Fit & Proper: Is cross-legged sitting bad?

As orthopaedic surgeons, we are constantly evaluating patients’ tics and antics. There are two types of patients. The anxious, accommodative type sitting in an unassuming manner and the affluent, maverick type sitting with one leg crossed over the other (nonchalant about the fact that people on either side are getting squashed). You can picture this in the first class compartment of a Mumbai local as well.  People cross their legs, whether it’s conscious or unconscious, for comfort, to stop legs from splaying, to take pressure off a foot, or for no reason at all! The big question is, whether crossed leg sitting is good or bad? 

Although it feels like a natural sitting position, you may have heard that sitting with your legs crossed leads to varicose veins, raises your blood pressure, and wrecks your posture. Dispelling a few myths, cross legged sitting has no significant cause or effect (long-term) on blood pressure and varicose veins. As far as joints and posture are concerned, there are a few observations worth sharing.  Crossing legs at the knee can stretch the piriformis muscle (small muscle in the buttock region, behind the hip joint), which in-turn can increase the stability of the pelvis. There is some evidence that leg crossing could reduce strain on abdominal muscles and indirectly improve pelvic stability. 

There are few negatives as well. Crossing legs leaves the body a little lopsided, so it is almost impossible to sit up perfectly straight (you lean to one side). People who sit cross-legged for long hours have poor spinal posture for most of the day. This could give rise to chronic lower back pain that may even extend to neck and shoulder blades.

Sitting cross-legged for several hours can lead to prolonged compression of the peroneal nerve (runs along the outer part of the knee). This can sometimes lead to numbness or weakness in the foot. We call it peroneal nerve palsy or a “foot drop”. Thankfully it is neither dangerous nor a sign of impending paralysis, and generally reverses in a few seconds to minutes. In reality long-term numbness is an unlikely consequence because as soon as we feel uncomfortable we tend to move.

Cross leg sitting has and will always be part and parcel of everyday ergonomics. In an ideal world, we must sit erect on a firm chair with feet flat on the floor, knees directly over the feet, and hips no lower than the knees. But then an ideal world would be full of affluent nonchalant mavericks, wouldn’t it?