What risks are associated with W-Sitting?
When children W-sit for longer periods of time, they are at risk for the following issues:
According to Jenn Gonzales, OTR/L
Chances are if you’re reading this, you have probably heard the term “W-sitting” which is why you’d like to know more. If it’s new to you, and you have little ones in your family then you are probably going to come across it at some point. It usually comes up when someone is speaking to a child and might sound something like this, “Please fix your legs and stop W-Sitting.” Ouch. First of all what does that mean and how could it possibly matter how my child chooses to sit? I hope this post will give you a quick snapshot of this issue.
Let’s look at the 5 W’s of W-sitting.
What is W-sitting?
It is a posture or way of sitting (on the floor, not in a chair) that resembles the letter W, hence the name. You are probably familiar with crisscross sitting, when kids fold their legs in front of them like a pretzel. W-sitting is when the child positions their legs out to the sides, with hips turned in and knees bent. If you were to look down on them from above, it would resemble the letter W. If you walk into any library story time, preschool or kindergarten classroom during circle time, you will find a few kids W-sitting. It happens.
Why do kids do it?
Children’s bodies will naturally assume positions that work for them. When a child W-sits, it’s their way of gaining extra stability in order to play and interact. In this position, the legs and hips act as a stable “base of support” (therapist’s love this term) which means that the core muscles of their trunk do not need to work to keep them upright. For a child with weak core muscles or lower muscle tone, it is a very convenient way of gaining stability to play or pay attention without having to activate their core muscles for balance and posture. Kids, after all, want to engage in what’s most meaningful to them- the fun stuff.
When is it a problem?
From a therapist’s perspective, it’s always a problem. Sound a little harsh? Let me explain. A therapist is always focused on giving a child the foundational skills they need to reach their full potential. W-sitting interrupts those skills and sets the child up for potential problems for a few reasons. First, it limits the child’s ability to rotate their trunk to the sides. This affects a child’s developing neurological and motor systems by limiting opportunities for developing hip and trunk strength, coordination of the two sides of the body (and brain) and the development of balance reactions. In addition, if a child chooses to sit in this position every time they are on the floor, hip and leg muscles are likely to become tight over time which can cause awkward patterns of walking, running and may cause back pain. Based on her expertise, a physical therapist in our practice Desiree Sotirin, encourages parents to pay close attention when their child begins to crawl. If you notice your child is trying to get out of the crawling position by moving directly back into sitting (W-sitting) without rotation then they are at risk for developing the habit of W-sitting. Finally, young bones and joints are growing therefore any habitual positions can gradually affect muscle strength, flexibility, and possibly joint structure over time. This may lead to a child walking with their toes or knees pointed inward or could result in underdeveloped arches in the feet. Our goal is to always facilitate success and be proactive about preventing problems for our little ones later on. So, if we can avoid or limit W-sitting for our kiddos why wouldn’t we?
Encourage your child to get in the habit of sitting crisscross, long sitting or side sitting when on the floor. Gentle positive reminders are the best. Instead of “Fix your legs” try “Please crisscross sit so you can be strong.” For a baby or toddler a quick tickle on the bottom of the foot is a fun way to put their little feet into a better position.
Provide plenty of alternative seating positions, especially if your little one already has tightness in their legs, very low muscle tone in their trunk, or are affected by a medical condition which affects muscle tone such as Cerebral Palsy. Alternate seating options that work great and are affordable would be bean bags, small step stools or chairs. For completing homework or other fine motor tasks such as coloring, try having them work while lying on their tummy, propped on their arms. This position facilitates improved visual attention to the task and works on shoulder stability and upper extremity strength- bonus!
If you suspect weak core muscles to be part of the problem, provide your child opportunities to work on their postural strength through yoga, playing Twister or walking on a balance beam. Crab walking, wheelbarrow walking, climbing up slides (just make sure no one else is on the way down!), and conquering the monkey bars are all fun and excellent challenges for the core muscles.
When should I consult a doctor or therapist?
If you notice that W-sitting is the only position your child can sit in on the floor or if you have concerns about the way your child walks, please talk to your child’s pediatrician. They can assess for any underlying difficulties and may refer you to a pediatric physical therapist for evaluation and individualized treatment.
Frequent movement breaks: Movement fires the nerve in the inner ear that tells the muscles to extend strongly against gravity and the brain to alert itself to the environment.
Make sure the children’s feet are resting flat on the floor: There is a mechanism that sends a postural signal to the spine to extend upward when there is pressure on the bottom of the feet.
Teach children to make sure that their sitting bones are pointing straight down while they are in their chairs: Do you know where your sitting bones are? Put your hand between yourself and the chair, and feel the large, pointy bone in your pelvis that protrudes downwards. When the feet are firmly touching the floor and the sitting bones are pointing directly downwards in the chair, a strong postural signal is sent up the spine.
Original article What risks are associated with W-Sitting?