My Toddler Has Knock Knees
The short answer
Knock knees (when the knees touch but the ankles don't when standing) are completely normal in toddlers and young children, especially between ages 2-5. This is actually a natural stage of leg development that most kids go through after their baby bowlegs straighten out. In the vast majority of cases, knock knees resolve on their own by age 6-7.
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By Age
What to expect by age
2-3 years
This is the age when knock knees typically appear. Your toddler's legs have straightened out from the bowlegged newborn phase and may now be overcorrecting slightly. When your child stands with feet together, you might notice their knees touch but there's a gap between their ankles. This is a normal part of skeletal development and usually doesn't affect how your child walks or runs.
4-5 years
Knock knees are often most pronounced at this age. It might look dramatic, but as long as your child can walk, run, and play comfortably without pain or tripping, this is still typical. The angle between the legs should start to gradually improve as your child grows. Most pediatricians will simply monitor this at annual check-ups rather than intervene.
6-7 years
By this age, most children's legs have straightened into a normal alignment. If your child still has very pronounced knock knees at age 7, especially if they're asymmetric (one side worse than the other), your pediatrician may refer you to a pediatric orthopedist to make sure everything is developing properly.
8+ years
Persistent knock knees after age 8 are less common and worth evaluating. In some cases, children who are overweight or have certain growth conditions may have knock knees that don't self-correct. An orthopedist can assess whether observation, physical therapy, or rarely, bracing or surgery might be helpful.
What Should You Do?
When to take action
- Your child is between 2 and 6 years old and has knock knees that look the same on both sides.
- Your child can walk, run, jump, and climb without pain, limping, or frequent falling.
- The knock knees appeared gradually as part of normal growth, not suddenly after an injury or illness.
- Your child's pediatrician has examined them and isn't concerned.
- Your child is over 7 years old and still has very pronounced knock knees.
- One leg is significantly more knock-kneed than the other.
- Your child complains of knee, hip, or ankle pain, or seems to tire easily during physical activity.
- Knock knees appeared suddenly or have gotten dramatically worse in a short period of time.
- Your child has sudden knee pain, swelling, or can't bear weight on one or both legs.
- Knock knees are accompanied by signs of illness, unusual bruising, or bone pain.
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Physical Concerns
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.
My Baby Only Army Crawls
Army crawling (also called commando crawling) is a completely valid and normal way for babies to move. Many babies army crawl for weeks or even months before transitioning to hands-and-knees crawling, and some skip hands-and-knees crawling entirely. What matters is that your baby is independently mobile and exploring their environment.
One Side of My Baby's Body Moves Differently
Babies should generally use both sides of their body equally. If one side consistently moves differently, is weaker, stiffer, or less coordinated, this warrants evaluation. Asymmetric movement can indicate hemiplegia (cerebral palsy affecting one side), brachial plexus injury, or other neurological conditions that benefit from early therapy.
My Baby Crawls Unevenly
While some variation in crawling patterns is normal, consistently favoring one side or dragging one limb while crawling warrants attention. Babies should use both arms and both legs relatively equally when crawling. Persistent asymmetry could indicate muscle tone differences, hip issues, or neurological concerns that benefit from early evaluation.
My Baby Still Has the Fencing Reflex (Persistent ATNR)
The asymmetric tonic neck reflex (ATNR, also called the fencing reflex) causes your baby to extend the arm on the side they are looking toward. It should integrate between 4-6 months. If the ATNR persists strongly beyond 6 months, it can interfere with bringing hands to midline, bilateral hand use, and rolling. Evaluation is recommended.
Signs of Ataxia in Babies and Toddlers
Ataxia refers to wobbly, uncoordinated movements that result from problems with the cerebellum (the brain's coordination center). Signs include an unsteady, wide-based gait, difficulty with precise hand movements, and intention tremor (shaking that worsens when reaching for something). If you notice these signs, evaluation by a pediatric neurologist is important.