As physical therapists, we often hear parents expressing concern about the postures their children adopt while playing at home and school. Among the various positions, W-Sitting is a common one that raises questions and concerns. In this blog, we’ll explore what W-Sitting is, why some children prefer it, and how it can impact their physical development.

What is W-Sitting?

W-sitting occurs when a child sits on the floor with their legs bent at the knees and feet positioned outward, forming a shape that resembles the letter “W” when viewed from above. This position allows the child to rest their bottom on the ground while their knees and feet are splayed out to the sides. It is particularly prevalent among younger children, especially those between the ages of two and five.

Why do children W-sit?

There are several biomechanical factors and neurological factors that can explain why some children choose to W-sit.

• Biomechanical factors: W-sitting offers stability. Children have relatively large heads compared to their bodies and shorter torsos, making it challending to maintain balance in other sitting positions, such as cross-legged. By sitting in the W position, they create a broader base of support, allowing them to focus on play without worry of tipping over.
• Neurological factors: Many children exhibit W-sitting because of developmental preferences. The position may help them feel more secure, reducing the amount of core muscle effort and postural reactions required to maintain balance while they explore their surroundings.

In summary, W-sitting provides advantages such as stability from a broader base of support, enhanced engagement in play without the distraction of maintaining postural control, and increased comfort, allowing children to reach for toys without shifting their position.

Disadvantages of W-Sitting

While W-sitting may have its advantages, it’s essential to be aware of the potential downsides as well.

1. Orthopedic Concerns: Despite recent research advocates that W-sitting does not lead to hip dysplasia, we often observe in our clinical practice that prolonged W-sitting can lead to musculoskeletal issues. This position may place undue stress on the hips and knees, potentially leading to alignment problems as the child grows.
2. Postural Control: W-sitting may inhibit the development of the core muscles needed for sitting upright in other positions. Without this essential strength, children may struggle with postural control as they grow, which can affect activities like writing or participating in sports.
3. Limited Movement: W-sitting can restrict a child’s ability to engage in rotational movements. This limitation can impact overall motor skill development, making it more challenging for them to walk or run efficiently.
4. Delayed Development of Other Sitting Positions: If a child becomes accustomed to W-sitting, they may be less likely to experiment with other, more developmentally appropriate sitting positions, such as cross-legged or sitting with one leg tucked.

Recommendations for Parents

• Encouraging Alternative Sitting Positions
  It’s essential to observe your child’s overall movement patterns and comfort levels. If you notice they frequently prefer the W-sitting position, it may be beneficial to encourage them to try other sitting positions to mitigate the potential negative impacts of W-sitting. Here are some suggestions:
  1. Cross-legged sitting: Encourage your child to sit with their legs crossed in front of them. This position promotes better posture and engages the core muscles.
  2. Side Sitting: Have your child sit with their legs bent to one side. This position can help improve hip flexibility and trunk rotation.
  3. Long Sitting: Encourage your child to sit with their legs straight out in front of them. This position helps stretch the hamstrings and promotes better posture.
  4. Short-sitting: Encourage your child to sit on a bench while performing tabletop activities. This position promotes an upright posture, helping to develop core strength and stability while enhancing focus and reducing fatigue.
• Create Opportunities for Movement
  Encourage a variety of play that promotes different positions. Activities like crawling, climbing, and sitting cross-legged can strengthen core muscles and improve postural control.
• Consult Professionals
  If you have concerns about your child’s sitting habits or overall development, consult our physical therapy team. We are happy to provide personalised insights and recommendations tailored to your child’s needs.

Conclusion

W-sitting is a common behaviour in young children. While it has some advantages, it’s essential to be aware of the potential disadvantages regarding orthopaedic and neurological development. By promoting a variety of play and being mindful of your child’s sitting habits, you can support their gross motor development and help ensure they are on their way to a healthy and active lifestyle. Remember, every child develops at their own pace, and being attentive to their needs will help them thrive.

If you need further information on this topic, feel free to contact the High Hopes team.

Sources:

• Pathways.org. “What Is W-Sitting?” Pathways.org, https://pathways.org/what-is-w-sitting/. Accessed Oct 22 2024.
• WebMD. “What to know about W-sitting in children.” Medically Reviewed by Dan Brennan, MD on February 20, 2024, Written by WebMD Editorial Contributors, https://www.webmd.com/children/what-to-know-about-w-sitting-in-children. Accessed Oct 22 2024.
• Rethlefsen SA, Mueske NM, Nazareth A, Abousamra O, Wren TAL, Kay RM, Goldstein RY. Hip Dysplasia Is Not More Common in W-Sitters. Clin Pediatr (Phila). 2020 Oct;59(12):1074-1079. doi: 10.1177/0009922820940810. Epub 2020 Jul 13. PMID: 32659120.
• Honig EL, Haeberle HS, Kehoe CM, Dodwell ER. Pediatric orthopedic Mythbusters: the truth about flexible flatfeet, tibial and femoral torsion, W-sitting, and idiopathic toe-walking. Curr Opin Pediatr. 2021 Feb 1;33(1):105-113. doi: 10.1097/MOP.0000000000000977. PMID: 33315688.