We recently came across the article entitled Why W-Sitting Is Really Not So Bad for Kids, After All and felt compelled to restate our side of the w-sitting debate!
As pediatric therapists, we have treated hundreds of kids and we have seen hundreds more in classrooms who are w-sitters. Our post about w-sitting has consistently been one of our most popular and most-read posts at The Inspired Treehouse and the w-sitting controversy continues to go on.
The W-Sitting Debate
While w-sitting can be a completely normal part of development for kids, it can also be a sign of underlying developmental issues.
As mentioned in the Today.com article, normal, internal rotation of the leg bones can be a cause of w-sitting.
We agree that this medical condition known as femoral anteversion can be a reason that children w-sit. Because of their already turned-in bone structure, this position is certainly more comfortable for some kids.
But, as the Boston Children’s website states, femoral anteversion only occurs in up to 10% of children. It’s not likely that most parents would be able to recognize femoral anteversion in their children and be able to attribute their child’s w-sitting pattern to this condition. Given this statistic, it’s also not likely that this condition could be causing all of the many cases of w-sitting that we see in our practice.
W-Sitting and Core Stability
The Today.com article goes on to say that “there is no evidence that it (w-sitting) is bad for core stability”. We disagree! So many kids choose the w-sitting position in the first place because of weak core muscles. W-sitting is a compensatory strategy to help kids gain stability. Children cannot gain strength or improve their core stability by grounding themselves to the floor!
Many pediatric therapists would argue that the w-sitting position limits kids’ ability to achieve active trunk rotation and weight shifting. Try it (if you can even get yourself into a w-sitting position). Sit with your bottom on the floor between your legs and try to rotate all the way to the left and then the right.
Now choose to sit in another position. Rebecca Talmud Spiegel, a fellow physical therapist, shows some awesome diagrams and pictures of alternative positions for your reference in her article, Adventures in W-Sitting. Rotate your trunk again. Isn’t it easier to move without your base of support planted firmly on the ground? Isn’t it easier to cross the midline with both hands?
W-Sitting and Developmental Milestones
So is this weight shifting and trunk rotation really that big of a deal? Any physical or occupational therapist would answer YES!
If a child is unable to assume any other sitting position, or primarily assumes a w-sitting position for play throughout the day – they don’t have access to the variety of movement experiences they need to acquire important developmental milestones.
As we mentioned in our previous article, What’s Wrong With W-Sitting?, we do not walk around correcting every single child we see in a w-sitting position. We completely agree that most children will explore this sitting position at some point in their development, moving in and out of it as they play. For the typically developing child, this is a-okay!
However, we want to educate parents that if a child chooses to spend the majority of her time on the floor in the w-sitting position, she is missing out on key aspects of motor development including bilateral coordination, balance, and strengthening.
And, w-sitting can be a signal of an underlying issue that needs to be addressed. Sometimes, a lack of core strength can be related to the failure of the integration of a primitive reflex as Integrated Learning Strategies explains in their post, Primitive Reflexes: The Answer Behind W-Sitting and How to Fix It.
We have been asked time and time again by readers for research-based evidence proving that w-sitting is problematic. Unfortunately, it simply doesn’t exist. We are relying on years of experience with observing, evaluating, and treating children to inform our opinion on w-sitting. And we’re not alone! Check out what some of our colleagues have to say about w-sitting:
Adventures in W-Sitting from Dinosaur Physical Therapy
Preventing W-Sitting from Pediatric Occupational Therapy Tips
Is W-Sitting Bad for Child Development? – A well-informed and more moderate point of view on w-sitting from CanDo Kiddo
W-Sitting and the Young Child – from North Shore Pediatric Therapy
What’s So Wrong With W-Sitting – from The Pediatric Therapy Center
For all of you researchers out there, I urge you to take this one on! We’d love to see a study that takes a closer look at w-sitters and non w-sitters, scoring them on their fine and gross motor abilities. Look at core strength. Find out who w-sits chronically and who doesn’t, comparing the two groups. I am willing to bet that there will be some discrepancies!
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Rebecca Talmud says
Great post! Thank you for taking this on!
Thanks so much, Rebecca!!
Danielle Thiessen says
Thank you for writing this. We have had several people commenting to us following the Today.com article as well. We couldn’t agree more with your rebuttal. Feel free to use our blog post as well!
