Best Exercises for Knock Knees (Genu Valgum) You Should Try 

Introduction

Proper knee alignment is an important factor that determines how we sit, stand, and walk. Many people suffer from conditions that can alter this alignment, which not only affect their posture and balance, but also their confidence to walk or stand. One such condition is “knock knees”. And what is a knock knee?  

Well, knock knees, which is also known as genu valgum, is a type of knee problem where the legs turn inward, with knees touching each other, while the feet are apart. This is commonly seen in infants as they are born with bowlegs, because their legs are folded in the mother’s womb. However, sometimes it might persist in adolescents or adults due to injury or other health problems¹. 

While the condition may impact walking, the good news is that many mild to moderate cases improve with proper management including a specific exercises regime. These can help achieve proper knee alignment, strengthen supporting muscles and reduce discomfort. In this guide, we will look at some of the best exercises that may help support better knee stability and overall leg alignment. 

What are Knock Knees?

As mentioned earlier, knock-knees is a condition where the knees bend inward and touch each other when a person stands with their legs straight. At the same time, the ankles remain separated¹. This inward angling of the knees can affect the alignment of the legs. While some individuals may not show any symptoms, the condition can cause leg pain, walking difficulty and alter the walking pattern in others². 

In children, knock knees are often considered a normal stage of growth and may gradually correct themselves as they grow. However, if the condition remains in older children or adults, it might be due to muscle imbalance, injury, or other health conditions¹. 

Causes of Knock Knees?

Knock knees can be caused by a variety of reasons. Following are some common knock knee causes. 

• Normal Growth and Development in Children: Knock Knees can be a temporary stage in many children’s lives. It’s common between 3-6 years and usually resolves by itself once the children grow². 
• Nutritional Deficiencies: Several nutritional deficiencies can affect leg alignment. Knock knees commonly occurs due to rickets, which is caused by severe deficiencies of nutrients like vitamin D or calcium^1,3. 
• Obesity: Excess body weight can place additional pressure on the knee joints which may influence knee alignment³. 
• Injury or Trauma: Injuries to the growth plates of bones can interfere with normal bone development. Knock knees can develop from this due to abnormal knee alignment. Sometimes one leg can be seen knock kneed¹. 
• Infections or Inflammation: These can also interfere with bone development. Knock knees can occur as a result of infections such as osteomyelitis or due to inflammatory conditions like arthritis^1,2. 
• Genetic Conditions: Some genetic conditions can affect the joints. Knock knees can occur from conditions like hypermobility syndrome, Ehlers-Danlos syndrome, etc². 

Symptoms of Knock Knees

Although sometimes knock-knees may be asymptomatic, the condition can potentially present with several noticeable signs and symptoms. The following are some symptoms, which may vary depending on the severity of the condition and the age of the person. 

• Knees touching each other when standing straight, while the ankles remain separated. 
• Unusual walking pattern with the inward angling of the knees making it look awkward or altered¹. 
• Knee pain or discomfort around the knee joints, making it difficult to walk². 
• Rubbing knees against each other while walking⁴. 
• Limited range of motion due to difficulty in walking. 
• Uneven wear of footwear because of altered walking pattern. 

How to Check Knock Knees at Home?

A simple self-check can help identify if you have knock knees. The following can be performed at home to check for a knock knee. 

• Stand in front of a mirror with your legs straight and your knees touching each other 
• Look in the mirror to see if the knees angle inward¹ while the lower legs move outward 
• Check whether your ankles touch or if there is a visible gap between them² 
• If there is a visible gap between the ankles, measure it and check whether it is less or more than 8 cm (more than 8 cm can denote knock knees)² 
• Notice if you feel any pain or difficulty while walking along with all the above given symptoms 

Note: This does not replace medical diagnosis; it might only give an initial idea about knee alignment. Please seek medical attention for confirmation. 

Diagnosis of Knock Knees

To confirm knock knees, healthcare professionals might perform a few examinations and tests to evaluate the alignment of the legs and identify possible underlying causes. These include: 

• Medical History Evaluation: The doctor may ask about growth history, previous injuries, nutritional status, or family history of bone conditions. 
• Physical Examination: The doctor will examine the legs while the person stands and walks to observe knee alignment and movement patterns³. 
• Assessment of Leg Alignment: The doctor might measure the distance between the ankles and knees to determine the severity of the condition⁵. 
• Imaging Tests: In some cases, the doctor may prescribe imaging tests such as X-rays to examine bone alignment⁵. 
• Blood Tests: The doctor may recommend blood tests if a nutritional problem is suspected. This might be to check levels of nutrients related to bone health. 

 Best Exercises to Correct Knock Knees

Exercises might help strengthen the muscles around the hips, thighs, and knees, which support better leg alignment. Regular strengthening and stretching exercises may improve stability and reduce the inward movement of the knees. The following are some of the best exercises for knock knees. 

