Parents of young children may have noticed that their child sometimes sit with their legs in a W-shaped position. With many differing views on this sitting position, parents are often confused about the impact of W-sitting on a child’s hips and legs development. In this article, SPD’s physiotherapist Cliodhna Kavanagh addresses the common questions that parents have regarding this sitting position.
What is W-sitting?
W-sitting is a sitting position where a child sits on their bottom with their knees bent and feet positioned outside their hips.
Though this position looks like kneeling, the child is actually sitting on the ground between their legs. Their knees can be close together or wide apart.
W-sitting gets its name as the child’s legs form the shape of “W” when sitting in this position. The W-sitting position is usually common among children between ages of 3 and 6.
Why does my child W-sit?
W-sitting may be a transitional movement as children learn to sit and crawl (typically, a child can sit independently between 5 and 9 months, and crawl by 6 to 12 months). This position gives children a wide base for stability, which takes them less effort to stay seated upright. It is more common for children with lower tone or hypermobile joints to W-sit as they feel more supported in this position.
Is this position always bad?
Not necessarily. According to the International Hip Dysplasia Institute, W-sitting is a position that is part of a child’s typical development. It is especially common in children around the age of three. Children may sit in the W position while they are transitioning between positions, or when they are playing as it provides a wider base of support and the child will not need to use their core (tummy) muscles to keep themselves upright. However, it may become a problem when a child sits in this position too frequently.
What are the risks associated with W-sitting?
Hip development and muscle tightness:
- W-sitting can increase a child’s risk of hip dislocation, especially those who have hip dysplasia (which may not be formally diagnosed). Hip dysplasia occurs when the hip socket does not fully cover the upper thigh bone. This condition can lead to pain and leg length differences.
- Prolonged W-sitting increases the risk of the child’s hip and leg muscles becoming short and tight, especially the hamstrings and lower back muscles. This can negatively affect their coordination, balance, and the development of gross motor skills in the long run. W-sitting further increases these risks for children who has increased muscle tone or conditions like cerebral palsy, where the likelihood of muscle tightness and contractures are already higher.
- W-sitting can cause the child’s thighs, knees, and feet to turn inwards. It can also cause in-toeing and flat feet.
As the W-sitting position is very stable, it makes it difficult for children to shift their weight from side-to-side as their hips are fixed in one position. In turn, children may find it challenging to rotate their upper body to do tasks that involve the use of both hands or cross their arm over from one side to the other.
As a result, they can only use objects on the right side of the body with their right hand and those on the left side of the body with their left hand. This will later affect their ability to write as it hinders the development of a hand preference, and other table-top activities that are important in school.
Weight shifting in sitting is an early building block for weight shifting in standing. This skill is important for developing standing balance which is necessary for activities like standing on one leg to wear their trousers. Weight shifting is also needed for the development of the ability to run and jump. As W-sitting makes it difficult for children to weight shift, this may affect their ability to develop the aforementioned skills.
When a child W-sits, they rely on the wide base of support of their legs and joint structures to keep themselves upright. This prevents the child from developing strong trunk muscles as they do not have to work as hard to keep themselves upright. Without a strong and stable trunk, children may find it challenging to use their hands for various activities, remain seated without falling over, and keep their body aligned while walking, running and jumping.
What should I do if I see my child W-sitting?
If the child is only W-sitting occasionally, and they can change positions easily throughout the day, there is no need to worry. However, if they are constantly sitting in this position, here are some suggestions that you can use to encourage them to adopt other sitting positions.
Ask them to move into a different position. Encourage them using positive vocabulary, such as: “Try sitting in a criss-cross position!” instead of “Don’t sit like that!”. Some positions to try are:
You can also provide your child with small stools or beanbags to sit on while playing. This will encourage them to move around often. You can also engage them in games such as twister, home obstacle courses or playing in the playground, to encourage movement.
Here are other exercises that you can try with your child:
- Crawling e.g. through tunnels
- Climbing – Strengthens and tones legs, stimulates development of foot arches
- Exercise and stretch the hip joints – Play a game of “Row row row your boat” with your child. Sit on the floor opposite your child. You can sit with your legs crossed or out straight in front of you. Hold on to each other’s wrists. Sway your body forward and backwards. You will be able to feel the stretch on the inside of your thigh.
- Rolling on floor with legs straight
- Core strengthening – Get your child to balance while sitting on a large ball, then get them to lift one leg off the ground and hold their balance. Alternatively, you can also get your child to lie on their back, lift their legs straight above them and ask them to make side to side “window-wiper” movements with their legs.
When should I speak to a healthcare practitioner?
Contact your child’s pediatrician or physiotherapist if you notice your child’s W-sitting is combined with other signs or symptoms, like low muscle tone, limited mobility, significant tightness in the hips, lack of balance, delays in fine motor skills, pain, or if they have been diagnosed with hip dysplasia. Frequently sitting in this position can affect development or potentially cause injury.
W-sitting is part of our children’s typical development so it is not something that parents should be overly concerned about. However, W-sitting should not be the child’s only way of sitting as this could be an indicator of other developmental issues. Lastly, if your child’s W-sitting behavior is associated with other symptoms mentioned above, please consult your child’s doctor or physiotherapist for further advice.
Dinosaur Physical Therapy – Adventures in W Sitting
International Hip Dysplasia Institute – W-Sitting and Hip Development