O-shaped legs

　　The most common causes of O-shaped legs can be divided into three categories:

　　1. Developmental factors

　　During the period of body development, due to malnutrition or intestinal diseases and other reasons, a lack of calcium, phosphorus, and other nutritional elements may occur, leading to skeletal development disorders, bone deformation, or poor development of articular cartilage, and the change of genu varum may occur;

　　2. Factors of imbalance

　　Due to long-term poor posture or incorrect use habits causing mechanical imbalance in the muscles controlling the dominant joint, long-term mechanical imbalance of the muscles can lead to joint displacement and the formation of genu varum. This type of joint displacement is completely different from the joint dislocation that everyone is familiar with. Joint dislocation is characterized by relative displacement of the corresponding joint surfaces, resulting in the loss of normal correspondence. Joint displacement is mainly manifested as joint rotation and abnormal joint space, in the case of the knee joint, it is when the two feet are standing parallel and close together, the patella rotates medially, which is caused by the overall rotation of the knee joint, not patellar subluxation. As long as the joint is corrected, the patella will return to the front, and on the anteroposterior X-ray film, the lateral and medial gaps of the knee joint are not of equal width, and the medial gap is significantly narrowed;

　　3. O-shaped legs caused by trauma or other diseases

　　The medial and lateral collateral ligaments of the knee joint are the stable structures of the knee joint's medial and lateral angles, which can make adaptive adjustments with the change of the joint. In general, the medial and lateral collateral ligaments are not the key factors in the formation of O-shaped legs, but in some cases, such as injuries causing lateral collateral ligament injury that destroy the stability of the knee joint, can also lead to O-shaped legs, which is more common in athletes, and surgical repair of the damaged ligaments is generally required during treatment.

　　People with O-shaped legs, when standing and walking, use the outer leg muscles while the inner muscles are not used. Therefore, the leg muscles develop unevenly, often with more outer muscles and fewer inner muscles. This forms a curved leg muscle contour line, giving the impression that the bones are curved. In fact, not all bones are curved, only a few are truly curved. If you want to determine whether the bones are curved, the most direct method is to take an X-ray film in anteroposterior projection.

　　Moreover, some unbalanced O-shaped legs are accompanied by outward displacement of the hip joint, which can lead to a larger gap between the two legs.

　　The normal knee joint distributes pressure evenly on the joint surface. However, in people with O-shaped legs, due to the inward varus of the knee joint, the body weight is excessively concentrated on the medial joint surface. Excessive pressure and friction can lead to wear of the cartilage surface on the medial side of the knee joint, collapse of the tibial plateau, and secondary osteoarthritis. As people age, joint pain may occur more easily, affecting normal walking activities.

　　O-shaped legs affect our physical beauty:

　　1. The S-shaped curve on both sides of the body is destroyed, the original inward curve to the knee joint is lost, or becomes an outward bulging curve, visually lacking that delicate beauty.

　　2. Due to the fact that people with O-shaped legs have more muscle on the outer side of the bones and less on the inner side, this leads to the lower limb contour line being more outward, making the hips appear wider and the lower legs particularly curved.

　　3. O-shaped legs, due to uneven muscle distribution, make both the upper and lower legs appear curved, causing the legs to lose the straight line of the curve and the person to lose some of their upright posture.

　　4. People with O-shaped legs have a huge gap between their two legs, which is very unattractive visually.

　　5. People with O-shaped legs, because the lower leg below the knee joint bulges outward more, it seems that the lower legs are very short.

　　6. People with O-shaped legs, due to the change in thigh curve, appear shorter from the front view, with an imbalance in the proportion of the upper and lower limbs.

　　7. People with O-shaped legs, due to excessive body weight concentrated on the medial side of the knee joint, are not easy to maintain balance when walking, tend to sway, form a duck-like gait, and have an unattractive walking posture.

　　Common symptoms of O-shaped legs:

　　1. Due to the fact that people with O-shaped legs have more muscle mass on the outer side of the lower leg and less on the inner side, this leads to the lower leg's outer contour line being more outward, making the hips wider and the lower legs particularly curved.

　　2. People with O-shaped legs, due to changes in the curve of the thigh, look shorter from the front, and there is a proportion失调 between the upper and lower limbs.

