Before we run for our standing desks, separating the myths from realities of this common and, for many, comfortable position; One expert explains

One recommendation: Don’t sit with your knees crossed for longer than it would take you to drink a cup of coffee.

Sitting for extended periods is unhealthy, increasing the risk for dozens of chronic conditions, from cancer and diabetes to cardiovascular disease, research shows. But does crossing your legs while sitting add to the problems? One expert, Naresh C. Rao, a doctor of osteopathic medicine and U.S. Olympic water polo team physician for the 2016 Summer Games, dispels some popular myths and explains how crossed knees affect whole-body wellness.

Myth and Reality

There is a lot of buzz about how sitting cross-legged can lead to varicose veins. But Dr. Rao, who is clinical instructor at NYU Langone Medical Center in New York City, says he hasn’t read any studies that prove this correlation. “Varicose veins tend to be hereditary and due to age or obesity,” he says. There is an association between prolonged sitting and an increase in blood pressure among people who already suffer from hypertension, he says. “But sitting cross-legged doesn’t lead to developing hypertension.”

Still, crossing your legs “is not a nice ergonomic position for your pelvis,” Dr. Rao says. The top knee puts pressure on the lower knee, while the pelvis is rotated and strained. The knees are at an unnaturally twisted angle, and you also hunch the lower back, giving it a little bit of torque, he says. The doctor doesn’t believe that regularly alternating which leg is on top will make much of a difference. “I wouldn’t put much credence in that. You might end up with two backaches instead of one,” he says.

Pressure Points

Knee health is related to core strength and proper back and hip function, he says. The most common cause of knee pain, Dr. Rao says, is keeping your knees in a misaligned position for a long period of time. “So I wouldn’t say you’re going to end up with knee pain, but if you already have knee pain, that twisted and bent position will make it worse.”

Over hours and years, the body will compensate and the strained feeling will be second nature. But the damage can be permanent—and painful, he says. “I see a lot of chronic dysfunctions that come from sitting in twisted positions,” including skeletal and lymphatic-system impairment, Dr. Rao says. He advises people who insist that knee problems stem from crossing their legs to first address the hip and pelvis joint, as well as the lower core. Physical therapy or osteopathic manipulative treatment with an osteopathic physician can reverse the symptoms and prevent further damage over time, says Dr. Rao.

“Sitting with your legs crossed is probably not the primary source of your aches and pains,” Dr. Rao says. Still, he doesn’t recommend sitting with knees crossed for longer than you would to drink a cup of coffee.

How to Sit

For people who have to sit for long periods, “I ask them to sit with their legs straight and feet forward, or to get a foot stool so their feet can lie comfortably flat,” he says. He also tells every patient who has a sedentary desk job to get up after every 55 minutes of sitting and walk around for 5 minutes. “That makes a huge difference,” he says.

Dr. Rao himself has a standing desk and tries to keep moving as much as possible. “As an osteopathic physician, I can say with authority that our bodies are meant to move, and if your structure is off, or your shoulder is achy or your knee is achy, you are either overtaxing your system or you’re not sitting ergonomically correct enough to optimize your body’s potential.” ■

By Heidi Mitchell

March 23, 2023 | 637 words