If you've started hiding your legs in front of the mirror

If you've been looking into correction, try changing the order first

Key points in 30 seconds

1. When the legs bow outward, body weight shifts onto the inside of the knee. In a study that followed 4,265 knees, bow legs raised the risk of developing arthritis on the inner side of the knee by about 1.5 times, and the risk of existing arthritis getting worse by about 3.6 times.
2. There is no high-quality evidence that bone angles in adults who have finished growing can be changed without surgery. We don't promise angles.
3. But not all of the visible curve is bone. Rotation of the pelvis and hip joints, muscle imbalance, and the way you stand and walk are areas that can be worked on.
4. Bones are the rebar, muscles are the cement. If you only correct alignment without building strength, things go back the same way.
5. Bow legs in children are mostly normal development, and scoliosis during growth calls for a specialist assessment first. We measure before any correction.

What we often hear

• "My pants never fit right, and I keep noticing my legs in photos."
• "When I stand, I lean on one leg, and when I sit, I cross my legs. People point it out, but I can't stop."
• "At a school checkup, they told me my spine is curved."
• "The inside of my knee aches when I go down stairs."
• "I'm worried my child's legs look bowed, like an O."

Body shape worries usually start in front of the mirror. But treatment starts not with the mirror, but with measuring angles.

What to look at before shape is load

When the legs bow, the body weight that the whole knee should share gets concentrated on the inner cartilage. The side that takes the load wears out first. The numbers above, 1.5 times and 3.6 times, are the result.

So with bow legs, the question to ask isn't so much "will my legs straighten?" as "how do we reduce the load that's shifted to one side?" That's why we explain things in this order even to people whose knees don't hurt yet.

What can change and what can't

Let's be clear about one thing first. The shape of adult bones isn't something non-surgical treatment can promise to change.

Insoles that raise the outer edge of the shoe to take pressure off the inside of the knee seemed promising, but in an analysis pooling several trials, they didn't reduce pain.

On the other hand, some things can change: how much the hip joints are rotated, imbalances in the muscles around the hips and knees, the alignment of the feet, and the way you stand and walk. A Korean study in which 47 women with bow legs and knee pain exercised for 12 weeks reported improvements in pain and some alignment measures. It's just one small study, but this is exactly where we focus our work.

Bones are the rebar, muscles are the cement

This is the comparison we use most often in the clinic.

If you only straighten bent rebar, it will bend again every time it's shaken, unless cement holds it in place. When the cement is solid, the rebar stays put. If refining alignment with Chuna (Korean manual therapy) is setting the rebar, then building strength and fixing habits is pouring the cement.

If you do only one of the two, things go back. That's because the bones didn't twist on their own in the first place; habits of favoring one side and muscles have been pulling in that direction for a long time. We've written up separately why corrected legs go back.

If you've been told your spine is curved

Scoliosis is broadly divided into two kinds.

Idiopathic scoliosis develops without a clear cause and is relatively common in people with a slim build. Just as a wire covered with thick clay doesn't bend easily but one covered thinly bends readily, the spine bends more easily in a body with less supporting tissue.

Functional scoliosis has a cause, such as a difference in leg length, a tilted pelvis, or a habit of favoring one side. In this case, treatment centers on addressing that cause.

More important than the distinction is knowing where the line is. For scoliosis in growing children and teenagers, and scoliosis with a large angle or that is progressing quickly, a specialist assessment comes before our treatment. Based on those results and the stage of growth, we take care of strength, balance, habits and pain, and we identify and refer cases that need a detailed assessment.

If your child's legs look like an O

Babies' legs naturally bow outward. They straighten on their own after walking begins, around age 2, then lean briefly toward knock-knees, and settle into adult alignment by school age. This is normal development.

What's needed at this stage isn't correction but telling normal from not. If any of the following four apply, imaging comes first.

• It keeps getting worse after age 2–3
• Only one leg is bowed
• Your child is clearly shorter than peers
• Your child complains of pain or limps

If you see these signs, instead of a correction program, we first refer you to the radiology clinic on the 2nd floor of the same building, which we work in partnership with. More details are in the post on bow legs in children.

Treatment follows this order

First, we measure. We use an X-body posture analysis to look at whole-body alignment and posture patterns, and, in partnership with the radiology clinic on the 2nd floor, take standing X-rays to measure leg angles. This is where we sort out whether it's a bone angle issue, a posture and muscle issue, or a mix of both. We don't make a correction plan without this distinction. If you have knee pain, we look at the joint first.

Second, we build the strength that holds things in place. We use Chuna to refine the alignment and movement of the pelvis and hip joints, and give you strengthening exercises for the hips and knees, down to the method and number of reps. We also work on habits that have been pulling the bones, like leaning on one leg or crossing your legs. If there's pain, we manage it with acupuncture and pharmacopuncture (herbal acupuncture), and if body weight is adding to the strain on your knees, we also set a weight loss goal together based on an InBody test.

Third, we measure again the same way. At set points, we measure the same indicators in exactly the same way and judge by how much they've changed, using measurements rather than feelings or photos. If nothing has changed, we don't repeat the same treatment; we go back to assessment.

Right after correction, things may feel awkward

After treatment, you may actually feel awkward or stiff. Your body has come to remember its long-twisted posture as normal, so the correct position feels unfamiliar at first.

This usually passes as your body gets used to the new position. But severe pain may be a different problem, so let us know right away. Going through it knowing what to expect is different from going through it unaware.

Frequently asked questions

Q. How many sessions until my legs straighten?
We don't promise angles. What we work on is posture, muscles, habits, knee load and pain. We'll tell you what can change, and by how much, based on measurements after we've measured.

Q. Once corrected, will it stay that way?
There are conditions. If the muscles and habits that caused the twist stay the same, things go back the same way. So when treatment ends, the goal is for you to leave with the exercises and habits you need to maintain it.

Q. I was diagnosed with scoliosis. Can a Korean medicine clinic treat it?
It depends on the type, the angle and the stage of growth. Scoliosis that's progressing during growth or that has a large angle calls for a specialist assessment first, and we take care of strength, balance, habits and pain based on those results.

What changes

No longer thinking about the inside of your knee as you go down stairs. The habit of checking your legs first in the mirror fading. And saying not "I'm going in for correction," but "I'm holding it with my own strength."

That's what we're aiming for.

How much things improve, and how fast, differs from person to person depending on how much is bone versus function, age, weight and strength.

Today's takeaway

Measure before you correct. The starting point is knowing how much of your legs is bone and how much is habit.

If you do get correction, make building strength part of the same package. That's what keeps things from going back.

If you'd like to see the research literature, we've written it up in the bow leg evidence post, and the order in which we look at posture is laid out in our treatment guide.

For questions or appointments, message us in English through the messenger at the bottom right of the page, or call +82-53-716-1175.