Is your child sitting in 'W' position, stop him RIGHT NOW

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If you often catch your child sitting in 'W' position and playing, immediately stop him, it could cause serious orthopedic problems. Here's why

You may have seen your children sitting in the ‘W’ position and playing for hours. But did you know that this is probably the most dangerous position and could pose serious orthopedic complications?

Most children with joint hypermobility and low muscle tone, sit and play in the ‘W’ position. In this position, the hips are twisted inwards and the knees are twisted outwards to an extreme degree. Such a position imposes abnormal stresses on the hips and knees.

theIndusparent.com spoke to Dr Amit Narayan, consultant, Ortho and Spine, PSRI Hospital, Delhi, to understand the problem. He explains, “If the child always sits in the ‘W’ position, the hips and knees adapt to the abnormal forces that the position imposes on these joints. An important consequence of sitting in ‘W’ position is the impact of the position on the position of lower leg and foot relative to the thigh."

He adds that this position leads to the lower legs developing excessive lateral rotation. "This means that the lower leg twists outwards more than usual with the foot pointing slightly to the side rather than straight forwards. This is sometimes referred to as tibial torsion," says Dr Narayan.

He further explains that when a child stands with his knee caps facing forwards, the foot is twisted outwards rather than pointing straight forwards. "When the child sits, the feet also turn outwards. The outward twisting of the foot relative to the thigh (tibial torsion) leads to excessive strain on the knees and later causes knee problems," says Dr Narayan.

This outwards twisting of the feet also affects running and walking because the child fails to develop good push off at the ankle. "Adults with tibial torsion and restricted rotation of the hips tend to suffer from iliotibial band (ITB) syndrome band syndrome and may develop arthritis of the knees," says Dr Narayan.

Why do children adopt the ‘W’ position?

Studies show that children usually adopt this position when they transition from crawling to sitting. In fact, the most common reasons for children to adopt this position are:

  • To have greater than normal range of movement and lax hip joints
  • To have wide base that requires less effort to move and stay upright
  • To enable additional trunk and hip stability for easier toy manipulation and play

While these advantages make it easier for the child to use this position for play, experts advise against it.

Why your child shouldn’t sit in the ‘W’ position?

Since this position restricts movement, it leads to children facing difficulty in balance. Children who use this position often are unable to develop truck rotation (twisting) or the ability to easily bend to their sides.

These two movements are essential for the body to maintain equilibrium. Apart from lack of balance, the other consequences of sitting in this position are:

  • This position can lead to hip dislocation, especially if the child has a history of hip dysplasia (abnormal formation of the hip socket that leads to arthritis)
  • If your child has complained about muscle tightness, this position will further aggravate it since the hamstring, hip adductors are in short range
  • This position could also lead to neurological problems in the posterior muscles, if used often by children

How to prevent health problems caused by ‘W’ position?

The best way to prevent health problems due to this position is to avoid making it a habit. The other ways you can help your child are:

  • Encourage your child to sit in different positions. Dr Narayan suggests, "When you see your infant sitting between his/her legs, gently move her legs to a better position and say something such as "Feet in front."
  • Hold his knees and feet if he is trying to sit in this position, this will make his choose one side and avoid this position altogether
  • Use the toys as a means to make him change from ‘W’ position to other positions

If your child is unable to sit in any other position other than the ‘W’ position, you should refer to a physiotherapist.

(Image courtesy: Lianabeer, Davidwolfe)

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Written by

Deepshikha Punj

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