But they look so cute when they do that?!- W-Sitting

As a pediatric physical therapist, and as someone who has torn both their ACLs by the time they were 15, I cringe whenever I see anyone sitting in the W-sit position.

So what is W-sitting? Rather than overwhelm you with a verbal description, here’s a picture:

There’s a slight disagreement on whether we (physical therapists) should be adamant to parents about not letting their children sit in this position, or that we should let children like this occasionally.

On the pro-side of sitting W-sit, people will likely say, “Well I sat like this my whole life and I’m fine.”  It is true, that if you do sit in that position you will likely not have any problems when you’re older.  On the other hand, sitting cross-legged or side-sit is a better position overall, so why not prevent yourself from having problems in the future and just not sit in that position!

So again, I go to the title of my post.  When I evaluate patients who are developmentally delayed, and then see that they W-sit, I ask the parents how long they’ve been sitting that way, they usually say, “Oh they always sit like that and we thought it was cute so we never corrected them.”

Different sitting positions:

W-sitting
note his slouched posture

side sitting

long-sitting

ring sitting

ring sitting

cross-legged sitting

cross-legged sitting

Why would a child sit in W-sit?

  • 1- It’s easier to return to sitting from a crawling position.  When you’re on your hands and knees, it’s easier to just sit backwards and let your legs splay out to the sides rather than bringing your legs around and sitting in cross-legged position.
  • 2- It’s easier to sit in W-sit rather than in cross-legged or sidesit or longsit position because you don’t need to use your hip, back, or ab muscles to stay sitting up.  Instead, you can just rest on your ligaments and slouch into that W-sit position.
  • 3- The child may have low muscle tone (condition where muscles aren’t as tight as they need to be and feel slightly mushier), and be more flexible, so it is easier for them to slouch into that position than sit in the other positions.
  • 4- The child may have tight hamstrings/hip muscles, and feels more comfortable sitting in W-sit position.

So why shouldn’t you let your child sit in W-sit?

  • 1- If you were told your child is prone to hip dislocation or has a diagnosis of hip dysplasia, sitting in W-sit may increase risk for hip dislocation.
  • 2- Sitting in W-sit doesn’t encourage use of hip, abs, back muscles, so your child will not be strengthening the crucial muscles needed to maintain proper posture and to balance in order to walk independently.
  • 3- Sitting in W-sit doesn’t encourage reaching across one’s body to reach for toys, which is an important skill needed to help us understand where our body is in space.  When a child begins to reach across their body to pick up toys and then transfer them to the other hand, they are gradually developing a hand preference.
  • 4- Sitting in W-sit can affect the position of a child’s hip joint as they grow and can result in in-toeing.
  • 5- Sitting in W-sit also leads to tight hamstrings and inner thigh muscles, which can affect posture and walking pattern later on, making it difficult for your child to sit in a cross-legged position, especially during circle time at school.

The best strategy to prevent W-sitting is to correct the position each time you see it so your child doesn’t make a habit out of it.  Encourage your child to sit in one of the other positions shown above.  If your child has tight thigh muscles, I recommend stretching their hamstrings.

If trunk or hip strength is the issue, than you should work on strengthening those areas.

Some tips on trunk /hip strengthening can be found in 2 of my past posts:  Sitting Balance and Progressing Crawling

Here’s an article I used for some of the info in this post.  

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Categories: Child Development, Humor in pediatrics

Tags: , , , , ,

8 replies

  1. Hi Natalie,

    I just have a question about your statement that if a child has tight thigh muscles, you would stretch their hamstrings. Conceptually, this just seems counterintuitive to me. By stretching the hamstrings, are you not necessarily then causing a contraction of the thigh muscles and thus making them tighter? I see it sort of like when you flex your bicep muscle, your tricep muscle is lengthening. Please correct me if I’m wrong; any insight would be appreciated!

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    • Hi Nik, thanks for your comment. I should update this post since I did it over a year ago and I see what you’re saying. I said “thigh muscles” to be general but I guess I should be more specific. With W-sitting, the hamstrings and hip adductors (muscles on the inner part of the thigh) become tight. So I would recommend stretching those muscles specifically.

      When you are passively stretching a muscle like in the picture I have, the stretch is coming from the passive movement of the leg into that position rather than the quad muscle tightening to move into that position. If a muscle is very tight, usually contracting the opposite muscle will not be strong enough to stretch the tight muscle.

