Can you please tell me about therapy for bowleggedness?
Bowleggeddness is a condition where a person’s knees point outward, causing increased pressure on the medial (inside) of the knee between the tibia and fibula and open space between these two bones on the lateral (outside) part of the knee. Besides having a less than desirable appearance, problems that could ensue as a result of this condition are ligaments being more prone to tearing, the wearing out of the meniscus (the shock absorber in your knee) and arthritis, increased pain and disability in the knee. These symptoms all result from the uneven pressure in the knee (similar to uneven tire wear).
Bowlegged people are usually born with this condition, develop it from walking or running with improper mechanics or have muscles that are out of balance. People who have had any type of reconstructive knee surgery are also more susceptible to developing bowleggeddness. A newsletter published by Duke Orthopedics and Duke Sports Medicine in spring of 2003 recommends that doctors carefully monitor people, particularly young people, for any improper leg bone alignment following reconstructive knee surgery. Even a misalignment as little as three degrees can lead to significant osteoarthritis problems later in life.
Braces, Orthodics and Proper Shoes
The first two treatment options that should be looked at are orthodics and knee braces. Orthodics used should help tilt the foot in to alleviate symptoms. However, most drug store brand orthodics are thicker on the inside (tilting the foot out) and could aggravate the problems. Knee braces work best if they come from your doctor rather than over the counter ones. They will help take pressure off the medial part of the joint. Stretchy knee sleeves can also help because, although they do not help with proper alignment, they put pressure on the skin that signals the muscles to counteract when needed.
Proper running shoes are also a must, “even if you’re not a runner,” says Doug Gross, a physical therapist and researcher at Boston University. He suggests visiting a running store where the sales people are more likely to recommend wearing the proper shoe that will help correct alignment issues.
Exercise is critical to overcoming the effects of bowleggeddness, but specific guidelines must be followed. Here is a checklist to consider:
- Pain and swelling can inhibit muscles and reduce their strength. Therefore, too stressful exercise can make symptoms worse.
- Beneficial strength exercises are gradual and should not invoke greater knee pain.
- As mentioned above, knee braces, orthodics or both should be considered before starting an exercise program and can make a difference in exercising safely.
- Exercises should not put too much weight on the knee. Therefore, pool workouts are a great choice.
- Strengthening the quadriceps is a primary goal and should be achieved with exercises simulating everyday activities. Body weight squats with proper mechanics is one example. Straight leg lifts are not ideal, according to Gross.
- Biking can help, although it can load the patellofermoral joint. Start with light resistance.
- Tailor made exercise programs under a doctor’s supervision are best.
Additional treatment options include acetaminophen (the key ingredient in Tylenol), cortisone shots and capsaicin cream (found in chili peppers). Tylenol should be limited to 4000 milligrams per day. Cortisone shots can be effective in increasing joint mobility but can wear off in time. Capsaicin cream can help some because it is thought to stop arthritis pain signals from getting through.