Bow leg correction exercises: will they really straighten your legs?

If you've tried following videos that promise "your legs will touch in a few weeks"

Key points in 30 seconds

1. There's no solid research showing that exercise can change bone angles in fully grown adults. "Your legs will touch in a few weeks" is, as far as bone goes, a promise beyond the evidence.
2. But how bowed your legs look is a mix of how much the hip joints are rotated, imbalance in the hip and thigh muscles, collapsed feet, and how you stand and walk, and these can change.
3. So the goal of bow leg exercises isn't to make your legs touch, but to reduce the load that shifts onto the inside of the knee. Bow leg alignment raised the risk of arthritis on the inside of the knee by about 1.5 times, and the risk of it progressing by about 3.6 times.
4. There are four things to do: strengthen the muscles at the side of your hips, line up your knees when standing up, split your weight between both feet, and keep your feet flat on the floor instead of crossing your legs.
5. If your knee is swollen and warm, hurts even at night, or suddenly locks, checking the joint comes before exercise.

What we often hear

• "I followed a YouTube routine for a month, but my legs in the mirror look the same."
• "Is it because I didn't do enough, or does it just not work?"
• "They tell me not to lean on one leg, but before I know it I'm standing on one side again."
• "The gap between my knees gets a bit smaller when I exercise. Does that mean they've straightened?"

"Just 10 minutes a day with this exercise, and your bow legs will straighten."

In the video, the legs are touching in a matter of weeks. So you probably tried following along: squeezing your knees together morning and night, tightening your legs, holding against a band.

A month has passed. Your legs in the mirror look the same. Did I not do enough, or was it never going to work?

Today, let's answer that question honestly, by separating what exercise can't change from what it can. Knowing this before you start is how you avoid being disappointed after a month, and how you'll recognize what has changed after three.

What exercise can't change is the adult bone angle

There's no solid research showing that exercise can change bone angles in fully grown adults. The angle where the thighbone and shinbone meet is largely set by the shape of the bones, and the established way to change it substantially is surgery that cuts the bone to adjust the angle.

So "your legs will touch in a few weeks" is, at least as far as bone goes, a promise beyond the evidence. Your legs not straightening in a month isn't because you didn't do enough.

So is exercise useless?

No. The bow legs you see in the mirror aren't made by bone alone.

How much the hip joints are rotated inward, how imbalanced the thigh and hip muscles are, how much the feet collapse inward, and how you stand and walk. With the same bones, depending on these, legs can look more bowed or less bowed. These can change.

The comparison we use in the clinic is that bones are the rebar and muscles are the cement. You can't easily change the angle the rebar is bent at. But depending on which side the cement supports firmly, the shape the building stands in and the strength it holds with will differ. On top of that, long-standing habits of favoring one side and the muscles have been pulling the bones in that direction. What exercise works on is that cement and those habits.

There's also a study. In a Korean study that compared groups of 47 middle-aged women with bow legs and knee pain, the group that did combined exercise three times a week for 12 weeks improved in pain and some leg alignment measures.

But you should also know three things.

• It's a single study of 47 people.
• Whether the change lasts hasn't been confirmed yet.
• A visible change like "the gap between the knees got smaller" and a change like "the bone angle changed" are different things.

Move the goal from the mirror to your knees

Before it's a problem of shape, bow legs are a problem of load. When the legs bow outward, body weight concentrates on the inside of the knee.

In a large follow-up study, bow leg alignment raised the risk of developing arthritis on the inside of the knee by about 1.5 times, and the risk of existing arthritis getting worse by about 3.6 times.

So think of bow leg exercises as exercises that ease the load bowed legs put on the knee and change the direction of the forces pulling on it. They're exercises for your knees 10 years from now.

Four things to do instead of "don't"

"Don't lean on one leg" is hard to follow. Before you know it, you're standing on one side again. Why we give you things to do instead of prohibitions is written in the knee walking post. For bow legs, here's how we change it.

One: strengthen the side of your hips. Lie on your side and slowly lift and lower your top leg. This builds the muscles at the side of the hips that keep the knee from collapsing inward. It's the part most often left out of bow leg exercises.

Two: check where your knees point when you stand up. Slowly stand up from a chair and sit back down, lining your knees up so they point toward your second toe. This builds thigh strength while teaching you the feel of the knee moving along the right path. If your knees keep caving inward as you stand, fix the direction before worrying about the number of reps. The reason is in the bow leg exercise post.

Three: when standing for a long time, put half your weight on each foot. If that's tiring, switch from one side to the other. The problem is less leaning on one leg itself than staying fixed in one position for a long time.

Four: when sitting, keep both feet flat on the floor. Make this your default posture, and when you want to cross your legs, alternate sides.

The right number of reps and speed differ depending on the state of your knee and your strength, so we set them together at your visit. After you've tried them, we'll ask how it went at your next visit.

Knees to get checked before exercising

If you have any of the following, the joint needs to be checked before you start exercising.

• The knee is swollen and warm
• It hurts at night even when you're resting
• The knee feels like it suddenly locks

How we work

First, we measure how much of your bow legs is bone. We look at whole-body alignment with an X-body posture analysis, and if needed, measure your leg angles while standing in partnership with the radiology clinic on the 2nd floor of the same building. If bone accounts for a large share, we tell you about that limit first.

Second, we work on muscles and habits. We use Chuna (Korean manual therapy) to refine the movement of the pelvis and hip joints, and prescribe the four things above adjusted to your body. If your knee hurts, we manage it with acupuncture and pharmacopuncture (herbal acupuncture).

For a few days after correction, you may feel awkward or stiff. Your body remembers the posture it's long been used to as normal, so the new position feels unfamiliar. It usually passes, but if it hurts badly, let us know right away.

Third, we measure again the same way as the first time. At set points, we measure the same indicators again and look at how much they've changed. We trust numbers over how things look in the mirror. We don't promise leg angles.

What changes

Instead of a month of hoping "maybe this time they'll touch" while watching videos and then being disappointed, three months of checking for yourself, every time you stand up, whether your knees point toward your second toe.

Along the way, you think less about the inside of your knee as you go down stairs, and while standing you suddenly notice your weight is evenly spread on both feet. That's what we're aiming for.

How much changes, and how fast, differs from person to person depending on the share of bone versus muscle and habit, age and weight.

Today's takeaway

Bow leg exercises are exercises that protect your knees. Bone angles don't change with exercise, but muscles and habits do.

There are two things to try today.

1. Stand barefoot with your ankle bones touching and take one front-view photo.
2. Write one line about which leg you mostly lean on, and which way you cross your legs, over the course of a day.

Bring that photo and note with you, and we'll estimate together how much of your bow legs is habit. We're open until 8:30 p.m. on weekdays, and on weekends and public holidays too.

The relationship between bow legs and knee arthritis, and the original exercise studies, are in the bow legs evidence post, and the order in which we measure and work on 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.