Cross leg or Genu Valgum is a type of knee deviation where the knees turn inward. If a person stands with a normal foot shape, the ankle to the hip is aligned. But if a person with crossed knees stands and puts his legs together, the knees stick together and the ankles move away from each other.
This happens because the femur and knee joint tilt inward. Then they put pressure on the leg bone and cause it to deviate.
It is normal to have a little distance between the ankles, but in people with Geno Valgoma, this distance is about 10 cm. Genu valgum is common in young children and usually corrects itself over time as the bones grow.
This complication is a natural stage of development in children, which becomes more obvious around the age of four. According to research, about 75% of children between three and five years old have crossed knees.
In general, the pattern of changes in the knee joint is such that they have knee braces from birth to about two years of age. Then the knees are slightly straightened and crossed again around the age of four.
Crossed knees will continue until the age of seven and eventually, they will be straightened, gender and racial differences have an effect on the severity and duration of crossed knees.
Crossed legs are not always a developmental stage and are sometimes considered a serious condition. When this condition of the knees continues after the age of seven or occurs in adults, it is recognized as a complication and should be treated.
This condition may occur due to genetic background or an underlying disease. For treatment, the cause of knee X must be determined first.
Accordingly, the crossed knee is divided into two different categories, and the physiological crossed knee is the first type and a natural stage of children’s development.
The pathological knee is the second type that occurs as a result of diseases such as rickets, previous tibial fracture, or multiple epiphyseal dysplasias.
Symptoms of Genu Valgum (crossed legs)
Crossed knees in children usually do not cause side problems other than the change of the knees, but if it continues after the age of seven or appears in adulthood, it may cause other symptoms. Some of these symptoms include:
Pain in the knees
Deformation and displacement of the knee, femur, and ankle joint from the normal position cause a lot of pressure on the ligaments and muscles. This pressure can cause pain in the knee joint.
Pain in the inner area of the knees occurs due to the stretching of the soft tissue and in the outer space of the knees due to the abnormal proximity of the tibia and thigh bones and their compression.
Changing the walking pattern
People affected by Genu Valgum walk may be bothered by the contact of their knees while walking. Then, people with this condition compensate for the lack of distance between their knees by changing their walking patterns.
The walking pattern of people with Genu Valgum is shunting, in which the person turns each leg outward while walking to step without striking or making contact with the other knee. Also, limping while walking is one of the results of changing the walking pattern.
One of the main symptoms of crossed legs is a change in appearance. As we mentioned, when a person stands, his knees are completely together, and there is a distance of about 10 cm between his ankles.
Other Symptoms of Genu Valgum
Having stiff and swollen joints, pain in the legs, hips and ankle joints, and feeling unbalanced when standing, are other symptoms associated with the cross knee.
Causes of cross legs (Genu Valgum)
Genu valgum occurs for various reasons. In general, it may be caused by the following:
- Normal development: As we mentioned, crossed knees are fairly common in healthy children under six or seven years of age and are just a normal part of their growth and development.
Although in some cases it may continue until adulthood, usually the legs gradually straighten as the child grows.
- Genetics: It seems that having a genetic history is one of the most important factors in suffering from this condition.
Sometimes some genetic abnormalities affect the growth of bones and joints and make their proper growth difficult.
- Rickets: Rickets is a bone disease caused by vitamin D and calcium deficiency.
This bone abnormality can be the cause of crossed knees in people of different ages.
- Underlying disease: Some bone diseases such as knee arthritis, joint rheumatism and dysplasia affect the way bones grow and as a result cause crossed legs.
Also, the presence of a tumor in the leg bone and neurological diseases such as cerebral palsy or spina bifida as a result of muscle tension on the bones can cause the knee to rotate inward.
- Injury or infection in the joint: An injury such as a fracture or infection in the growth area of the bones around the knee can cause the knee to rotate inwards.
- Pressure: The loosening of the ligaments of the knee joint causes excessive pressure on the joint and increases the risk of Geno Valgoma.
- Overweight or obesity: As you know, excess weight puts more pressure on the knees. This pressure causes cross legs and aggravates this condition. The results of a study showed that 71% of children with Genu Valgum were obese.
Complications and problems of crossed legs
Mild genu valgum in children does not cause severe complications, but in adults, due to the severity of this condition, it may cause complications. Genovalgoma complications include:
- Early knee arthritis, due to bearing double pressures by the knee joint
- Changing the location of the center of gravity of the body, due to the balance and unequal distribution of pressure in the legs
- Frequent dislocation of the patella bone due to the inclination of this bone to the outside
- Occurrence of secondary complications such as flat soles and toes deformity
- The feeling of pain in the inner and outer region of the knee, ankle and thigh
- Early fatigue and inability to take long walks
- Increased wear of the knee joint while walking
- Inability to do some sports activities
- Swelling, dryness and inflexibility of the joints
- Inability to walk in advanced stages
- Short stature and unpleasant appearance of the legs
- Increased vulnerability of the knee joint
- Limping and changing walking pattern
- Achilles tendon shortening
Diagnosis of crossed legs in children
The doctor first performs a physical assessment and asks about the child’s age and medical history.
