O-legs are also often referred to as soccer legs, especially throughout Germany. Certainly not entirely without reason, because the sport of soccer can promote the visible malposition of the legs – but this has nothing to do with the ball. Therefore, clearly not only footballers suffer from bow legs.
What are bow legs?
O-legs are fundamentally understood to be nothing more than a leg position and leg shape that deviates from the physical axis norm. That’s why bow legs are also counted among the so-called axis malpositions in medicine and in technical jargon. But what does this mean? It means nothing more than that the legs are each at a more or less drastic angle to the outside. Normally, the legs should run very straight to each other. A very similar deviation are the knock-knees. The bowlegs get their name from the fact that between the legs there is an oval or even round recess – depending on how pronounced the malposition is.
Causes
Causes bowlegs can present very many. On the one hand, the deformation of the legs can be congenital. This is usually noticeable in early childhood. The problem here, however, is that initial deformities of the legs during growth are absolutely nothing unusual. A large proportion of children suffer from bow legs or even knock-knees at a very young age. In about 70 percent of cases, the deformities correct themselves as the child grows. Other reasons, however, could be bone fractures, consequences of paralysis, diseases such as rickets and osteoporosis, or severe obesity and also overloading of the legs caused by sports.
Symptoms, complaints and signs
The symptoms of bow legs are limited to the musculoskeletal system. They affect the legs, feet, and in some cases, the back and spine. In many cases, however, people with mild bow legs have no symptoms at all and do not develop excessive wear and tear due to the deformities, even as they age. Primarily, pain can occur. These are particularly noticeable in the knees. The inner sides of the knees are particularly stressed. The pain can also radiate. The pain usually increases with exertion. They are also stronger after getting up in the morning than during the day. The pain may be increased with traction or pressure. The bow legs further promote increased joint wear, which can promote osteoarthritis. As the condition progresses, the feet may become malpositioned, resulting in what are known as bow-lowered feet. These can reduce the load-bearing capacity of the ankle joints and the feet in general. If only one leg is affected by the malalignment, the spine becomes involved and there is corresponding back pain. The hip may shift as a result of adjustment. Signs of bowlegs include sciatic pain, the typical gait, and, less commonly, headaches. Most often, the symptoms show up bereis to childhood.
Diagnosis and progression
Depending on how severe the deformities and malpositions are, bow legs can already be recognized at a first examining glance. However, the typical symptoms, such as pain and movement disorders, do not always have to accompany the diagnosis. Many people live their entire lives with slight bow legs without ever experiencing serious symptoms. Nevertheless, the risks of bow legs should not be completely underestimated. Because the joint cartilage may wear out more quickly here, there may be an increased risk of arthrosis in old age. If complaints occur, which is especially the case if the deformity is very severe or not congenital but arises “suddenly,” various examinations can determine the degree and cause of the deformity. The best examples are X-rays and special walking analysis.
Complications
Due to bowlegs, those affected sometimes suffer from severe pain. This can also lead to significant restrictions in the job or in everyday life, so that the patient may no longer be able to perform his or her job. However, bow legs do not necessarily lead to complications in every case. It is not uncommon for patients to live with bow legs for the rest of their lives and experience no particular discomfort. Due to bow legs, however, the risk of osteoarthritis in the joints can be significantly increased, so that those affected are usually dependent on regular examinations to avoid this complication.A malpositioning of the legs can also occur and have a very negative effect on the patient’s everyday life. As a rule, direct treatment of bow legs is not necessary in children. In most cases, this deformity disappears again on its own with adulthood. In severe cases, however, surgical interventions are necessary to alleviate the symptoms. The treatment itself can last for several years. However, the patient’s life expectancy is not negatively affected by bow legs.
When should you go to the doctor?
Bow legs do not represent a reason for medical treatment from a medical point of view. It is an optical blemish that has no disease value. A visit to the doctor is therefore not necessary in normal cases. If severe deformations of the skeletal system are noticed within the growth and development process of the offspring, they can be addressed during a check-up with a doctor. If there are limitations of movement or pain during locomotion, a visit to the doctor is necessary to clarify the cause. Abnormalities of gait, a limp, or pelvic obliquity should be investigated. If necessary, corrective measures are indicated. On the other hand, people with bow legs who can move around in everyday life without complaints do not need medical help. If the visual changes cause mental or emotional irregularities, a visit to a doctor or therapist is recommended. Mood swings, a lowered state of mind or loss of well-being should be discussed. If withdrawal from social life or refusal to participate in usual athletic activities is evident, a physician should be consulted. Personality changes, a persistent feeling of sadness, abdominal pain, malaise, sleep disturbances, or headaches may be signs of psychological distress and should be presented to a physician if they persist for several days or weeks. If a feeling of illness sets in, consultation with a physician is also advised.