1. Side Leg Raises

• This exercise strengthens the hip and thigh muscles, which might help in a range of motions⁶ like keeping the knees properly aligned during walking and standing. 
• How to perform: 
  • Stand straight and lift your right leg to the side slowly 
  • Pause, then slowly lower it back down 
  • Keep your hips level 
  • Do the same with the left leg to complete one set 
• Duration: 8-12 repetitions on each side for 1-2 sets daily. Take 30-90 seconds of rest between each set⁶. 

2. Squats

• This exercise might strengthen the lower leg muscles and help keep the knee stable, preventing it from moving inward or outward. 
• How to perform: 
  • Stand with your feet shoulder-width apart or slightly wider 
  • Keep your feet flat on the floor 
  • Let your toes point forward or slightly outward 
  • Lower your body until your thighs are almost parallel to the floor 
  • Slowly return to the standing position 
  • Do not let your knees move inward or outward⁷ 
• Duration: 10-15 repetitions per set, 2-3 sets per day 

3. Clamshell Exercise

• This exercise might strengthen the hip abductor and glute muscles⁸, which play a key role in stabilising the knees and reducing inward knee movement. 
• How to perform: 
  • Lie on your side and bend your knees 
  • Keep your feet together and raise your top knee 
  • Keep your hips stacked and steady 
  • Slowly lower the knee back down 
• Duration: 10 repetitions on each side,⁹ 2 sets per day 

4. Glute Bridge

• This exercise might strengthen the gluteal and hip muscles, which in turn might benefit knee alignment¹⁰. 
• How to perform: 
  • Lie on your back with your knees bent and feet flat on the floor, hip-width apart 
  • Keep your arms by your sides 
  • Slowly lift your hips upward until your body forms a straight line from shoulders to knees 
  • Hold the position for a few seconds and then slowly lower your hips back down 
• Duration: 12–15 repetitions, 2-3 sets per day 

5. Side Lunges

• This exercise engages the lower leg and knee muscles more while moving side to side¹¹. 
• How to perform: 
  • Stand with your feet a little apart 
  • Step to the side with your toes pointing forward 
  • Bend your knees and lower your body into a side lunge 
  • Push through your bent leg to stand back up, then repeat on the other side 
• Duration: 8-12 reps per side, for 1-3 sets daily¹² 

6. Crab Walk Exercise

• This exercise might strengthen the core, hips, glutes, and legs, improving lower-body stability and coordination, which can help support proper knee alignment in children with knock knees. 
• How to perform: 
  • Sit on the ground with your arms and hands behind you 
  • Bend the knees and keep the feet on the floor 
  • Lift your body from the ground, facing upwards 
  • Move forward or backward for the set distance 
• Duration: 3 sets, 2 min break between each attempts¹³ 

Note: These exercises are recommended to be performed under the guidance of an expert to avoid unnecessary injury or worsening the current condition. 

Benefits of Knock Knee Exercises

The above-mentioned exercises focus on strengthening the hip and leg muscles, activating the rotatory leg muscles and stretching the inner thigh muscles. Combined, these knock knee exercises may show the following benefits. 

• Improve leg alignment by helping the knees line up properly 
• Reduce knee and hip pain¹⁰ 
• Enhance walking patterns and posture¹⁰ 
• Increase lower body strength¹³ 
• Improve balance and coordination¹³ 
• Protect knees and hips from strain or injury 
• Improve appearance, walking style, and overall self-confidence 

Treatment Options for Knock Knees

Knock knees treatment depends on a person’s age, the severity of the condition, and whether it causes pain or difficulty with movement. The following suggests treatment approaches. 

• Observation in Children: Since knock knees in young children often correct naturally as they grow¹, regular monitoring is usually recommended. 
• Physiotherapy and Exercises (in Adolescents and Adults): Strengthening and stretching exercises for the thighs, hips, and glutes might improve knee alignment, reduce pain, and enhance mobility for conditions like osteoarthritis (a cause of knock knees). However, more studies are required to confirm these benefits¹⁴. 
• Braces or Orthotics: Special knee braces¹ or shoes that might help guide proper alignment and reduce stress on the knees. Might be beneficial for children and in adults. 
• Weight Management: Managing obesity¹ by maintaining a healthy weight might reduce pressure on the knees and reduce worsening of the condition. 
• Medication: Pain relievers or anti-inflammatory medicines may be prescribed if there is discomfort or joint inflammation¹⁵. 
• Surgery: In severe cases or when knock knees persist into adulthood and cause significant pain or functional issues, surgical options such as guided growth surgery or osteotomy may be considered^1,4. 

When to See a Doctor?

