Knock knees, medically known as genu valgum, describe a lower body alignment where the knees angle inward and touch while the ankles remain separated. This condition raises questions about the best approach to correction. While orthopedic specialists typically address severe structural misalignment, many individuals explore complementary approaches. This article examines genu valgum and assesses the role of chiropractic care as a potential intervention.
Defining Knock Knees: Genu Valgum
Genu valgum is characterized by a coronal plane deformity where the knees converge toward the midline of the body. When standing with the knees together, the lower legs turn outward, creating a noticeable gap between the inner ankles. This visual presentation indicates a misalignment between the femur (thigh bone) and the tibia (shin bone).
The condition is categorized into two types: physiological and pathological. Physiological genu valgum is a normal, self-correcting developmental stage in most children, typically peaking around three to five years of age and resolving by age seven or eight.
Pathological genu valgum is less common, persisting beyond childhood or presenting asymmetrically, and is often linked to underlying issues. Causes include skeletal issues like rickets due to Vitamin D deficiency, trauma, infection, or genetic bone disorders. An intermalleolar distance greater than 8 centimeters when the knees are touching is often used as a clinical indicator of abnormal alignment.
Standard Medical Approaches to Correction
For most young children presenting with physiological genu valgum, orthopedic specialists primarily recommend observation. Since the majority of these cases resolve naturally as the child grows, active intervention is usually not necessary before age seven. Observation is maintained unless the deformity is excessive, asymmetrical, or progresses rapidly.
When the condition persists or is related to a pathological cause, a multi-faceted treatment plan is implemented. Physical therapy is commonly prescribed to address secondary effects, such as strengthening the surrounding musculature, including the hip abductors and external rotators, and correcting gait abnormalities. These exercises focus specifically on improving muscle balance to reduce undue stress on the knee joint.
Orthotic devices, such as shoe inserts, may be recommended to improve foot mechanics and stabilize the kinetic chain from the ground up, particularly if excessive pronation (flattening of the arch) is present. Bracing is rarely indicated for physiological cases but may be used in certain pathological presentations. Surgical intervention is reserved for severe, progressive cases that cause functional impairment or persist into adolescence.
Two main surgical procedures exist to correct the bone angle: guided growth surgery and osteotomy. Guided growth, or hemiepiphysiodesis, involves temporarily placing a small plate or staple on one side of the growth plate in children to slow the growth on that side, allowing the bone to gradually straighten. For skeletally mature adolescents and adults, an osteotomy is performed, which involves surgically cutting and realigning the misaligned bone, typically the femur, to restore a proper mechanical axis.
Chiropractic Methods for Lower Body Alignment
Chiropractic care for genu valgum is viewed as a complementary approach focused on managing musculoskeletal imbalances and accompanying pain. It is important to note that chiropractic adjustments alone are not considered a primary method for achieving true structural correction of a fixed bony deformity. The skeletal angle itself, especially in severe or pathological cases, requires orthopedic management.
A chiropractor’s approach centers on the entire kinetic chain, recognizing that knee alignment is influenced by the mechanics of the feet, ankles, hips, and pelvis. Adjustments may be applied to the spine, hips, and knees to improve joint mobility and function. By restoring proper movement in the sacroiliac joints and the lower back, the practitioner aims to reduce rotational stress transferred down to the knees.
Treatment often involves soft tissue work and prescribed exercises targeting muscle imbalances that contribute to the inward knee angle. For example, a chiropractor may focus on strengthening weakened gluteal muscles and stretching tight hip adductors and quadriceps. This focus improves overall posture and gait, which can alleviate symptoms like pain in the knee, ankle, or hip caused by altered weight distribution.
While chiropractic care can help manage secondary symptoms and improve functional alignment, it is best utilized in collaboration with other healthcare providers. For structural issues like genu valgum, combining chiropractic support for biomechanical function with the orthopedic standard of care, such as physical therapy or surgical evaluation, provides a comprehensive approach to the condition. The goal is to optimize the body’s mechanics, not to physically reshape the bone structure.