Yes, bow legs (genu varum) in adults often worsen with age because the uneven load on the knee joint accelerates cartilage wear and can lead to osteoarthritis, causing increased bowing and pain over time, though treatment can help manage symptoms and slow progression. While mild bowing in children usually corrects itself, persistent or worsening bowing in adults results from underlying issues like bone degeneration, not natural straightening, and can become more pronounced due to age-related changes and increased stress on the joint.
As people with bow legs begin to age, the abnormal stresses on the cartilage will lead to joint breakdown and painful arthritis. Pain on the inside of the knee is usually a sign of the cartilage taking most of the stress. Pain on the outside of the knee may be indicative of where the ligaments are being stretched out.
Exercise, stretching, strengthening, physical therapy, and vitamins will make your muscles and bones stronger but will not change the shape of the bones. The only way to truly change the shape of the legs is to cut the bone and straighten it. This is called an osteotomy and is an enduring, structural alteration.
Adults and Bowlegs
In adults, bowlegs do not resolve spontaneously, but rather tend to worsen as arthritis leads to further malalignment. Bowlegs in adults is an independent risk factor for knee joint degeneration and pain.
If your child has bowlegs along with any of the following symptoms, they may have a more serious condition: Bowlegs that continue to get worse after the age of 2. Asymmetric appearance of the bowing. Limp when walking.
Non-Surgical Treatments for Bowlegs
Weight Management – Reducing excess body weight to minimize joint stress and prevent the worsening of the condition. Low-Impact Exercises – Activities such as swimming or cycling can help strengthen leg muscles without excessive joint strain.
Rickets is a bone disease in children that causes bowed legs and other bone deformities. Children with rickets do not get enough calcium, phosphorus, or Vitamin D — all of which are important for healthy growing bones.
If left untreated, people who are bowlegged may experience pain, increased deformity, knee instability and progressive knee degeneration (arthritis). Correction of the deformity leads to improved knee mechanics, better walking, less pain, and prevents the rapid progression of damage to the knee.
The causes of bow legs are varied and include: Genetic factors, where children may inherit the condition from their parents. Environmental factors, such as nutritional deficiencies during childhood, particularly lacking vitamin D and calcium. Obesity in children, which can increase stress on the knees and legs.
Wearing braces minimizes pressure on your knee joint and straightens your knee, fixing bow legs in adults.
As your baby starts walking, their legs should start to straighten out. This typically occurs between the ages of 11 and 18 months. In most cases, the condition isn't serious and there aren't any lasting side effects. If your child's legs haven't straightened by age 2, call their healthcare provider.
In individuals with bow legs, the outward tilt of the shinbone at the knee occurs even as the thigh bone remains straight. This alignment leads to tightened adductor muscles along the inner thigh and weakened abductor muscles on the outer thigh.
High-impact exercises such as running, soccer, basketball, and tennis can place excess pressure on the joints and ligaments. For this reason, they're generally not recommended for people with bowlegs, who already have a higher risk of developing joint and ligament injuries.
Stages of knee osteoarthritis
The #1 mistake making bad knees worse is excessive rest and a sedentary lifestyle, leading to weaker supporting muscles, stiffness, and a vicious cycle of more pain; instead, gentle, consistent movement (like walking, swimming) is crucial to strengthen the joint and improve function, though it must be balanced with avoiding activities that cause sharp pain. Other major errors include ignoring pain signals, carrying excess weight, wearing unsupportive shoes, and poor movement patterns, says Parkside Sports Physiotherapy and Coastal Empire Orthopedics.
The legs usually straighten by age 7 or 8. Rarely, bow legs can be caused by a more serious medical condition, such as: rickets, a bone growth problem due to lack of vitamin D or calcium. It's more common in developing countries where children don't get enough foods fortified with vitamin D.
2. Suggested Exercises for Bowed Legs
By your 40s and 50s, your knees start showing the effects of years of use. Old injuries, daily stress and early cartilage breakdown can lead to soreness and stiffness – even if you haven't had a recent injury. “As cartilage wears down, knees become less cushioned and more prone to pain and swelling,” says Dr.
Bow legs are characterized by the outward curvature of the legs at the knees, which can alter biomechanics, joint health, and overall athletic performance. Although bow legs can present unique challenges, many professional athletes have not only adapted but thrived with this condition.
For children under 2 years of age, bowed legs are normal. Doctors call this type of bowed legs physiologic genu varum. Around 18 months, the bowing should gradually improve. Around ages 3 to 4, the child's legs should have a normal appearance.
Complications of untreated bow legs include: Difficulty walking and running. Deformities, such as a difference in leg lengths if only one leg is bowed. Higher risk of arthritis later in life.
Bowleg deformity is more than an issue of appearance. It can also cause knee and hip pain; limited mobility, particularly in the hips; difficulty walking or running; or instability in the knees. The symptoms may get worse as the patient grows. Knee arthritis is common in adults with bowleg deformities.
Bowlegs are usually easy to see, but most cases self-correct by age 3. If your child still shows any of the following symptoms after age 3, please see your pediatrician: Bowed legs that continue or worsen after age 3. Knees that do not touch when the child is standing with feet and ankles touching.
Early-walkers. A child walking before 11 months can increase the risk for Blount's disease and, consequently, bow legs. Childhood obesity. Excessive weight can place pressure on the joints, resulting in conditions that lead to bow legs.