While mild knock knees in children often improve naturally, it is important to seek medical advice in certain situations. Consulting a doctor ensures proper evaluation and timely treatment if needed. 

Consult a doctor if: 

• The gap between the two ankles is more than 8 cm with the knees together 
• One or both knees appear swollen, stiff, or warm, with severe pain 
• One leg is noticed with knock knee, or both legs have different lengths 
• The current problem is worsening 
• The child is very short or underweight compared to their age 
• The child or you are limping or find it hard to walk 
• The child is younger than 2 or older than 5 
• Knock knees occurring in  adulthood² 
• Exercises don’t provide any potential benefits 

Also Read: Best Frozen Shoulder Exercises for Pain Relief

Conclusion

Knock knees, or genu valgum, is a common condition that often appears in children and may persist into adolescence or adulthood. While mild cases in children can improve naturally, targeted exercises, physiotherapy, and proper management can help strengthen supporting muscles, improve knee alignment, reduce discomfort, and enhance walking and posture. Early evaluation is important for the best outcomes, and with the right management and guidance, knock knees can often be effectively managed, allowing for better mobility, balance, and confidence in daily activities. 

Frequently Asked Questions (FAQs)

References

1. Knock Knees. 2024. Doi: https://medlineplus.gov/ency/article/001263.htm 

2. Knock Knees: NHS. 2023. Doi: https://www.nhs.uk/conditions/knock-knees/ 

3. Knock Knees (Genu valgum): Nemour’s Kids Health. doi: https://kidshealth.org/en/parents/knock-knees. 

4. Patel M, Nelson R. Genu Valgum. 2023. Doi: https://www.ncbi.nlm.nih.gov/books/NBK559244/ 

5. Bow-Legs and Knock Knees. 2024. Doi: https://www.schn.health.nsw.gov.au/bow-legs-and-knock-knees-factsheet 

6. Corliss J. Move of the month: Standing side leg raise. 2023. Doi: https://www.health.harvard.edu/heart-health/move-of-the-month-standing-side-leg-raise 

7. Lorenzetti S, Ostermann M, Zeidler F, et al. How to squat? Effects of various stance widths, foot placement angles and level of experience on knee, hip and trunk motion and loading. BMC Sports Sci Med Rehabil. 2018;10(1):14. doi:10.1186/s13102-018-0103-7. https://pubmed.ncbi.nlm.nih.gov/30026952/ 

8. Kaleem S, Noor R, Salman Bashir M, Ikram M. Effects of clamshell exercises in terminal extension lag after ACL reconstruction. The Knee. 2024;48:226-233. doi:10.1016/j.knee.2024.04.007. https://pubmed.ncbi.nlm.nih.gov/38763073/ 

9. Hip and Knee Rehabilitation. Doi: https://www.veteranshealthlibrary.va.gov/rehab/PhysicalTherapy/HipKnee/3,16209 

10. Lehecka BJ, Edwards M, Haverkamp R, et al. BUILDING A BETTER GLUTEAL BRIDGE: ELECTROMYOGRAPHIC ANALYSIS OF HIP MUSCLE ACTIVITY DURING MODIFIED SINGLE-LEG BRIDGES. Int J Sports Phys Ther. 2017;12(4):543-549. https://pubmed.ncbi.nlm.nih.gov/28900560/ 

11. Riemann B, Congleton A, Ward R, Davies GJ. Biomechanical comparison of forward and lateral lunges at varying step lengths. J Sports Med Phys Fitness. 2013;53(2):130-138. https://pubmed.ncbi.nlm.nih.gov/23584319/ 

12. Side Lunges. Doi: https://hw.qld.gov.au/blog/exercise/side-lunges-2/ 

13. Train Like an Astronaut: Adapted Physical Activity Strategies. Doi: https://www.nasa.gov/wp-content/uploads/2018/05/spacewalk_-_adapted.pdf 

14. Bennell KL, Hunt MA, Wrigley TV, Hunter DJ, Hinman RS. The effects of hip muscle strengthening on knee load, pain, and function in people with knee osteoarthritis: a protocol for a randomised, single-blind controlled trial. BMC Musculoskelet Disord. 2007;8(1):121. doi:10.1186/1471-2474-8-121. https://pubmed.ncbi.nlm.nih.gov/18067658/ 

15. Painkillers and Arthritis Pain Relief. Doi: https://www.arthritis-uk.org/information-and-support/understanding-arthritis/arthritis-treatments/drugs/painkillers-and-nsaids/ 

16. Crowell KR, Nokes RD, Cosby NL. Weak Hip Strength Increases Dynamic Knee Valgus in Single-Leg Tasks of Collegiate Female Athletes. Journal of Sport Rehabilitation. 2021;30(8):1220-1223. doi:10.1123/jsr.2021-0043. https://pubmed.ncbi.nlm.nih.gov/34153942/ 

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