Physical therapist John Duffy tries to put a long-standing controversy to rest:
Over the years people have asked about kids sitting this way, but since my kids never did, I never explored the topic deeply. Shallow checking on the internet will find that it’s comparable to your kid sitting on radioactive plutonium. Deeper research finds that there really isn’t any evidence to support the claims. PT’s that I know and trust to dig deep haven’t found anything either…
The hips of young children tend to be rotated inward — a normal anatomic condition called femoral anteversion which self-corrects as their bodies grow by 8 years old. Until it does, many children prefer to sit normally on the floor in the “W-sitting” position, which is a more comfortable and more stable position for them. Persistent femoral anteversion may be associated with an “intoeing gait,” where the toes point inward while walking. This is more often than not a benign condition that bothers parents and grandparents much more than it does children. Still, for many years pediatricians and orthopedists recommended that parents force their children to sit in the “criss-cross applesauce” (cross-legged, “Indian style”) position in order to prevent intoeing. A. Pawlowsi asked two pediatric orthopedists whether parents should worry if they see their child W-sitting:
“In my opinion, absolutely not,” Weiss said. “I have no problem with a child W sitting. They’re not going to change the shape of their legs. They’re not going to change their alignment by sitting like that. They’re just responding to their natural anatomy.”
If your child wants to sit in a W position, it means there’s no excessive stress on his joints, muscles or knees because kids know how to avoid pain in their bodies, she added.
A child cannot dislocate his hip by sitting this way, both doctors said. There’s no evidence it’s bad for core stability or will cause future orthopedic problems, they noted.
When should parents worry?
If, in addition to W sitting, you see your child develop a limp, a weakness in the lower extremities, or a pigeon-toed gait with the feet very abnormally facing in towards the mid-line when walking or running, that requires more attention, Novais said.
Hip dysplasia is sometimes associated with the excessive turning in of the thighbone, he noted. An X-ray will reveal if the hip is developing normally.
Kids who have low muscle tone, or hypotonia, may also like to sit in a W position because it increases their balance, he added.