Understanding W-Sitting in Kids: What’s Normal and When to Be Concerned
W-sitting often raises concerns among parents, teachers, and even social media discussions. The message you often hear is, “W-sitting is bad!” But is it really? Here’s a look at what the research says and when it’s time to worry.
What is W-Sitting?
W-sitting is when children sit on the floor with their knees bent, legs splayed outward, and feet behind them in a “W” shape. This position is common among preschoolers and often preferred because it provides a stable base of support. Contrary to some myths, W-sitting does not:
- Affect hip bone shape or cause hip dysplasia.
- Lead to arthritis or degenerative joint issues.
- Cause intoeing or delays in motor development.
*** In typically developing children
Why Do Kids W-Sit?
Most kids W-sit because their hip structure allows it to be comfortable. Young children have naturally increased hip rotation (femoral anteversion), which tends to decrease as they grow.
Femoral anteversion is NOT a structural abnormality or a deformity. It is a normal part of development. There is a wide range of normal.
W-sitting does not cause femoral anteversion, however femoral anteversion means W-sitting is comfortable – that’s why so many kids choose it! It also means sitting cross-legged may be uncomfortable and difficult.
As children grow, their hips “unwind” and the amount of femoral anteversion reduces and you will see them “grow out” of W-sitting by 8-10 years old.
For 95% of kids, there is no cause for concern. W sitting is comfortable during early childhood and they will usually outgrow W-sitting by age 8-10. Recent research has suggested that 64% of children ages 3-6 years preferred to sit in the W-sit position, however only 6% had in-toeing gait, which means that not all children who W-sit in-toe, contrary to popular belief.
Why the Concern?
W-sitting on its own isn’t harmful for most children. However, if a child only sits in a W-position and has difficulty moving in and out of other postures, there could be an underlying issue. About 5% of children may have other conditions like high muscle tone (e.g., cerebral palsy) or low muscle tone (e.g., Down syndrome) that make W-sitting a compensatory posture. In these cases, W-sitting can limit muscle use and may require intervention.
When to Seek Help
If your child is experiencing:
- Pain or fatigue
- Frequent falls or tripping
- Gross motor delay
- Persistent in-toeing, especially if it’s only on one side
- Low muscle tone
- High muscle tone
W-sitting is the only position they use and they cannot get in and out of this position easily
It may be worth consulting a paediatric physiotherapist for an assessment.
Compensatory Postures
For children with conditions that affect muscle tone, for example high tone (in cerebral palsy or spina bifida) or low tone (in Down syndrome) and connective tissue laxity in (Down syndrome or Ehlers-Danlos syndrome)—certain compensatory sitting postures, like slouched sitting or W-sitting, are common. These positions provide a wide, stable base, making it easier for the child to sit hands-free and engage in play. However, relying on these postures long-term can limit their ability to use postural muscles effectively, making it harder to reach, rotate, or move in and out of position. Over time, this lack of movement may affect bone and muscle development.
Physiotherapists and occupational therapists can support these children by introducing alternative positions, supports, and seating options to encourage safe, hands-free play in postures that better promote movement and muscle use.
Final Thoughts
For most kids, W-sitting is natural and temporary. While certain conditions can make it a red flag, parents shouldn’t worry unless there are additional concerns. Encourage varied sitting positions, but don’t stress over the occasional W-sit – your child is likely to grow out of it naturally.
source https://hubandspoke.health/understanding-w-sitting-in-kids-whats-normal-and-when-to-be-concerned/
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