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Building Blocks Pediatric Occupational Therapy Services

Fairfield Connecticut Occupational Therapist

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W-Sitting

July 18, 2022 By admin

 

What is w-sitting?

W-sitting is a sitting position in which the child’s knees are bent in front of them and their feet are positioned to either side of their hips.

Why do some children w-sit?

W-sitting gives the child a wide base of support while sitting on the floor which makes it easier for them to balance upright while sitting. This sitting position also doesn’t require as much core strength in order to sit upright.

Should I worry about my child’s w-sitting?

If you only see your child w-sitting occasionally, this sitting position should not be a cause for concern. W-sitting is a very common sitting position for young children when they are playing; children often shift between multiple sitting positions while playing on the floor. Many children will naturally grow out of w-sitting after around age 4. However, if your child w-sits often or w-sitting is the only sitting position they use while playing, this may cause harm over time and indicate developmental delays.

What does w-sitting indicate?

W-sitting can have multiple causes as well as be associated with multiple conditions including:

  • Lack of core strength
    • Since w-sitting does not require children to use their core muscles as much as other sitting positions, children with weak cores may w-sit to compensate for lack of core strength
  • Tight hip muscles
    • While w-sitting, the hips are in an internally rotated position which does not allow for stretching of the hip muscles. Children with tight hip muscles may sit in the position to compensate for tight-hip muscles.
  • Cerebral Palsy
    • Children with cerebral palsy develop spasticity (increased muscle tone) over time including tightness in the hip and thigh muscles which makes it easier to w-sit compared to sitting cross-legged
  • Low tone
    • Children with low muscle tone may prefer the w-sitting position because it requires less core strength to maintain a balanced upright position
  • Joint hypermobility
    • Children with hypermobile (double jointed) joints often w-sit because in order to provide enough stability to maintain an upright posture with hypermobile joints the muscles must work harder. Joint hypermobility is associated with low tone.
  • Gross motor delays
    • W-sitting may indicate that your child has a gross motor skill delay
  • Habit
    • Children may w-sit simply due to habit or because they have not out grown this sitting position from early childhood

Consequences of w-sitting

  • Decreased core strength
    • W-sitting does not require children to use their core muscles as much as other sitting positions, so if your child sits in this position for long periods of time, your child core strength will develop more slowly
  • Muscle Tightness
    • Over time, w-sitting can lead to tightness in the hips, knees, and ankles
  • Delayed Fine Motor Development
    • W-sitting makes it difficult to cross midline (reaching across from one side of the body to the other). Crossing midline is important in the development of bilateral integration which is crucial for the development of fine motor skills like writing.
  • Delayed Gross Motor Development
    • W-sitting can also delay gross motor development due to lack of cross-body movements (crossing midline) and consequently slower development of bilateral integration which is also important for the development of gross motor skills
    • Lack of weight shifting (from one side of the body to the other) while w-sitting can lead to poor balance when not sitting in this position
  •  Irregular Bone Growth
    • W-sitting can lead to differences in the way a child’s bones grow as they are developing
    • Over time, this can lead to overstretched ligaments, joint pain, and an increased risk of injury
  • Pain and injury
    • W-sitting can lead to knee and back pain and injury
  • Pigeon-toed walking
    • W-sitting can cause a child to walk in a pigeon-toed pattern (feet turned in)
  • Risk of hip dislocation
    • Due to internal rotation of the hips during w-sitting, this sitting position may cause hip dislocation (especially in children with hip dysplasia)

What should I do about my child’s w-sitting?

Encourage your child to choose different positions when you notice them w-sitting. Suggest some of these sitting or kneeling positions when your child is playing on the floor:

  • Criss-cross
    • Sitting with the legs crossed in front of the body
  • Long sitting
    • Sitting with the legs straight in front of the body
  • Side sitting
    • Sitting with the knees bent and both feet pointing to one side
  • Tall kneel
    • Kneeling in an upright position with the bottom off of the floor
  • Ring sitting
    • Sitting with the knees bent pointing to each side of the body with the feet touching in front.
  • 4-point quadruped
    • Kneeling on all-fours
  • Sitting on a stool or pillow

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