My Child W-Sits: Should I Worry?
The W-sitting position is when a child sits on the floor with their legs splayed outward. When you stand in front of your child and look down directly over their head, their legs form the letter “W.”
Physical therapists and orthopedic surgeons dislike children sitting in that position, especially if they have motor developmental delays or low muscle tone. However, if your child moves in and out of that position to sit in other ways on the floor while playing, the W-sit position should not pose a problem for your child. However, if it’s the only way your child sits, it becomes something to worry about.
The Problem with W-Sitting
Under age two, the bones and joints are not fully hardened and are prone to deformity caused by poor alignment. For example, the femoral head (top of the femur or thigh bone) grows into the preferred alignment when a child sits in various positions during the first year. Suppose the child mostly sits in a W-sitting position. In that case, the femoral head will develop an abnormal alignment, leading to poor hip, knee, and ankle joint development. Surgical repair is the only remedy for these problems. Therapists and doctors recommend limiting W-sitting to prevent joint issues, future surgeries, and the associated pain. Share on X
What Does W-Sitting Cause?
Developmental experts caution against young children W-sitting because the hips are forming. If the baby sits in the W-sitting position most or all of the time, the hip sockets will form abnormally. Abnormally shaped hip joints can cause the rest of the leg to be crooked. Common problems that develop are are knock knees and fallen ankles (flat feet).
Remember, your baby’s bones are forming. If abnormal stresses (W-sitting) are applied to the bones and joints while the bones are hardening and forming, deformity can result.
Why Do Low-Toned Children Love To W-Sit?
Some babies are born with lower-than-normal muscle tone. Some conditions, such as Down Syndrome, cause low tone, and sometimes, no known cause exists. Low muscle tone causes weakness. When the core muscles are weak, the W-sit position is easier for a child.
Low muscle tone often goes hand in hand with lax joint ligaments, leading to joint instability and pain. While there is no cure for low tone or lax ligaments, increasing the probability the child’s bones and joints form normally is a primary goal of physical therapists (PTs). PTs also treat adults with hip pain, hip joint replacements, and arthritis. Your child can develop these conditions later in life if the bones and joints form abnormally. Prevention of these future problems is why PTs discourage W-sitting.
What To Do About It
If your child prefers to sit in the “W” position, please do not nag them. Some children can not sit in other positions due to hip or muscle tightness or weak core muscles. If your child has these conditions, sitting in other positions feels unstable. Try helping your child sit in a side-sitting position while playing on the floor. You can gently reposition their legs during the day. Expect your child to return to the preferred W-sit position because they feel comfortable and stable there. Your plan should be to reposition consistently but not nag.
Finally, seek a referral for a physical therapy evaluation to get personalized recommendations and assistance.
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Disclaimer: All information presented is general education and is not intended as specific prescriptions for your child. If you have concerns about any aspect of your baby’s development, talk with your doctor. If your child receives any intervention or therapy, this information is not intended to be used without their knowledge.
