LEG AXIS MALALIGNMENT (KNOCK KNEES AND BOW LEGS)
WHAT IS A LEG AXIS MALALIGNMENT?
Sometimes it only shows up in photos or on a closer look: the knees do not stand quite straight, but tilt slightly inwards or outwards.
In so-called knock knees (genu valgum), the knees are angled inwards ("knee-ing in"). The opposite is bow legs (genu varum), in which the knees point outwards ("knee-ing out").
What matters is the mechanical leg axis: ideally, it runs in a straight line from the hip through the knee to the ankle. In reality, however, many people have slight deviations, often without symptoms.
CAUSES OF LEG AXIS MALALIGNMENTS
In children
During growth, a certain "disorder" of the leg axis is completely normal. Development continues until about the age of 11. Many children initially have knock knees, which later correct themselves.
In adults
If knock knees or bow legs persist in adulthood, they are usually:
- genetic
- or the result of long-term incorrect loading
A muscle imbalance can "train in" the leg axis.
Typical examples:
- Football players often develop bow legs through heavy loading of the adductors
- Flat, pronated feet can encourage knock knees
SYMPTOMS OF A LEG AXIS MALALIGNMENT
A leg axis malalignment rarely causes acute pain. The problem develops gradually.
The load is distributed unevenly:
- with bow legs, the inner side of the knee is loaded more
- with knock knees, the outer side of the knee
This can lead to:
- knee osteoarthritis
- start-up pain
- pain under load
- sensitivity to the weather
in the long term.
In addition, the entire body statics can be affected:
- pelvic obliquity
- altered posture
- gait abnormalities
TREATMENT OF LEG AXIS MALALIGNMENTS
During growth
As long as growth is not complete, so-called growth guidance can help. Here, growth on one side of the knee is deliberately slowed to correct the axis.
In adulthood
Surgical correction (osteotomy) is rarely necessary and is only carried out in complex cases.
In most cases, functional therapy takes priority.
WHAT YOU CAN DO YOURSELF
1. Insoles: useful, but not always the solution
Orthopaedic insoles can help, especially for knock knees in combination with flat, pronated feet.
But important:
Insoles relieve load, but they do not replace the work of the muscles.
That is why the cause should always be treated too: muscular balance.
2. Choosing shoes for everyday life and sport
The right choice of shoes can make a big difference:
- neutral shoes
- or models with targeted support
With knock knees, support on the inner side of the foot can make sense. With bow legs, rather not.
At the KINEO Runners Lab, you can have your running and shoe mechanics professionally analysed.
3. Sport is allowed, but consciously
Training is not forbidden. On the contrary.
What matters is:
- do not ignore pain
- check your technique
- manage your load
A running analysis helps to recognise and correct incorrect loading early.
4. Can you train away knock knees or bow legs?
Partly yes, but not always completely.
With targeted training, you can:
- strengthen weak muscles
- release tense structures
- improve coordination and stability
This is called leg axis training.
But:
Genetically determined axes cannot be completely "trained away", but they can certainly be improved functionally.
5. A simple training rule
- with knock knees: strengthen the gluteal muscles and the outer side of the hip
- with bow legs: stretch and control the adductors (inner side of the thigh)
HOW KINEO PHYSIOTHERAPY CAN HELP YOU
A leg axis malalignment often develops silently. Only years later do pain or signs of wear appear.
When you have symptoms, we at KINEO do not only analyse the knee, but the entire musculoskeletal system.
Holistic analysis
With a dynamic gait analysis, we look at:
- foot strike
- knee alignment
- pelvic position
This lets us see where the load really arises.
Individual therapy
Based on this, we create:
- a targeted stretching and strengthening programme
- a functional home training programme
In addition, we use:
- manual therapy
- mobilisation techniques
- dry needling
Training & rehabilitation
In addition, we offer:
- Medical training therapy (MTT) in Zürich Wipkingen and Escher Wyss & Thalwil
- Coordination training with the SensoPro trainer
If an operation is necessary (osteotomy), we also accompany you through rehab.
FAQ: LEG AXIS MALALIGNMENT
1. Are knock knees or bow legs dangerous?
Not directly, but in the long term they can increase joint loading and lead to wear and tear.
2. Can I do sport with knock knees or bow legs?
Yes. What matters is not the axis itself, but whether pain or incorrect loading occurs.
3. Do insoles really help?
They can relieve load, but they do not replace active muscle training.
4. Can I correct my leg axis completely?
Only partly. Functional improvements are possible, structural (genetic) axes not completely.
5. When should I see a physiotherapist?
When pain, unsteadiness when walking or overuse symptoms occur, or for prevention before problems arise.
