"Little ones tend to sit in a variety of different positions—some of which can look uncomfortable. One of those sitting positions that tends to get a lot of attention is W sitting: a common name used for when a child sits with their legs rotated inward and bent/flexed so that the legs kick out to the sides of their bottom, making a W shape with the lower body. W sitting is a normal sitting position in children, but it gets a lot of attention and discussion regarding whether or not it’s a bad position for kids. As a pediatric physical therapist, I have mixed feelings—while W sitting may not be inherently detrimental for your child, it can lead to some developmental disadvantages. Here are a few considerations to make if your child uses the W position while seated.
W sitting and walking
I want to again emphasize that W sitting is a normal sitting position in children. At young ages, hips have increased flexibility and this position is well within the normal range of motion for the hips. The internet contains some misinformation regarding W sitting and how it can lead to walking issues in the future, however, this is not research-supported. It has not been proven that W sitting can cause “pigeon-toed” walking or “in-toeing.” W sitting and in-toeing are often related because many children who walk with their toes pointed inward have the bone and joint alignment that also makes W sitting more easily able to persist throughout childhood.
To summarize it a little more succinctly, everyone’s hips have a certain amount of rotation and torsion, and this amount of rotation is not determined by W sitting. So if your child walks with their toes pointed inward and also has a preference for W sitting, it’s likely because your child already has the foundational bone structure that led to those two things—not that W sitting led to the walking pattern. And if your child has this type of bone structure, it could be uncomfortable for your child to sit in a ring sitting or criss-cross sitting position.
Potential for pain with W sitting
There are still some disadvantages of the sitting position. When a child sits in a W, they get used to taking their joints to the end of the available range of motion, which can lead to increased flexibility. This flexibility may predispose your child to pain or later in adulthood. Our joints like to exist in a happy medium range of motion. When we take our joints to the end range, or at the end of their available motion, the ligaments and other joint structures can be stressed, leading to potential for pain.
Decreased core activation
When you look at a child sitting in a W position, their sitting base is very wide compared to a ring sitting/criss-cross sitting position. When we widen our base, we essentially create side kickstands to help support our body when sitting in that position. Those kickstands make it easier to create stability in that sitting position. Think of it in another way, standing on both feet widely separated (large base) is easier than standing on one foot (small base). When our bodies rest in those large bases of support, our core doesn’t have to kick on to help maintain balance. Thus, those kiddos who prefer to W sit don’t work on activating their core as often, which can lead to difficulty with core activation with balance skills and motor skills later in childhood.
Delayed gross motor skills
While sitting in a W with a wide base of support, it can also be difficult to transition out of the sitting position. Those kickstands make it tricky to transition over the hips to new positions. Subsequently, it’s easier to stay sedentary and can lead to delays in gross motor skills.
Alternative sitting positions for kids
So while the W sitting position isn’t fundamentally bad for your child, there can be subsequent deficits that stem from the sitting preference. If you notice that a W sitting posture is your child’s preferred sitting posture, try to mix in new sitting postures to prevent the above-listed deficits. You can encourage side sitting, ring sitting, or sitting more in appropriately sized chairs. If you are concerned that your child has a difficult time sitting in other positions, they may benefit from physical therapy to improve core strength or assess your little one’s alignment. You can always request a referral to physical therapy, where you can receive more individualized assessments and recommendations.
Mary Noreen Cheng, PT, DPT
While not a mother yet, Mary Noreen gets her baby fix as a full-time pediatric physical therapist in Chicago. She loves to advise on all-things related to gross motor development and kids health, and especially loves to snuggle with her dozens of cousins and godchildren.