Although many children W sit and a large number of them “out-grow” it without any functional or physiological issues, there are a few negative effects that may require an evaluation for intervention.
- Frequent falls or trips
- A higher falling frequency has been noted in individuals with femoral anteversion. Those children with femoral anteversion fell four times more often during running and three times more often during fast walking than their healthy peers. (Leblebici et al., 2019)
- Reports of pain or discomfort in the child’s hips or legs
- If you notice your child cries and points at their hips, knees, ankle, or feet, they may be in pain due to an abnormal alignment of their legs.
- Delayed development of gross motor skills (Leblebici et al., 2019)
- Watch how your child plays with peers their age. You may be able to see discrepancies in their abilities that could be a cause of concern.
- For example: Children should be able to jump forward approximately four inches by the time they are two years old. If they are not completing this task and you watch other children their age playing at the playground jumping around, this may be a signal of some gross motor delay.
- Abnormalities with gait (such as in-toeing, “pigeon-toed,” while walking)
- In-toeing was detected in approximately 6% of children who preferred W sitting (Altinel et al., 2007). In-toeing may be due to femoral anteversion as mentioned above, tibial torsion (a rotation of the lower leg bones), or abnormalities of the position of the feet.
- Another abnormality associated with W sitting is flat feet which may lead to further orthopedic issues as the child ages (Chen et al., 2010)
- Difficulty achieving seated positions other than W sitting
- If you are attempting the alternative positions, and your child is unable to obtain or maintain the positions, that may indicate tightness in the joints.
- Fatigue after short periods of activity
- During prolonged walking (for example: grocery shopping, walking at the mall), children with femoral anteversion showed rapid onset of fatigue as compared to their healthy counterparts. (Leblebici et al., 2019)
If you continue to struggle with W sitting, or find that despite these strategies, any of the above listed concerns arise, consider seeking support from a trusted therapist. A skilled pediatric physical therapist will be able to evaluate your child to further investigate range of motion, strength, alignment, gait pattern, and overall gross motor development. They can provide exercises and various activities or interventions that are used to improve these categories if an issue is noted. The physical therapist would also be able to make a recommendation if further specialists need to be involved. At Carolina Pediatric Therapy, we have a team of physical therapists who are prepared to walk beside you on your journey.