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Knock knees, or genu valgum, is a condition where a child’s knees bend inward, touching each other while their feet remain apart. This misalignment is common in young children, particularly between ages 2 and 4, and typically improves with growth.
While mild knock knees often resolve as children grow and their legs strengthen, some cases can persist into adulthood, potentially leading to lasting changes in posture and gait. It's important to understand typical childhood development to identify any issues early.
Infants: Knock knees are uncommon in infants, who typically have bowlegs (legs curving outward) until around age 2.
Toddlers: Mild knock knees often begin to appear between ages 2 and 4. If the inward knee tilt and pronation of the feet continue past age 4, it is advisable to consult a podiatrist.
Young Children: As children grow, their knee alignment typically straightens, reaching a neutral position by age 7.
Causes and Risk Factors of Knock Knees
Causes and Risk Factors of Knock Knees
Normal Development: Knock knees often occur as part of natural development in toddlers, with alignment usually improving over time.
Nutritional Deficiencies: A lack of nutrients like vitamin D or calcium can impact bone growth, potentially causing conditions like rickets, which can lead to knock knees.
Medical Conditions: Skeletal dysplasia (rare genetic disorders affecting bone development) may result in knock knees.
Obesity: Extra weight places stress on the knee joints, potentially contributing to misalignment.
Leg Length Discrepancy: A difference in leg length can lead to uneven posture and misalignment of the knees.
Flat Feet: Flat feet can alter the alignment of the legs, potentially contributing to knock knees.
Hypermobility: Excessive joint flexibility may increase the risk of knee misalignment, including the development of knock knees.
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Signs and Symptoms of Knock Knees
Signs and Symptoms of Knock Knees
Inward Knee Position: The most noticeable symptom is the inward angle of the knees (“X-shaped) when standing, with the feet positioned apart.
Knee Pain: Some children with knock knees may experience pain or discomfort in their knees, especially with physical activity.
Limping: In some instances, the misalignment can cause the child to limp while walking.
Uneven Gait: The knee position can lead to an uneven walking pattern, affecting balance and posture.
Irregular Shoe Wear: Children with knock knees may experience uneven shoe wear, particularly on the inner part of the sole.
Treatment and Management of Knock Knees:
Treatment and Management of Knock Knees:
Physical Therapy: Strengthening exercises for the knees, legs, and hips can improve alignment and alleviate discomfort. Stretching exercises can also help if tight muscles contribute to misalignment.
Orthotic Devices: Customized insoles, ankle-foot orthoses, or supramalleolar orthoses can support the foot and improve lower limb alignment, especially when flat feet are involved.
Supportive Footwear: Shoes with proper support and cushioning help reduce knee strain and increase comfort.
Knee Orthoses: In severe or persistent cases, knee braces may be used to help realign the knees.
Addressing Underlying Conditions: Treating conditions like nutritional deficiencies or skeletal dysplasia is crucial to prevent further misalignment.
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