Evidence and Science

The W-Sitting Controversy

90 Minutes — $59 — 60-Day Access

A No-Fluff W-Sit Deep Dive

A growing number of physicians and orthopedists are advising parents to let their children W-sit because it is comfortable for them. What do you think? Jury still out on this one? Are you on Team W-Sitting? Team Crisscross Applesauce?

Allow us to present you with the significance, evaluation, and interventions of habitual w-sitting, especially for children with potential orthopedic issues and ligament laxity and cerebral palsy.

In this 90-minute on-demand course, Billi begins with an explanation of the controversy over the issue of W-sitting and the related state of evidence to support both sides of the issue. Bringing the sciences of full-term neonatal posture and bone geometry to the discussion, she relates the typical hip neonatal and knee joint alignments to typical strategies used to acquire the ring-sitting position. It’s pure gold. 

Then she addresses the pathomechanics and pathokinesiology inherent in habitual and prolonged W-Sitting with legs and feet in lateral rotation (i.e. W-Sit-LR), and the physiologic adaptation of soft tissues, bones, and joints to routine use and the condition known as “miserable malalignment syndrome.”

And to bring it home, Billi concludes with an extensive list of ideas for researchers. 

Customer Reviews
Interesting take by orthopedists about structural effects of the atypical posture/muscle imbalances.

Learn it. Apply it. Work it.

After the 90 minutes are up, and you’ve cranked through each section, you’ll be able to 

✔️ Explain the biomechanical benefit that typical full-term newborn alignment of the leg and foot brings to the independent acquisition of the ring-sitting position.

✔️ Name three of the hip muscles used by typical infants to drive and decelerate the transitions between ring-sitting and quadruped positions.

✔️ Compare the triplane alignment of the femoral head and neck axis (HNA) in ring sitting and in W-sitting positions.

✔️ Discuss the influence of W-sitting-LR on the incidence of lateral weight shifts of the torso in play.

✔️ Describe the rotary forces applied to the femur during transitions between W-Sitting-LR and kneel-standing positions.

✔️ Discuss the status of evidence regarding the contributions of habitual W-Sit-LR to musculoskeletal problems after childhood.

✔️ Describe the condition of the long bones and knee joints in “miserable malalignment syndrome.”

✔️ Explain the science that associates habitual, prolonged W-sitting-LR with miserable malalignment syndrome.

✔️ Distinguish between common advice and kinesiologically healthy alternatives to W-Sitting.

And For The Cherry On Top

Continuing Education Credits

PHYSICAL THERAPISTS: Upon course completion, you’ll earn a total of 1.50 contact hours which are accepted for PT continuing education credits in over 40 states via Redefine Health Education. For a list of states that accept these CEUs and information about obtaining them in those that do not, please visit Redefine Health Education's website

 ORTHOTISTS/PROSTHETISTS: This on-demand online course earns you 1.75 Category I scientific credits through the American Board for Certification (ABC). Full participation in this course is required to be eligible for the full amount of credits approved, which means you need to watch the 90-minute course, answer 10 quiz questions, get 80% correct to pass, and complete an evaluation form. 

OCCUPATIONAL THERAPISTS: Our application to AOTA for Approved Provider status is in process. Email us for further details.

A Peek Inside

The moment you enroll in The W-Sitting Controversy Course you gain 60-days' access to the content topics shown.

From start to finish, Billi brings her experience, research, and discernment to the improvement of your practice.

Beginning with The Dispute.

Please note: this course is available on demand, and may be accessed at any time during your 60-day access period, which begins on the date you purchased the webinar, not the date you hit play.

Section 1: Biomechanical Contributions to Early Sitting Acquisition
Typical Features of Newborn Lower Extremity Alignment
Musculoskeletal Components of Ring-Sitting Acquisition and Position Transitions

Section 2: Biomechanical Factors in W-Sitting and its Acquisition
Biomechanical Factors

Section 3: Physiologic Adaptation of Muscle and Fascia Applied to W-Sitting-LR
Physiologic Adaptation - Muscle and Fascia

Section 4: Physiologic Adaptation of Bones and Joints Applied to W-Sitting-LR
Modeling Mechanisms
Miserable Malalignment Syndrome

Section 5: Should We Discourage or Ignore W-Sitting-LR?
W-Sitting: Discourage or Ignore?
Examining Common Interventions
Strategies for Indoor Play

Section 6: Summary
Ideas for Researchers
Question and Answer 

Section 7: Wrapping Up
W-Sitting: Test Your Learning
Course Evaluation: The W-Sitting Controversy

The Big Three

The Big Three course bundle gives you access to three courses at one low price of $133, and includes The Golden Rule of Managing Pediatric Orthopedic and Motor Development, Part 1 and Part 2, and The W-Sitting Controversy.

Customer Reviews
Great course!
Meet Your Instructor

Billi Cusick

Billi Cusick, PT, MS, NDT, COF/BOC, is an internationally known pediatric physical therapist whose specialty is the orthopedic development and orthotic management of children with cerebral palsy and other neuromotor deficits. 

She has been teaching these and related topics since 1978, including presentations by invitation for the APTA, AACPDM, AOPA, and AAOP and more than 460 full programs and workshops worldwide.

Billi received her BS in PT from Bouve College at Northeastern University in Boston, MA in 1972, and her MS in Clinical and College Teaching for Allied Health Professionals from the University of Kentucky in Lexington in 1988. She is an Associate Professor for the Rocky Mountain University of Health Professions – Pediatrics Program – Provo, Utah (2006-present) and is NDT basic- and baby-trained.