Pooja – Prayer positions and KneePain
As #OrthopaedicSurgeons, we are constantly evaluating patient tics and antics. Of note, busy consultation and waiting rooms have 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! Sitting cross-legged on the ground for Pooja-Prayers is deep-rooted in our Indian culture. So, is this position, good or bad for your knees? What does science have to say?
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 leg sitting has no significant cause or effect (long-term) on #BloodPressure and #VaricoseVeins. 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), which in turn can increase the stability of the pelvis. Crossing legs may also reduce strain on abdominal muscles and indirectly improve pelvic stability.
On the flip side, 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 and may develop chronic lower back pain. This may extend all the way up to the 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 your knee). This can sometimes lead to temporary numbness or weakness in the foot.
The actual problem doesn’t lie in the cross-legged sitting position though. Getting up from the floor is the real issue. The knee has to absorb a very high load when one hauls body weight up from a floor-based sitting to a standing position. This movement is the commonest cause for sudden sharp shooting pain in middle-aged knees. It often leads to tearing of the (meniscal) cartilage inside. So, the take-home message is that you can cross your legs routinely but avoid doing that on the floor because getting up could potentially lead to a problem.
Cross leg sitting has and will always be part and parcel of Indian ergonomics. Pooja-prayer offerings and sitting cross-legged on the floor go hand-in-hand. In an ideal world, we must sit erect on a firm chair with feet flat on the floor, knees over the feet, and hips no lower than the knees. But then an ideal world wouldn’t have muted celebrations on our favourite Gudi Padwa, No?
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