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‘Knock’ Knees

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Introduction

Genu Valgum – commonly known as ‘knock’ knees, refers to a structural abnormality in which knees angle in and touch when in standing. There will also be an increased gap between the feet – usually more than 8cm. It is considered a relatively normal finding in young children which can become more obvious when they are around 3 or 4. They will usually grow out of it after the age of 7. Very few people will continue to have Genu Valgum in to adolescence and it will not typically produce any symptoms. However, specialist assessment and examination is warranted by a GP/Physiotherapist if developed in older children or in adulthood as this may relate to an underlying bone condition.

Signs & Symptoms

A gap of more than 8cm between the ankles when a person stands with their knees together is the most obvious symptom of knock knees. They don’t usually cause any issues but in severe cases this can give you knee pain or difficulty with walking or running. Long term, knock knees can be a risk factor for developing Osteoarthritis in the affected knee(s).

Causes

  • Rickets.
  • Increased pressure on the knee due to overweight or loose ligaments.
  • Previous injury or infection.
  • Underlying arthritis.
  • Genetic conditions that affect bone growth.

When To See A GP/Physiotherapist

  • The distance between the ankle is more than 8 cm (with knees together).
  • If it is getting worse.
  • Children under the age of 2 or older than 7.
  • Severe knee pain or swelling.
  • Only one side is affected.
  • Sudden onset after a trauma.

Assessment & Diagnosis

The GP/Physiotherapist may take few measurements, and they may refer you to an Orthopaedic surgeon for further assessment. They may also arrange a blood tests or X-ray to ascertain if there is any underlying causes to your knock knees. Once a diagnosis has been confirmed, you will be provided with education on the conditions and the treatment options will be explained so that you can make an informed decision on your care.

Self-Management

Adults can develop knock knees due to being overweight. Active weight loss is recommended alongside strengthening exercises for the hips & knees which your Physiotherapist can help you with this. If knock knees are secondary to arthritis, your GP or Physiotherapist may request a secondary opinion from an Orthopaedic surgeon. Your Physiotherapist can also provide advice on braces which can help with normal knee alignment.

Physiotherapy

In most cases knock knees don’t need any specific surgery or braces. Strengthening exercises for your thigh and buttock muscles can help avoid the deformity progressing if symptoms do not settle. Your Physio will create a bespoke home exercise programme that will be modified as you improve so that you can continue to make progress. We provide ongoing support and guidance for you to be able to effectively manage your symptoms and limit the progression of further complications.

Escalation of Treatment

This will be a last resort and done rarely, there are 2 types of surgeries to correct a Genu Valgum:

 

 

Note that extensive Physiotherapy is recommended before and after surgery.

Additional Resources

NHS information – click here.

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