Gait Problems in Children

Orthopaedic conditions are those affecting the musculoskeletal system. This system consists of bones, joints and muscles all working under the control of your brain.
Most orthopaedic conditions are temporary and just a part of growing up. However some conditions need prompt treatment.

What are some common orthopedic conditions in children?


This happens when your child stands with his feet and ankles together but his knees remain far apart. Bowlegs are usually physiological, meaning that they will straighten when your child starts to walk and by age three, most children grow out of this condition.However, if bowlegs persist beyond the age of three years, further assessment is needed to exclude underlying pathological causes.


This is a condition where the legs curve in at the knees so much that the ankles are separated when your child tries to stand with his feet together. Many children become knock-kneed between the ages of three and five. When they are about six years old, the body straightens naturally and most children can then stand with their knees and ankles touching at the same time. Sometimes pathological knock-knees occurs and the distance between the ankles usually exceeds 15cm.


This refers to the absence of an arch on the bottom of your child’s feet between his toes and heel. Flatfeet happen when most of the foot surface is in contact with the ground. Most babies are born with almost no arch in their feet but this develops after they start walking.

How should these conditions be treated?

  • Bow legs
    • physiological bow legs do not need treatment as they will resolve spontaneously
    • pathological bow legs :
      • determine underlying cause
      • close observation
      • surgery may be required
  • Knock-knees
    • physiological – no treatment necessary
    • pathological – treat according to cause
  • Flatfeet
    Flexible flatfeet cannot be fixed but they usually do not cause any pain or problems. Your child may need to wear arched inserts in the shoes if they have foot pain.
Last reviewed : 26 April 2012
Content Writer : Dr. Lynster Liaw Chiew Tung
Reviewer : Dr. Tang Swee Ping