Knock-knees, or genu valgus, usually follows the stage of bowing, and is most notable around the age of 2 to 4 years. As with bowlegs, there are “normal” knock-knees and there are knock-knees associated with rare disorders or diseases related to bone growth and metabolism. Rare entities such as Morquio’s syndrome, Gaucher’s disease and osteogenesis imperfecta have knock-knees as part of their syndrome complex. The “normal”, developmental, knock-knees usually resolves around the age of 8 or 9 years. The above 4 criteria can also be used to monitor children with knock-knees.

Nighttime complaints of “leg pains” is very common in active children between the ages of 4 to 10 years. The area of pain is typically in the thigh and calf muscles. These “pains” are commonly called “growing pains” because it was once thought that the pain is muscle pain during a growth spurt. It is not common though in the teenage population, in which a large growth spurt occurs. There may be some validity to the theory that the growth of bone and muscle in these earlier years may be disproportionate, and therefore cause true musculoskeletal pain, although there is no definitive evidence for this.

Whatever the cause, this entity called “growing pains” does exist in this age group and therefore the child should not be ignored. Massage and warm baths are sometimes helpful. If the pain is not symmetric (in both legs), is accompanied by weight loss or fever, or very localized with redness, then you should see your child’s physician.