w sitting day to day parenting

What’s Wrong with W Sitting in Children?

Day2DayParenting Behavior, Challenging Behavior, Child Development 33 Comments

Do you see your child or someone else’s child sitting with their bottom on the floor and their legs out beside them, forming a “W” shape? This is commonly called “W sitting.” You may think “wow, look how flexible they are.” Although flexibility in your muscles is a good thing, W sitting is not. The negative effects of the W sitting position may not be apparent right away, but there can be long term changes and complications from sitting this way. Try sitting in a “W” position yourself…it’s not very comfortable, is it?

How W Sitting Affects Muscles and Joints

When a child “W” sits, it puts his hip joints into extreme internal rotation. This tightens the muscles on the inside and stretches the muscles on the outside of the hips. Since everything is connected, what happens at the hips also affects the joints at the knees and ankles. This extreme rotation can cause a knock-kneed position and/or in-toeing of the feet. This is stressful on the joints and can affect balance and coordination. In very young children whose bones are still developing and hardening, this can cause long term effects on the positioning and quality of the hip, knee, and ankle joints. The positioning of the child’s feet when in a “W” sit can increase the likelihood of a less-than-ideal foot position. This could be in-toeing or out-toeing as the child’s feet tend to go one way or the other (vs. straight back) when sitting in a “W.”

If your child is prone to have tight muscles (they may have been diagnosed with hypertonia-high tone, or a condition that includes high tone), W sitting is that much more stressful and detrimental to your child’s joints. However, this position is not good for any child even if her muscles are loose or are of average tone.

In addition, W sitting can be a sign of weak trunk muscles as this position allows children to create a stable base and use the ligaments around their hips to stabilize themselves instead of using their core muscles. This too is stressful on their hip joints.  Encourage your child to sit to play with their legs in other positions. They may need some support at their hips or body by you or by an outside support (such as a boppy style pillow). While out of the W sitting position, use toys to get them to reach up, out to the sides, or to reach forward and return to an upright position. There are a lot of other activities that you can do to increase your child’s core muscle strength. Speak to your child’s doctor or physical therapist if you think they may benefit from this.

Breaking the Habit of W Sitting

Even after proper trunk strengthening, it is hard to break children of the habit of W sitting. It takes a lot of time, a lot of patience, and a lot of verbal and physical cueing but will be well worth it in the long run. Anytime you see W sitting in children, help them to move into a better position. There are several options: circle sit, pretzel sit, side sit, and long sitting. Always pair the physical prompting with words such as “fix your legs,” “sit on your bottom,” “feet out,” or whatever words work for you and your child. Eventually your child will reposition himself with the verbal cues only. This may take a while if your child is very young as he may not be old enough to understand the verbal cues. Praise your child when he repositions himself with cues and especially when he repositions himself on his own or when he chooses to sit a different way.

By: Jaime Ruffing, PT

          

 

 

Day2DayParentingWhat’s Wrong with W Sitting in Children?

Comments 33

  1. Pingback: Just a Mom | Musings by Mama

  2. Jason Tachell

    Is there any scientific evidence that w sitting has ever done any damage to anyone? If you have any references or studies that you could send me that would be great.

    1. Tammy

      Not sure about evidence, but we have a foster child that always sits this way, and her poor feet and ankles are so twisted looking…… Never knew it mattered until a therapist told me. Not worth the risk. We have two toddlers that are starting to sit like this, and I will be directing them to change positions every time I catch them doing it.

    2. Theresa

      I don’t know about scientific evidence, but my daughter sat in this way for a solid 4 years and we can still see the abnormal curving at her ankles and feet. We were told if she were to chose a sport like cheer or volley ball we have issues with her ankles being able to support her. I guess we will have to see

    3. Leah Smith

      Hi Jason, I am 53 years old and was a W sitter. Back then, no one knew what problems this could cause. I have been in chronic pain since I was 26 years old with sciatica, dysfunctional SI joints, ileo tibeal band tightness and pain, etc. All of the problems that I am reading about from W sitting have happened to me except knee pain. I hope that if you have a W sitting child, that you will try to retrain them to sit properly. Thanks

