a problem until they reach an older age and notice that everyone else around them have straight aligned legs. This deformity causes your knees to touch and your ankles to remain separated.

Your legs will turn inward and it can cause pain and discomfort along with embarrassment. This condition is normal among children under the age of 2. However, genu valgum as it is called in the medical field can affect some people all the way up into their adult years.

Knock kneed adults have options available to treat this problem such as exercises, braces, and specially designed inverted shoes. However, most adults with this problem turn to surgical procedures to correct knock knees.

Knock knee surgery is only an option if other alternatives don’t work. Usually other knock knee correction methods will help if the deformity is a mild case. However, if too severe alternative knock knee treatments will only help improve the appearance of this lower leg deformity not correct them.

Knock Knee Surgery

knock knee surgery

When other treatments for knock knees or bow legs aren’t effective surgical procedures are recommended (usually for severe cases). The name of the surgery used the most to treat knock knees and bow legs is osteotomy, which realigns the bones in your leg to the proper angle of the knee by adding or removing a small section of bone.

To really get a good idea of what this form of surgery is about it’s a good idea to learn more about the anatomy of the knee.

The goal of osteotomy is to help prevent/reduce the pain of osteoarthritis, slow down the wear and tear of the knee due to them knocking together, and preventing a knee replacement surgery which is much more serious.

Femor  Osteotomy (reshaping of the thigh bone)

The surgical procedure for knocked knees most often carried out is called femoral osteotomy, while high tibial osteotomy is more commonly performed for bow legged patients.

Femoral osteotomy will involve the surgeon operating around the lateral part of the femur and the leg to help straighten/realign the knees. This surgical procedure helps knock kneed patients because it relieves the wear on the lateral (exterior part) of the knees that this leg deformity often causes.

High Tibial Osteotomy or HTO (reshaping of the shin bone)

In HTO the surgeon will focus on the medial (inside) area of your knee to shift weight towards the lateral (outer) position of the knee, which will cause your leg to shift inward a little.

It’s pretty much like realigning a knee that’s bow legged to a more knock knee position. This form of osteotomy is commonly performed on bow legged patients because of the amount of wear they develop on the medial (interior part) of their knees.

A high tibial osteotomy involves removing a piece of bone from the exterior part of your knee so that your leg will bend inward. To give you a better description it’s kind of like realigning a bowlegged knee to a position that’s knock kneed. After the surgery is complete your weight will be moved to the lateral or exterior part of your knee.

During this surgery the doctor will put you under local anesthesia and then they’ll determine the right size of the bone they’ll end up taking out. In order to determine this they’ll use an X-ray or CT scan before beginning the operation.

Once everything is ready an incision will be made along the exterior of your knee right beneath the kneecap. At the top of your tibia plateau guide wires will be drilled in and then the tibea plateaue will be lowered on the exterior. The top of your tibia plateau will then be attached using screws or staples by the surgeon.

On the day of the surgery you will most likely be told not to consume any food or beverage so that you won’t vomit while you’re under the anesthesia.

Difference Between Knee Replacement and Osteotomy

The main difference between these forms of surgery is that an osteotomy will maintain/preserve the natural tissue around the knee and all the bones and ligaments such as the femur, tibia, and patella.

If you still want to be able to do certain activities like running, climbing, squatting, or be able to play the sports you love then an osteotomy is best. Meanwhile, a full knee replacement will replace all your bones and ligaments with prosthetic that take a longer time to recover from and makes it harder to return to a full range of motion in the knee.

Moreover, when a full knee replacement is performed it will high impact sports or activities are usually not possible with a full knee replacement since the natural tissues and ligaments in the knee will be removed and replaced with a prosthetic knee joint, while a full knee replacement removes everything.

Moreover, the typical prosthetic components used during a knee replacement will last around fifteen years before it needs to be replaced, which means another surgery.

Before Surgery

Prior to the surgery doctors may ask you to keep your legs cleaned to reduce the risk of infection.

If the osteotomy requires for a piece of bone to be inserted rather than taken out then either a synthetic bone will be used or a bone from the body of another person. Sometimes the bone needed to be inserted to complete the surgery will be taken from the pelvic bone of the patient.

