Bowed legs, a condition often naturally correcting in toddlers, can persist into adulthood due to early walking. This tibial varum creates increased compressive forces on the medial knee joint, inhibiting growth and worsening the bowing. Over time, this amplified pressure significantly accelerates the development of medial knee osteoarthritis. Even a slight 5-degree bowing can shift the knee's load distribution dramatically, placing 90% of the weight on the inner knee. This can lead to a painful varus thrust gait.
Management strategies range from using a cane to reduce medial joint compression and valgus unloader braces and valgus posts, though these have limitations in long-term use and proven effectiveness, respectively. More intrinsically, strong hip abductor muscles and the iliotibial band can stabilize the lateral knee and lessen the progression of medial knee osteoarthritis, regardless of the degree of bowing. Exercises like lateral step-ups and curtsy lunges are recommended for strengthening these muscles without overloading the knee. Early and consistent hip strengthening is crucial, as these exercises are less effective once a significant varus thrust develops. Simple gait modifications like a shortened stride or forefoot strike can offer relief when varus thrust is present.