Paediatric Physiotherapy
Bow Legs & Knock Knees Physiotherapy for Children
Curved or knocking knees are part of normal growth for most children — but knowing when a pattern is on track, and when it's worth a closer look, isn't always obvious from home. We help you tell the difference.
Why It Matters
Curved or knocking knees are usually a normal growth stage — assessment tells you if this is one of those times
Nearly every child's legs pass through bow legs and then knock knees on the way to adult alignment. It's rarely an emergency, and it's genuinely useful to have someone track it against expected patterns rather than guess from watching your child play.
What We're Assessing
Alignment of the knees and lower legs, whether both sides match, and how this compares to what's expected for your child's age.
Why Timing Matters
Leg alignment follows a fairly predictable pattern through childhood — knowing where your child sits on that pattern is what turns worry into a plan.
Two Ends, One Spectrum
Bow legs and knock knees are opposite directions of the same developmental process — most children move through both as they grow.
Coordinated Care
We work closely with your paediatrician, and can flag when further imaging or an orthopaedic opinion may be worth discussing.
Two Ends Of One Pattern
Bow legs and knock knees, explained simply
Most children pass through both stages on the way to adult leg alignment — it isn't two separate problems, but two points on the same growth curve.
The knees stay apart while the ankles touch, giving the legs an outward curve. This is the typical shape of a baby's legs at birth and through the first year or two of walking.
Most bowing gradually straightens on its own as a toddler grows, usually moving toward a neutral position by around age two.
The knees touch or turn inward while the ankles sit apart. This is the typical next stage after bow legs straighten out, usually most noticeable in the preschool years.
For most children this settles gradually on its own as the legs continue to grow, moving toward the mild, stable alignment seen in most adults.
A Useful Starting Point
Typical variation vs. patterns we'd like to review
This isn't a diagnosis tool — it's a guide for whether booking an assessment sooner is a good idea. When in doubt, an initial review costs you little and rules a lot out.
- Curve or knock is roughly even on both legs
- Appears at an age that broadly fits the usual pattern of growth
- Seems stable or gradually improving over recent months, rather than getting more pronounced
- Your child walks, runs and plays without pain, tripping, or an obviously uneven gait
- One leg is noticeably more curved or knocked than the other
- The pattern seems to be getting more pronounced rather than settling with age
- Still present with no improvement well past the age it's typically expected to resolve
- Accompanied by pain, an unusual gait, short stature for the family, or reduced activity
These are general guides, not fixed cut-offs. An assessment will always consider your child's full growth history, walking age and family pattern.
What Contributes
Common contributing factors
For most children, leg alignment is simply following its expected growth path — assessment looks at the fuller picture rather than a single cause.
01
Normal Growth Sequence
Nearly every child is born with some degree of bow-leggedness, which typically straightens and then swings toward knock knees before settling — this sequence alone explains most cases.
02
Family Pattern
Leg alignment and the age it settles at often run in families, so a parent's own childhood pattern can be a useful reference point.
03
Early Walking Habits
How and when a toddler starts weight-bearing and walking can influence how the pattern looks in the early stages, without necessarily changing the eventual outcome.
04
Underlying Growth Conditions
Less commonly, persistent or asymmetric alignment can relate to a growth plate or metabolic issue — this is exactly what an assessment is designed to help rule in or out.
What To Expect
Our approach to assessing your child's leg alignment
Every plan starts with a proper look at how your child's legs align, move and bear weight before we recommend anything — no generic reassurance handed out without a look first.
01
Assessment & History
We talk through your concerns, birth, walking and family history, then assess leg alignment, symmetry and gait in detail.
02
Clear Explanation
Findings are explained in plain terms against expected patterns for your child's age, so you know exactly where things stand and what to watch for.
03
Monitoring or Guided Plan
Most children simply need periodic review to confirm things are progressing as expected. Where a plan is genuinely useful, we build one around your child's needs and coordinate with your paediatrician as required.
Care Across Every Stage
Where your child sits on the growth curve
Leg alignment follows a broadly predictable path through childhood — here's a general sense of what's typically expected at each stage.
