As parents, we constantly observe our children’s development, from their first steps to how they play and interact with the world. You might have noticed your little one sitting in a peculiar way: with their knees bent, feet positioned outside of their hips, and legs forming the shape of a “W” when viewed from above. This is known as “W-sitting,” and it’s quite common among toddlers and young children, especially those with naturally flexible joints or low muscle tone. While occasional W-sitting might not be a concern, if it becomes a child’s preferred and only sitting position, it can signal underlying issues or potentially lead to developmental challenges.
At Belief Shaping Therapies, we believe in empowering children to move, grow, and thrive through purposeful, personalized interventions. As one of the best occupational therapy centres in Dubai, our goal is to guide parents and caregivers in understanding developmental red flags and the right ways to support a child’s growth. One common concern many parents raise is W sitting — but what does it really mean, and when should you worry?
What is W Sitting in Children?
“W sitting” is when a child sits on the floor with their knees bent, legs splayed to the sides, and feet tucked behind them. From above, their legs resemble the shape of the letter “W.”
While this position is often seen in toddlers with flexible joints or low muscle tone, consistent W sitting may signal underlying issues that require attention from a qualified occupational therapist in Dubai.
Why W Sitting Might Be a Concern
Occasional W sitting is usually harmless, but if it becomes a habitual posture, it could:
- Lead to musculoskeletal problems like hip dislocation or twisted leg bones
- Delay the development of motor skills and core strength
- Affect postural control, balance, and coordination
These complications can impact everything from playing to handwriting — daily functions that require a strong, stable body.
Understanding the “why” is crucial to building a treatment plan.
Understanding the “why” behind prolonged W-sitting is crucial for addressing it effectively. While a fleeting W-sit during play is usually harmless, habitual W-sitting as a primary posture can create problems. Occasional W sitting is not harmful, but if it becomes a child’s preferred and only sitting position,
🚫 Musculoskeletal Issues:
- Hip Dislocation: For children with existing hip instability, W-sitting can put undue stress on the hip joints, increasing the risk of dislocation.
- Tibial Torsion: This position can contribute to the inward twisting of the shin bone.
- Femoral Anteversion: It can also encourage the inward turning of the thigh bone, affecting gait and posture.
🚫 Delayed Motor Skills:
- Limited Trunk Rotation: W-sitting locks the trunk, hindering the development of rotational movements essential for crossing the midline (e.g., reaching across the body to grab a toy).
- Poor Core Strength: This position offers passive stability, meaning children don’t need to engage their core muscles, which can lead to delayed development of core strength crucial for posture and balance.
- Hindered Bilateral Coordination: The fixed position limits the ability to use both hands together effectively across the body, impacting tasks like cutting with scissors or buttoning clothes.
🚫 Poor Postural Control:
- Prevents Muscle Use: W-sitting prevents the activation of the muscles needed for dynamic, upright posture, which are vital for active engagement in play and learning.
- Limits Dynamic Movement: It restricts the child’s ability to shift weight and move dynamically while sitting, affecting the development of both fine and gross motor skills.
How Occupational Therapy Helps with W-Sitting
Occupational therapists (OTs) play a pivotal role in addressing W-sitting by focusing on the underlying reasons for the preference and equipping children with the strength, control, and habits needed for healthier sitting.
1. Identify the Root Cause: An OT begins with a thorough evaluation to understand why a child prefers W-sitting. This can stem from:
- Poor core strength
- Low muscle tone (hypotonia)
- Joint hypermobility
- Balance or coordination difficulties
- Delayed postural control
2. Strengthening the Core and Trunk: Weak core muscles often lead to W-sitting because it offers easy, passive stability. OTs introduce engaging activities designed to improve core strength, such as:
- Animal walks (like bear walks, crab walks, or wheelbarrow walks)
- Therapeutic yoga poses (e.g., plank, boat pose)
- Swinging or climbing activities (which also develop dynamic balance)
- Ball activities (sitting and bouncing on a therapy ball, catching while sitting) These exercises help children gain the necessary strength to sit upright comfortably in other positions.
3. Improve Postural Control and Balance: Children who habitually W-sit often struggle with maintaining upright balance when transitioning to or holding other sitting positions. Occupational therapy works on improving these areas through activities like:
- Sitting on a therapy ball or balance cushion to challenge stability
- Core engagement games that encourage reaching and twisting while maintaining a seated position
- Dynamic seated play involving twisting, stretching, and leaning to build active postural control. The primary goal here is to help the child tolerate alternative sitting positions without quickly fatiguing or losing balance.
4. Encourage Alternative Sitting Positions: A crucial part of therapy involves teaching and practicing healthier positions for floor play. OTs guide children towards:
- Criss-cross (“pretzel”) sitting
- Side sitting
- Long sitting (with legs extended straight in front)
- Tall kneeling Therapists may use visual prompts, gentle physical guidance, or positive reward systems to reinforce these better habits and make the transition fun and achievable.
5. Environmental Modifications: Sometimes, simple adjustments to the environment can promote better posture. OTs may recommend:
- Small stools or benches for seated play activities
- Wedge cushions or floor seats to provide added trunk support
- Raising activity surfaces so that prolonged floor sitting isn’t always necessary for play.
6. Parent and Teacher Education: A significant component of occupational therapy is empowering caregivers. OTs provide training to parents and teachers on how to recognize W-sitting and gently redirect the child. This includes:
- Teaching alternative phrases like “Let’s sit like a pretzel!” or “Try legs in front like a rocket ship!”
- Suggesting mini-movement breaks to prevent fatigue and slouching during prolonged sitting
- Providing home exercise plans to reinforce strength building and postural improvements outside of therapy sessions.
7. Monitor for Red Flags: In rare instances, persistent W-sitting can be a symptom of, or exacerbate, more serious conditions such as hip dysplasia, certain neuromuscular conditions, or severe low muscle tone. OTs maintain a watchful eye for such “red flags” and can collaborate with physical therapists, orthopaedic specialists, or developmental paediatricians if further medical evaluation or intervention is deemed necessary.
The Role of Occupational Therapists at Belief Shaping Therapies
At Belief Shaping Therapies, our occupational therapists in Dubai play a vital role in helping children overcome physical, sensory, and developmental challenges through personalized care. We don’t just focus on correcting habits like W sitting — we look at the whole child.
Here’s how our expert team supports your child’s growth:
- Individual Assessments to understand the root cause of postural habits or delays
- Customized Therapy Plans that address motor skills, strength, coordination, and daily function
- Fun, Engaging Activities that make therapy feel like play — not work
- Caregiver Training to ensure support continues at home and in school
- Collaboration with Specialists when needed, for a holistic treatment approach
Belief Shaping Therapies, Recognized as one of the best occupational therapy centres in Dubai, we are committed to helping every child gain confidence, independence, and physical strength — while keeping their unique needs and personality at the heart of everything we do.
Whether your child needs help with W sitting, sensory regulation, or fine motor skills, our best occupational therapists in Dubai are here to support them — every step of the way.