What Are Knock Knees
Knock knees are legs that curve inward at the knee, often preventing the ankles from coming together without shifting one knee in front of the other. In order to understand knock knees, also called genu valgum, it is important to first understand normal alignment of the legs. In the normal situation, when standing, the hips, knees and ankles all fall on a straight line. In other words, when you draw a line from the hip to the ankle, that line passes directly through the center of the knee. If that line passes to the outside of the knee , this is called knock knees . If that line passes to the inside of the knee , this is called bowlegs .
The International Center for Limb Lengthening has taken care of many adults and children with knock knees. Many toddlers have knock knees that will correct on their own during their elementary school years if they do not, surgical correction may be deemed necessary. In adults, knock knees do not resolve spontaneously, but rather tend to worsen as arthritis leads to further malalignment. Knock knees in adults are an independent risk factor for knee joint degeneration and pain. It has been demonstrated that correction of knock knees prior to the onset of end stage arthritis can delay or prevent the need for total knee replacement.
What Causes Knees To Bend Inward
There are many reasons why someone might have knee valgus, but its important to note that the condition is much more common among children. In fact, the NHS reports that many children under the age of 4 have knock knees.
More often than not, knee valgus disappears on its own by the age of about 7. However, the condition can be caused by many different underlying issues in children. These include:
- Rickets A condition in children that leads to weak bone formation. It can be caused by vitamin D deficiencies, kidney disease, tumors, genetics, or malabsorption problems.
- Injury Serious injuries that affect the knees or leg bones could cause problems for growing children.
- Genetics Some people are genetically predisposed to have bone or joint development issues.
- Obesity Excessive pressure on the joints from obesity can cause issues with knee formation.
In adults, other causes are more likely. These include:
- Rheumatoid arthritis An autoimmune form of arthritis that often causes joint pain and swelling.
- Osteoarthritis The most commonly diagnosed form of arthritis. Its often considered to be the result of wear and tear and is more common with age.
- Pediatric Orthopedic Issues Unresolved or chronic orthopedic issues that crop up in childhood can lead to knock knees later in life.
That being said, especially in children and teens, knee valgus can be idiopathic. This means that the condition has no known cause and that it developed naturally on its own.
Is Knock Knee Surgery Possible For Someone In Their Late Twenties
There is no fixed age limit for corrective surgery for knock knees. The surgical technique used may vary depending on age. Children can take advantage of their remaining growth to guide the bones straighter with minor surgery. Adults can benefit from osteotomy surgery on the knee to obtain a correction. Patients over sixty years of age may receive a different type of osteotomy than younger patients to ensure timely healing. Older patients with arthritis will often receive a knee replacement to treat both problems. It is important to consult with a physician to determine the best course of treatment.
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Symptoms Of Knock Knees
If someone with knock knees stands with their knees together, their lower legs will be spread out so their feet and ankles are further apart than normal.
A small distance between the ankles is normal, but in people with knock knees this gap can be up to 8cm or more.
Knock knees don’t usually cause any other problems, although a few severe cases may cause knee pain, a limp or difficulty walking.
Knock knees that don’t improve on their own can also place your knees under extra pressure, which may increase your risk of developing arthritis.
Cstrengthening Of The Quadriceps
If the thigh muscles are weak, they will have a difficult time stabilizing the knee in the neutral position.
Straight Leg Raise
- Lie down on your back.
- Lock your knee by flattening it onto the floor.
- Make sure you can feel your quadriceps muscles engaging.
- Lift your locked leg up/down.
- Repeat 30 times.
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Knock Knee Correction Shoes
There are also knock knee correction shoes that help fix your gait and align your knees properly so that any pressure or strain on the joints due to your knocked knee can be relieved.
You also have orthotics, which are corrective orthopedic inserts that can be inserted into any shoe and help relieve excess pressure on your knees, ankles, and feet.
For those who want to know how to fix knock knees without surgery, you may not be able to completely get rid of a child or an adults genu valgum by wearing corrective shoes or inserts but at the very least you can drastically improve the way you walk and reduce the pain due to your knock knees.
The best type of corrective shoes for knock knees will have great arch support so that your feet have a better chance at being properly aligned while you wear them.
Also, optimal ankle support is important so you can control the alignment of your heel and lower leg. Youll also want to make sure the shoe has enough space on the inside so that you can insert an orthotic if you need added knee alignment effectiveness.
