Does your child often sit like this, with their legs in the shape of a “W”?

What is w-sitting?
W-sitting is a position in which children rotate their hips inward and sit on their bottom with their feet splayed out on either side of them, resulting in their legs being in the shape of a W. It is a position that is very common with children and may not be a problem on its own. However, w-sitting can become a problem if it is the preferred sitting position for children. W- sitting gives children a wide base of support, making it easier for them to balance and maintain upright posture. It takes less strength to maintain an upright position and stay balanced when in w-sitting, as compared to other seated positions. Therefore, children with weak core muscles often utilize the w-sitting position.
Why can excessive w-sitting be harmful?
- W-sitting does not require as much activation of trunk muscles, which contributes to impaired core strength and balance.
- It may lead to excessive hip flexibility
- It may lead to muscle tightness through the legs
- It can result in the bones of the leg rotating inward. We often see this in children that in-toe when they walk (aka pigeon toe).
- It inhibits exploration and movement between positions
- It confines children to play only in midline positions and limits trunk rotation. It is important to play outside of midline in order to develop bilateral coordination and higher level motor skills.
- It may put excess stress on the knees, hips, and ankle joints.
- It can lead to delayed motor skills and development
What can you do at home to help?
- Break the habit. Children often fall into the habit of w-sitting, making it their preferred position.
- Be consistent about instructing your child to switch into a different position
- Physically assist your child into a different position, if they need assistance
- Give clear and concise instructions to switch positions (i.e. “fix your legs/feet,” “feet in front,” “sit on your bottom,” “criss cross applesauce,” etc.). Choose one phrase that works for your family and stick with it.
- Instruct other family members, daycares, teachers, etc. to be consistent about correcting the position. Educate them about the risks associated with frequent w-sitting.
- Some alternative positions include:
- Criss cross sitting
- Side sitting
- Sitting with feet straight out in front of body (aka long sitting)
- Kneeling with heels directly under their bottom

When is it time to consider PT?
If your child:
- Has difficulty keeping up with peers
- Often w-sits and is unable to maintain other positions
- Walks/runs with their toes pointed inwards
- Falls often
- Is not meeting motor milestones. Or if you have any other general concerns about their physical development.
Physical therapy will help with strengthening, stretching, and with meeting motor milestones. PT will help teach your child proper body mechanics and positioning, and to aid in the overall physical development of your child.
Please reach out to your pediatrician if you have any concerns. Pediatric Therapies Hawaii offers full physical therapy evaluations if you have any concerns about your child’s physical development.
Resources:
https://pathways.org/what-is-w-sitting/#:~:text=W%2Dsitting%20is%20when%20a,Pathways