Valgus knee, commonly known as “knock-knees,” is a condition where the knees angle inward, appearing to touch while the ankles remain separated. This alignment positions the lower legs outward, away from the body’s midline. While often seen in young children and correcting naturally, it can persist into adulthood or develop later due to various factors.
Understanding Valgus Knee and Its Development
Valgus knee is characterized by the knees coming together, with a noticeable gap between the ankles when standing. In children, this alignment is often a normal part of development; about 75% of children aged three to five exhibit knock-knees, with approximately 99% of these cases resolving naturally by age seven or eight.
However, valgus knee can also develop or persist due to several factors. Muscle imbalances, such as weakness in hip abductors or gluteal muscles, can contribute to the knees collapsing inward. Biomechanical issues affecting the kinetic chain can also lead to this misalignment. Other potential causes include prior injuries, like a tibial plateau fracture or growth plate damage, as well as conditions such as severe vitamin D deficiency (rickets), obesity, or knee arthritis.
Conservative Strategies for Correction
Conservative strategies for addressing valgus knee primarily involve targeted exercises, physical therapy, and supportive devices. Exercises aim to strengthen specific muscle groups and improve lower limb alignment. Strengthening hip abductor and gluteal muscles can help stabilize the pelvis and prevent the inward collapse of the knees. These muscles play a significant role in controlling femur (thigh bone) position during movement.
Stretching tight muscles, such as adductors (inner thigh muscles) and hamstrings, can improve flexibility and reduce forces that pull the knees inward. Incorporating exercises that promote proper knee tracking and foot mechanics further supports alignment. Physical therapy involves a comprehensive assessment to identify specific muscle imbalances or movement patterns contributing to valgus alignment. Therapists may also use manual techniques to improve joint mobility and soft tissue flexibility.
Orthotics or bracing can provide external support and guidance for proper alignment. Orthotics help address excessive foot pronation, often associated with valgus knee, by supporting the arch and influencing leg alignment. Braces can gently guide bone development and encourage more neutral alignment over time. Lifestyle adjustments, such as maintaining a healthy weight, also reduce stress on the knee joints and support corrective efforts.
Surgical Interventions for Valgus Knee
For severe valgus knee cases where conservative methods are insufficient, surgical interventions may be considered. These procedures are reserved for individuals experiencing persistent pain, significant functional limitations, or progressive deformity. One common surgical option is an osteotomy, which involves reshaping the bone. A surgeon might perform a femoral or tibial osteotomy to realign the bones and redistribute weight across the knee joint.
During an osteotomy, a small wedge of bone is removed or added near the knee joint to correct angulation. This procedure aims to reduce stress on the affected knee compartment. Recovery involves a period of non-weight-bearing and rehabilitation. In severe cases, particularly for older adults with significant joint degeneration, total knee replacement surgery might be considered to correct the valgus deformity and alleviate pain.
When to Seek Professional Guidance
Consult a healthcare professional, such as an orthopedic surgeon or physical therapist, if you observe persistent valgus knee alignment, especially with symptoms. Signs warranting evaluation include ongoing knee pain, discomfort in the hips, ankles, or feet, or difficulty walking or running. Instability in the knee joint or reduced hip range of motion also suggests the need for medical assessment.
Professional guidance is important if valgus knee appears to be worsening, if there is a noticeable difference in alignment between the two legs, or if home-based conservative measures do not yield improvement. A healthcare professional can accurately diagnose the underlying cause, which may involve physical examination, gait analysis, and imaging studies like X-rays. This evaluation allows for a personalized treatment plan tailored to the individual’s condition.