      The quad muscles (muscles on front of the thigh) are already flexible from sitting in the W-sitting position so there’s little concern about them growing tight with stretching..
      It also takes a lot of time for a muscle/joint to become tight and is usually the result of being in a certain position for repeated amounts of time like in W-sitting, or like in kids who walk on their toes where their calves become tight.

      hope that helps, if not, I can try to be clearer! 🙂 And I will add a second stretch for kids who W-sit.

      Like

  2. I notice that you don’t mention sitting on your feet. All three of my kids and I sit with our knees bent and both feet under our bottom, so our legs are under us rather then to the side. I have never had a problem, and I am unlikely to stop as it is how I am comfortable. Just more curious then anything.

    Like

    • Hi Ashley, thanks for your comment. I’d have to do a little research to give you the specifics on how sitting with your legs underneath you affects lower extremity alignment. But what I can tell you that it doesn’t have the same effect as W-sitting because the femur is still in a relatively neutral position in the joint, vs W-sitting when the leg is turned out, it causes the femur to be at a different angle in the joint.

      I had 1 patient that sat like the way you described, and sat like that a lot for hours playing video games, and parents brought him because his feet were turned in. I can’t say if the posture affected his alignment or if he was already like that naturally.

      But usually if you are sitting in a certain way with rotation for an extended period of time, it can have a twisting/bending effect on the bone. So that’s the only thing I would worry about is if a child sits on their knees with their feet tucked under them, then they are rotating the lower part of their leg. If they sit like that for long periods of time, then there’s a chance it can twist/bend the tibia (in a growing skeleton), but again, I’d have to look up if this has been researched before I can tell you for sure!

      For now i’d say it’s ok in terms of the femur position, but I’m always a fan of changing positions frequently when sitting on the floor so kiddos don’t fall into poor postures if they sit in 1 position for too long.

      let me know if that makes sense!

      thanks,
      Natalie

      Like

  3. I sat in the w position till about 10 years of age or so and would like to add to what you’ve written. I can’t comment on some of the possible issues you’ve mentioned such as tight muscles but there are other issues I have noticed as a result of sitting this way. My w sitting was so extreme that I was able to sit with my lower legs at a 90 degree angle to my thighs, although I didn’t usually sit like this – I just did that to show off! I stopped w sitting eventually because my knees started to lock into position, probably because of a slight dislocation, and I would have to shift onto my knees till the knee clicked into place and I could move freely again which was quite painful. I did have poor muscle tone in my trunk and developed a slouch. I now have hyper-flexible knees and hips (to certain angles only) which enables me to do some yoga positions very easily but gives poor stability in others. I have knee problems too but it is hard to tell how much is genetic as my mother has issues too, but I’m sure they weren’t helped by sitting in this way.

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    • Thanks for you comment and for stopping by my blog! Sorry to hear you are having knee instability now! But it is a good example for parents to see what can happen long term if W-sitting isn’t corrected.

      Like

  4. Hi. I am an 18 year old
    guy into the habit of w-
    sitting. I want to get rid
    of this habit but my thigh
    muscles wouldn’t bulge.
    I’ve tried sitting cross
    legged but it causes an
    immense amount of pain
    everytime i attempt that.
    Also it results in an
    unsuccessful attempt.
    Otherwise i dont have
    any problem. My shape
    and flexibility of my legs
    are ok and i manage to
    play good football too. My
    body shape is ok too and
    i dont face any problems.
    But i want to change this
    habit of w-sitting. And
    even as i type this, i’m in
    this posture. Can you
    please suggest me how
    to reduce this habit and get into the cross legged posture?
    Also, is this thing
    hereditary? Like if i w-sit,
    is it possible that the
    genes of w-sitting may
    pass on to my child too?

    Like

    • Hi thanks for visiting my site! If you have been W sitting for a long time, your hip muscles are probably very tight now so you would have to stretch your hip muscles to get that flexibility back. You may also have to see an orthopedic doctor to make sure your hip alignment is ok to attempt sitting in a cross-legged position because that may be causing your discomfort. Also the act of w sitting is not hereditary, but if you have hyper flexible joints and more flexible muscles then your children may also present that way so you would have encourage proper sitting patterns instead of W sitting if they do look super flexible. Hope that helps, let me know if you have any questions!

      Like

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