Many families are unaware of why W-sitting is not recommended and how sitting in this position can affect their child's development. So, let's take a look and see why W-sitting can be problematic and how we can discourage this position.
How do children present when they W-sit?
Below is a picture of what W-sitting looks like. The child sits on their bottom with knees bent and their legs turned away from the body. Looking at the pink line, we see the letter "W". In this position, a child is comfortable as they have a wide base of support; which gives them more stability and prevents children from losing their balance/falling over. Children in this position don't have to do much work to hold their trunk upright; which is why they are more likely to sit and play in this position.
What issues arise from W-sitting?
1) Lack of cross body coordination: This position only allows a child to play with whatever is directly in front of them and prevents them from crossing midline. In this position, a child will not use their right hand to reach across to the left side and instead will keep their right hand next to the right side of their body; therefore not allowing for any trunk rotation. The same thing happens with the left side. Crossing midline allows for trunk rotation and this is important for brain development and bilateral coordination skills; which allow the child to use both sides of their body together. Delays may be found in developing hand dominance, crawling, kicking a ball, throwing a ball to a target, skipping, galloping, handwriting, etc.
2) Restricts hip movement: W-sitting causes abnormal stress on the hips; which can lead to future orthopedic problems. In this position, the hips present with an excessive range of internal rotation (picture A). External rotation of the hips then become restricted and thus makes it difficult for a child to sit with legs crossed (picture B). Also, if the child already has a diagnosis of hip dysplasia, this position increases the chances of hip dislocation.
3) Knee and ankle: Along with the hips, a lot of stress is placed on the knees and ankles. In this W position, the lower leg turns outward with both feet pointing to the side rather than pointing straight. In the picture below, you can see how the lower leg and ankles are not aligned with the knees and hips.
4) Poor development of core muscles: The child tends to lean forward with a rounded back in a W-sitting position secondary to their pelvis tilting back. This leads to weak core muscles. The child in this position do not engage their core muscles to sit upright and instead rely on their wide base of support of their legs to keep them upright and provide stability.
5) Difficulty to shift their weight: W-sitting makes it difficult for the child to shift their weight from one side of their body to the other. Weight shifting is important for balance and postural control. It is also important when developing the ability to walk, run, and climb the stairs.
How to prevent w-sitting?
1) Make your child aware of the difference between W-sitting and sitting with crossed legs. Use phrases such as “fix your legs” or “criss cross apple sauce” or “feet in front”. You will find yourself repeatedly saying these phrases, but remember that once your child picks up on it, they will correct their sitting position. Have patience and start correcting early on!
2) Suggest alternative positions for your child to sit:
Criss-cross or tailor sit: Sit with legs crossed like a pretzel. This is the best position for a child to sit in as it allows the child to cross midline; which is needed to develop bilateral coordination skills. This position places the hip, knees, and ankle joint in proper alignment.
Long sit: Sit with legs straight out in front. If playing games, have your child lean back against a wall with legs straight out. This is a great way to keep the hips, knees, and ankles in proper alignment along with stretching out the muscles on the back of the legs (hamstrings, calf muscles).
Side sit: Sit with both knees bent to the same side. This position allows for weight shifting and decreases the stress placed on the hips. Try and switch sides after a few minutes if your child is comfortable playing in this postion.
Lie on stomach: Lie down on stomach while playing. Prop up on forarms to read books or color instead of taking a nap ;)
Sit in a small chair/low stool at a table with both feet flat on the floor and hips and knees bent to 90 degrees
Heel sitting: Sit with bottom directly on heels with knees pointing straight ahead and feet in a neutral/straight position. This is a great position to prevent children from sitting with a rounded back.
Tall kneel: Have the child play in a tall kneel position at a table top/against a couch. This is a great way to strengthen the child's trunk.
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