Bowlegs are also often referred to as soccer legs, especially in Germany. Certainly not without a reason, because football can promote the visible misalignment of the legs – but that has nothing to do with the ball. It is therefore clearly not only footballers who suffer from bowlegs.

Bowlegs are basically nothing more than a leg position and leg shape that deviate from the physical axis norm. That is why bowlegs in medicine and in technical jargon are also among the so-called axis malpositions. See aviationopedia for Lemierre Syndrome Explanations.

But what does that mean? This means nothing more than that the legs each extend outwards at a more or less drastic angle. Normally the legs should be very straight to each other. A very similar deviation is the knock-knees. O-legs get their name from the fact that there is an oval or even round gap between the legs, depending on how severe the deformity is.



O-legs can have many causes. Firstly, the deformity of the legs can be congenital. This is usually noticeable in early childhood. The problem here, however, is that initial deformities in the legs as they grow are absolutely not uncommon.

The majority of children suffer from bow legs or knock knees at a very young age. In about 70 percent of cases, the misalignments correct themselves as the growth progresses.

Other reasons could also be broken bones, the consequences of paralysis, diseases such as rickets and osteoporosis, or severe obesity and also overloading of the legs caused by sport.

Symptoms, Ailments & Signs

Symptoms of bowlegs are limited to the musculoskeletal system. They affect the legs, the feet and in some cases the back and spine. In many cases, however, people with slight bowlegs do not have any symptoms at all and do not develop any excessive signs of wear and tear due to the deformities, even in old age.

Pain may be the primary cause. These are particularly noticeable on the knees. The insides of the knees are particularly stressed. The pain can also radiate. The pain usually increases with exertion. They are also stronger after getting up in the morning than during the day. The pain can be increased by tension or pressure.

Bow legs promote increased joint wear and tear, which can promote arthrosis. As the disease progresses, the feet can become misaligned and this can lead to so-called flat feet. These can reduce the resilience of the ankles and feet in general.

If only one leg is affected by the deformity, the spine is involved and the associated back pain. The hip may shift as a result of an adjustment. Signs of bowlegs are sciatica, the typical gait and – more rarely – headaches. Most of the time, the symptoms appear in childhood.

Diagnosis & History

Depending on how severe the deformations and misalignments are, bowlegs can be recognized at first glance. However, the typical symptoms, such as pain and movement disorders, do not always have to accompany the diagnosis. Many people live their entire lives with slight bowlegs without ever experiencing any serious symptoms.

Nevertheless, one should not completely underestimate the risks of bowlegs. Because the articular cartilage wears out faster here under certain circumstances, there can be an increased risk of osteoarthritis in old age. If symptoms occur, which is the case above all when the misalignment is very severe or not congenital, but occurs “suddenly”, various examinations can determine the degree and cause of the misalignment. The best examples of this are X-rays and special running analyses.


Due to the bowlegs, those affected sometimes suffer from severe pain. Significant limitations can also occur at work or in everyday life, so that the patient may no longer be able to carry out his or her work. However, bowlegs do not always lead to complications.

It is not uncommon for patients to live with bowlegs for the rest of their lives and not feel any particular symptoms. Due to the bowlegs, however, the risk of arthrosis in the joints can be significantly increased, so that those affected usually depend on regular examinations to avoid this complication. A misalignment of the legs can also occur and have a very negative effect on the patient’s everyday life.

As a rule, no direct treatment of bowlegs is necessary in children. In most cases, this misalignment disappears on its own with adulthood. In severe cases, however, surgical interventions are necessary to relieve the symptoms. The treatment itself can last for several years. However, the life expectancy of the patient is not negatively influenced by bowlegs.

When should you go to the doctor?

From a medical point of view, bowlegs are not a reason for medical treatment. It is an optical defect that has no medical value. A visit to the doctor is therefore usually not necessary. If strong deformations of the skeletal system are noticed during the growth and development process of the offspring, they can be addressed by a doctor as part of a check-up. If mobility is restricted or there is pain when moving, a doctor’s visit is necessary to clarify the cause.

Gait abnormalities, limping or a tilted pelvis should be examined. If necessary, corrective measures are indicated. On the other hand, people with bowlegs who can move around in everyday life without any problems do not need medical help. If the visual changes lead to mental or emotional irregularities, a visit to a doctor or therapist is recommended. Mood swings, reduced well-being or loss of well-being should be discussed.

