This is our second Tip Tuesday installment brought to you by our friend Lisa Barich, PT, C/NDT. Today, we are actually asking a question that we at ABS Behavioral Services had about: Why is “W” sitting bad??
There are two types of W-sitting:
Type 1 the child sits on the floor, the bottom is between tbe legs, and the knees are bent with the feet and lower leg rotated away from the body
Type 2 the child sits on the heels, and the knees are bent with the feet and lower leg rotated toward the body.
Sitting like this is a pretty common occurrence in small children, so why is this bad?
In these positions, a child’s base of support is wider and his center of gravity is lower, allowing for increased stability through the hips and trunk. It’s a convenient position for play because they do not have to work on keeping their balance while also concentrating on toys. In these positions, a child may not achieve active trunk rotation and cannot shift his weight over each side making it difficult to reach toys that are outside of their immediate reach. It is so important for kids to be able to weight shift and rotate in order to develop adequate balance reactions (think of the ability to catch their fall when they are running) and for developing the ability to cross midline.
W-sitting may cause the hip and leg muscles (hip flexors and hamstrings) to become shortened and tight which may lead to “pigeon toed” walking and could increase chance of back or pelvis pain as they grow. One study also suggests that W-sitting as a preschooler may increase the likelihood of a child becoming flat footed in both feet (European Journal of Pediatrics, Chen KC, 2010)*.
“W” sitting is not as great of a concern for children who otherwise are developing typically but if there are already orthopedic concerns such as intoeing, hip dysplasia, muscle tightness in the hips or hamstrings or neurologic concerns/developmental delays, other sitting postures are more desirable. “W” sitting reinforces the overuse of muscles that we do not use for stability such as hip flexors, hamstrings and internal hip rotators. Children should be using hip extensors/abductors/external rotators and core strength for stability. With the “Back to Sleep” push, children are spending less time using spinal extensors and hip extensors/abductors/external rotators to play, which are typically the muscle groups that are weakest when development is atypical.
So, what can you do if your child is W-sitting? The best way to ensure your child does not W-Sit is to prevent it before it even become as habit. Correcting W-Sitting with your child can be playful – it doesn’t have to require constant hovering, nagging or anything negative at all. Ask your child to get up and get a favorite toy, use a “secret” code word to cue him to change position, give him alternate places and ways to sit such as: up on a chair at a kiddie table, give a pillow to sit on, or even suggest that he lay on his tummy and play.
Please contact Lisa if you have any questions or concerns about your child:
Lisa Barich PT, C/NDT