Is Indian Habit of Cross-legged Sitting,Squatting linked to Anterior Knee Pain, asks Study

The study is published in the Journal of Post Graduate Medical Education and Research, published by Jaypee Journals.

Indians, by nature and lifestyle have a habit of sitting cross legged. Moreover, with the use of Indian style toilets, squatting is also a general part of the Indian behanviour. It remains a question whether such habits are provocative in causing the anterior knee pain.

This question was analysed in the latest research by Parikh TK, Arumugam S at Ramachandra University, Chennai and published in the Journal of Post Graduate Medical Education and Research, published by Jaypee Journals.

Parikh TK et al performed the study to evaluate the association between anterior knee pain (AKP) and traditional Indian habits of cross-legged sitting and squatting which involve deep knee flexion.

A case control study was carried out in 225 patients and 225 age and sex matched controls at a tertiary care university hospital in South India over 3 years. Males and females between 18 and 55 years were evaluated using a clinical proforma of history and musculoskeletal examination. The details of deep knee flexion habits with quantification of duration were noted and participants were categorized into those who sat and did not sit cross legged, and squatters and nonsquatters. Odds ratios and chi-square tests were calculated for both these categorical variables. A subgroup analysis and stratified analysis were also performed.

The researchers found that the Odds ratios for cross-legged sitting and squatting were not significant at 0.88 and 0.92 respectively. Sixty-nine point three percentage of the AKP cases and 72% of the controls sat cross legged (p = 0.534) and 67.6% of the AKP cases and 69.3% of controls habitually squatted (p = 0.685). Stratified analysis revealed a protective effect of cross legged sitting in AKP cases with quadriceps muscle tightness.

The researchers concluded that the study did not find an association between AKP and Indian habits of deep knee flexion. More than 65% of all the participants regularly engaged in these habits.

These positions are integral to daily habits of many Indians. The advice to AKP patients to avoid them due to their probable AKP association is not supported by the current study. Clinicians can consider the impact on the patient's quality of life before advising against these positions.

Reference

Parikh TK, Arumugam S. Are Indian Habits of Cross-legged Sitting and Squatting associated with Anterior Knee Pain? J Postgrad Med Edu Res 2017;51(1):1-6.

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