Floor sitting, the majlis and your knees

Floor sitting in daily life

In Qatar, the floor is a natural place to sit. Men gather in the majlis, families eat together on the floor, and many people sit cross-legged or on one heel for hours during visits, Ramadan evenings and Eid. Many expatriate families from South Asia and elsewhere also sit and eat on the floor at home.

For healthy knees, this is generally fine. Deep bending keeps the joint flexible. For knees with arthritis, a meniscus problem or a recent operation, the long hours and particular positions can cause pain, stiffness and swelling.

Which positions load the knee

• Cross-legged sitting: the knee is deeply bent and rotated, which loads the inner meniscus and the inner side of the joint.
• Sitting on the heels: the deepest bend, which compresses the back of the meniscus and the kneecap.
• Sitting on one heel with the other knee raised: common in the majlis and at meals, with deep bend and twist on the lower leg.
• Squatting: loads the kneecap and the back of the knee heavily.
• Getting up from the floor: often the hardest moment, because the thigh must lift the body from a deep bend, sometimes with a twist.

Making the majlis kinder to your knees

Small changes allow most people to keep joining family and friends on the floor.

• Change position every 15 to 20 minutes rather than holding one posture for an hour.
• Sit on a firm floor cushion to raise the hips, which reduces the depth of knee bending.
• Stretch one or both legs out in front when you can, which many hosts accept without comment.
• Lean against the wall cushions so that your back, not your knees, takes the effort of sitting.
• Choose a spot near a wall, pillar or sturdy piece of furniture to help you rise.
• Many majlis now have a few chairs or low sofas. Using one is a practical choice during a flare of pain or after surgery.

Getting up and down safely

Going down: put one hand on a support, step one foot back, lower the back knee onto a cushion, then sit to one side.

Getting up: roll onto your hands and knees or onto one knee, bring the stronger leg forward with the foot flat, place your hands on the front thigh or a support, and push up. Avoid twisting on a bent knee as you rise. Practise this with a physiotherapist if it is difficult, since thigh and hip strength make the biggest difference.

Floor sitting after knee surgery

After surgery, the return to floor sitting depends on the operation and on how much bend the knee has regained. The timings below are conventional ranges, and your surgeon will advise on your own knee.

After knee arthroscopy, many patients return to floor sitting over a few weeks as swelling settles. After a meniscus repair, deep bending and cross-legged sitting are usually avoided for around six weeks or longer. After ACL reconstruction, comfortable floor sitting often returns over several months.

After knee replacement, most people regain enough bend for chairs, stairs and cars. Some can later sit on the floor or cross-legged, but many find it uncomfortable or difficult to get up, and use a cushion, a low seat or a chair. If floor sitting is important to you, raise this with your surgeon before the operation.

When to see a knee surgeon in Doha

Book an assessment if the knee catches or locks when you stand up from the floor, if you feel a sharp pain on the inner side after sitting cross-legged, if the knee swells after gatherings, or if you can no longer get up without help. These can be signs of a meniscus tear or arthritis that can be treated.

At Aman Hospital, Dr. Gelber will examine the knee, check how far it bends, and explain options from exercise and injections to surgery, taking into account how you live and sit at home.