　　3. People with O-shaped legs, due to too much body weight concentrated on the inner side of the knee joint, are not easy to maintain balance when walking, tend to sway, and form a duck-like gait, which is unattractive.

　　4. People with O-shaped legs have more outward protuberances below the knee joint, making the lower legs seem very short.

　　5. The S-shaped curve on both sides of the body is destroyed, and the arc that should converge at the knee joint is gone, or it becomes an outward膨胀 curve, visually lacking that delicate beauty.

　　6. Due to uneven muscle distribution in O-shaped legs, both the upper and lower legs seem curved, so the legs lose the straight line and the whole person loses a bit of posture.

　　O-shaped legs are mainly due to calcium deficiency and heredity as the two basic factors for the formation of O-shaped legs, but the more direct reason is still related to walking posture, standing posture, sitting posture, and some sports.

　　Walking with an 'X' shape, standing in a slight pause posture, wearing high heels for a long time, sitting in a circle, kneeling, and squatting in a horse stance, etc., will exert an outward force on the knee joint, and this force will pull the lateral collateral ligament of the knee joint. If this continues for a long time, as Puan Feng Ling believes, it will lead to the relaxation of the lateral collateral ligament of the knee joint. The collateral ligaments on both sides of the knee joint are the stable structures of the internal and external angles of the knee joint. When the lateral collateral ligament is relaxed, the greater force of the medial collateral ligament will pull the tibia of the lower leg inward, forming genu varum, that is, O-shaped legs.

　　Preventive measures:

　　1. It is walking posture. You must never walk with a wide 'X' shape. When walking with a wide 'X' shape, the legs exert force to the side, giving the knee joint an outward push. In this way, with every step, the lateral collateral ligament of the knee joint is subjected to a pull and impact, and over time, the lateral collateral ligament of the knee joint will become loose, the lateral stable structure of the knee joint will become unstable, and the knee joint will rotate inward, forming O-shaped legs.

　　2. It is sitting posture. You cannot sit with your legs crossed, nor can you sit in a circle or kneel.

　　3. Posture. You cannot stand in a slight pause posture with the center of gravity on one leg. When standing in a slight pause posture, the leg on which you are standing will also receive an outward force, and the internal rotation angle will increase. Over time, this will form O-shaped legs or exacerbate O-shaped legs.

　　4. Sleep posture. It is absolutely forbidden to cross your feet when sleeping.

　　5. Exercise. Activities such as playing football, practicing martial arts, and playing table tennis can lead to O-shaped legs, which is well-known. In fact, many track and field sports, if the posture is not correct, will give the knee joint a relatively intense outward impact, which can lead to O-shaped legs. Therefore, the proportion of O-shaped legs among athletes is very high. In addition, the Puan Feng Ling finds that there are many leg-folding actions in yoga and Qigong, which may also lead to and exacerbate O-shaped legs. These actions need to be avoided.

　　1. To check the O-shaped leg in a standing position, the patella should face the front, the inner edges of both knees should be close together, and the patella separation can be seen. When standing, the ankles of both feet should be close together, and the legs and knees should be pressed inward to close together, and the distance between the medial sides of the two knees is the active knee distance.

　　2. In addition, in X-ray examination, the angle formed by the baseline of the knee joint with the long axis of the femur and tibia, or the relationship with Mikulicz force line, can be used to explain the degree of genu varum.

　　1. For mild cases, improvement can be achieved through diet and nutrition. In addition to supplementing vitamin D and ensuring the absorption of calcium, it is also necessary to balance nutrition in all aspects, providing a good foundation for calcium absorption.

　　2. For moderate leg deformities, treatment intervention is required, using the method of muscle injection of vitamin D2 and vitamin D3, while improving diet and nutrition, and paying more attention to outdoor exercise.

　　3. For severe leg deformities, in addition to vitamin D2 and vitamin D3 injections, attention should be paid to diet and nutrition, outdoor exercise, and regular check-ups until the development is basically fixed.

　　1. Surgical correction

　　Surgery is suitable for very severe O-shaped legs or patients with osteoarthritis or joint pain. The advantage of surgery is passive treatment and immediate correction, without the need for perseverance and persistence. The disadvantage is that the surgical technique is different, most of which require osteotomy, with high pain and risk and high cost.

