What Is “W” Sitting And Why Occupational Therapists Have Concerns

“W” sitting is when toddlers sit with their bottom between both legs, with hips twisted inward and knees twisted outwards away from their bodies. Children will sit in this way to make up for weaknesses they may have in their hips and trunks, if they suffer from low muscle tone or if they experience hyper mobility of their joints, otherwise known as double-jointed.


Habitual sitting in this way can have many detrimental effects on your child’s muscle development and flexibility. It can tighten and shorten leg muscles, lead to tight hip muscles and weak balancing skills. Down the line, all of these reasons can negatively affect their future development of coordination, balance and gross motor skills.

How “W” sitting Affects Development
Due to their low muscle tone, children will sit in the W formation because it is easier and requires less strength to keep the trunk upright. Over time, a large range of internal rotation develops in their hips. Exceeding the normal rotation of about 45 degrees, a child who consistently sits in the W formation can develop an internal rotation range of about 80-90 degrees. Due to this increase, the external rotation of the hips becomes very limited. This makes it very uncomfortable for the child to then sit with their legs in front of them.

Children also struggle developing a dominate hand because they are not able to do a lot of across the body movements. Therefore, activities on the left side of their body are done predominantly with their left hand and activities on the right side of their body are done mainly with their right hand. This can lead to difficulties with coordination later on if the child does not have a hand preference.

Internal Tibial Torsion
This is a condition where the tibia bone twists inward, causing the feet to turn inwards as well. This is otherwise called “intoeing.” This is related to W sitting and can affect the way in which your child walks. With feet turned inwards, it can cause problems with coordination and he or she may frequently trip or fall.


Changing the Habit
In order to change your child’s habit of W-sitting, helping them work on the flexibility of their hips and knees is an important step. If your child does sit in the W formation, some suggestions to give to them are sitting cross-legged or with their legs off to the same side of their body. If they still have trouble avoiding the W formation on the ground, suggest sitting in a small chair or on a small bench. These different positions allow your child to shift their weight from side to side much more easily. It also engages their back and hip muscles in a healthier way and promotes proper growth and development.