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Why “W” Sitting Is a Problem “W” sitting is a common sitting posture seen in children where they sit back with their knees in front and legs/feet positioned behind them. Children assume this sitting posture because it provides hip and trunk stability and a wide base of support making it difficult to fall to the sides or backward. Children are better able to manipulate toys without worrying about trying to keep their balance. This position is easy to get in and out of. Children simply sit back from a hands and knees or kneeling position, moving in a forward and backward plane. Children with “hypotonia” prefer this sitting position due to the stability it provides. Hypotonia, or low muscle tone, is associated with “floppiness” or postural limpness. Children with low muscle tone lack ligament, muscle and tissue resistance thus providing inadequate support for their joints. They will tend to maintain positions that provide the most support, however, the least function. There is no trunk rotation, weight shifting, or balance reactions required when a child moves in and out of “w” sit. All of these components are needed in order to develop refined motor skills such as walking, handwriting, skipping and other high level motor skills. If a child is consistently sitting in a “w” sit and moving in and out of this position, they are not working on these motor components. There are orthopedic concerns as well. The hips and knees are placed in a position that could permanently shorten leg and ankle muscles and tendons. The outer hip muscles and leg muscles are not used. “W” sitting also places added stress on the hip and knee joints and could predispose a child to adolescent or adult joint pain. “W” sitting should be avoided. The easiest way to prevent children from sitting in this position is to not have children sit in this position from the beginning. If a child discovers “w” sitting, you should encourage them to sit with their legs in front in a long sit (straight legs) or tailor sit (crossed legs) or to the sides in a side sit (both knees to one side). These positions help to develop trunk strength and control as well as keeping the legs in a better position for function. If you suspect that your child has difficulties sitting in other positions, moving in and out of sitting or may have low muscle tone, it is important to contact your pediatrician and request an evaluation by a physical therapist. Physical therapy addresses motor issues through therapeutic activities that help the body strengthen and move more efficiently. Please contact Theraplay, Inc. and schedule to see one of our specially trained pediatric physical therapists, should you be concerned. © Theraplay, Inc. 2009