My Toddler Has Severe Knock Knees
The short answer
Mild knock knees are a normal developmental phase that peaks around age 3-4 and typically resolves by age 7-8. However, severe knock knees (where the distance between ankles is greater than 8-10cm when knees touch), asymmetric knock knees, or knock knees that worsen after age 4 should be evaluated by a pediatric orthopedist.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
As bowed legs straighten, they often overcorrect into mild knock knees. This is a normal progression. Mild knock knees at this age are not concerning.
Knock knees typically peak at age 3-4. Some degree of knocking is completely normal. If the distance between ankles when knees are touching is very large, or if it is much worse on one side, mention it to your pediatrician.
Knock knees should be improving by age 4-5. If they are worsening, severe, or causing your child difficulty with walking or running, evaluation is recommended.
Most physiological knock knees resolve by age 7-8. If significant knock knees persist, a pediatric orthopedist can evaluate for underlying causes and discuss treatment options if needed.
What Should You Do?
When to take action
- Knock knees are symmetric and mild.
- Your child is between 2-5 years old.
- Knock knees are improving over time.
- Your child runs and plays without difficulty.
- Knock knees are severe (large gap between ankles when knees touch).
- Knock knees are much worse on one side.
- Knock knees are getting worse after age 4.
- Sudden worsening of knock knees.
- Pain or difficulty walking due to knee alignment.
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 Toddler Has Knock Knees
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.
My Baby's Bowed Legs Are Not Straightening
Physiological bowing (normal bowed legs) should begin straightening after age 18-24 months. If bowing persists beyond age 2, worsens, or is asymmetric (more on one side), it may indicate Blount disease, rickets, or other conditions that benefit from treatment. Most persistent bowing is treatable when caught early.
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.