How Is Knock Knees Diagnosed
On physical appearance, with the patient standing upright, the knees touch each other, but there is a wide space between the ankles. The best way to diagnose knock knees is by taking a standing X-ray, and drawing the straight line on the image from the hip to the ankle. If that line passes to the outside of the knee, there is genu valgum present. Additional diagnostic lines can be drawn to determine if the source of the angular deviation is coming from the femur or the tibia .
When looking at childrens X-rays, we also pay attention to the quality of the bone and the width of the growth plates. Children with nutritional vitamin D deficiency, vitamin D-resistant rickets , or with kidney failure, for example, have widened, irregular growth plates and can present with genu valgum. In children where vitamin D deficiency, vitamin D-resistant rickets, or kidney failure are suspected as the cause of knock knees, additional blood tests can be done to specifically look for those issues.
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How We Care For Knock Knees At Boston Childrens Hospital
As a national and international orthopedics referral center, our Orthopedic Center has vast experience managing all aspects of knock knees. Our Lower Extremity Program offers comprehensive assessment, diagnosis, and treatment for children and young adults with conditions affecting their lower limbs. We have extensive experience treating disorders of the feet, ankles, knees, legs, and hips. Whether the patient is an infant, child, or adolescent, our goal is to help our patients live full, independent lives.
How Is Genu Valgum Treated
Treatment for genu valgum depends on the cause and severity of your symptoms.
For example, if rickets are causing your knock-knees, your doctor will likely prescribe vitamin D and calcium supplements to help restore your levels.
Your doctor may also prescribe prescription-strength nonsteroidal anti-inflammatory drugs if over-the-counter options, like naproxen , arent providing relief.
A typical treatment plan will include one or more of the following:
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Next Steps And What You Need To Know
Patients must keep in mind that undergoing multiple surgeries to yield desired results and reach their body goals is a realistic possibility. Because each patients experience with lipedema is unique, treatment and recovery time will vary from individual to individual. Also, optimal treatment trajectory is contingent on the stage of a lipedema patients knock knees disorder. To learn more about knock knees and discover a viable, life-changing treatment option for you, please contact our Total Lipedema Care office to schedule a personal consultation with Dr. Schwartz. Expect a full medical evaluation and health history discussion to best assess your customized treatment plan that will ensure successful lipedema management and potential reversal of knock knees.
To learn more, please contact our Beverly Hills, California office to schedule a consultation with any of our highly trained specialists.
How To Fix Knock Knees Without Surgery Best Exercises To Correct Knock Knees
Learning how to fix knock knees without surgery is something many people struggle with. This condition which is also sometimes called genu valgum occurs when the legs point inwards and start to knock against each other while you walk or stand up straight.
This alignment problem in the knee will keep your knees knocking against each other until a knock knee correction occurs.
Even though it isnt life threatening, the constant knocking of the knees can eventually cause a lot of pain, damage, and degeneration around the joints.
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Symptoms For Knock Knee In Adults
Knock knees in adults will usually display much more serious symptoms because the misalignment of the legs and knees is severe. If youre an adult and notice one or more of these symptoms listed below you should definitely begin looking into different treatments for knock knees:
- You have a limp when you try to walk or difficulty walking.
- You have moderate to severe knee pain or pain in your hip area.
- You have an almost lopsided or crooked appearance with your legs when you stand.
- You feel moderate to severe soreness in your joints to the point you feel stiff.
If you notice one or more of these symptoms listed above its time to consider your options for knock knee treatment.
Exercises To Help Knock Knees
To help fix the knock knees muscle imbalance, it’s important to strengthen the gluteal and quad muscles and stretch your IT band. These exercises can all help your patella move in a more normal pattern, says Kaiser Permanente.
Perform the following exercises to help knock knees twice a day. If any exercise increases your pain, stop and talk to your doctor.
âMove 1: Bridgesâ
âMove 2: Clamshellsâ
âMove 3: Wall Squatâ
âMove 4: IT Band Stretchâ
âMove 5: Toe Towel Scrunchingâ
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What Causes Knock Knees In Adulthood
The most common cause for knock knees in adults is usually an underlying condition such as:
- Genetics.
- The pelvic muscles.
All of these muscles work together to keep your knees stabilized and aligned properly.
However, if you want to fix your knock-kneed appearance the main muscles you need to focus on strengthening are your hip abductors, hip adductors, and hip flexors.
If these muscles become too weak or tight over time they can lead to a misalignment of the knee by causing your femur to rotate inward.