　　1. External fixator combined with osteotomy of the tibial tuberosity in the inverted U shape.

　　The main advantages of this method are: simple, safe osteotomy operation, fast bone healing, not prone to delayed healing, and the use of external fixators facilitates the control of the angle of整形 correction, which can make the bone healing angle accurate and easy to adjust. Patients can walk on the ground during the treatment process, and the lower limb muscles will not atrophy.

　　2. Osteotomy of the tibial tuberosity in the inverted U shape, with external fixation with a cast after surgery.

　　According to statistics, the complete correction rate of O-shaped leg deformity can reach more than 70%.

　　2. Non-surgical correction methods

　　The manipulation of bone setting can quickly treat O-shaped legs, usually within one or two months to achieve correction.

　　The principle of leg binding and the straight O instrument is basically the same, both of which are through the relaxation of the medial collateral ligament of the knee joint to restore the stable structure of the inside and outside of the knee joint. This makes the tibia externally rotate to achieve the correction goal.

　　Non-surgical correction methods have the advantage of low cost and low risk, but the disadvantage is that active treatment is required, and the effect is slow, requiring long-term persistence. Without perseverance, the goal of correction cannot be achieved.

　　1. Correction using a straight splint and leg binding method

　　This method is simple and easy to implement, adjusting the ligaments at the knee joint through the pressure generated by splints and bindings. The advantage is that it does not require surgery and is easy to operate, but the disadvantage is that it requires persistence, and splints and bindings are prone to cause damage to the blood vessels and nerves in the knee joint area, with severe cases leading to nerve necrosis.

　　2. Instrument correction

　　The instrument also adjusts the cruciate ligaments on the inside and outside of the knee joint. The disadvantage is that it requires active treatment, and the duration of the correction cycle needs to be determined based on the patient's constitution and perseverance, which is much more expensive than splints or bindings. The advantage is that it can avoid damage to the blood vessels and nerves in the knee joint area.

　　3. Corrective Insoles

　　Corrective insoles are higher on the outer side and lower on the inner side, which can provide the calves with an outward rotating force during walking and standing, preventing the aggravation and formation of O-shaped legs caused by poor posture. Convenient to use, but effective for mild O-shaped leg patients, not suitable for patients with severe O-shaped legs.

　　4. Exercise

　　The specific correction methods of O-shaped legs through exercise are as follows:

　　(1) Stand upright, feet together, support the knees with both hands to do a squatting and standing movement facing forward, and do 20-30 times.

　　(2) Bend over, support the knees with both hands to do circular movements to the left and right, and do 20-30 times.

　　(3) Stand with feet slightly apart, bend over, and support the knees with both hands to do an inward movement of the knees, stopping for 10 seconds each time, and doing 5-10 times.

　　(4) Stand with feet parallel. First, rotate the toes outward and inward around the heel as an axis; then rotate the toes outward and inward around the toes as an axis, and do 20-30 times each.

　　(5) Sit on a chair and try to hold a book between the calves for a certain period of time. If you tie the knees together with a rubber band, the effect will be more significant.

　　(6) Kneel on the legs, hunch over, and move the feet outward and forward slowly, and the waist also straightens up gradually. Do 15-20 times.

　　(7) Squat with hands on hips, upper body straight, legs apart 15-20 cm, toes slightly outward. During inhalation, knees come together and slowly squat down, trying to squat deeply and stay for a moment, feeling the leg muscles tense. During exhalation, slowly open the knees, stand straight, and repeat 10 times. Squatting with knees and thighs close together is very effective for correcting O-shaped legs. The deeper the squat, the better the effect.

　　It is very important to prevent and prevent the aggravation of O-shaped legs, especially for those caused by congenital and organic diseases. The vast majority of O-shaped legs are caused by poor habits after birth (sitting cross-legged, kneeling, exercise, walking posture, etc.). Pay attention to these in daily life to avoid the formation of O-shaped legs. Even for patients who have been corrected through various methods, attention should be paid to various bad habits to prevent the recurrence of O-shaped legs.