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What causes bow legged? 6 possible conditions

What Is Bowlegs (Congenital Genu Varum)?

Bowlegs is a condition that causes your legs to appear bowed-out, meaning that your knees stay wide apart even when you stand with your ankles together. This condition is fairly common in infants because of their cramped positioning in the womb.

Typically, no treatment is necessary for bowlegs in infants. A child’s legs will begin to straighten when they start to walk, usually between the age of 12 and 18 months. In most cases, there are no lasting side effects from bowlegs.

However, bowlegs can sometimes be a sign of an underlying disease, such as Blount’s disease or rickets. You should contact a doctor if your child has bowlegs beyond the age of two.

In the long term, bowlegs can lead to arthritis in the knees and hips. Treatment options include braces, casts, or surgery to correct any bone abnormalities.

Bowlegs is also known as congenital genu varum.

Causes of Bowlegs

Many infants are born bowlegged due to their positioning in the womb. Usually, this is no cause for concern and the legs will begin to straighten out once the child becomes a toddler.

Some other causes for bowlegs include:

Blount’s Disease (Tibia Vara)

In Blount’s disease, the bones of a child’s shin develop abnormally, with a curve below the knees. As a child starts to walk, the bowing of the legs becomes worse. This condition may be apparent early on, but in some cases symptoms may not be noticeable until the child reaches adolescence. Over time, the bowlegs can lead to joint problems in the knees.

Blount’s disease is more common in females and among African Americans. Children who are obese are at greater risk, as are those who begin walking early. According to the Boston Children’s Hospital (BCH), a child should normally start walking on their own between 11 and 14 months of age. (BCH)

This disease is also called “tibia vara.”


Rickets is a condition resulting from prolonged vitamin D deficiency. This softens and weakens the bones, causing the legs to bow.

Paget’s Disease

This metabolic disease negatively affects the way your bones break down and rebuild. As a result, they do not rebuild as strongly as they should. Over time, this can lead to bowlegs and other joint problems. Paget’s disease is more common in older people and can be successfully managed with early diagnosis and treatment.


The most common form of dwarfism is caused by a condition known as achondroplasia. This is a bone growth disorder that can result in bowlegs over time.

Other Causes

Bowlegs can also be a result of:

  • bone fractures that have not healed properly
  • abnormally developed bones, or bone dysplasia
  • lead poisoning
  • fluoride poisoning

Recognizing the Symptoms of Bowlegs

This is a very recognizable condition. If you have bowlegs, your knees will not touch when you stand with your feet together and ankles. Bowed legs are symmetrical, appearing the same on both legs.

In most cases, bowlegs start to improve when a child reaches 12 to 18 months old. You should talk to your pediatrician if your child’s legs are still bowed beyond the age of two, or if the condition becomes worse.

Diagnosing Bowlegs

Bowed legs are easy to spot, but a doctor can tell you how severe the condition is, or whether it is caused by an underlying disease.

During your visit, your doctor will likely take your child’s leg measurements and observe him or her walking. Your doctor may also order an X-ray of the knees and blood tests to confirm diagnosis. Imaging tests can help your doctor view any bone abnormalities in the legs and knees, while blood tests can determine if bowlegs is caused by an underlying condition such as rickets or Paget’s disease.

Treatment of Bowlegs

Treatment is not usually recommended for infants and toddlers unless an underlying condition was identified. Treatment may be recommended if your case of bowlegs is extreme or getting worse, or if an accompanying condition is diagnosed. Treatment options include:

  • special shoes
  • braces
  • casts
  • surgery to correct bone deformities
  • treatment of diseases or conditions that cause bowlegs

Long-term bowing of the legs can lead to arthritis in the knees and hips.

Can Bowlegs Be Prevented?

There is no known prevention for bowlegs. In some cases, you may be able to prevent certain conditions that cause bowlegs. For example, you can prevent rickets by making sure your child receives sufficient vitamin D, both in their diet and from exposure to sunshine.

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See a list of possible causes in order from the most common to the least.



Rickets is a nutritional disorder that can develop if you do not get enough vitamin D, calcium, or phosphate. Rickets leads to poor functioning of a bone's growth plate (growing edge), softened and weakened bones...

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Achondroplasia is a bone growth disorder that causes disproportionate dwarfism. Dwarfism is defined as a condition of short stature as an adult. People with achondroplasia are short in stature with a normal sized tors...

Read more »



A fracture is a broken bone that typically occurs when a bone is impacted by more force or pressure than it can support. In an open fracture, the ends of the broken bone tear the skin.

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Bone Tumor

Bone tumors are masses of abnormal cells within the bone. Depending on the cause, these tumors may be malignant (cancerous) or benign (non cancerous).

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Paget's Disease of the Bone

A typical human skeleton consists of 206 bones. Bones are constantly being broken down and rebuilt. If this process is altered, bones can break down and re-form abnormally and in ways that compromise the integrity o...

Read more »


Brittle Bone Disease (Osteogenesis Imperfecta)

Learn about brittle bone disease and what causes it. Find information on the types, symptoms, and treatment options.

Read more »

This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.