Thank you, Danielle….we will add your post to our list!!
I called it frog sitting when I was young, and I say that way because it hurt to sit cross legged, like the other kids. Now, in my mid 50s, I am having hip/groin pain. I have never had any problems with balance or athletics. The only reason it ever bothered me was because in kindergarten, sitting my way took up more room, so I was always being told to sit right, which I couldn’t. My mother comforted me by saying she had the same problem, and she was fine.
Now one of my grandchildren prefers to sit that way, although she is very agile and can sit cross legged.
What does the inability to sit cross legged mean?
Wish I could “like” this article 100x. As a pediatric professional in a different discipline, I’m very in touch with the idea of underlying problems that go undiagnosed and thus untreated because another professional has said that it “could be completely normal.” The real problem then becomes that if it’s not, a child may go for a longer period without critical early intervention that could support their growth and development in positive ways. Bravo for a well-written counterpoint that may support parents in getting early intervention and support to help young children develop in a strong and sound way!
I am an adult who W sat for the majority of my childhood. I was “fine” a very active person, until at 43 years old I hip pain sidelined me. I was diagnosed with hip dysplasia and underwent a Peri Asatabular Osetomy (PAO) Since then I have connected with other PAO for hip dysplasia patients and anecdotally would say most of them also W sat as children. More long term research is needed in this area for sure!
Jessica Sager says
I agree with imploring those in the field to study this. Having research-based evidence is crucial not just to the issue at hand, but to the integrity of argumentation in general. I hope people will take this up!
In Germany, where I now live, all babies have a hip ultrasound at 1 month of age to check the angle of the hip joint. If it is too open, they are prescribed stiff “undies” to encourage the bone to form more concavely. I wonder if W-sitting over time has the opposite effect, thus contributing to the dysplasia situation Alice mentions. I also wonder if the muscular weakness indicated by W-sitting is implicated in the ankles-crossed standing of so many women and girls, particularly those who wear heeled shoes. Have a look around a train station sometime – it’s everywhere!
I wish this article would have been out when my son was little, Now 13 and always a W sitter, he can’t sit criss cross (applesauce). It hurts his legs. (muscles not stretched. He also runs with his feet and ankles swinging out instead of kicking back. At almost 6 foot tall at 13 this looks funny. Wish I had this info earlier.
Hi Cher…thank you for your comment. I am hoping that maybe your son has experienced such a rapid growth spurt that his muscles have not had the chance to stretch with this quickly lengthening bones and that, maybe, he will gain some flexibility as the growth slows down! Tell him to stretch those legs! :)
What I don’t see in any of the articles criticising W sitting is any clarity in correlation-vs-causation. Certainly W sitting is CORRELATED with the many conditions that cause low muscle tone or connective tissue issues. These conditions also cause developmental delay. I know this very well – my daughter has one, Fragile X syndrome. But the W sitting did not cause her developmental delay. It did not cause her low core strength. It did not cause her flexibility. And while it’s surely essential that she improve her core strength, her balance, and her coordination, what child ever did this while playing on the floor? We do these things through climbing, bouncing, drawing, running, and all the other things like it.
I myself have poor core strength and poor posture when sitting. What will really improve that measurably – nagging me to sit up straight? Or getting me out doing crunches and real activity? Once my muscles are stronger I will naturally sit straighter. That’s a natural consequence – not the primary cause.
NICK HEAP says
THANK YOU FOR TEACHING MY PHYSICAL THERAPIST MEGAN AT THE CARDINAL CUSHING CENTERS ABOUT W SITTING
Stephen Dobbins says
I can see why it’s important to get kids to learn not to w-sit. When I was young nobody told me it was bad to sit this way. So I sat this way all my life and could never sit any other way because it was extremely uncomfortable. So I I just sat in the w-sit position all my life. Now I am 43 years old and the only way I can sit is in the w-sit position. It is extremely relaxing and comfortable to w-sit. I’m not saying it is good for me, I just find it very comfortable to sit this way. It is the only way I can sit without my legs falling asleep and going numb. One thing I know of is that w-sitting can cause your legs to curve inward at the knees and not be straight like they are supposed to be which could cause problem with the knees when you are older.
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