  3. Post
    Author
    EarlyInterventionSupport

    I am not sure of specific scientific studies on “W sitting”, but the clinical evidence of prolonged “W sitting” causing long term damage is overwhelming. Many adults who “W sat” as children and thus continued to “W sit” as adolescents and adults needed hip and/or knee replacements later in life. In addition to our website article on why to discourage children from W Sitting, here are a few more examples of what prolonged “W sitting” can do and why it should be discouraged:
    http://physical-therapy.advanceweb.com/Article/does-your-child-w-sit.aspx
    http://www.eorthopod.com/rotational-deformities-in-children/topic/233
    http://www.aafp.org/afp/2003/0801/p461.html
    http://theinspiredtreehouse.com/child-melting-look-w-sitting/

    1. Bridget O

      Correlation does not equal causation. I’m an adult and I’ve always been a W-sitter. I will admit that I do actually have hip problems, but I sit this way because it makes my hips feel better. I’m flexible enough to sit this way because I have hypermobility, which seems to be common in people who w-sit into adulthood (from my experience!)

      It seems MUCH more likely to me that people who w-sit are predisposed to these hip problems, rather than w-sitting is causing them. Sitting ‘indian style’ is extremely painful for my hips because it pushes them outward and they subluxate, so I’ve always just sat w-style. My knees are double-jointed and it’s never caused any pain there, and I still don’t have knee issues, despite the rest of my joints apparently going to hell.

      Maybe try to keep that in mind when you see your child w-sitting — maybe they’re sitting that way because it’s genuinely comfortable and sitting in other ways is uncomfortable or painful for them. A child might not speak up because they think it’s wrong to hurt when they’re sitting how everyone else seems to sit.

      1. Dara

        I’m 31 years old and still prefer to sit this way for many of the same reasons. Sitting “criss cross” for more than 10 minutes causes my lower leg and feet to fall asleep. Same if I sit on my feet.

  4. Apryl

    Hello!

    I work for a company called SureStep and we are a manufacturer of braces for children with low muscle tone as well as other medical diagnoses. We have recently launched a new product, our SureStep Criss Crossers, that were designed specifically for children who w-sit.

    I hope that you all find this information helpful!

    Apryl Veldman
    Inservice/Marketing Coordinator

  5. Joni Redlich, PT, DPT, PCS

    It’s not so black and white. No need to scare parents who see their child w sit here and there. As long as it’s used as one of a variety of sitting positions there shouldn’t be any concern.

    Children who w sit frequently need to have their overall pelvic/trunk mobility addressed. “Fix your feet” will get a child out of the position, but does not address their transitions that are leading to the position over and over again.

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  7. Melinda D

    From what age is it important to correct? My girl is 9 months old, learning to sit and this is her first sitting position. Not able to sit on her bottom yet. Do I need to correct right away? Not strong enough to keep her legs together when sitting on her heels.

  8. Betsy Gamza

    Hi Melinda! In order to avoid bad habits from forming, I would say yes, it is important to go ahead and correct her sitting position now. She will get a feel for the way that her body should be positioned in sitting and also the feel for the way her body should move in to and out of that position. If she is not able to sit up independently in this position, try offering her some support…sit in a “corner” or between your legs, use rolled towels or a boppy to assist her in the sit. Gradually, you should be able to fade out that support. I hope this helps!

  9. precia

    Hello. My son is 3 years old and has been sitting like this since before his first birthday. He doesn’t sit in any other position. I never thought this was a bad thing. Ive noticed that his feet go inward when he walks and his knees are a little unusual looking. Im worried there is too much damage caused at this point :/ should I contact his Dr about this?? Thanks

    1. Carol Hill

      I know what you are saying because I did the same thing from very small and I suffer with hip and back pain.

      My mother did everything to stop me but I didn’t want to stop so do your best to stop him because this way of sitting is hurting him in so many ways.

  10. Betsy Gamza

    If it will put your mind at ease, it won’t hurt to ask the doctor at your upcoming well visit. You can also have him evaluated by a physical therapist at your local early intervention provider of services for ages 3-5. In the meantime, though, go ahead and correct his positioning when in sitting. Retraining the muscles to find a more appropriate position is always a good idea, no matter how much time has passed. Good luck!

  11. Amina

    Hi, I started sitting like this when i was about 8 years old, when I started High School people started pointing out that I walked with knocked knees, I’m currently 18 years old and aside from once or twice I haven’t sat like this in 2 years, but I still walk with knocked knees, I never had this problem when I was younger so I’m sure it was caused by sitting in the ‘W’ position. Is it possible at my age that I can correct this problem without surgery?

