Due to abnormal force lines, people with O-leg are at higher risk of knee injury compared to people with normal leg shapes. Increased medial pressure and unbalanced forces on the medial and lateral joint surfaces tend to cause excessive medial loading, which leads to damage to the meniscus of the articular cartilage, patellar slippage, and force line deviation resulting in strain on the patella, patella tip, and femoral slide. Mechanical adjustments can be made through custom orthopedic shoes and arch pads to achieve improvement and correction.