What is W-sitting?
W-sitting is a sitting position in which children sit with their knees bent/rotated inward and their feet tucked under them, while their bottom is resting on the floor between their legs – creating the w-shape that gives this position its name. Parents and therapists usually notice children W-sitting between ages 3 to 6, but you may also observe it with younger or older children.
Why do Children gravitate towards W-Sitting?
W-sitting is a more stable position for children because they rely on their joints to keep them upright instead of their muscles. It also leaves their hands free to play without challenging their balance. Children with low muscle tone, hypermobility in the joints or decreased balance and truck control are also more likely to W-Sit. While this is a normal position for a child to briefly move in and out of during the day, it should not be maintained for prolonged periods of play.
What are the Negative Effects of W-Sitting?
Pediatric therapists routinely work to correct this sitting posture to prevent additional impairments. Let’s explore some of the reasons W-sitting is not recommended for children:
Overuse of this position can delay development of postural control and stability. This effects coordination balance and the development of motor skills.
Children who W-Sit do not have to work as hard to engage their core and hold their trunks upright – instead, they rely on their joint structures (and not their muscles) to hold them up. This causes increased posterior pelvic tilt which can result in poor sitting posture, decreased core activation, reduced trunk rotation, and delayed fine motor development.
In some studies, W-Sitting points to an increased risk of developing joint abnormalities such as a pigeon-toed gait pattern. This walking pattern is correlated with excessive tripping, clumsiness, instability when walking and running, and decreased balance and body awareness.
What are some Alternatives to W-Sitting?
You can provide consistent and positive verbal reinforcement to the child such as, “legs out” or “sit on your bottom, please”. The verbal prompts used will take the place of physically adjusting the child’s position. You can also use physical cueing such as a gentle tap on the leg. Here are some alternative positions for your child:
Cross-legged, or “criss-cross applesauce”: This is a common position in which children sit with feet crossed and knees apart.
Side-sit: in this position, both knees are bent, weight is shifted to one hip, and both feet are out to the same side. This removes stress from the hip joint structures, allowing for easy transitions in and out of sitting. Encourage sitting on both the right and left sides to promote equal development.
Long-sit: In this position the child’s bottom is firmly on the floor with their feet are straight out in front of them. You can also provide back support by having the child lean against a wall or pillow.
Short kneel: Children sit in a folded kneeling position – their feet tucked together under their bottom. kneeling can be a great way to strengthen hip and core muscles, just be sure that they do not shift back into the W-position.
Half kneel: Children position themselves with one foot tucked under their bottom and the other foot flat on the ground.
Praise your child when they reposition themselves. W-Sitting can quickly become a habit; early identification and encouragement is the best method to prevent any adverse outcomes from sitting in this position.
When Should You Worry About W- Sitting?
While W-Sitting is a natural position for children to move in and out of during play, they should not depend on it for support and balance. If your child frequently utilizes the W-Sitting position and you notice any of the following, discuss them with your child’s pediatrician to determine if an evaluation is necessary.
Ask for a referral for a physical therapist for further assessment if your child:
develops a limp,
expresses discomfort or has signs of hip pain
exhibits weakness in their lower extremities,
uses a pigeon-toed gait when walking
Ask for a referral for occupational therapy for further assessment if your child:
appears to have low muscle tone or weak core strength: signs of poor muscle tone include frequent falling or clumsiness, and overall poor posture
is unable to sit alone in any position other than a “W”
seems clumsy or uncoordinated
has trouble with fine motor delays (cutting paper with scissors, tying shoelaces, etc.)