Paediatrics, by video or in person
Bow Legs and Knock Knees in Children
The signs, the danger signs that mean hospital now, and how to see a doctor by video from anywhere in Nigeria.
Signs to look for
Bow Legs and Knock Knees in Children
- A gap between the knees when the ankles are together (bow legs)
- Knees that touch while the ankles stay apart (knock knees)
- Bowing that is getting worse after about two to three years of age
- Bowing or knock knee on one side only
- A child who is shorter than others of the same age
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Most babies and toddlers have bow legs, with a gap between the knees when the feet are together. This is how legs grow. Bow legs usually straighten by about two to three years of age. Many children then go through a stage of knock knees, where the knees touch and the ankles are apart, which is common between about three and five years and usually straightens by about eight or nine. Neither needs special shoes, splints or exercises. A few children have bowing or knock knees from a real problem. In Nigeria the commonest is rickets: soft bones from too little calcium or vitamin D. A study in Nigerian children found that low dietary calcium was the main problem, and that calcium, with or without vitamin D, healed rickets better than vitamin D alone. Rarer causes include Blount's disease, a growth problem at the top of the shin bone. A paediatrician can tell the difference with an examination and, if needed, an X-ray and blood tests.
Medically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Symptoms
- A gap between the knees when the ankles are together (bow legs)
- Knees that touch while the ankles stay apart (knock knees)
- Bowing that is getting worse after about two to three years of age
- Bowing or knock knee on one side only
- A child who is shorter than others of the same age
- Pain in the legs, a limp, or tiring quickly when walking
- Swollen wrists or ankles, late teeth or frequent fractures, which can point to rickets
When to See a Doctor
See a doctor if bow legs are still present or getting worse after about three years of age, if knock knees are getting worse after about eight, if only one leg is affected, if the curve is severe, or if your child is short for their age, limps or has leg pain. These need an examination and sometimes an X-ray and blood tests for rickets. A paediatrician by video can look at your child walking and standing on camera and tell you whether an in-person examination is needed. Take your child to a hospital the same day for a leg that is suddenly painful, swollen or hot, a child who will not stand or walk, or a fever with a painful limb.
Treatment options
- Watching and measuring for most children, because normal bow legs and knock knees straighten with growth
- No special shoes, splints, braces or exercises, which do not straighten normal legs
- Calcium and vitamin D treatment for rickets, at the dose a doctor sets, with a better diet
- Blood tests and an X-ray where rickets or another cause is suspected
- Referral to an orthopaedic surgeon for a curve that does not correct, or for Blount's disease
- Guided growth surgery or an operation to straighten the bone, only for the few children whose legs do not correct
What it costs on Mezo
Starting cash prices for the treatments used for this condition.
Common Questions
Are bow legs in babies normal?
Yes. Most babies and young toddlers have bowed legs. It is part of normal growth. The legs usually straighten by about two to three years without any treatment.
Will tying my baby's legs or massage straighten them?
No. Binding the legs, massage, special shoes and splints do not change how the bones grow. Normal legs straighten on their own; abnormal ones need a doctor.
How do I know if it is rickets?
Rickets is more likely if the bowing is getting worse after two or three years, if your child is short, has swollen wrists, late teeth or bone pain, or eats little milk, fish or other calcium-rich food. A doctor confirms it with blood tests and an X-ray of the wrist or knee.
Can rickets be treated?
Yes. Calcium and vitamin D, at the dose your doctor sets, heal the bones in most children over some months, and many curves then straighten. A few children with a severe curve need surgery later.
Need Help?
A children's doctor on a video call, who tells you whether your child needs to be examined in person.
See a paediatrician by videoIf any of the danger signs on this page applies, go to the nearest hospital now instead.
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Paediatrics in Lagos →Paediatrics in Abuja →Paediatrics in Port Harcourt →Paediatrics in Jos →Paediatrics in Ibadan →Sources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Bow Legs and Knock Knees in Children: Information for Parents. United Lincolnshire Hospitals NHS Trust. Patient information.
- Bowlegs and Knock-Knees. American Academy of Pediatrics (HealthyChildren.org). Patient information.
- Rickets and osteomalacia. NHS. Patient information.
- A comparison of calcium, vitamin D, or both for nutritional rickets in Nigerian children. New England Journal of Medicine 341(8), 1999. Peer-reviewed.
Links last checked 3 November 2026.
Medical Disclaimer: This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.