Before the surgery the surgeon will most likely recommend that you quit taking certain medications that could counteract with the procedure.

You’ll also most likely be told to stop smoking a couple weeks before the beginning of the surgery. The reason smoking is not allowed is because the nicotine can help cause complications during or after the surgery.

Determining What Kind of Osteotomy Should be Performed

To determine what form of osteotomy needs to be performed whether for knock knees or bow legs the surgeon will take measurements of the alignment of your legs. These measurements will help the surgeon determine wither the femur (thigh bone) or the tibia (shin bone) needs to be operated on.

How severe your bowed legs or knocked knees are will determine the size of the piece of bone that needs to be removed or added should be to achieve the proper correction/realignment in the legs.


Recovering from an osteotomy can be tough, which is why doctors will keep you in the hospital and monitor you for a few days after the surgery is over.

The typical time frame for a person to begin walking again after this surgery without any help is around 3 months. Some patients don’t recover post surgery until 6 to 12 months later.

It’s best to keep the incision on your knee as dry as possible to help the recovery. After a month your doctor will ask you to come back in so an X-ray examination can be performed to see how well your bones are healing.

During the first week or two after the osteotomy you will most likely feel some discomfort, swelling, and/or pain. This is normal but if you feel that your pain or discomfort is too much for you to handle you should contact your doctor immediately.

Preventing Infections

While in the hospital nurses and doctors will advise you on effective ways to keep the wound clean and free of infection so that you can heal properly. To help decrease the chance of your knee swelling post surgery doctors will advise you to keep your legs elevated as much as possible.

Preventing Deep Vein Thrombosis

Ice packs and certain medical devices will be recommended to prevent severe swelling and other complications such as Deep Vein Thrombosis (DVT).


Ice is an important part of recovery as putting some on your knees for a half hour a couple to a few times daily can help with reducing the pain you’re experiencing. Try to keep your knee elevated as much as you can to help cope with pain you’re feeling, especially while you’re sleeping.


A machine called continuous passive motion is sometimes used while in the hospital to help with recovery.

This machine is used while you’re laying on your back to help your legs stay in the air and elevated, and to also move your leg from a straight to a bent position repeatedly.

This CPM machine helps with initializing range of motion in your knee and legs after the surgical procedure.

Pain Medications

Usually patients will be given pain medication to help with recovering from this surgical procedure. Doctors will tend to your knee by bandaging it and putting it on ice if necessary.

Encouraging Circulation

Doctors may also recommend that you move your feet around every now and then to help encourage circulation, which is a good thing.

Preventing Stiffness in the Knee

To help your joints in your knees from getting too stiff after the procedure you may be advised to do some simple motion exercises.


If you experience any feelings of fever don’t be scared because this is common after the procedure. Nurses will give you medications like acetaminophen to help you get through it.

Crutches, Braces, and Casts

A knee brace is sometimes used during the recovery of the surgery to help push your knee in the right position. In other cases the doctor may feel that putting your knee in a cast for a month or two is the best way to help it recover and realign the way it should.

Once the knee brace, cast, or crutches are no longer required (usually 2 to 6 weeks) you’ll then be advised to begin exercises to help regain your normal motion in your legs.


Some of these exercises include stretching, aerobic, and weight training exercises. All of these exercises main goal is to help your knee recover it’s strength and realign the way it should.

The goal of these exercises is to build up a little range of motion until you regain full movement in your legs, which can take up to 4 weeks.

Once you have progressed properly with the simple motion, stretching, and strength training exercises you’ll then start doing more intense exercises such as walking or running.

Working out the legs on an exercise bike or other exercises that will help make the legs stronger will be recommended.


Like with any surgical procedure there are some risks associated. Some of these risks include:

  • Allergic reactions
  • Problems with breathing
  • Excessive bleeding
  • Infections
  • Bones don’t heal properly
  • Blood clot inside the leg
  • Blood vessel or nerve gets damaged
  • Inflammation
  • Bones don’t align properly

These risks are some of the main reasons why people with this leg deformity want to know how to correct knock knees without surgery. However, surgical procedures may be your only option if your knock knees or bow legs are too severe.

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