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Developmental Phases

What are they?

Developmental phases are stages that one's lower extremities undergo until a final growth period has been achieved. There are certain terms that are used which refer to these developmental phases. They are genu valgum or "knocked knee" and genu varum or "bowlegged." Genu varum or bowlegs are common/normal for toddlers until about 18 months of age. Genu valgum or knocked knees are normal in children between 2-4 years of age. A majority of these developmental conditions correct themselves and the child usually grows out of it. As your child grows you may notice the different configurations that their legs undergo but in most cases, these are normal and require no specific care. If there is any concern that these earlier growth phases are becoming permanent, a physical examination should be performed by your foot specialist.

What causes it?

In general, these developmental phases are considered normal. However, in certain cases, abnormal growth patterns can produce obvious orthopedic problems. The main etiology or cause of such a problem is growth in the uterus. Often times, the uterus becomes a very "tight" environment as the child grows. When this occurs, the child rests his/her feet and legs against the uterine wall, which can cause certain foot and leg deformities. Hereditary factors are another possible etiology for this condition. If one of your family members suffers from a growth condition, your tendency to develop a similar growth deformity significantly increases.

How is it treated?

The treatment of developmental growth phase abnormalities is usually determined by the presence or absence of symptomatology. Many times, if a child has a severe case of bowlegs or knocked knees he or she will complain of painful feet, which are frequently flat in appearance. If this occurs, certain orthotics or "cookies" can be made to support the feet and can be worn in the shoes. Stretching exercises can also be performed to stretch muscles in the legs or feet that seem to be tensed. Occasionally, foot and leg braces are used and in rare and severe cases, surgery is utilized. These developmental phases are quite difficult to manage. Therefore, a proper and timely exam needs to be performed by a well-trained specialist. The treatment of prolonged developmental growth phases in the lower extremities largely depends upon whether or not there are symptoms. In the absence of clinical symptoms or patient complaints, these growth stages are rarely treated.

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