Understanding Knock-Knees (Genu Valgum) in Children: A Comprehensive Approach with Khi Tam Health Hub

As a mother, observing every detail of your child's development, especially their walking and posture, is natural. When you notice your child's knees angling inward, touching when they stand with their feet slightly apart – a condition commonly known as "knock-knees" or medically as genu valgum – it can certainly cause concern. Many parents may also feel confused when a doctor diagnoses "completely normal" development, yet they observe "very severe knock-knees" in their child. 

At Khi Tam Health Hub, we deeply understand these concerns. While most cases of knock-knees in children are a normal part of development, we believe that a comprehensive and thorough assessment provides clarity and the best way forward for your child. 

Knock-Knees (Genu Valgum) in Children

The developmental journey of your child's legs: What's normal? 

It's important to remember that for many children, knock-knees are a temporary and natural phase of development: 

• Birth to 18 months: Many infants are born with slightly "bowed legs" (genu varum). 

• 2 to 5 years: This is the most common age for physiological genu valgum to become noticeable. Developing bones and strengthening muscles naturally lead to this inward knee alignment as children gain balance and improve their gait. 

• 5 to 7–8 years: In most cases, physiological genu valgum naturally corrects itself as children grow and their skeletal structure matures, typically around 7 or 8 years of age. If a previous doctor examined your child and concluded their development was "normal," this often refers to this typical developmental pattern. However, your persistent worry and perception of "severity" are valid reasons to seek a more detailed look. 

  
  

When to consider a deeper look: Important signs of a comprehensive issue. 

While often benign, when knock-knees begin to show signs of affecting the entire body, it requires a specialised assessment. At Khi Tam Health Hub, we pay particular attention to the following signs, which indicate that the genu valgum may have progressed to a pathological form or is causing related issues: 

• Severe knock-knees affecting spinal balance: When the degree of knee misalignment is significant, it can lead to changes in the alignment of the entire lower limb and impact the pelvis, resulting in spinal deviation (scoliosis). This is a very concerning sign that requires thorough examination. 

• Uneven shoulders and leg length discrepancy: Imbalances originating from the legs can propagate throughout the body. Uneven shoulders or a difference in leg length (one leg appearing shorter than the other) are clear indicators that the body is compensating for the misalignment in the legs and knees, leading to uneven pressure on joints and the spine. 

• Impact on gait, especially "V-shaped gait": If you observe an abnormal walking pattern in your child, such as the toes pointing outwards excessively when walking (a "V-shaped gait" often associated with flat feet combined with knock-knees), this indicates that the walking mechanism has been altered to adapt to the genu valgum. 

• Pain or functional difficulties: While your child may currently walk, run, and jump normally, any complaints of pain in their knees, hips, ankles, or noticeable limp are important warning signs. 

• Asymmetry: Even if the condition is severe on both sides, if one knee is significantly more "knocked" than the other, or if only one leg is affected, this is a clear sign of pathological genu valgum. 

• Underlying health factors: In some cases, pathological genu valgum can be linked to conditions such as severe vitamin D deficiency (rickets), metabolic bone diseases, or other systemic issues. Our comprehensive approach helps to identify or rule out such factors. 

  
  

Potential future health risks of unaddressed pathological genu valgum 

While physiological genu valgum usually resolves without long-term problems, severe or pathological knock-knees, especially when they already affect overall body balance, can lead to more serious complications later in life if left unaddressed: 

• Early onset arthritis: Uneven weight distribution across the knee joint (due to knock-knees) and other joints (like hips and spine due to compensation) will increase pressure on the cartilage, leading to premature wear and tear and early onset osteoarthritis in adulthood. 

• Chronic pain: Pain in the knees, hips, back, and feet can become chronic due to structural misalignment and uneven pressure on the joints. 

• Patellofemoral pain syndrome: Misalignment of the knee joint affects how the kneecap tracks, leading to pain around the kneecap. 

• Permanent deformity and limited mobility: If left uncorrected, the misalignment can become permanent, causing significant difficulty with walking, running, jumping, and participating in physical activities. 

• Psychological impact: Children may feel self-conscious about their gait and appearance, affecting their self-esteem and social interactions. 

  
  

Khi Tam Health Hub: Comprehensive health care package for children under 6 years old. 

