Positive Health Online

Forget finger printing and DNA testing – good old physical clues can still be used as evidence in court. The shape of your legs, for example, could be enough to convict you. I have in front of me a cutting from a tabloid newspaper of a few years ago. Trapped by Bandy Legs reads the headline. The piece of news is about a robber who denied being implicated in hold-ups, but was judged guilty anyway after a podiatrist gave evidence in a criminal trial. That's because the thief was caught on CCTV, seen from the back, walking away. His distinctive bow-legged gait was enough for our podiatrist to identify him as the guilty party.

What bemuses me is that the podiatrist told the Old Bailey that only five per cent of the population has this kind of bow-legged stride. This figure sounds to me a gross underestimate. The reason for the five per cent figure must be due to the fact that orthopaedists, physiotherapists and the like are only interested in severe distortions. Just a short trip in my high street is enough to enable me to see plenty of bow-legged people and as many knock-kneed ones. In other words, distorted legs are common, normal ones are rare.

It's easy to check whether or not your legs depart from the norm. All you have to do is to stand up, feet together. In this position, your feet should be in contact, without strain or discomfort, from heels to the end of your big toes. The top of your thighs, your knees, calves and inner (medial) ankle bones should also touch slightly. The long axis of the leg should pass through the middle of the knee, ankle and second toe. Your toes should be spread out and the sides of your feet should be oblique and in a straight line, apart from the inner (lateral) ones, notched by the longitudinal arches which should be visible. Any departure from this ideal shape would mean that you have bow-legs (genu varum), knock-knees (genu valgum) or lock-knees (genu recurvatum), flat or hollow feet, hallux valgus, quintus varus or hammer toes. In any case, the chances are that your thigh bones are rotated inwards.

If the bow-legged and knock-kneed shapes were just an aesthetic problem, they would not be worthy of this space. But as shape conditions function, it's reasonable to expect musculoskeletal troubles to arise from misalignment between the upper and lower leg. Knees are often the site of pain and dysfunction from an imperfect arrangement of parts of the leg. Take for example, the commonest problem affecting knees, known as patella syndrome or anterior knee pain (chondromalacia patellae). This condition is common in young people but does not spare older ones. It causes three main symptoms: knee pain, subjective feeling of instability as if the knee will give way, and frequent, but of short duration, blocking of the knee joints. Although many studies have been done to find a cause to this annoying condition, specialists are still in the dark.

A careful morphological examination will reveal, in most cases, an inward rotation of the thighbone, a lock-knee as if the knee was bent back, bow-legs or knock-knees. In this far from ideal condition, the knee joint is under undue constant pressure which literally scrapes the cartilage in the kneecap. In due time, if nothing is done to stop this pathological process, the knee joint will become arthritic to a point of irreversibility. Classically, treatments offered for these conditions are unfortunately analytical and local. Toning up of the quadriceps is a common form of treatment; sadly, it is useless at best and harmful at worst. Acquired physical distortions usually start from the top of the body. The primary departure from normal shape is a deepening of the concavities of the spine (lordosis). This is caused by a chronic shortening of the dorsal muscles (the muscle chains of F Mézières). But the shortening does not stop at the back; it spreads down to the legs. As the lordosis tend to turn on themselves, the concavities appear to be deeper on one side of the spine. This asymmetric shortening is commonly evidenced in the legs where one of them will usually present a more severe inward rotation, outward or inward bending, and backward bending.

Since all these distortions are caused by an excess of muscle tone in the muscle chains, a rational treatment will concentrate on decreasing it, and this is the modus operandi of the Mézières' method. Apart from cases where a dysplasia of the trochlea is found, the prognosis is good as long as the condition is not too advanced.

Should I add that bow-legs are not caused by horse riding and other mythical causes? And if bow-legs give a distinctive gait, as the podiatrist of our tabloid story claims, they also give a distinctive pain.