Knock knees, bowlegs, pigeon toes? Usually nothing to worry about!

Babies have to fold into a tight little ball as they develop in their mom’s womb, right? When they come out, and stretch and move those little arms and legs, we realize what a miracle it was that they ever fit inside! Their bodies are so used to being curled up that it takes a long time until their stature or shape resembles what we expect a kid to look like.

By Kate Land MD, Thriving Families, Kaiser Permanente June 27, 2019

It’s normal to watch young children transition from being bowlegged then knock-kneed on their way to standing in a straight posture. This process actually takes years.

Along the way, parents often worry and ask, “What’s normal?” Here’s the developmental path they usually take:

  •  Infants  and toddlers have legs that look bowlegged, toes that turn in, and feet that look flat.
  •  Young kids  often have in-turned or “knock” knees and out-turned feet.
  •  Teens  have straighter legs and feet, and visible arches in their feet. But even if their feet still look flat, it’s not usually something to worry about.

Let’s take a closer look at these stages.


Babies often have feet that look turned in (called intoeing). This appearance is usually normal. Remember – they were curled up in a ball inside their mother, and it takes months for their body to “straighten out.”

One form of intoeing at the front part of the foot is called metatarsus adductus and disappears by age one.

  • Gently stretching the foot can help reduce the intoeing.
  • Corrective shoes aren’t necessary.

Sometimes intoeing is caused by a slight rotation at your baby’s hip or lower leg – both of which they outgrow over time. Your pediatrician will examine your baby’s feet, knees, and hips at birth and at each checkup. Be sure to let them know if you’re concerned.


Children whose legs curve outwards at the knee are said to look bow legged. This often looks worse than it is. In little kids, their diapers increase the appearance of bowing, and they tend to walk with their legs slightly bent, which makes their knees look further apart.

If you’re concerned – show your pediatrician. They’ll likely have your child lie down and stretch out their legs to confirm how straight they actually are!

Knock knees

After those bowlegs get better, kids’ legs often start to appear curved out at the knees. Just like bowlegs, knock knees are something kids usually outgrow without treatment. No special braces are needed!

As they get older, their legs will reach the shape they’ll have as adults. And while some adults do have legs that are slightly knock kneed or bow legged, it’s not to a degree that needs any treatment or is at all limiting.

When should you worry? Definitely see a pediatrician if you notice the curves in your child’s legs aren’t getting better, have gotten worse, only affect one leg, or if they have pain.

Always feel comfortable asking us to look at your child’s legs or feet if you’re concerned!

About the Author
Kate Land MD is a pediatrician at Kaiser Permanente’s Vacaville Medical Center. She believes that, as parents, we each must find what works best for our families — without guilt or judgment of ourselves or others. Dr. Land believes that her three children have taught her about life’s joys and struggles. She has stated that as a mother and pediatrician blogger, “I want to share some of these lessons with other parents. There are many ways to raise children well and we can all learn from each other and enjoy the path together.” Dr. Land’s full biography can be found on My Doctor Online.

Source Thriving Families

  Further reading

Intoeing (Pigeon Toes, Femoral Anteversion, Tibial Torsion, Metatarsus Adductus), Gonzales AS, Mendez MD, StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. 2019 Jun 3. Full text

Foot and ankle history and clinical examination: A guide to everyday practice, Alazzawi S, Sukeik M, King D, Vemulapalli K. World J Orthop. 2017 Jan 18;8(1):21-29. doi: 10.5312/wjo.v8.i1.21. eCollection 2017 Jan 18. Review. Full text

Angular deformities of the lower limb in children, Espandar R, Mortazavi SM, Baghdadi T. Asian J Sports Med. 2010 Mar;1(1):46-53. Full text

Association of Soccer and Genu Varum in Adolescents, Asadi K, Mirbolook A, Heidarzadeh A, Mardani Kivi M, Emami Meybodi MK, Rouhi Rad M. Trauma Mon. 2015 May;20(2):e17184. doi: 10.5812/traumamon.17184. Epub 2015 May 25. Full text

Does soccer participation lead to genu varum? Witvrouw E, Danneels L, Thijs Y, Cambier D, Bellemans J. Knee Surg Sports Traumatol Arthrosc. 2009 Apr;17(4):422-7. doi: 10.1007/s00167-008-0710-z. Epub 2009 Jan 30.

Genu varum and genu valgum in children, Greene WB. Instr Course Lect. 1994;43:151-9. Review.

Also see
Analyzing a child’s gait: What’s normal and what’s worrisome Daily Herald
Bowlegs and Knock-Knees American Academy of Pediatrics
Bowlegged Baby: Common Occurrence or a Cause for Concern? Flo
Bowed Legs (Blount’s Disease) OrthoInfo
Bowed Legs & Knock Knees OrthoKids, Pediatric Orthopaedic Society of North America (POSNA)

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