Who should not w-sit? For many children, W-sitting should always be discouraged. This position is contraindicated (and could be detrimental) for a child if one of the following exists:
- There are orthopedic concerns. W-sitting can predispose a child to hip dislocation, so if there is a history of hip dysplasia, or a concern has been raised in the past, this position should be avoided.
- If there is muscle tightness, W-sitting will aggravate it. This position places the hamstrings, hip adductors, internal rotators and heel cords in an extremely shortened range. If a child is prone to tightness or contractures, encourage anther pattern of sitting.
- There are neurologic concerns/developmental delays. If a child has increased muscle tone (hypertonia, spasticity), W-sitting will feed into the abnormal patterns of movement trying to be avoided (by direction of the child’s therapist). Using other sitting postures will aid in the development of more desirable movement patterns.