Why Do Children Choose to W-Sit?
Is W-Sitting Bad?
It is common and harmless for children to move in and out of the W-sitting position during play, in fact occasional W-sitting is usually not a cause for concern, but habitual or extended use of this position can lead to several potential issues such as:
- Hip Dislocation: Children with existing hip problems are at greater risk for dislocation due to the strain W-sitting places on the hips and joints.
- Limited Trunk/Core Strength: The wide stance of the W position reduces the need for core muscle engagement, potentially leading to weaker trunk muscles over time.
- Impaired Balance and Midline Crossing: W-sitting can hinder a child’s ability to rotate their upper body and perform movements that cross the midline, which are crucial for developing bilateral coordination.
- Muscle Tightness: Children prone to muscle tightness, or hypertonia, may experience increased tightness in the hips, knees, and ankles from prolonged W-sitting, potentially leading to conditions like walking ‘pigeon-toed.’
- Postural Problems: W-sitting can contribute to postural issues such as swayback, where the spine curves excessively inward, affecting balance and coordination.
What Are Some Alternative Seating Positions?
Criss-Cross Applesauce
Side-Sitting
Long Sitting
Butterfly Sitting
Kneeling
Squatting or Low Chairs
Use a Kiddie Chair or Activity Table
Fun Activities to Strengthen The Core & Balance
Incorporating fun, engaging activities that build core strength and improve balance can also help discourage W-sitting:
- Obstacle Courses: Create courses that require your child to use their whole body, engaging in movements that strengthen core and leg muscles.
- Action Songs: Songs like “Row, Row, Row Your Boat” involve movements that help exercise the hip joints.
- Hands and Knees Play: Activities like playing with shaving cream, coloring, or assembling puzzles while on their hands and knees are great for building core strength and working out the arms.
- Crawling Games: Games that involve crawling on hands and knees, such as navigating through tunnels, encourage the use of different muscle groups and promote better sitting habits.
- Crab Position: Encourage your child to sit in a crab position, with their feet on sliders or paper plates. Have them straighten one leg at a time to knock over a bowling pin or kick a ball, making the activity fun and engaging.
- Dead Bug: Have your child lie on their back with their arms and legs in the air. You can balance a toy on their feet or shins and encourage them to hold the position. This exercise strengthens both the core and leg muscles.
- Knee Walking: Have your child knee walk between two tables to build a block tower or move toy pieces. This activity strengthens the core and gluteal muscles and can be made more challenging by pushing a weighted laundry basket.
References:
Michaud, P. A., & Renaud, A. (2001). W-Sitting in Children: What Should the Occupational Therapist Know? Physical & Occupational Therapy in Pediatrics, 21(2-3), 61-76.
Murnane, A., & Gahimer, J. (2005). Pediatric Therapy and Postural Development: Implications of W-Sitting. The American Journal of Occupational Therapy, 59(4), 440-448.
Knudson, S. E., & Galloway, J. C. (2008). Addressing Lower Extremity Postural Control in Pediatric Occupational Therapy. Journal of Pediatric Rehabilitation Medicine, 1(1), 23-30.
Heathcock, J. C., Bhat, A. N., Lobo, M. A., & Galloway, J. C. (2007). The effects of lower-extremity position on motor activity in infants with and without brain injury. Pediatric Physical Therapy, 19(1), 12-18.
When to Seek Help
If W-sitting is the only position your child uses, or if you notice concerns with their walking, low muscle tone, clumsiness or overall motor development, it may be beneficial to consult a paediatric therapist, such as an occupational therapist or physiotherapist. These professionals can provide targeted strategies to address any underlying issues.