Birth–2 yrs
Bow Legs Expected
Most toddlers show a natural outward curve in the legs as they begin standing and walking, gradually straightening toward a neutral position.
2–4 yrs
Shift Toward Knock Knees
Alignment typically swings the other way in the preschool years, with knock knees usually at their most noticeable around this stage.
4–7 yrs
Gradual Settling
The knock-kneed appearance usually starts to ease during these years as alignment moves toward its eventual adult pattern.
7 yrs+
Review If Still Pronounced
Most children have settled into a stable, mild alignment by now — a pattern that's still pronounced or asymmetric at this stage is a reasonable time to have it properly assessed.
Who's Looking After Your Child
Led by a Paediatric Physiotherapist with Advanced Specialist Training
Every plan is guided by clinical standards adapted thoughtfully for growing bodies, and backed by ongoing professional development.
Session Fees
Straightforward pricing
Speak with us about insurance direct billing eligibility.
$260 / 45 mins
Assessment and guidance at our Bukit Timah clinic, with a follow-up plan if one is needed.
$350 / 45 mins
Singapore-wide, for children more comfortable in a familiar environment.
Direct billing available with select insurance providers — see our full fees page for all services.
Common Questions
Frequently asked questions
At what age should I get my child's legs checked?
There's no fixed age — many parents book simply for reassurance during the toddler or preschool years, and it's especially worth booking if the curve or knock seems uneven between the two legs, or if your child is past 7 and it's still pronounced.
Do I need a doctor's referral first?
No referral is required to book an initial assessment. If your child has an existing diagnosis or is under a paediatrician's care, we're glad to coordinate directly with them.
Will my child need braces or surgery?
The great majority of bow legs and knock knees resolve on their own without bracing or surgery. These are only ever considered for more pronounced or persistent cases, and would be discussed with your paediatrician or an orthopaedic specialist — not something we prescribe directly.
Does my child need X-rays?
Not usually. Most cases can be assessed clinically. Imaging is only considered where alignment looks asymmetric, unusually pronounced, or isn't following the expected pattern for age — and would be arranged in coordination with your paediatrician if needed.
How many sessions will my child typically need?
Many children need only an initial assessment plus a periodic review to confirm things are on track. Where a more active plan is useful, we'll give you a clear expected timeline after the initial assessment.
Is this covered by insurance?
Coverage depends on your specific policy. We offer direct billing with select insurance providers — reach out and we'll help confirm your child's eligibility.
Ready to get a clear picture?
Book an initial assessment and we'll give you an honest read on where your child is at — and a plan if one is needed.
📍 557 Bukit Timah Road, #02-03, Crown Centre, Singapore 269694 · 📞 +65 8836 8526
Meet Our Paediatric Physiotherapist
Ahmad Iqbal Bin Kamari, a paediatric physiotherapy specialist, has carefully reviewed the information on this page.
Principal Paediatric Physiotherapist
- Master of Advanced Paediatric Physiotherapy Practice (Monash University, Australia)
- BSc (Hons) in Physiotherapy (SIT-TCD))
- FIFA Diploma in Football Medicine
- Full registration with Allied Health Professions Council, Singapore, and Health and Care Professions Council, UK
Ahmad Iqbal Bin Kamari blends high-level clinical precision with an energetic, child-centered approach to paediatric physiotherapy. Holding a Master of Advanced Paediatric Physiotherapy Practice from Monash University, a BSc (Hons) from SIT-TCD, and a FIFA Diploma in Football Medicine, he brings specialist clinical training from KK Women’s and Children’s Hospital (KKH) and Evelina London Children’s Hospital. His rich expertise spans Early Intervention, Special Education (SPED), youth sports care, and his leadership as a Special Olympics Clinical Director.
At the heart of his practice—and his teaching as an SIT faculty member—is the belief that real movement progress starts with trust. Ahmad designs every session to be a safe, warmly tailored environment where children and youth feel completely comfortable to explore, play, and challenge themselves. By meeting each young person at their level, he turns therapy into an engaging experience that builds both physical strength and lasting confidence under his care.
- Early Intervention
- Special Education (SPED)
- Youth Sports & Adapted Athletic Care