Chances are, if you know what W-sitting is, you or someone you know sits just like that. Occupational, physical, and developmental therapists often express their disapproval whenever they see a child sit in this position. More and more parents are catching on to the fact that this is a posture to keep their children out of. The most common questions they have are 1) why is it so bad? and 2) what is there to do to help change this habit?
What is W-sitting?
Many children with low muscle tone, decreased core strength, increased joint laxity, or hip instability, will sit and play with their knees together, bottom on the floor, and feet out to both sides.
Why do some children like to sit this way?
Simply put, a young child’s joint and bone structures will allow them to sit in this position. Certain medical diagnoses, such as Down syndrome and femoral anteversion, are often associated with this preferred sitting posture. In this position, children are more comfortable and don’t have to work as hard to hold their trunks upright. Instead, they are spreading their lower limbs out over a wider base of support, thus relying on their joint structures and not their muscles, to hold them up to play.
Why do therapists recommend against it?
While the knees together and feet out position is fine as a transitional position, our hips are not designed to be in the W-sitting position for a long period of time. Prolonged sitting in this position places significant stress on inner hip muscles and joint structures. The young musculoskeletal system will then develop in such a way that just creates more and more instability of the hips. If a child gets used to sitting and playing in this position, weaknesses and orthopedic misalignments will only travel up and down the musculoskeletal chain. Children who W-sit well into their preschool to school years often experience decreased trunk strength, poor attention, in-toeing, poor posture, clumsy coordination, and frequent loss of balance.
How to help a child out of the position?
Many parents would tell me that they are at their wits’ end, constantly instructing their child out of the W-sit position. While repetition and consistency are key, habits are difficult to change, especially with verbal reprimands alone. Change things up and give your child other sitting postures as options:
1) The most common alternate position is with feet crossed and knees apart. “Criss-cross applesauce” is what we usually tell children when we see them W-sitting. They respond well to this simple cue.
2) Side-sitting is a great alternative if sitting with knees out is too difficult. In side-sitting, both knees are bent, weight is shifted to one hip, and both feet are out to the same side. This takes away stress from the hip joint structures, allowing for easy transitions in and out of sitting.
3) Long sitting with feet forward and back supported is a great way to stretch out those hamstrings and keep hip/knee joints in neutral.
4) If a child has a hard time sitting and playing, I let them kneel with their feet tucked together under their bottom. As long as they don’t slowly shift back into the W-shape, kneeling is a great position to strength their hip and core muscles.
5) Half-kneeling with one foot tucked and the other foot flat on the ground will keep the hips in neutral alignment. In this position, muscles will be active and hip joint structures will not be put under damaging stress.
6) Finally, squatting or sitting on a low chair will also help keep a child out of W-sit during play.
If you are still looking for ways to keep your child out of this injurious habit, talk to a therapist. Physical therapists will come up with ideas and exercises tailored to each individual child and find the best ways to improve his or her posture and alignment.