Genu Valgus — Symptoms, Causes & Treatment

Genu valgus deformity, also known as "knock knees," is a condition in which the knees angle inward and touch each other when the legs are straightened. This results in a wide gap between the feet when standing with the ankles together.

The exact cause of genu valgus may vary from person to person and can involve a combination of genetic and environmental factors. There are various causes of genu valgus, a few of them are mentioned below:

• Genetics, some children inherit this condition from their parents.
• Injury or infection that affects the growth plates in the legs.
• Obesity can also increase the risk of developing knock knees.
• Poor nutrition can also contribute to the development of genu valgus.
• Conditions such as rickets or Blount's disease.

The severity of these symptoms may vary depending on the individual and the underlying cause of the condition. The common symptoms of genu valgus may include:

• Visible deformity of the legs.
• Knee pain, especially after physical activity or extended periods of standing or walking.
• Difficulty walking or running due to instability in the knee joint.
• Increased risk of falls due to the abnormal alignment of the legs.

Pathology:
Genu valgus deformity occurs when there is an imbalance between the forces acting on the inner and outer aspects of the knee joint, causing the knee joint to tilt towards the midline of the body. This leads to increased pressure on the inner aspect of the knee joint and can cause the development of arthritis over time. In addition, the abnormal alignment of the legs can cause strain on the muscles and ligaments, leading to pain and instability in the knee joint.

Physical Examination:
A physiotherapist may perform a physical examination to assess the alignment of the legs and the degree of deformity, and evaluate the strength and stability of the knee joint.

X-rays:
X-rays can provide a clear image of the bones in the legs, showing the degree of deformity and any underlying conditions that may be contributing to the condition.

MRI (Magnetic Resonance Imaging):
MRI can provide a detailed view of the soft tissues, including the muscles, ligaments, and tendons surrounding the knee joint. This test may be recommended if there is suspicion of an underlying injury or condition affecting these structures.

CT Scan (Computed Tomography):
The scan can provide a detailed view of the bones and can be helpful in assessing the degree of deformity and any underlying conditions affecting the knee joint.

Gait Analysis:
Gait analysis involves assessing the way a person walks or runs, and can help identify any issues with balance or stability that may be contributing to the condition.

Blood Tests:
Blood tests may be recommended to assess for any underlying medical conditions that may be contributing to the development of genu valgus, such as rickets or Blount's disease.

Joint Aspiration:
In some cases, joint aspiration may be recommended to remove fluid from the knee joint and assess for any signs of inflammation or infection.

Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs), Acetaminophen, Corticosteroids, etc.
Note: Medication should not be taken without the doctor’s prescription.

Surgery:
In some cases, surgery may be recommended to correct genu valgus, particularly if the condition is severe or is causing significant pain or functional limitations. The goal of surgery is to realign the knee joint and restore normal alignment to the lower extremities. There are several surgical procedures that may be used to correct genu valgus, including:

• Osteotomy: This involves cutting and reshaping the bones in the leg to correct the alignment of the knee joint. The bone is then held in place with screws or plates while it heals.
• Arthroscopy: This is a minimally invasive procedure that involves making small incisions in the knee joint and using a small camera to guide the surgeon as they make repairs or corrections to the joint.
• Ligament reconstruction: In some cases, damage to the ligaments in the knee joint may contribute to the development of genu valgus. Ligament reconstruction involves repairing or replacing damaged ligaments to help stabilize the knee joint.

Thermotherapy:
Thermotherapy or heat therapy is used to reduce pain and inflammation in the knee joint.

Transcutaneous electrical nerve stimulation (TENS):
TENS involves the use of low-frequency electrical impulses to stimulate the nerves surrounding the knee joint. This can help to reduce pain and swelling in the knee joint.

Neuromuscular electrical stimulation (NMES):
NMES involves the use of electrical impulses to stimulate the muscles surrounding the knee joint. This can help to improve muscle strength and reduce instability in the knee joint.

Interferential current (IFC):
IFC involves the use of high-frequency electrical currents to stimulate the nerves surrounding the knee joint. This can help to reduce pain and improve blood flow to the affected area.

Ultrasound therapy:
Ultrasound therapy involves the use of high-frequency sound waves to penetrate the skin and stimulate blood flow to the affected area. This can help to reduce pain and inflammation in the knee joint.

Electrical muscle stimulation (EMS):
EMS involves the use of electrical impulses to stimulate the muscles surrounding the knee joint. This can help to improve muscle strength and reduce instability in the knee joint.

Strengthening exercises:
Strengthening exercises can help to improve the strength of the muscles surrounding the knee joint, which can help to reduce instability and improve overall knee function. Exercises may include squats, lunges, leg presses, and resistance band exercises.

Stretching exercises:
Stretching exercises can help to improve the flexibility of the muscles surrounding the knee joint, which can help to reduce pain and improve range of motion. Exercises may include hamstring stretches, quadriceps stretches, and calf stretches.

Balance and stability exercises:
Balance and stability exercises can help improve the knee joint's stability, reducing the risk of falls and other injuries. Exercises may include single-leg stands, balance boards, and agility drills.

Manual therapy:
Manual therapy techniques such as massage, joint mobilization, and stretching can help to improve circulation, reduce pain and inflammation, and improve overall knee function.

Gait analysis and training:
Gait analysis can help identify any issues with walking or running that may contribute to the condition. Gait training may be used to help improve overall movement patterns and reduce stress on the knee joint.

Patients with genu valgus should wear comfortable shoes with good arch support. This can help improve posture and reduce strain on the knees. Low-impact exercises such as cycling, swimming, and walking can help strengthen the muscles around the knees and improve overall fitness. Healthy weight should be maintained as excess weight can put additional strain on the knees and exacerbate the symptoms of genu valgus. Even assistive devices can be used in some cases, such as knee braces or custom orthotics can help improve alignment and reduce pain associated with genu valgus.