Footprints Therapy

W Sitting, Kneeling, Side Sitting, Long Leg Sitting

Problems, & Solutions

Parental Concerns

  • Clumsy when walking
  • Funny gait
  • Tripping
  • Flat footed
  • Pigeon toed
  • Knock kneed
  • Difficulty sitting or standing straight
  • Complaints of hip/knee/foot pain
  • Growing pains
Cross leg sitting

  • Begins at 6 months
  • Promotes symmetry
  • Rotation of torso allows for crossing midline to play
Precursors to Development of Sitting Balance

  • Practicing tummy time
  • Legs must be in line with pelvis
  • Pushing up on extended elbows
  • Going into sitting with rotation of the torso
Consequences of too little tummy time

  • Inadequate development of hip extension
  • Pushing into W sitting with widely abducted hips
  • Feet turned in out
  • When placed in sitting, they are in long leg or ring sit
  • Hips internally rotated
  • Feet either turned out or facing each other
  • Wide base of support

  • Tight ITB’s
  • Hard to rotate to play
  • Flexed lumbar spine
  • Genu valgum
  • Pigeon toed or flat feet

  • Hips internally rotated
  • Feet turned in or out
  • Same problems elicited in standing
Long leg sitting

  • Hips internally rotated
  • Rounded lower back and pelvis
  • Chin poked forward
  • In standing, same issues are present
Side Sitting

  • One hip is internally rotated and weight taken on the inside of the foot
  • The other hip is externally positioned and weight is taken on the outside of the foot
  • The spine is side bent
  • In standing, the pelvis rotated and there is an apparent shortening of one leg
  • There may be a postural scoliosis
Ring Sitting

  • Hips are abducted
  • Child can not rotate the torso to play
  • Achieves prone or creeping by flopping forward
  • ITB’s tight
  • In standing, wide base of support and a waddling type of gait
Repercussions to Adults

  • Lumbar spine problems
  • Hip problems
  • Tight hip flexors
  • Tight ITB’s
  • Chondromalacia patella
  • Patella femoral syndrome
  • Medial or lateral tibial torsion
  • Multitude of foot aliments

  • Do not allow the child to get into this position in the first place
  • Put babies in prone to play
  • At 6 months, legs should be in line with pelvis in prone
  • In sitting, legs should be crossed and toys placed on one side to allow for rotation of the torso to play
  • Guide baby to assume sitting from hands and knees with body to one side
Alarm Bells – seek help

  • Baby cries when placed in prone
  • Cannot lift the head/neck easily on tummy
  • Hips widely abducted when in prone

Modify the environment if child cannot sit cross legged
Sit on bench with feet supported
Should not sit on knees at mealtime

Should not sit in long leg sitting
Osteopathic intervention to correct structural problems
Physiotherapist or occupational therapist to address blocks to normal development and facilitate their acquisition
Orthotist or podiatrist to provide orthotic intervention