Friday, December 5, 2014

W-Sitting in Children: What's wrong with that?

December 5, 2014  In by Stephanie

W-sitting is when your child sits on the floor with knees together and feet on either side of their hips. It is called that because if you look at them from above, it looks like they are making a W with their body.
If you see your child temporarily sitting in this position, or use they it as a transition stage to move in and out of other sitting positions or movements, it is fine.
What is not fine is if your child sits in this position for extended periods of time while playing on the floor.
I first learned about W-sitting when I took my first Itsy Bitsy Yoga teacher training back in 2005. In that training, we learned how if we see a kid sitting like this in yoga class to gently remind parents to have their child sit another way, because W-sitting is hard on the knees and hips and can cause damage.
W-sitting requires the hips to be positioned in extreme internal rotation – way past what is functional – which causes problems with the hips and knees down the road. Major muscle groups become very tight, causing in-toeing during walking (aka pigeon-toed walking). Kids who chronically W-sit have more shallow hip sockets, which can cause severe problems later in life. W-sitting is also hard on the knee joints due to excessive forces on the joint, making your child more prone to ligaments damage during play than non-W-sitting kids.
But in that training, I don’t remember being taught why a child would sit like this in the first place.  Only later when Penelope started sitting like this, and during her diagnosis of Sensory Processing Disorder, did I find out the ever-important why.
So, why do kids W-sit?
Kids who W-sit do so because requires less muscle strength and is therefore easier to balance. They W-sit because it is easier for them, and they can get away with playing on the floor without having to cross the mid-line. It takes a massive amount of core strength to sit “criss-cross applesauce” or other ways of floor sitting in where you can rotate your trunk and cross the mid-line of the body to move around. Low tone and not crossing the mid-line are huge red flags for developmental issues in your child.
I am still wrapping my mind around low tone and how it is related to sensory/spectrum kids, but the best I can describe it is that kids with low tone are often floppy and tire easily. They require more energy to move their bodies because the muscle fibers and brain synapses are not there or not functioning properly – just sitting up for them can feel like they ran a mile.  If it takes so much energy for them just to sit up, can you imagine the energy required for them to ride a bike or run or simply hold a pencil? So a kid with low tone is gonna do W-sitting, because they can sit and play longer without feeling exhausted. They can focus less on balancing and using their muscles and more on playing. Penelope is exhausted after school; she wants to lay down or have me hold her like a baby because she is so tired from working her core muscles to hold herself upright, she’s also exhausted from sensory overload. Kids with low tone are often very clumsy, falling or bumping into things and can have gross motor or fine motor delays. Just like babies are little geniuses in figuring out the easiest and most reliable way to be fed in order to survive, kids are geniuses at compensating for their weaknesses to get by.
When I say the mid-line of the body, I am referring to an imaginary line down the center of your body that creates the left and right sides of your body. Again, kids who W-sit, often do so, so they can avoid crossing the mid-line. Many children with sensory processing disorder have trouble crossing their midline, ie. bringing an arm or leg across the line to the other side of the body, or even reading across a page with both eyes. Kids who find crossing the mid-line difficult usually compensate by turning their entire body or their head in the direction they need to move their limbs or eyes in. They’ve learned that when they move their whole self, they no longer need to overreach their limits.  This is a great post with some ideas of things you can do at home to practice crossing the mid-line with your child.   This one is good as well. 
Penelope has a really hard time with this. She will turn her entire body to reach for something instead of simply reaching across her body to get it. And she also scoots her left hand and body further to the left, so that her right hand doesn’t need to cross the mid-line as she is writing. She is working on this at her Occupational Therapy sessions, and I am praying we cover a lot of ground this year, so that when she starts Kindergarten next year  she will be more caught up with her peers.
This is also why it is really important for babies to not skip or speed through the crawling stage. Crawling is an important way a child can set up neurological pathways for later crossing the mid-line activities, so in the same way that W-sitting can be a red flag, skipping the crawling stage can also be a red flag. In Penelope’s case, she didn’t crawl for long, as she quickly figured out standing up and walking – which meant she didn’t have to deal with crossing the mid-line to move around. See? Babies are geniuses!

If you see your child W-sitting, don’t freak out- I just want to bring this information into your consciousness so that you know it may be a red flag for other stuff.
If you do see them sitting this way often, gently show them other ways to sit, including: criss-cross applesauce (aka Indian style), mermaid sitting (with both legs to one side), pike position (both legs out front), kneeling (similar to W-sitting, but feet are under butt/hips). Closely monitor how often they W-sit if they are resistant to other types of sitting.
Some other great things to do with your child to help them build core strength, practice crossing the mid-line, and fully integrate the Symmetrical Tonic Neck Reflex is to do yoga Moon Toe and Twistie are great one for babies to practice crossing the mid-line, and Frog pose and Cat/Cow are great for older tots and kids. Climbing on a rock wall is also awesome, very similar to what the body/brain needs to do while crawling.
If you practice yoga, you might be thinking to yourself, “Hey, wait a minute, W-sitting is hero’s pose or virasana! I do that in yoga class! Why can’t my child sit like that if I am doing this pose in yoga??” Hero’s pose or Virasana can be a relaxing and rejuvenating stretch for your thighs, knees and ankles ifyou ease into the pose extremely gently and do the pose very consciously, fully bringing your awareness to your legs so as not to injure yourself. If you are doing this pose as a stretch but your knees want to pop up, or your butt can’t get all the way down so that your knees, feet and butt all on the floor, that is a sure sign you are not flexible enough yet for the full pose. In this situation, stretch one leg out in front of you and do a half hero pose until you can safely do the full pose. Eventually, to deepen the pose, you drop back on your elbows and and then onto your back, so you are all the way on the floor. Again, this is a great stretch for your thighs, knees and ankles, but you must only do it very consciously for a few minutes to not do damage to your body.
In summary, W-sitting is a sign of poor balance, poor coordination, and the bad thing about that, is your kid needs good balance and coordination not only to ride a bike, jump or play ball, but to read, write and speak.