Physiological Variants

Physiological variants refer to the range of changes that can occur as part of musculoskeletal development and usually refer to changes in the lower limbs. Such changes are often a cause for concern in parents or carers.  

Physiological variants include leg alignment issues, flat feet, knock knees, bow legs, out-toeing, in-toeing or tip-toe walking. 

It is important to understand gait and motor milestones and lower limb development in the healthy child to appreciate physiological variants, when observations may warrant concern, what conditions to consider and when referral for further assessment is needed.

There is a wide variation in lower limb development and minor variants, such as flat feet or knock-knees, are a common cause of parental concern. Sometimes they can be confused with indicators of underlying pathology.