Although crossing one leg over the other may give a feeling of stability and comfort or suggest attention, confidence, and control, many of us were subjected to severe reprimands because of it in our childhood, as part of a set of instructions that were believed to be related to “politeness and discipline,” before they turned over time into something resembling “medical facts.”
So write three professors of physical therapy at the University of Technology Sydney, in a recent article on the website “The Conversation”, asking: Is crossing one leg on top of the other really harmful?
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Why do some cultures refuse to cross one leg?
In many Western societies, crossed legs are associated with femininity, elegance, and reserve, but what is considered sophisticated in one culture can be offensive in another.
In a number of Eastern or traditional settings, for example, sitting cross-legged in front of adults is seen as disrespectful, and three main factors can explain this:
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Sitting on the floor historically
In Japan, for example, the chair was not an inherent part of the lifestyle, as the floor was covered with tatami mats, and the “tatami room” remains to this day a shared space in which work activities, drinking tea, and socializing are carried out on the floor, which makes crossing one leg over the other on a chair a strange and culturally unacceptable position.
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Show the soles of the shoes
In many Arab and Asian countries, showing the sole of a shoe is considered an offensive sign, and placing one leg on top of the other places the sole of the shoe directly facing others.
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Legacy health warnings
Such as “Sit properly,” “Don’t cross one leg, you will hurt your back or knees,” and “You will get varicose veins,” are advice that is repeated within the family and at school without necessarily being based on scientific evidence.
Is crossing one leg over the other harmful?
“There is little evidence that sitting cross-legged harms the back, strains the hips or knees, or causes varicose veins,” says Bruno Terutti Saragiotto, associate professor of physical therapy at the University of Technology Sydney, based on a 2021 systematic review that looked at musculoskeletal pain, sedentary behavior and sedentary behavior.
He explains that the problem for many people is “the confusion between the feeling of discomfort and the actual harm.” Staying in this position for a long time may cause a feeling of stiffness, pressure, or a desire to move, so the person assumes that his body is being harmed, while in most cases it is just a natural signal from the body that it is time to change the position, not a sign of damage or injury.
This is in line with “modern thinking about posture and pain,” which rules out the existence of one sitting position that is ideal for everyone, and believes that the most important thing is variety in postures and movement, according to a research article published in the Journal of Orthopedic and Sports Physiotherapy in 2019.
Your back is stronger than you think
According to Joshua Payet and Mark Overton, lecturers in physical therapy at the same university, the “cross-legged” position is often classified among the “bad positions” that are thought to twist the spine and cause damage to it, but research has not found “one ideal sitting position that protects everyone,” nor a single daily sitting position that alone causes harm.
In a study published in 2012, physical therapists from several countries were asked to choose the “best sitting position” for the spine. Their answers were remarkably different, leading the researchers to say that our perceptions of the “ideal posture” are shaped by tradition and professional culture as much as by scientific evidence, and that the back is originally “strong, flexible, and designed to withstand a wide range of postures.”
Once again, the researchers point out that the problem often does not lie in the type of posture, but rather in staying in one position for a long time, whether that is sitting cross-legged, fully erect, or hunched over a laptop.
Does crossing one leg strain your hips and knees?
Another common accusation is that crossing one leg “strains the hips or knees.” However, a review of the available scientific literature indicates that there is no clear evidence that this position causes inflammation or damage to the joints.
It is true that crossing the legs changes the angles of the joints for a limited period, but it does not usually expose them to exceptional forces. In daily life, the hips and knees bear much higher forces than those that arise from sitting in this way, whether when climbing the stairs, getting out of a chair, running, jumping, or carrying shopping bags.
Research conducted in 2023 on the long-term effect of different sitting positions on joints concluded that the available studies are few and the evidence is “inconclusive”, and does not support old advice warning against crossing one leg over the other. In contrast, the updated medical guidelines focus on:
- Maintain regular physical activity.
- Strengthening the muscles surrounding the joints.
- Maintain a healthy weight.
- Managing the load on joints during work and sports.
Not to avoid a specific “sitting habit.”
Varicose veins… who is really responsible?
Traditional advice accuses placing one leg on top of the other as a cause of varicose veins, but research indicates that the most important factors in the appearance of varicose veins are:
- Getting older.
- Family history.
- Pregnancy.
- Obesity.
- Some professions that require standing for long periods.
Sitting with one leg crossed over the other may temporarily change blood flow in the legs, but that does not mean it causes varicose veins. The studies available so far do not support considering this habit a direct cause of varicose veins, compared to known risk factors.
When is it recommended to avoid this position?
Despite the generally reassuring picture, there are special cases in which doctors recommend avoiding crossing one leg on top of the other for a limited period of time, such as some cases of hip replacement surgery, where the patient is sometimes advised not to cross the legs in the first weeks after the operation until the tissues heal.
Even here, recent research suggests that some of these restrictions may be too much for many patients, and that easing them did not in one trial increase the risk of early dislocation of the prosthetic joint.
The doctor may also advise avoiding certain sitting positions in other cases, to protect a sensitive area or to relieve pain, but these are individual recommendations that do not mean that crossing one leg over the other is “harmful for everyone” or that it is a habit that should be avoided completely.
Your body is less fragile than you think…but move more
The researchers conclude that our bodies are able to adapt to a wide range of sitting and moving positions, and that varying movement is more important than chasing one perfect position.
In other words, you can sit with one leg crossed over the other, cross-legged, legs spread, or slightly bent back, as long as you do not remain in the same position for long hours without movement.
Get up every now and then, change your body position, walk a little, and return to work or conversation. “The healthiest sitting position is often one that you do not remain in for the next hour,” the physical therapy researchers summarize.
Their most important message is that your body is probably less fragile than you think: Don’t let fear of a particular sitting position guide you, but rather let movement and variety guide the way you sit and your entire day.
