Is Bowleg (O-Shaped Legs) Caused by Bent Bones?

Many people mistakenly believe that bowleg (genu varum) means the leg bones themselves are bent. Even some non-specialist doctors hold this common misconception.

In reality, genu varum is far more complex. According to medical literature, there are two main types: mechanical varus deformity of the tibia due to bony changes, and soft tissue imbalance–induced varus. Most people are unaware of the latter, leading to the mistaken conclusion that bowlegs are irreversible.

When the deformity is due to bone structure changes, it generally cannot be corrected through physical means. However, if it results from soft tissue imbalance, it can be improved. In fact, even in surgical corrections for genu varum, about 72.1% of the correction can be attributed to restoring soft tissue balance—meaning a large portion of the condition is modifiable.

Correction methods for bowlegs include:

• Surgery

• Devices or braces

• Splints

• Leg strapping

• Targeted exercises

• Orthotic insoles

Surgery is typically recommended for severe cases or when complications such as osteoarthritis and joint pain have developed. The benefit of surgery is that it's a passive treatment—results are immediate and don't require long-term commitment. However, surgical procedures often involve bone cutting (osteotomy), which comes with high cost, significant pain, and potential risks depending on the surgical technique.

Statistically, the full correction rate for bowleg deformities can exceed 96%. Non-surgical methods, though slower, follow a similar principle: they work by relaxing the medial collateral ligament of the knee and restoring balance between the inner and outer knee structures. This encourages external rotation of the tibia to achieve alignment.

The advantages of non-surgical correction are lower cost and reduced risk. However, these are active treatments, meaning they require consistent effort and patience. Without persistence and discipline, the desired correction may not be achieved.