Bowed Legs – Another Knee Issue

February 27, 2011 at 9:32 pm 22 comments


Normal - Bow - Knock

Though I’ve written much about knock knees and a little bit about normal knee alignment, I have yet to address bowed legs.  It’s time!

True bow legged-ness comes from malformed femurs and tibias that arc laterally.  It is normal for babies to have bowed legs before the bones ossify and are still cartiligenous.  Eventually, the knees knock a bit and then straighten out remaining slightly knock kneed in normal knees with the femurs tilting inwards/medially.

But what about true bow legs.  They could come from rickets or Blount’s disease, but if you don’t have these diseases and still have bowed legs…what is it from and how can you “correct” them or strengthen so that they don’t become painful, arthritic, etc.?

Well, it seems that healthy people with bowed legs get it from activities that demand the bones to grow outwardly like horse-riding/jockey .  Some people don’t ride horses but still have bowed legs.  Often times, people who press back in their knees while standing in their youth develop imbalances that can cause a bit of bowing of the bone.  Also, habitual patterns cause legs to look bowed, but may actually not be bowed.

As an adult we need to look at the alignment of our knee caps to our feet.  Just as I wrote in  the previous article Knock Knees and Pilates, the middle of the knee cap ought to align with the middle of the foot (2nd toe joint and center of ankle).  When I used to think I was bow legged, I was really pressing back in my knee caps, nearly hyper-extending and rotating in wards/medially.  My inner thighs were rather weak and my external rotators were tight and over-worked.  With much imbalance, I do believe I was rotating inwardly in order to fight the pull of my external rotators wishing to rotate my knee cap outward because of my weak adductors.

And that seems to be the “going” thought about bowed legs that are not from disease or horseback riding:  weak adductors.

Wait a minute!  Wasn’t that the issue with knock knees?  And other normal knees?  Yes, yes, indeed.  The issue with human knees, in general, is weak adductors.  Weak inner thighs and mis-alignment from imbalances and lack of awareness.

We all need stronger adductors.  Even with strong ones, that doesn’t mean that you’ll correct your seemingly or slightly bowed legs.  There are 2 issues connected to this:

1 – Balance
It’s about balance…and…those gemelli and obturators that I wrote about in One more tidbit about knees…all knees…. You must make sure you or your client is not pressing back into the knee joint, but is stacking bones and stabilizing them them with well balanced strength of muscles and healthy ligaments and tendons.  Both knee caps and feet facing straight forward and proper support/engagement from gemelli and obturators, adductors…and balanced quadriceps, hamstrings, glutes…and more.

2 – Development
If you actually have bowed femurs and tibias, you cannot correct the bow of the bone once your bones have calcified (when you’ve stopped growing).  All corresponding muscles and other bones have developed in ways to manage this bow.  Strengthening and restoring balance to the muscles and some alignment will never straighten the bones, but will help support the knees (hips, ankles and feet, too) so that the bowing doesn’t create problems in the future.  What sort of problems?  Arthritis, mainly.

Now, that’s just a start on bowed legs.  Will you please ask me questions about it so I can know what you need and then provide?

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22 Comments Add your own

  • 1. Pro Blogger News  |  February 28, 2011 at 3:49 am

    Bowed Legs Another Knee Issue…

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  • 2. sandi  |  March 13, 2011 at 10:20 pm

    for the most part, will people with knee issues (knocked or bowed) need to be slightly externally rotated to maintain a heel and midline connection? what about running on the reformer for someone who is bow legged? Would you externally rotate in that exercise or do parallel hip width?

  • [...] Bowed Legs – Another Knee Issue2011/02/27 [...]

  • [...] Bowed Legs – Another Knee Issue2011/02/27 [...]

  • 5. The Vertical Workshop's Pilates Teacher Blog  |  December 6, 2012 at 10:22 pm

    [...] Bowed Legs – Another Knee Issue2011/02/27 [...]

  • 6. how to fix bow legged | Bow LeggedBow Legged  |  June 18, 2013 at 12:48 am

    […] Bowed Legs – Another Knee Issue | The Vertical Workshop's Pilates … what about true bow legs. They could come from rickets or Blount's disease, but if you don't have these diseases and still have bowed legs…what is it from and how can you “correct” them or strengthen so that they don't … […]

  • 7. sophia  |  August 3, 2013 at 10:44 pm

    I have slightly bowed lower legs but unfortunately, since I am fully grown( 37), there is nothing much I can do to change the appearance of my legs. If you look straight at me, my lower body looks odd and the line that should be vertical in a normal lower leg, where the ankle meets the tibia, is not straight. I believe I did not get enough vitamin d and calcium growing up. Also, I think the strain of having abnormally distributed standing weight contributes to the calf muscles working overtime, causing them to be bigger permanently. This can look odd on someone who is otherwise thin. I have not worn dresses or shorts in 19 years now because of how funny my legs look.

    • 8. theverticalworkshop  |  August 6, 2013 at 10:01 pm


      Thank you for reading this article and writing a comment.

      Of course, it’s your own opinion of yourself that your legs look “funny”. No one else will find them funny or offensive. I encourage you to wear what you’d like and know that if other people have issues with your legs…they have issues with themselves.

      Nearly everyone has some sort of “disfigurement”. Our opinions of ourselves are very powerful.

