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As your child grows, you notice every little change. One common observation that often gives parents pause is the appearance of “knock knees,” or genu valgum. If you’ve watched your toddler walk and noticed their knees touch while their ankles are apart, you’re not alone. The question “Why do some kids have knock knees?” is one of the most common queries pediatricians hear. The good news is that in the vast majority of cases, knock knees are a completely normal and expected part of a child’s growth and development. It’s Usually Just a Phase Knock knees rarely appear in infancy. Instead, they typically become most noticeable between the ages of 2 and 5. This is part of a natural lower-leg alignment shift. Babies are often born with slightly bowed legs, which gradually straighten out as they start walking. This straightening can then “overcorrect,” leading to the classic knock-kneed appearance. This physiological genu valgum is the body’s way of finding its ideal alignment for bearing weight and walking efficiently. The condition often peaks around age 4, and then the legs naturally begin to straighten again on their own. Most children outgrow it by the time they are 7 or 8 years old without any intervention whatsoever. When Should a Parent Be Concerned? While knock knees are usually harmless, there are specific signs that warrant a conversation with your pediatrician. It’s a good idea to seek medical advice if you notice: The condition is severe: The gap between your child’s ankles is more than 4-5 inches when they are standing with their knees together. It’s asymmetric: The knock knees are significantly worse on one leg than the other. It causes problems: Your child experiences pain, limping, difficulty running, or complains of their knees “giving way.” It persists or worsens: The knock knees don’t improve after age 7 or seem to be getting worse. In rare cases, knock knees can be caused by underlying factors such as obesity, a knee injury, infection, or metabolic bone diseases like rickets (a vitamin D deficiency). Treatment: From Observation to Intervention For typical developmental knock knees, the best treatment is often no treatment at all. Doctors will usually recommend a “watch and wait” approach, monitoring your child’s growth during their annual check-ups. If an underlying condition is identified, treatment will focus on that primary cause. For the very small percentage of children who do not outgrow the condition and have significant functional issues, bracing or, in extremely rare and severe cases, surgery may be considered. However, these interventions are not common. For parents in Thane, Mumbai seeking expert guidance, consulting a specialist can provide immense peace of mind. Dr. Vinod Dubey, a top pediatric orthopedic surgeon in Thane, emphasizes that “understanding the difference between normal developmental alignment and a pathological condition is crucial. Most children with knock knees are simply on a predictable growth curve, and our role is to monitor and reassure, intervening only when absolutely necessary to ensure a healthy, active future for your child.” Frequently Asked Questions (FAQs) 1. At what age do knock knees correct themselves? Knock knees typically start to improve on their own around age 5-7 and are usually resolved by age 8. 2. Are knock knees normal in a 3-year-old? Yes, knock knees are very common and considered a normal part of development in 3-year-olds. 3. Can obesity cause knock knees? Yes, excess weight can put additional stress on a child’s developing joints and may worsen or contribute to knock knees. 4. What is the difference between bow legs and knock knees? Bow legs (genu varum) curve outward, while knock knees (genu valgum) curve inward, causing the ankles to be apart when the knees are together. 5. Do knock knees require surgery? Surgery is very rarely needed and is only considered in severe cases that cause pain or functional problems and do not improve with age.