If you've ever worried about the way your child is sitting, read this before you make them change.

By Cassie Shortsleeve
June 04, 2019
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Recently, a story about the dangers of kids sitting in the 'W' position went viral, catching the attention of parents everywhere.

The gist: While sitting in this position under the age of two is likely safe, according to some reports, if this position becomes a go-to after age two, it can negatively impact a child's overall development, so it's best to encourage kids to change their on-the-ground positioning.

But not *everyone* is in agreement about that—and many experts say that the idea that sitting in the 'W' position can cause postural, orthopedic, or muscular problems down the line is little more than a dated myth. Here, a little bit behind the 'W' position itself, whether or not it's truly harmful, and what to do if you find your child seated this way.

What the 'W' Position Is

The 'W' sitting position might remind you of hero pose in yoga. More or less, it's a position where a child's bum is on the ground and their legs and knees are in front of them splayed out to the sides.

It's most commonly seen in toddlers (and kids even sit in it up to about age eight or nine). Part of the reason kids might sit this way? It's common for children to be born with their femurs (the thigh bones) turned in, a condition called femoral anteversion.

"The reality is that most of us have femoral anteversion — it's excessive femoral anteversion that allows kids to sit in the 'W' position," says Greg Hahn, M.D., a pediatric orthopaedist at Johns Hopkins All Children's Hospital.

Illustration by Emma Darvick

Why Docs Once Thought Kids Sitting in the 'W' Position Was Dangerous

Old-school thinking among orthopedists in the 1960s and 1970s said that intoeing, or having your toes point inward when you walk, was a muscular or soft tissue issue — and that it was possible to train kids not to do it, explains Dr. Hahn. By having kids avoid positions like the 'W' sitting position, the thinking was that you'd avoid stretching out the muscles, which was what was allowing them to continue to intoe.

But research, notably by pediatric orthopedist Lynn Staheli, M.D., then found that intoeing was simply a normal variation (much like being tall or left-handed) — and something that self-resolves without any treatment (read: a changing of position or braces).

Plus, if you watch people walk, you'll notice most don't do so in a perfect, straight ahead line — most people toe in or out a bit and in children, it's just more pronounced, says Dr. Hahn.

The True Effects of the 'W' Position

In short, while the myth that you have to avoid the 'W' position might live on, Dr. Hahn says "the position doesn't cause any long-term problems so we don't worry about it."

Dr. Hahn also notes that he's unaware of any study linking the position to osteoarthritis issues.

Furthermore: "Research by the International Hip Dysplasia Institute and others has shown that increased Femoral anteversion does not cause hip dislocations and does not harm the hip socket," says Charles T "Chad" Price, M.D., a pediatric orthopedist and medical director of the International Hip Dysplasia Institute.

He adds that if children do have femoral anteversion 'W' sitting can be more comfortable and should be allowed. "Spontaneous correction occurs with growth in almost all cases." While intoeing is very common in young children, it's rarely seen in adults regardless of sitting habits, he says.

Your takeaway: No need to tell your child to change positions if you see them sitting in the 'W' position.

"It's no different than having a kid sit 'criss-cross applesauce'. It's not a problem. It's not bad posture where you have to encourage a kid not to sit that way,'" says Dr. Hahn.

A more important issue to be aware of? Tech neck — a growing concern among doctors as kids spend more and more time hunched over devices looking down, adding unnecessary weight to the muscles of the back. "This can lead to back pain," he says.

Instead of focusing on their legs, make sure they're looking at devices at eye level to sidestep any strain on their backs.

Comments (1)

Anonymous
August 19, 2020
This is complete misinformation. You should be ashamed of yourselves as such a far reaching parent resource. Did you actually do the research that this topic requires? You interviewed orthopedic doctors. Did you actually reach out to any pediatric physical or occupational therapists who actually works daily year after year with kiddos affected long-term by W-sitting? There are so many long term effects of sustained W-sitting that pediatric orthopedic doctors would never see and adult orthopedic doctors would just treat with surgery such as arthritis/malalignment injury of the hips/knee/ankles. There is also a higher risk of injury associated with kiddos who may have hip/knee laxity that allows them to fall into the W-sitting position. There is a difference between neurotypical kiddos who transition in and out of W-sitting easily and those who have global issues and that W-sit is a classic sign that something else needs to be addressed and the child's development is going to be impacted. You are absolutely doing a disservice to parents out there who are dealing with W-sitting in their child and who are looking for any excuse to stop listening to their hardworking therapists who are trying to prevent these long term orthopedic issues/injuries from coming up years down the road. Please do your research before broadly publishing something that could negatively impact an entire generation of children. Do you know that the entire online pediatric physical therapy community is aghast at this article and what it claims? Outgrowing in-toeing? That's like saying a child would outgrow low muscle tone. Do NOT make such a sweeping generalized statement about all children. Did you even read the rest of the research by the Hip Dysplasia Institute where it cautions against such positions? Please redact this article or modify it to say that parents should continue to listen to their medical professionals who actually see and work with their individual child in person as opposed to believe a poorly-researched fluff piece on a parenting website. Once again, you should be ASHAMED of yourself for undoing our years of hardworking pediatric developmental experience and parent education in one ridiculous article. -Outraged Pediatric Physical Therapist