W-sitting is a term often used by physical therapists to describe a sitting position where the child sits on their bottom with their legs turned out. If you looked at them from a top view their legs look like the letter W.
Why is it an issue?
Reduces core strength: in a W-sitting position the child has a wide base of support which makes it much easier for the trunk to maintain sitting. Oftentimes, when children have a weak core or decreased trunk strength, they will assume this position because they have to use less core muscles. This position makes it much easier for children with a weak core to reach and play with toys, however it interferes with the development of core muscles needed to maintain unsupported sitting.
Stress on Joints: sitting in this position places undue stress on the hip and knee joints. It may also lead to tightness in the hips, knees, or ankles.
Static Position: this position does not allow for a child to rotate or turn their trunk which can interfere with developing sitting balance and trunk strength, but it also interferes with a child developing fine motor skills. It's important for a child to be able to twist their trunk and reach across their body. In this position the child has a hard time crossing midline which is an important developmental milestone. In this static position children tend to play with items on their left side using their left hand and items on their right side of their body using their right hand. This can interfere with the development of hand preference which can impact other skills such as handwriting. It is important for children to play in dynamic positions that allow for free movement.
When should I worry about W-sitting?
The overall research on whether W-sitting is concerning is limited and opinions on the issue vary depending on who you ask. Some believe that it is an alternate form of sitting while many therapists think that it should be a position that children avoid. Overall, a good rule of thumb for parents is to ensure that your child is engaging in play in a variety of positions. If your child is only in this position occasionally then it is always a good idea to offer them alternate sitting options. However, if this is a position that your child is constantly using this may indicate the need for some physical therapy to help improve trunk and lower extremity strength.
Alternatives to W sitting:
If you notice your child W-sitting, you can offer them an alternative sitting position. Here are a few developmentally appropriate floor sitting positions that you should encourage:
Ring sitting- this position is sometimes also called “criss cross”. This position also offers a wide base of support, but it allows for free movement of the trunk so that the child can work on reaching and crossing midline.
Long sitting- in this position your child sits on their bottom with their legs straight out in front of them. Maintaining their sitting balance in this position is much more challenging because their base of support is smaller. However, they are able to engage their core muscles and this position also offers the added benefit of stretching their hamstrings.
Side sitting-in this position your child sits with both knees bent and to one side. This position really works the trunk muscles and also allows for upper extremity weight bearing. Be sure that they vary what side their legs go to so that they are working the trunk equally.
On their belly-tummy time is not just for infants! In this position your child can work on strengthening their trunk extensors while also working on shoulder stability.
Heel sitting-this is a slightly more advanced sitting position. In this position your child has their legs folded underneath them and their bottom is touching their heels. This position allows for fluid and optimal movement around the floor in order to reach toys. Your child can easily move into quadruped or even walk on their knees in order to reach items.
Tall or High kneel-this position is similar to a heel sitting position, however, your child's bottom is not touching their heels. This position is even more advanced and works not only on core strength but engages the hips which are all important muscles needed for walking. This is a great position to play in if your child is playing at a low table.
W-sitting can be a normal developmental position if it is used for brief periods of time. Children should be encouraged to engage in play in a variety of floor sitting positions that encourage balanced development and W-sitting should be used infrequently.
If you notice that your child only favors this position or has difficulty holding some of the other positions mentioned, you should speak with your pediatrician or therapy might be an option to consider.
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