W-Sitting: If you have children and/or work with young children you have probably seen it. You have probably also heard how it is ‘bad’. But what is it and is it something we should be concerned about? What does the research say?
What is W Sitting:
The medical term that allows for W-sitting is Internal Femoral Torsion. W-sitting is when a child is sitting on their butt, their knees are out in front of them, but their feet are on either side of their hips. From a bird’s eye view, the shape looks like a W.
While the position looks uncomfortable and/or painful it actually isn’t for most children. Children have the ability to rotate their hips to a greater degree than adults and more range of motion in these joints. Most children find the position comfortable and relaxing.
There is a lot of debate if W-sitting can cause long-term problems. The International Hip Dysplasia Institute presents a lot of information regarding W sitting as normal development.
Why Do Children W-Sit:
The main reason is they find it comfortable and relaxing. This is because the position changes the center of gravity. Think of it as a tripod stand, the three legs of the stand are increasing the base of support and distributing the weight further.
Children also W-sit because their core muscles are not fully developed. When a child W-sits, their core does not have to work as hard to remain balanced.
The Concerns Regarding W-Sitting and What Research Says
- Each child is unique! Always ask your pediatrician for their medical advice regarding your child.
Hip Dislocation:
Some people worry that the position causes an increase in hip dislocation. The theory is that the position, which internally rotates the hips (joints turning inward), will cause too much pressure thereby pushing the femoral head (‘ball’ of your leg) out of the joint
What Does Research Say:
The International Hip Dysplasia Insititute states that W-sitting does not impact developing hips and it similarly does not contribute to a medical condition of hip dysplasia.
According to Naccarato (2019)
“A 2019 study based out of the Children’s Hospital, Los Angeles observed 27 children who underwent radiographs measuring the hips and pelvic bones, revealed that regardless of the positions they sit in there is no significant difference in measurements of the hips. These findings suggest that there is no greater risk for children who ‘W’ sit to develop hip dysplasia than those who don’t.”
Research by Goldstein et al., (2019) connected a similar study where they looked at the relationship between W sitting and hip development. Their study included 27 patients. They concluded that w-sitting does not affect the risk for developmental dysplasia of the hip in healthy children.
Tight Muscles:
Sitting in this position could possibly increase muscle tightness in your legs and hips. The fear is this could affect the child’s coordination and balance. The muscles that could be affected are the hamstrings, hip adductores, and the Achilles tendons
What Does the Medical Professional Say:
Charles Price, a pediatric orthopedic surgeon at the Arnold Palmer Hospital for Children in Orlando, Fla. states:
“When you’re young, your hips and thighs both tend to have an innate twist to them, which eventually “untwists” as you get older. In newborns, the twist in the thigh bone is about 45 degrees, whereas in adults, it’s about 20 degrees. That’s why most kids who ‘W’ sit will eventually grow out of it by the age of 10. Sitting in the ‘W’ position won’t prevent kids from growing out of this twist.”
Crossing Midline:
Another concern many have about W-sitting is the decrease of bilateral coordination skills. Crossing midline is a fancy term for being able to use one hand to complete tasks in different planes of your body. Right-hand does things on the right and the right-hand does things on the left. The thought process with W-sitting is that because the positioning creates a bigger base it limits the amount your core can twist, thus what we sometimes see is children using a specific hand for a specific plane i.e. right hand for things on the right and left hand for the things on the left side.
Timothy Carey, a pediatric orthopedic surgeon with the Children’s Hospital at London Health Sciences Centre in London, On reminds parents that “You’re very stable, you can use your arms and reach around and do things without having to worry about losing your balance. As long as they’re generally moving around and playing and doing other activities, it’s not a concern”.
Tips and Tricks Regarding W-Sitting
Different Sitting Positions:
I really dislike the term ‘fix your legs’ which is commonly paired with correcting w-sitting. For a small child, what does that equate to? Try to make it fun and not make note of the position.
- “Do you think you can sit like Ms. Taylor”
- “Ohhh can you kneel like this”
- “Look how long your legs are!”
Try offering toys/activities on a low table to encourage different positions like standing or kneeling!
Here are some other positions children can sit in!
- criss-cross sitting
- side-sitting
- long-sitting
- Squatting
Try Different Seating Accommodations!
An easy and cheap hack is sitting on a pillow → an uneven surface will increase core strength leading to a decreased need for more support. Also, it is a lot harder to w-sit on an uneven surface
- Bumpy cushion
- Bilibo Chair
- Bean bag chair
- Stool
- Rocking chair
- Therapy ball chair
Playtime outside!!
Playing outside or play that encourages gross motor is always a win.
Check out this blog on positioning during virtual learning for some more tips and tricks!
Goldstein, R. Y., Nazareth, A., Ziarati, P., Mueske, N., Rethlefsen, S., & Kay, R. (2019). Hip dysplasia is not more common in W-sitters. Pediatrics, 144, 1. doi:http://dx.doi.org/10.1542/peds.144.2_MeetingAbstract.770
Naccarato, A. (2019, Dec 19). Here’s why we can all relax about ‘W’ sitting. Today’s Parent (Online), Retrieved from https://www.proquest.com/magazines/here-s-why-we-can-all-relax-about-w-sitting/docview/2328929442/se-2?accountid=143111
