My 2 YO Walks Like a Cowboy

Dear Mamas,

My 2 yo son has been walking since 10 months and running since 10 months and 1 day. It seems like he does all things physical earlier than expected. He’s also noticeably bow-legged, and walks with a cowboy swagger. I feel like I’m watching a bad western from the 1960s and fear that any day now he’ll greet me with “Howdy, pardner”!

Our pediatrician (who we adore and trust) says this is part of normal toddler development, but my friends are starting to notice and question it. A mom on my block recently told me that her older brother wore leg braces for a similar problem when he was a child.

Am I ignoring something serious? Will it affect his growth in the future? Should I overrule the pediatrician and take him to a specialist?

I don’t think riding the rodeo is such a great career path.

Thanks!

Dear Rodeo Mama,

This is a question we get all the time, from cowboys and cowgirls alike. Never fear, bowing (the technical term is genu varum, literally angle-kneed) is a normal part of child development. In fact, infants are most often born with bowed legs — you just can’t tell because they’re not upright and walking around.

Physiologic bowing (which means the kind that’s part of normal development and not caused by disease) usually begins to straighten out at about 2 years, but there’s lots of room for individual variation here. Often, the knees then start to go in the other direction and 3 or 4 year-olds can look knock-kneed. After that the legs correct to form typical adult alignment by around 6 to 7 years. There’s a wide range of normal and physiologic bowing doesn’t require any treatment other than observation.

Another benign condition called internal tibial torsion (inward twist of the tibial bone in the lower leg, caused by positioning in the womb) can make bowing look more pronounced than it is because the knee caps appear to be pointing outward, exaggerating that cowboy look. Fortunately, tibial torsion also tends to correct itself at about the same time as physiologic bowing.

There are some disease processes that cause pathologic, or abnormal, bowing of the legs. The most common of these are rickets, caused by a deficiency or abnormal metabolism of the vitamins and minerals needed to make healthy bone, and Blount’s disease, which affects the relative rate of growth of the upper shin bone, causing the outer portion to grow faster than the inner, creating a bowed appearance.

Both of these lead to abnormal appearing bones, not just that cowboy look, and they are unlikely causes for your guy, especially if your pediatrician is aware of your concern and is following his growth.

Bottom line — it’s overwhelmingly likely that by the time your little guy starts school he’ll be well on his way to looking more like a surfer than a cowboy. Is that a good thing?

One more important point raised by your question is how sensitive we moms are to the comments and evaluations of other mothers. Back in the day, lots of kids with physiologic bowing were put in corrective leg braces. If we’d known then what we know now (that treatment wasn’t necessary and it would correct naturally), they’d have been spared months of discomfort and reduced mobility.

But your neighbor has no way of knowing that, and her childhood experience dialed up your worry and made you question your well-loved family doctor. The other moms who comment on your kiddo’s gait are coming from a place of comparison with their children — which has nothing to do with yours.

It just goes to show how fragile our mommy confidence can be in the face of all the vast possibilities of normal and healthy. So stand up tall, ask the questions that need to be asked, and try not to compare Josh to Jon because they’re not the same children. Thank goodness for that!

We love getting all of your questions and want to give you everything that our combined brains have to offer. So keep sending them in! 

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?


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One response to “My 2 YO Walks Like a Cowboy”

  1. Are Bowlegs Bad?

    […] very common question, so we’re glad you asked. We’ve talked about this in a past post (My 2-YO Walks like a Cowboy), and common questions need to be repeated […]

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