Knock Knees
Knock knees, where a child’s knees angle inward and touch while the ankles remain apart, is one of the more visually noticeable developmental patterns parents notice as their child grows.
At Emerald Hill Podiatry, we assess it in the context of normal childhood development, since most cases are a passing phase, while keeping an eye out for the cases that benefit from closer monitoring or support.
What Are Knock Knees?
Knock knees, medically known as genu valgum, describes a leg alignment where the knees angle inward toward each other, so that when a child stands with their knees together, there’s a noticeable gap between the ankles. It’s a very common and typically normal part of leg development in young children, and in most cases straightens out gradually as the child grows.
The Typical Age Pattern in Children
Leg alignment naturally changes several times through childhood. Toddlers often start out slightly bow-legged, then shift into a knock-kneed pattern around ages two to four, which is usually at its most noticeable during this stage. From there, the legs generally continue to straighten, with most children’s alignment settling into an adult-like pattern by around age seven or eight. Because this progression is a normal part of development, mild to moderate knock knees at the typical age are rarely a cause for concern on their own.
How the Alignment Affects the Feet and Gait
When the knees angle inward, it changes how weight travels down through the legs and into the feet with each step. This can lead to:
- A tendency for the feet to roll inward (overpronate) to compensate for the knee alignment
- An altered, sometimes less efficient walking or running pattern
- Uneven wear on the inside edges of shoes
- In more pronounced cases, knee discomfort during or after activity as the joints compensate for the alignment
When to See a Podiatrist
See a podiatrist if:
The inward angle of the knees seems unusually pronounced for your child's age
One leg is noticeably more affected than the other
There's no improvement, or it appears to be worsening, as your child gets older
Your child complains of knee or leg pain, or seems to tire quickly during activity
You'd simply like reassurance about whether the pattern is following a normal course
Get Your Child's Knock Knees Properly Assessed
Supporting Balanced Alignment as the Legs Develop
Because most knock knees resolve naturally through growth, treatment focuses on monitoring, comfort, and support rather than correction in most cases.
Options include:
- Gait and Alignment Assessment — measures the degree of knee angling and evaluates how it's affecting your child's walking pattern and foot position
- Custom Orthotics — supports the feet where overpronation is developing as a result of the knee alignment, easing strain further up the leg
- Monitoring Through Growth — periodic review to confirm the alignment is following the expected pattern of improvement, or to flag if further assessment is needed
What to Expect at Your Assessment
Your podiatrist measures the alignment of your child’s knees and ankles, checks how it’s affecting foot position and gait, and compares this against the typical developmental pattern for their age. In most cases, this gives parents clear reassurance and a timeline for what to expect, with referral for further assessment if the pattern falls outside the norm.