      I wish you all of the best! Continue to strengthen yourself in body and mind!
      – Shari

  • 9. alex  |  August 10, 2013 at 1:39 pm

    Okay my doctor said my knees are aligned normaly but i still have a gap between my knees how can i trength my inner abductors/thigh to pull them together im 16yrs old

    • 10. theverticalworkshop  |  August 11, 2013 at 10:26 am

      Thank you for reading this article.
      Indeed, you can strengthen your adductors/inner thighs and your quadratus femoris, obturators and gemelli.
      What exercise do you currently do? Maybe I can assist you with what you already do. Or I can guide you to some good exercises.
      – Shari

      • 11. alex  |  August 11, 2013 at 11:15 am

        Currently i dont do any because i dont know what do. Will these exercises bring my gap together?

      • 12. theverticalworkshop  |  August 14, 2013 at 5:24 pm


        I must suggest that you do some sort of exercise. I could recommend Pilates exercises…but it wouldn’t really work to do separate exercises to spot train. A full-body exercise is what you need. Something that has great variation. My greatest suggestion is to swim. I say this because it is extremely full body and there are so many strokes. In the effort of keeping your legs along a center-line as you kick legs, your inner thighs/adductors will strengthen and your deep external rotators of your thighs (obturators, gemelli and quadratus femoris) will strengthen. These will help. Also…Breast stroke will be amazing for it because of the outward to inward action of your legs. It’s amazing exercise.

        Pilates is spectacular but is not always easy to find or afford. What city do you live in? I can recommend a good studio/teacher for you. And if studio work is not an option, I will recommend books and videos for you.

        All the best,
        – Shari

      • 13. alex  |  August 14, 2013 at 6:49 pm

        I weight train squats calf raises leg press everything you can think of but I cant seem to connect my legs theres always a gap and in citrus heights

      • 14. theverticalworkshop  |  August 15, 2013 at 3:39 pm

        Alex, maybe there was an “autocorrect” in what you wrote, but I don’t know what “citrus heights” is. Can you explain.
        To “close the gap” or strengthen to adjust your bowed legs, you need to do adductor/inner thigh exercises. And exercises that strengthen your quadratus femoris, gemelli and obturators.

        For adductors, at most gyms, there are weight machines you sit on and hug your thighs toward each other. You can tie a middle strength stretchy theraband (elastic band) around a stable object (weight machine or weight bench…or something that is so grounded it absolutely will not break free) and wrap it around your ankle of one leg. Standing strongly, you pull that leg to the other leg working against the tension.

        Here are some reasonable exercises to stretch and strengthen your adductors:

        for those other muscles (quad fem, obturators and gemelli)…working with rotating discs is helpful. Do you know about those?

        – Shari

      • 15. alex  |  August 12, 2013 at 7:56 pm

        What are some exercises i can do? And will they pull my knees closer together

  • 16. Jules  |  August 14, 2013 at 2:34 pm

    Hi. I really dont understand the exercise procedures. Could you be more explicit by excluding the medical terms and rather using a layman’s language? I’m 19 and i think am done with growth, but is there really no hope of re-aligning my legs to be atleast straighter or to reduce the severity of it?

    • 17. theverticalworkshop  |  August 14, 2013 at 5:27 pm

      Hello, Jules,

      I appreciate that it is difficult for you to understand the anatomical terms. The blog is written for Pilates and fitness professionals who have this vocabulary. I generally go back and forth between scientific and laymen language. My apologies if it doesn’t resonate with you.

      It might be interesting for you to “google” the terms that you don’t know and see if you can apply them.

      Do you take Pilates or do any exercise at all?
      What city do you live in? I can try to advise you of a good teacher.

      All the best,
      – Shari

  • 18. Randeep kaur  |  September 7, 2013 at 2:35 pm

    Hi m randeep from india.. I am 27 year old.. My legs are unshaped means bow legs.. Thats why i always feel shy in front of others.. I want streighten my legs can u help me out.. Really i am very dipressed..

    • 19. theverticalworkshop  |  September 8, 2013 at 3:08 pm

      Hello, Randeep, thank you for reaching out to me. I’m so sorry that you are uncomfortable with your bowed legs. It is difficult to make an assessment when we do not see each other. We can do a session together via Skype. I can help with an assessment and exercises. However, you must know that I cannot straighten out the bones…I can just help you strengthen to have better alignment and musculature. And that will make you look different.

      Now…do you know if you had “Blount’s diseases” or “rickets” when you were young?
      Do you do any exercise?
      Did you ride a lot of horses when you were young?

      The answers to these questions will help me understand why your legs are bowed as they are.

      And could you send me a photo of you standing upright with shorts or a skirt on so that I can see your legs. You can email me this photo at

      All the best,
      – Shari

  • 20. Amar  |  October 17, 2013 at 9:39 am

    Hello, even I am bow legged but for last 1 month I have started doing squat exercise, I can feel that my lower leg is straightening gradually, also I feel a pain in my lower leg and knees after doing exercise but that is because bone is turning inward.

    • 21. theverticalworkshop  |  October 18, 2013 at 4:14 pm

      Amar, When you do your squats, pay careful attention that you align the middle of your knee cap with your second-toe-joint. Then you are more likely to get good strength with less pain.

  • 22. Eliza Brock  |  March 17, 2014 at 11:02 pm

    For me my bowed legs were straightened quite significantly with ballet! I still struggle with using my inner thigh muscles as they are quite weak but having done 17 years of ballet they have become a lot straighter than any of my other family members with Bowed legs. My parents chose not to put my legs in braces but enroll me in ballet and it has worked wonders to help my muscles work around my deformed bones haha


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