What Causes Pathological Knock Knees
Pathological knock knees can occur in some neurological conditions, such as cerebral palsy or spina bifida, as a result of the altered muscle pull on the bones.
So pathological knock knees may be one of the early signs of an underlying disorder. Bone diseases resulting from poor mineralisation, such as rickets, may present through large knee angles during childhood. When pathological knock knees are seen in combination with short stature and other bone and joint misalignment, a skeletal dysplasia or metabolic bone disorder may be the cause.
Obesity during adolescence is also associated with more severe knock knees, and is more commonly seen in children with flat feet and those with hypermobile joints.
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What Is The Outlook For Genu Valgum
In the vast majority of cases, parents can expect that a childs genu valgum will resolve by age 8.
For older children and adults with genu valgum, a course of physical therapy and exercises can help realign their knees. It can also strengthen surrounding muscles and avoid stress damage to other joints.
If these efforts arent successful, surgery may be performed to realign your knees.
In time, untreated knee misalignment can cause pain and problems in functioning. One
What Impact Do Knock Knees Have On The Knees Hips And Ankles
Knock knees can cause the kneecaps to be off-center, which increases pressure and pain in the front of the knee. Knock knee alignment places high stresses on the outside of the knee, causing additional knee pain. These stresses often lead to . Abnormal hip rotation is often associated with knock knees and can cause hip pain. This needs to be recognized and addressed with any corrective surgery for the knock knees. The ankles may struggle to keep the foot flat on the ground. The ankle and foot will need to compensate to make up for misalignment at the knee, often leading to ankle pain.
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What Is Knee Valgus
Knee valgus is a condition where the legs curve inward toward the middle of the body. They shift inward at the knee, causing both knees to touch, even when the feet are far apart.
Knock knees are the opposite of bowlegs . With bowlegs, the legs bend outward at the knee so that the knees dont touch .
The Knock Knee Correction Procedure
Osteotomy is performed under general anesthesia. During the procedure, Dr. Assayag will remove a thin wedge of bone from either the femur or tibia. This decision regarding which bone to target is based on x-ray findings that identify where the deformity is. After the cut is made, Dr. Assayag will realign the bones and use plates and screws to anchor the bones in their new position.
There are two primary types of osteotomy. In one type, Dr. Assayag removes a wedge of bone and fills the gap with a bone graft. The graft is secured with a place and screws while it heals. In the other type of osteotomy, Dr. Assayag removes a wedge of bone and brings the remaining edges together. They are fixed in place with metal hardware.
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How To Fix Knock Knees
Many parents wonder how to fix knock knees or bow legs, but if your child has one of these conditions theres no need to worry about. Just keep things under control.
Only if the situation doesnt improve or tends to get worse with growth, it is better to see a specialist.
Knock Knees also called valgus knee, is a condition when the knees touch each other and the ankles are widely separated. On the contrary, bow legs or varus deformity is when the knees are separated from one another and the ankles are close together. Both attitudes can be considered normal only at certain stages of a childs life
When should we worry?
The direction of childrens legs varies a lot until adolescence. During gestation the position of the fetus is curled up and this explains why the knees are physiologically varus at birth. Around 18-20 months the knees often become knocked.
This process continues up to 5 years, when the knees tend to realign. Around 10-11 years, they take the final position that will persists in adulthood.
However, there may be cases in which Knock Knees and Bow Legs do not correct themselves with growth, but they may worsen, instead.
Bow Legs that worsens in the first 20 months of life could indicate an underlying disease.
Anyway also the childs weight can determine this condition: a chubby baby, who starts walking early, around 9-10 months, is often bow legged because his/her weight, burden on the knees and pushes them outwards.
What causes Knock Knees and Bow Legs?
When To Get Medical Advice
Knock knees in children aren’t usually a cause for concern and should improve as your child gets older.
However, visit your GP if:
- the gap between the ankles is greater than 8cm while standing with the knees together
- there’s a big difference between the angle of the lower legs when standing compared with the upper legs
- the problem seems to be getting worse
- a child under the age of 2 or over the age of 7 has knock knees
- only one leg is affected
- there are other symptoms, such as knee pain or difficulty walking
- you have any other concerns about the way your child stands or walks
- you develop knock knees in adulthood
Your GP will examine your or your child’s legs, ask about any pain or walking difficulties, and may take some measurements.
They may refer you to an orthopaedic surgeon and arrange an X-ray of your legs and blood tests to check for underlying problems.
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