At Khi Tam Health Hub, we are proud to introduce a special health and balance care package designed for children under 6 years old. With a deep understanding of the comprehensive impacts of genu valgum, we offer a personalised monitoring and support pathway, providing parents with complete peace of mind regarding their child's musculoskeletal development: 

• Regular specialised check-ups by Master Sridevi To Hai: Children will receive regular check-ups directly from Master Sridevi To Hai – our experienced specialist. She will thoroughly assess the child's musculoskeletal condition, balance, and overall gait (including "V-shaped gait" if present). This helps in early and comprehensive detection of related issues. 

• Guidance for parents on daily musculoskeletal care: Master Sridevi To Hai will diligently guide mothers on simple but effective methods and exercises to perform daily musculoskeletal care for their children at home. This empowers parents to actively accompany their child in their developmental journey and prevent complications. 

• Close and comprehensive monitoring until age 6: Khi Tam Health Hub will closely monitor the child's development with the family until they turn 6 years old. During this period, we focus on supporting the child's body to self-correct naturally through daily care instructions and regular check-ups. 

• Specialised gait training and leg realignment if necessary: If, after monitoring until age 6, the child's knock-knees do not show significant improvement, or if systemic signs (like spinal deviation, uneven shoulders) persist, we will move to a more intensive intervention phase. This includes specialised gait training and leg realignment through appropriate methods such as custom-made feet insoles or specific exercises to optimise leg and overall body alignment. 

  
  

Other services at Khi Tam Health Hub for comprehensive support: 

• Body balance assessment: We conduct thorough body balance assessments using advanced techniques to meticulously evaluate your child's overall postural alignment, weight distribution, and stability, with particular attention to the connection between knock-knees and other parts of the body like the spine and shoulders. 

• Gait training: For children requiring intervention, our expert therapists provide tailored gait training, including specific exercises to improve walking patterns, strengthen supportive muscles, and promote a more efficient and aligned gait, helping to reduce uneven pressure on joints. 

• Custom feet insoles: We offer custom feet insoles designed to provide proper arch support and evenly distribute pressure across your child's feet. These custom insoles can help optimize foot posture, which in turn can positively influence the alignment of the knees, hips, and even the spine. 

  
  

Your next step: A comprehensive consultation  

Seeking a second opinion and a comprehensive evaluation is entirely reasonable when you have persistent concerns about your child's health, especially when signs of whole-body involvement have appeared. 

At Khi Tam Health Hub, we are committed to providing you with: 

1. Expert assessment: A detailed examination by specialists trained in paediatric musculoskeletal health, with the direct involvement of Master Sridevi To Hai. 

2. Clear explanations: We will explain our findings in an easy-to-understand manner, discussing with you whether the genu valgum is physiological or requires further intervention, and especially its relationship with spinal, shoulder, and gait issues. 

3. Personalised action plan: Based on the assessment results, we will propose the most suitable care pathway for your child, from home care to specialised treatments if needed, with the goal of not only improving their legs but also restoring overall body balance. 

   
   

Don’t let worry linger. 

Contact Khi Tam Health Hub today for a comprehensive consultation and to start a holistic health care package for your child. We are here to empower you with knowledge and provide the dedicated support your child needs for healthy development and confident movement. 

Address: Flat 1, Khi Tam Therapy Bennet Court, 1 Bellevue, London, United Kingdom, SW17 7EG  

Phone: 073 79010998  

Email: booking@khitamtherapyuk.com  

Website: www.khitamtherapyuk.com  

References & further reading: 

• American Academy of Orthopaedic Surgeons (AAOS) – OrthoInfo: A reliable source for patient information on various musculoskeletal conditions. Search for "Knock-knees" or "Genu Valgum" for comprehensive overviews. 

• Children's Hospital of Philadelphia (CHOP): A leading paediatric institution with extensive information on developmental conditions. Search "Genu Valgum" on chop.edu. 

• Journal of Paediatric Orthopaedics: Professional journals often publish research on the natural history and management of genu valgum. For a general understanding, a basic web search for "Physiological Genu Valgum natural history" can yield accessible summaries. 

• National Institutes of Health (NIH): Provides access to various health topics and research. For more in-depth research, PubMed (pubmed.ncbi.nlm.nih.gov) can be searched using terms like "child genu valgum long term outcomes" or "pathological knock knees." 

Disclaimer: This article provides general information and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider for any health concerns or before making any decisions related to your child's health and treatment.