W-sitting
in children: A habit worth breaking?
“W-sitting” or “W-sit” is a term used to
describe a sitting position in which a child sits on the floor with their legs
forming a “W” shape on the floor (knees bent, legs rotated and facing away from
the body).
When
is it ok?
Children often move into and out of this position during
play or when transitioning from crawling to sitting. W-sitting is OK and
perfectly normal if used in this way. It temporarily widens the base of
support, giving the child a greater sense of stability and balance during play.
When
is it NOT ok?
However, this position should not be encouraged for prolonged
periods of time during play as it will lead to future orthopaedic and
musculoskeletal issues, affecting muscles and joints of the back and lower
limb. Long-term W-sitting is NOT encouraged as it will make the child become
reliant on this position for added trunk/hip stability to allow for easier toy
manipulation and play. Their trunk muscles will not be activated sufficiently
for them to learn and practice weight shifts during rotation and lateral (side)
movements of the body.
W-sitters are often
children with:
·
Low muscle tone
·
Hypermobile joints
·
Difficulty with balance
Side effects of
W-sitting:
·
May develop sway back posture
·
Walk and stand with feet turned inwards
·
Weak trunk and low back muscles
·
Tight hamstrings and low back muscles
Why
do children choose to W-sit?
In W-sitting the legs are rotated outwards and spread wide
apart. This means that there is a larger base of support and hence less work
required by the trunk muscles to stabilise the body. The trunk muscles are
important for maintaining an upright posture and reacting to shifts in balance.
Possibly these children have not developed sufficient trunk rotation (twisting)
or lateral flexion (bending to side) for weight shifts and so relies heavily on
the wide base of support for maintaining stability during physical activity and
play.
Correcting
the Habit
Often W-sitting becomes a habit very quickly
and it is important to address it promptly.
Encourage other ways of sitting:
·
Cross-legged
·
Side-sitting with both legs out to one side (make sure they
alternate the side)
·
Sitting with legs straight out forward as able (hamstrings can
be stretched at the same time)
·
Sitting on a low stool or a cushion
Exercises
and Activities
1. Strengthen the trunk
muscles
a) Side to side rotation: Lying on the back
with knees bent, slowly rotate legs from side to side but not letting knees
touch the floor.
b) Side-sitting transfers: Start with side-sitting on one side.
Without using their arms, the child moves from side-sitting onto their knees,
then transfer to side-sitting position on the other side. Repeat in the other
direction.
c) Seated marches on swiss ball: Sitting on a large swiss ball,
ask the child to lift one foot off the ground and then the other, alternating
side to side similar to marching.
d) Reaching on swiss ball: Sitting on a large swiss ball, hold
objects at different distances and heights for the child to reach out for. This
will train their trunk muscle control and strengthen the trunk muscles.
e) Bottom-walking: Sitting on the floor with
legs straight out in front, the child bottom-shuffles by lifting one side of
their bottom off the floor and moving forward, alternating side to side.
2. Back
strengthening/Hip and shoulder stability
a) Superman arm/leg lifts: With the child on all 4′s, you can
get them to do alternate arm lifts, leg lifts or combined arm-leg lifts
(diagonal) – whilst maintaining stability and balance at all times.
b) Walking on all 4′s: You can get the child to walk on all 4′s
(like a dinosaur), by lifting both arm and leg from one side forward, followed
by the other side. This will encourage the training of stability in the
shoulders and hips.
3. Hamstrings Stretching
The hamstrings muscle group runs down the back
of the thigh and is usually tight in W-sitters, as they prefer to keep their
knees in a flexed position. It is therefore important to stretch these muscles
regularly to improve their flexibility.
Some exercises can become games for children eg. to stretch
hamstrings you can ask the child to walk their fingers down the front of their
legs as far as they can, aiming all the way to their toes, keeping the knees
straight. Or if they are in long-sitting position, you can ask them to walk
their fingers down their legs over the stretched out leg, as far as they can to
their toes and hold the position, counting together 1 to 10.