Treatment and therapy
What the treatment of bow legs might look like depends primarily on the severity of the deformity and also on the age of the patient. In children, no special therapy is needed in most cases because the deformity often grows by itself over the years. To be on the safe side, however, it is possible to get to the bottom of possible malpositions now. If these are present, this can result in further and permanent deformation of the legs. If bow legs occur in old age, the procedure is similar. If the deformity is not too drastic, it can be slowly and carefully counteracted with special shoe soles and orthopedic shoes. Of course, the treatment can quickly take several months or even years. Faster and more effective are surgical interventions. However, these are actually only used in the case of more severe and highly pathological deformities. And: If there is an underlying disease, this must absolutely be treated in the first place.
Outlook and prognosis
The natural course in the case of malalignment of the knee joint cannot be accurately predicted. A possible long-term consequence is premature osteoarthritis of the knee joint. Because the inner area of the joint experiences more stress with a bow leg, this area experiences more wear and tear. Additionally, the medial meniscus is overused, which can lead to medial gonarthrosis. The inner joint bone of the femur in particular is damaged in this case. This can lead to pain in the patient and, in severe cases, limit mobility. In these cases, a knee joint prosthesis may be necessary to alleviate the symptoms. In other cases, however, affected individuals do not notice any consequential damage even after years. Even though gonarthrosis is considered a possible complication, its likelihood cannot be predicted. Similarly, there is no scientific prediction of how the extent of malalignment of the knee joint will affect the likelihood of developing osteoarthritis. Despite surgical correction of the leg axis, there is still theoretically the possibility of arthrosis developing. However, the percentage of patients with knee joint prosthesis 10 years after surgical therapy is only 25%. Surgical therapy is not always necessary, so that consequential damage can also be specifically prevented with orthopedic means.
Prevention
Bow legs can only be prevented to a very limited extent. With children, one should always make sure that they do not develop postural disorders. Likewise, one should always make sure that children are not already struggling with excessive excess weight at too young an age. The same applies, of course, to those affected in adulthood. Otherwise, you can only pay attention to your own posture and take action as soon as possible when the first signs of bow legs appear.
Aftercare
O-leg follow-up care is required when symptoms occur as a result of a surgical procedure such as an adjustment osteotomy. Following surgery, the patient must remain in the hospital for about four to five days. If severe swelling occurs, the inpatient stay may be even longer. Full weight-bearing on the operated leg may only take place when the healing of the bone can be proven by an X-ray examination. However, partial weight-bearing is allowed. For about six weeks, the patient uses walking aids such as crutches. Thanks to a newly used stable-angle plate system, he can usually resume full weight-bearing activities after two to three weeks. In order to advance the course of recovery, various physiotherapeutic treatments are performed. These include physiotherapy, lymphatic drainage, kyrotherapy or manual therapy. From the 3rd to 4th week, the patient is also allowed to do water gymnastics such as aqua jogging or crawl swimming or to ride a stationary bike. Before discharge, the doctor prescribes aids for the patient that can be used at home. During follow-up care, the patient is given regular injections to counteract thrombosis (blood clots). When the patient can return to work depends on his or her profession. Office work, for example, can be resumed after about six weeks. For occupations that require physical exertion, up to three months may pass.
What you can do yourself
In most cases, people with bow legs have no physical health impairments. The musculoskeletal system functions without symptoms and a worsening of the condition is not expected. Nevertheless, bow legs represent an optical flaw for many of those affected. Under certain conditions, wearing inserts or special orthopedic shoe soles can bring about a change in the deformity in everyday life. In children and adolescents, there is the prospect that the deformity will grow as the growth and development process continues. Physiotherapeutic exercises should be carried out to support this. Stress caused by lifting or carrying heavy objects should be avoided. In addition, when performing sports activities, the types of sports performed should be reviewed. In some patients, a change in sporting activities already leads to an alleviation of the symptoms. If bow legs develop in adulthood, chronic diseases are often present. In these cases, the doctor’s instructions should be followed in order to minimize the discomfort and delay the progression of the disease. If the bow legs developed due to excess weight, the patient’s own weight should be reduced as quickly as possible. Sufficient exercise and a healthy as well as balanced diet can reduce the weight. It is recommended for the maintenance of health to regulate the body weight according to the BMI.