If there is a withdrawal from social life or a refusal to participate in usual sporting activities, a doctor should be consulted. Personality changes, persistent sadness, abdominal pain, feeling unwell, trouble sleeping, or headaches can be signs of psychological distress and need to be seen by a doctor if they last for several days or weeks. If a feeling of illness sets in, it is also advisable to consult a doctor.

Treatment & Therapy

What the treatment of bow legs might look like depends primarily on the severity of the deformity and also on the age of the patient. In most cases, no special therapy is required for children, since the deformity often grows together over the years.

To be on the safe side, however, you can already get to the bottom of any incorrect posture. Because if these are present, this can result in further and permanent deformation of the legs. If bowlegs occur in old age, the procedure is similar. If the misalignment is not too drastic, you can counteract it slowly and carefully with special shoe soles or orthopedic shoes.

Of course, the treatment can quickly take several months or even years. Surgical interventions are faster and more effective. However, these are actually only used for stronger and severely pathological malpositions. And: If there is an underlying disease, it must be treated first.

Outlook & Forecast

The natural progression of a misaligned knee joint cannot be precisely predicted. A possible long-term consequence is premature arthrosis of the knee joint. Since the inner area of ​​the joint is subject to greater stress in the case of a bow leg, this area is subject to greater wear. In addition, the inner meniscus is overstrained, which can lead to medial gonarthrosis. In particular, the inner joint bone of the thigh bone is damaged. This can cause pain in the patient and, in severe cases, limit mobility. In these cases, a knee joint prosthesis may be necessary to alleviate the symptoms. In other cases, however, those affected do not notice any consequential damage even after years.

Although gonarthrosis is considered a possible complication, its likelihood cannot be predicted. There is also no scientific prognosis as to how the extent of the misalignment of the knee joint affects the probability of arthrosis developing. Despite an operative correction of the leg axis, there is theoretically still the possibility of arthrosis developing. However, the proportion of those affected with a knee joint prosthesis 10 years after surgical therapy is only 25%. Surgical therapy is not always necessary, so that consequential damage can also be prevented with orthopedic means.


Bow legs can only be prevented to a very limited extent. With children, you should always make sure that they do not develop any postural disorders. You should also always make sure that children do not have to struggle with being overweight when they are too young. The same applies, of course, to those affected in adulthood. Otherwise, you can only pay attention to your own posture and take action as quickly as possible when the first signs of bowlegs appear.


Follow-up care of the bowleg is required if symptoms occur as a result of a surgical procedure such as a corrective osteotomy. After the operation, the patient has to stay in the hospital for about four to five days. If severe swelling occurs, the inpatient stay will be longer.

Full weight bearing of the operated leg may only take place when the healing of the bone can be demonstrated by an X-ray examination. However, partial loads are permitted. For about six weeks, the patient uses walking aids such as crutches. Thanks to a newly used angle-stable plate system, he can usually start with full loads again after two to three weeks.

In order to advance the course of recovery, different physiotherapeutic treatments are carried out. These include physiotherapy, lymphatic drainage, cryotherapy and manual therapy. From the 3rd to 4th week, the patient can also do water aerobics such as aqua jogging or crawl swimming or ride a stationary bike. Before discharge, the doctor prescribes tools for the patient to use at home.

During the follow-up treatment, the patient is regularly given injections that counteract thrombosis (blood clots). When the person who has been operated on can work again depends on his or her profession. Office work can be resumed after about six weeks. For jobs that require physical exertion, it can take up to three months.

You can do that yourself

In most cases, people with bowlegs do not have any physical health problems. The musculoskeletal system works without any problems and a deterioration in the condition is not to be expected.

Nevertheless, bow legs represent an optical flaw for many of those affected. By wearing insoles or special orthopedic shoe soles, a change in the deformation can be achieved under certain conditions in everyday life. In children and young people, there is a chance that the bad posture will grow as the growth and development process continues. Physiotherapeutic exercises should be carried out to support this. Strain caused by lifting or carrying heavy objects should be avoided. In addition, the sports practiced should be checked when carrying out sporting activities. For some patients, a change in physical activity already leads to a reduction in symptoms.

If bowlegs occur in adulthood, chronic diseases are often present. In these cases, the doctor’s instructions must be followed so that the symptoms can be minimized and the progression of the disease can be delayed. If bowlegs are caused by being overweight, you should reduce your own weight as quickly as possible. Sufficient exercise and a healthy and balanced diet can reduce weight. To maintain health, it is recommended to regulate body weight according to the BMI specifications.