Parents bring their kids in for a physical therapy evaluation for many different reasons, from toe-walking to neuromuscular conditions to decreased ability to keep up with peers. Regardless of the diagnosis, about 25% of my clients under 5 also present with w-sitting. When brought to the attention of the parents, typical responses range from, “I’ve never noticed that before; is that bad?” to“I w-sat as a child, and I turned out fine.” Physical therapists will most always work to correct this sitting posture and some of the underlying impairments. Here are some of the reasons w-sitting is not healthy for children.
What’s wrong with w-sitting?
- Decreased Core Activation – Due to the wide base of support afforded with w-sitting, less core muscle (trunk extensors and abdominals) activation is required to maintain position. This wide base of support also limits the child’s need to weight shift from side to side during play, resulting in decreased use of lateral and posterior balance reactions.
- Poor Posture – “W”-sitting encourages excessive posterior pelvic tilt, which can result in slouching. Excessive hunching over results in minimal trunk extensor activation. This creates a cycle of poor sitting posture due to muscle weakness, resulting in poor sitting posture.
- Pigeon-Toed (In-Toeing) Walking Pattern – Increased hip internal range of motion, decreased hip external range of motion, and hip abductor weakness can contribute to an in-toeing gait pattern. It should be noted, however, that some in-toeing gait can be attributed to femoral anteversion.
- Decreased Trunk Rotation – Poor trunk extension due to posterior pelvic tilt can limit ability to turn trunk from side to side. This is important because decreased trunk rotation during play can impair the body’s ability to integrate left and right sides of the body, leading to decreased coordination
- Delayed or Impaired Fine Motor Development – This delay is usually due to a combination of the impairments already mentioned above, such as decreased trunk rotation and poor core strength. These impairments can lead to decreased play involving midline crossing and poor development of bilateral coordination. High level fine motor tasks, such as fastening a button, requires a coordinated effort between left and right hands.
NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!