What is bow-legs?

O-leggedness (the medical term as genu varum) refers to the space between the knees is more than half an inch when both feet stand with ankles closely touched. This is not only a problem of cosmesis. People with O-legs have greater compressive pressure on the inner side of the knee joint than that on the outer side. The inner cartilage of the knee joint becomes more vulnerable to wear and tear. With aging, the curvature of the bow-legs could progressively increase, which predisposes the further cartilage deterioration resulting early onset of degenerative arthritis.


  • Congenital/genetic predisposition
  • Use of baby walker or learn to walk prematurely
  • Poor sitting or sleeping posture in childhood, such as Japanese sitting or sleeping on tummy with bending knees
  • Excessive practice of certain sports, such as soccer, could bring deterioration to the O-legs.
o leg


  • Swelling of the knee joint
  • Compression pain at the inner side of knee
  • Stretching pain at the outer side of the knee
  • Out-toeing gait
  • Increased swaying during walking


  1. Custom prescription foot orthoses /sandals:Correct mechanical axis of the knee during walking to reduce the excessive loading of the knee joint and knee cap
  2. Using functional knee brace for O-legs:Apply the principle of four-point lever to correct the knee curvature through a system of decompression forces. The functional brace could effectively increase spacing of the inner aspect of the knee joint, reduce cartilage compression, alleviate pain, and delay deterioration
  3. Supplementation:For people with degenerative arthritis, supplement containing natural eggshell membranes could enhance joint nutrition and relieve pain. It has been evidence-proven to be likely effective than traditional glucosamine and chondroitin
  4. Hyaluronic acid injections:Hyaluronic acid is injected into the joint to cushion the damaged cartilage for further wearing, however, regular injections are required
  5. Knee replacement surgery:Partial or total replacement of the degenerated part of the joint, but there are always risks associated with surgery
  6. Medication:Pain-killers are mostly prescribed by physical doctors to relieve pain. This may provide immediate pain relief which is, however, short lasting
  7. Muscle strengthening exercises of the knee: Focus on strengthening the external rotators of the thigh bone (or femur) and control the deterioration of curvature of the bow-legs, particularly suitable for people with O-leggedness at mild to moderate levels

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Let you know self-management to avoid joint replacement for O-legs !