How Bow Legs and Knock Knees Affect Knee Pain
Table of Contents
Normal lower-limb alignment and deformities
In normal lower-limb alignment, the weight-bearing line (mechanical axis) passes through the center of the knee joint. With genu varum (bow legs), the load line shifts toward the medial side of the knee and excessive pressure is placed on the medial compartment, while with genu valgum (knock knees), the load line moves laterally and stress concentrates on the lateral compartment. These alignment problems cause asymmetric wear of the joint cartilage and become a direct cause of osteoarthritis.
Bow legs and medial compartment osteoarthritis
The most common form among Koreans is bow legs (genu varum), in which 60–80% of body weight is concentrated on the medial side of the knee during walking. As people age, the medial cartilage wears first, and as cartilage wears the bow-leg deformity worsens, creating a vicious cycle. When the overall lower-limb varus angle is 5 degrees or more, the progression of medial osteoarthritis is about 4 times faster than normal.
Knock knees and lateral compartment loading
Knock knees (genu valgum) is less common than bow legs, but when found in young women it can lead to early degeneration of the lateral meniscus and lateral cartilage. When accompanied by lateral tilt of the patellofemoral joint, chondromalacia may develop together.
Korean medicine correction and treatment
- Chuna manipulation: Corrects pelvic asymmetry and tibiofemoral malrotation to move the load line back toward the center. Whole lower-limb alignment, including the sacroiliac and hip joints, is evaluated.
- Acupuncture: Releases muscles and ligaments tightened by medial (bow legs) or lateral (knock knees) overload, and supports activation of the weakened opposite-side muscles.
- Custom insoles: A lateral wedge insole reduces medial loading by about 5–10% in bow-leg patients. The clinic prescribes them after foot-pressure analysis.
Lower-limb strengthening and lifestyle care
For bow legs, strengthening the vastus lateralis and hip abductors (gluteus medius) is important; for knock knees, balanced training of the vastus medialis and adductors is the priority. Clamshell exercises and side band walks build strength around the hip joint and contribute to better lower-limb alignment. Avoid prolonged floor-sitting and squatting, and maintain joint flexibility with regular stretching.