W-Sitting and Hip Dysplasia

Often times as therapists, teachers, and parents it has been past practice to discourage children from w-sitting.  We often recommended alternative sitting positions other than w-sitting. The negative effects that we often describe do not have research to support it. Examples of these negative effects that are not evidence based are the following:

  • hip muscle tightness
  • hip dysplasia
  • lack of crossing midline
  • in toeing
  • decreased weight shifting
  • poor postural control muscles.

What Does the Research Say About W-Sitting and Hip Dysplasia?

A prospective study was recently completed to explore the relationship between w-sitting and hip dysplasia in 104 children with an average age of 9.9 years old. Each participant had a hip/pelvis radiography where measurements of hip dysplasia were recorded. In addition, parents and the children filled out a survey about the child’s sitting habits.

Following statistical analysis, the researchers determined the following:

  • 46% had current or past w-sitting.
  • 11% were current, preferred position w-sitters.
  • 22% were current, non preferred position w-sitters.
  • 13% were w-sitters in the past.
  • 54% never were w-sitters.

Among all the children there was no difference in measures of hip dysplasia therefore the researchers concluded that w-sitting in children is not associated with hip dysplasia.

Reference:

Rethlefsen, S. A., Mueske, N. M., Nazareth, A., Abousamra, O., Wren, T. A., Kay, R. M., & Goldstein, R. Y. (2020). Hip Dysplasia Is Not More Common in W-Sitters. Clinical Pediatrics, 0009922820940810.

The Core Strengthening Handbook
Often times as therapists, teachers, and parents it has been past practice to discourage children from w-sitting.   We often recommended alternative sitting positions other than w-sitting.