Sunday 1 March 2015

W-Sitting



W-sitting is an ATYPICAL way of sitting on the floor;  the buttocks rest on the floor while the lower legs point outwards and back.  Toddlers and preschool kids are often seen in w-sit position while playing with toys. For the child, it is a stable position and hence w-sitting becomes a habitual behavior quickly. 

If a child w-sits for prolonged periods of time, the consequences would possibly be any or all of the following:
Hip joint distortion—muscles and soft tissues on the medial aspect of the joint would be hyperflexible, whereas the same on the lateral aspect of the joint would be tight and contracted. 

Knee joint and feet distortion—the abnormal position of w-sitting would naturally place the knees and ankles in an abnormal position with similar consequences as the hips. 

Pigeon-toe gait---the distortions at the hips, knees, and ankles lead to in-toeing or pigeon-toe walking. This gait deviation does not only matter cosmetically, but leads to abnormal bone development of the lower leg.

Core muscle stability—remains  under developed  as a result of prolonged w-sitting position, since the muscles of the abdomen and back have to work minimally during w-sitting rather than being challenged. 

Crossing midline and Bilateral coordination—remain poor secondary to lack of trunk rotation that characterizes w-sitting. 

Conversely, if a child is frequently observed to w-sit, one or more of the following could be suspected:
Increased internal rotation of the hips.
Laxity of the hip joint ligaments.
Low muscle tone.

Children with neurological conditions such as cerebral palsy,  hypotonia, and autism are highly likely to assume the w-sit position. They should be encouraged to sit in cross-legged or long-sitting positions during floor time. Otherwise they are at risk of learning higher functions that involve reaching, manipulation of objects, as well as writing.