Q: Our preschooler has a really hard time sitting ‘crisscross applesauce’ during circle time. He instead sits with his legs in a W shape. Do we need to break him of this habit to protect his knees?
A: As you may have already discovered, there are differing opinions on the topic of W-sitting.
It can be common for younger children to prefer to sit in this position as it’s actually a more natural position for their hips.
Often young children may be born with a slight in-turning of their thighbones in relation to their hip joints (increased internal hip rotation). Typically, over time, this increased hip rotation decreases through normal growth and movement and the thighbones straighten out, thus making cross-legged sitting the more comfortable position.
In addition to being more comfortable due to the internal rotation of the hips, W-sitting requires less truncal or core strength and therefore can offer increased stability for upright sitting for young infants and children.
One concern with this position, however, is that it may be an indication of something more going on, such as internal rotation of the hip persisting into an older age.
Other concerning issues among older kids who rely on this sitting position would be trouble walking or running, knees that bump into each other more than usual or the feeling or appearance of being pigeon toed.
It could also mean a child isn’t developing the adequate core strength and is compensating for more stability and balance by W-sitting.
Another concern for children who prefer to sit in this position for extended periods of time is that they’re inadvertently limiting their upper-body rotation, which can make them less able to reach across the body with the opposite hand, which can impact fine-motor and hand-eye coordination skills in the future.
Regarding your specific question, it doesn’t appear that W-sitting would be putting undue stress on any of the leg joints, including the knees.
However, I would recommend gently encouraging your son to start transitioning to another sitting position. If the crossed-leg position isn’t comfortable, he could sit long-legged or with his legs both to one side.
If he still seems to want to continually sit in the W position, I would recommend discussing this with your primary physician.
Kimara Gustafson is a Minneapolis mother who works as a pediatrician at M Health Fairview Masonic Children’s Hospital and the Adoption Medicine Clinic, both at the at the University of Minnesota.
