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Friday, October 6, 2017

The Low Down on W-Sitting By Trisha Roberts


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W-sitting refers to a sitting posture where the buttocks are between the feet and the lower legs are bent at the knees and positioned behind the body to either side, thus forming a W shape.







When a person W-sits the medial (inside) sides of the knees are stressed.  This can lead to overstretching of the ligaments and potentially to an unstable knee and orthopedic problems.


Why do children W-sit?  Why is this bad?

Almost all children will W-sit occasionally, but persistent, prolonged W-sitting is to be discouraged because of the potential harm to the knee and hip joints.

 Children with low muscle tone frequently develop this type of sitting as their preferred method of rest.  It gives them a very large base of support, making them more stable and requiring less energy to maintain; it helps them compensate for their weak musculature. They can play and manipulate toys with their arms, using less energy to keep their trunk and pelvis controlled.   But again, reliance on this position can stress the ligaments and muscles in the hips and knees, and these children already tend to have very lax, flexible joints because of their low muscle tone.

Children with high muscle tone (hypertonia) and sometimes children with spastic Cerebral Palsy (Spastic CP) sit this way.  It should be discouraged because it feeds into their abnormal patterns of movement. W-sitting can aggravate muscle tightness, as it places hip internal rotator muscles, hip adductor muscles and heel cords in a shortened position. W-sitting can lead to more muscle tightness and possibly contractures.

When a child depends on W-sitting it can inhibit or delay them from developing the movement patterns, balance and coordination needed for higher level skills like walking, kicking, running, and skipping. They may also develop poor standing posture and gait abnormalities.




W-sitting can cause hip dislocation, especially if a child has hip dysplasia (a condition of instability, or looseness between the head of the femur and the acetabulum of the pelvis).



Children frequently move backward into a W-sitting position when they are crawling, as it is easier for them to move in and out of sitting and quadruped (all fours), requiring less energy and effort than rotating to one side or turning to sit with legs out front (long sitting).



Very little trunk rotation occurs when a child W-sits.  They are less likely to cross midline and tend instead to manipulate objects on their left side with their left hand and toys on their right side with their right hand.  This can cause delays in developing a hand preference and could lead to future coordination problems.  Additionally, because of the limited amount of trunk rotation allowed in W-sitting, children don’t practice and learn to weight shift diagonally and develop the ability to transition smoothly in and out of positions like sitting and quadruped (all fours) with good rotation.



Other sitting positions to encourage:

Long sitting:   sitting with legs straight out front




Side sitting:  both legs are to one side of the buttocks







Heel sitting:   buttocks rest on the heels (can also be referred to as low kneeling)

Sitting on heels or feet rather than between legs


Crossed Legs:  legs are crossed over each other in front (also referred to as Taylor sitting, Indian style, or “criss-cross applesauce”)


Taylor or Indian Sitting



Cue Your Child:

Children who W-sit find this position very comfortable and stable.  You will need to work with your child to change this pattern.  When you see them W-sitting, give them a positive command like, “Pretty Legs” or “Fix Your Legs”.  (You might want to try something even more meaningful to your individual child, like, “Princess Legs” or “Rocket Ship Legs”) If your child goes to a day care or school, you will want to communicate with the teachers or care providers so that everyone working with your child will be discouraging W-sitting and using the same cues.


Be Consistent!  W-sitting is a habit that needs to be eliminated for the good health of your child. 







Blog Administrator:  Trisha Roberts
proeducationaltoys@gmail.com


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