What is w-sitting?:
W-sitting (sitting on the knees with the bottom on ground and heels outside of hips) is one of many positions children choose to sit in. It is common for children to move in and out of this position while playing, only spending brief moments w-sitting. While developing children use this position at times, all parents need to be aware of the possible future problems that can occur during the growing years if there is excessive use of this position.
Why children w-sit:
Children who have difficulty with motor control, balance, or coordination typically w-sit in order to give themselves more trunk and hip stability. This added stability enables them to more easily manipulate a toy and to play. When in this position the child is actually unable to move their trunk. Moving laterally (side to side), rotational (twisting) weight shifting, and movements crossing the midline become very difficult in this position. Lateral and rotational weight shifting is important for balance activities while the child is playing outside and for crossing midline while doing table-top activities. In other words, w-sitting limits important movements used to develop balance and coordination skills.
Problems that may result from w-sitting:
1. Orthopedic concerns
Ø W-sitting can predispose a child to hip dislocation
Ø Poor hip and knee alignment cause strain on the joints
Ø Rotational (twisting) force is placed on the bones of the lower leg and can cause them to grow twisted or bow-legged.
Ø In children with muscle tightness, this position will shorten the hamstrings (back of the thighs), adductors (muscles that bring the legs together) and internal rotators (turn knees together).
2. Other concerns
Ø Less trunk rotation allowed
Ø Allows forward/backward movement, but little movement sideways or twisting (this can interfere with crossing midline and with hand dominance)
Ø Feeds into low tone, by allowing the body to be “lazy”, and not have to work to keep upright (less trunk control used in this position).
Prevention:
1. Prevent w-sitting from becoming a habit.
Ø Anticipate and catch it before the child learns to do it.
2. Children should be taught alternative sitting positions.
3. Remind children to “fix their legs” when they assume this position.
Alternatives to w-sitting:
1. Ring sitting (criss cross)
2. Side sitting (knees and feet together on one side)
3. Kneeling (sitting on feet as long as heels aren’t outside of hips)
4. Long sitting (knees kept straight in front of body).