If the child is two to four years old, does not feel pain, and both feet bend inward to the same extent, there is no need to perform any tests. Probably, in this situation, the doctor advises you to be careful and make sure that the crossed leg gets better with the growth of the child until the age of seven.
But in some cases, such as children whose legs are not straight after the age of seven, one knee is turned more than the other, only one of their legs is turned, and they feel pain, limp, weakness or difficulty in running, need more investigation and referrals. Your doctor may order x-rays and blood tests to look for healed fractures or rickets.
Blood tests can help diagnose rickets.
How to prevent crossed legs
To prevent crossed legs, doctors recommend the following:
- Because the heavy weight puts more pressure on the knees and provides the basis for the deviation of the knees from the correct alignment. Losing weight plays a very important role in preventing X-foot.
- Taking vitamin D and calcium and making up for nutritional deficiencies helps strengthen bones, prevent osteoporosis, and keep knees in the right alignment.
- Knee arthritis may be one of the complications of crossed knees, but it can also be its cause. Therefore, if you are suffering from this disease, be sure to treat and control its symptoms.
- Correct your posture for physical exercises and walking.
- Corrective movements and physiotherapy help to prevent Geno Valgoma and control it.
- Do not ignore injuries such as broken bones and treat them thoroughly, because unhealed injuries can cause clubfoot.
Cross leg treatment
After the diagnosis of Genu Valgum, it is necessary to treat them if there is an underlying disease such as arthritis or rickets. Then it is treated using surgical and non-surgical methods.
No treatment method is used for children under seven years of age, the only way to treat this condition is to go through the growth stages until this age.
But Geno Valgoma treatment for other developing children and adults includes a wide range of treatment methods.
This spectrum includes lifestyle changes, the use of nonsteroidal anti-inflammatory drugs, exercise programs, physical therapy, and finally surgery. In the following, we will learn more about each of these methods:
- Drug therapy: Different drugs are used in the process of treating clubfoot. For example, non-steroidal anti-inflammatory drugs are prescribed to reduce knee or ankle pain. If you are experiencing pain in your knee, you can first try over-the-counter non-steroidal anti-inflammatory drugs such as naproxen. If it is not effective, the doctor may prescribe stronger drugs.
If rickets is causing the knee to bend, your doctor will likely prescribe medication such as vitamin D and calcium supplements.
- Regular exercise: The doctor may recommend simple exercises and stretching or refer the person to a physical therapist.
Exercise and stretching can help strengthen the leg muscles and realign the knees.
- Lose weight: Obesity can put more pressure on your knees and make them bend inwards. If you are overweight, you can consult a nutritionist for proper diet and weight loss.
- Physiotherapy: According to the severity of the symptoms, the cause of the disease and your medical history, the physiotherapist will design a treatment plan including corrective movements and other physiotherapy techniques and help you in doing it.
Physiotherapy can strengthen the muscles around the knee and prevent excessive pressure on other joints.
- Corrective movements: For most people with Geno Valgoma, exercise can help realign and stabilize their knees. Your doctor or physiotherapist first evaluates your walking, then suggests exercises to strengthen leg, hip and thigh muscles according to the conditions and helps you to do them.
- Massage therapy: Massage therapy is one of the methods used in physiotherapy. This method includes many techniques and includes rubbing and softening of body muscles.
In massage therapy, more emphasis is placed on the biceps muscle and external and internal collateral ligaments. In general, different techniques of manual therapy are used to treat crossed knees.
- Prosthetic orthosis: If your feet are uneven in length as a result of Geneva Valgum, a suitable insole on the shorter side can even out your foot length and help regularize your walk.
It is also effective in relieving leg pain. For children whose cruciate knees are not resolved by age 8, using a brace or splint can help their bones grow properly.
- Surgery: When Geno Valgum is severe or when exercise is not effective in relieving pain and stabilizing the knee, your doctor may recommend surgery. In general, there are two different types of surgery.
This is a very informative post about Genu Valgum, also known as crossed legs. I had no idea that it was a natural stage of development in children and that it typically corrects itself over time. Can you please explain more about the different surgical methods used for treating Genu Valgum in adults? Thank you!
Thank you so much Ella for taking time to read the article and your question!
There are two main surgeries to treat Genu Valgum or knock knees including Distal Femoral Osteotomy (DFO) with or without Tibial Osteotomy and Growth Manipulation (Epiphysiodesis and Hemiepiphysiodesis).
The main method used for adults is DFO.
Distal femoral osteotomy, or DFO, surgery involves creating a cut in the femur just above the knee to reshape the bone and realign the entire limb.