    1. Betsy Gamza

      Hi Amina,
      Thank you for your question! As bones are softer at a younger age, it is probably best to consult an Orthopedic doctor for evaluation. I’m glad you broke the habit! 🙂 Good luck!

  12. Ashley B

    I sat like this as a child, and at 30, I already have a lot of knee and hip problems. I was an “extreme” W-sitter, in that I would actually w-sit and tuck my legs as close to myself as possible. I wish we knew then what we know now! I would play like that for hours!

  13. Shalynn

    I have “W sat” my ENTIRE life. I was born with my thigh bones twisted inward and had to wear “backwards shoes with a bar between them” at night. My mother tells me about it all the time. I still “W” sit. The only way to of fixed my thigh bones would of been to have broken, turned, and refuse the bones back together. It would have been a very long and painful process. According to your article the “W” sit is uncomfortable, but to me it is the most comfortable way to sit. My feet will even be “flat” on the floor touching my sides, my “W” sit is so tight. So, don’t be so quick to judge someone for “W” sitting as there may be an underlying condition/reason for it. Also, at 22 I have not had ANY problem with my hips or knees at all.

  14. Angus

    I am 38, my mother is 62 and my gran, who is now not with us but who died at 80 are/were all w sitters. It is the most comfortable for us. My mother an I have been told we are hyper mobile but this has never caused any of us any problems. I guess we are all built differently and what’s right for one person is not right for the next. It feels awkward to sit other ways on the floor so I will continue to do this when I’m sat on the floor! (Not that often) I know plenty of older people who are not w sitters who still have hip and knee problems. Do what’s right for you and if you are a parent stop beating yourself up. We can only do our best…and even then we often get it wrong.

  15. Margot

    I disagree.

    I’ve always heard that ‘W’ sitting is bad for hip joints, bad for ankles, bad for a ton of stuff… yet I’m going to say that it is all total and complete bullsh*t.

    Since I was a baby I’ve been W sitting, no-one thought anything of it. I can still sit in W position comfortably at age 23..

    I’m an elite female cross country and track runner who has run a mile in less than 5 minutes…

    Not only that, but I’ve NEVER been injured in the 8 years that I’ve been competing.

    I’m one of the only track people I know who has never been injured…

  16. neda

    i was sitting w shape my whole childhood i remember it as if it was yesterday but no one told me not yo do that im 27 now and im havin knee malalignment also my kneecap moves around easily my hip is pumped out i dont like my leg shape at all i dont know what is the solution……

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  18. Daphne George

    I am 80 years of age. I have and still do sit in the W position. I am very mobile, have very strong knees and legs, and I have never heard such rubbish in all my life. I have four sons, two of whom can sit in the W position and two who find it a physical impossibility. For heavens sake get a grip. There are far too many ‘child experts’ around telling people what is good and bad for their children,without any sound or long term investigations in some cases, and this seems to be one of them. If your child sits down like this, OK. We are not all constructed in the same way, and I am a good advert. for W sitting, if one is needed.

  19. Ann

    Hi
    I’m also curious regarding w sit because I have daughter 19mos sitting w position and I always change her sitting position whenever i saw her siiting that way and I notice that her bone on her feet and knees are not straight and when she is walking she always falling down even she is not running please help me best ways to change her sitting position and will straight her walking without falling off

    1. Post
      Author
      Day2DayParenting

      Encourage a long sit, or taylor sit (legs crossed in front). Continue to help her change her sitting position whenever possible. Use a verbal prompt such as “fix your feet”, “Criss cross apple sauce” or “feet in front” to help remind her to change her sitting position. If you have concerns about her legs or walking, consult your pediatrician or a pediatric physical therapist.

  20. Poornima

    My son is 5 years 10 months he used to sit use w sitting now from past 2 years he will sit with one leg with still w position now we are not allowing him to sit like this, does this create any hip problems for him I could see he is lifting his one leg slightly is it possible to correct now at this age or does he needs any hip or knee replacement surgery
    Please suggest me

    1. Post
      Author
      Day2DayParenting

      Dear Poornima,

      It sounds like your are describing a side-sitting position if he sits with one leg back and one leg towards the front. This position is considered ok, only full W-sitting with both legs behind him and his bottom dropped between his legs is to be discouraged. But if you are still concerned, you can encourage long sitting with both legs extended forward or a taylor sit with both legs crossed in front of him.

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