Hesperian Health Guides

Chapter 11: Club Feet, Flat Feet, Bow Legs,and Knock-Knees

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HealthWiki > Disabled Village Children > Chapter 11: Club Feet, Flat Feet, Bow Legs,and Knock-Knees

What Is a Deformity and What Is Normal?

Sometimes parents worry because they think a part of their child’s body is abnormal or deformed. But in small children, often what seems unusual is within what is normal, and will get better as the child grows. For this reason, it is important to know what variations are normal and which may be problems.

Note: For children born with parts of their bodies missing or shortened, see Chapter 12 on birth defects.

1. Many children are born with their feet somewhat bent or crooked. To learn the difference between a normal bend caused by the baby’s position in the womb, and true club feet, see the next page.
DVC Ch11 Page 113-1.png
CURVED FEET: NORMAL in the first weeks or months of life
‘FLAT’ FEET: NORMAL until age 2
DVC Ch11 Page 113-2.png
2. ‘Fat’ or ‘flat’?—When most babies begin to walk, they walk on the insides of their feet, with their legs wide apart. Also their feet still have baby fat on the bottom. As a result, the feet look very flat. In nearly all cases, they will get better by themselves.
3. A baby’s legs often bend outward (‘bow legs’), like this. This bending starts to disappear at the age of 18 months. Then the legs slowly straighten until they actually bend inward a little, like this. a child with bow legs BOW LEGS:
until about
18 months
DVC Ch11 Page 113-4.png
KNOCK-KNEES: NORMAL between 2 and 12 years
a child with knock-knees
4. This ‘knock-kneed’ position generally develops around age 2. By age 5 or 6 the knees begin to straighten.
DVC Ch11 Page 113-5.png

Note: Children with brain damage sometimes develop a ‘knock-knee’ way of standing or walking. If the child with knock-knees also moves or walks in a stiff or jerky way, or shows other problems, check for signs of brain damage. (See Examining The Nervous System and Chapter 9 on cerebral palsy.)

IMPORTANT! In any child who develops bow legs or knock-knees, check for signs of rickets and other problems. See Chapter 13.

This page was updated:21 Nov 2019