There’s a huge hidden downside to standing desks that no one told me about

It’s grueling.
It’s grueling.
Image: Reuters/Eliseo Fernandez
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It wasn’t fear of cancer, heart attacks, diabetes or even early death that did it. The reason I switched to a standing desk was, simply, to find a reprieve from pain. Since I graduated from college, back pain and its cruel confederates—neck, shoulder, and hip pain—have been unshakable facts of life. I’m not talking about the odd lumbar throbbing after a late night at the office; low-grade agony was pretty much a given, flaring into something more blinding a few times a month. Workday, weekend, vacation—it didn’t really matter, nor did the number of treadmill miles or chaturangas I’d banked that month.

Then in May, I read about how a standing desk helped allay a blogger’s chronic back woe. I was sold. I set my iMac on top of a small table on my home desk and put in a request for a standing desk at work. Vindication was almost instant. Within a week, my back pain started receding; a month on, and I’d almost forgotten about it. Aside from a weird hip glitch in August, the back pain is still mostly gone.

But in its place came something new. Fetching a dropped pen one day, I noticed bulbs of pinkish flesh ballooning out over my shoes, which, when removed, revealed swelling wider in girth than my feet and lower legs. Cankles, in other words.

My ankles these days.
My ankles these days.
Image: Mia Mabanta

For those who don’t know, this portmanteau of “calf” and “ankle” is a slur for shaming women out of wearing capri pants and into surgery if their ankles are any heftier than a ballerina’s. It’s a nasty term. But as a description of my new standing-desk malady, “cankles” was irresistibly apt. And it turned out I needed a casual, efficient term to field the questions that followed after propping my feet on a chair at after-work drinks, or to explain that, no, I didn’t need crutches for those sprains.

Going into this whole standing desk thing, I knew to expect foot pain. That’s why I splurged on squishy pads called “anti-fatigue mats.” Grotesquely distended ankles, though—nobody had mentioned that. I started wearing two sets of insoles while standing on two anti-fatigue mats. But by late afternoon each workday, there were my cankles, peeking out from my pants-cuffs.

A bit of googling, however, clarified that I’m not the only standing-desk convert to suffer sudden-onset cankles. And the medical explanation is really pretty obvious. Unsurprisingly, it’s a very common affliction among nurses, waitresses, and anyone else who spends the whole day on their feet. ”Blood pooling while standing is common if the legs aren’t periodically moving,” Dr. Todd Manini of the University of Florida told me, though he noted that neither the positive nor negative effects of standing desk use have been well researched.

They’re now a lot less swollen, thanks to a regimen that includes marching in place and leaning on stools. What keeps nagging me, though, is why I had never heard of this problem—and what else people don’t tell you about the standing-at-work craze.

I have a few ideas:

1. Switching from sitting all day to standing all day is a radical physical transition.

My office standing desk.
My office standing desk.
Image: Quartz

The media barrage about sitting’s lethalness makes it easy to assume that the sooner you ditch a chair, the healthier you’ll become. Not true.

The shift is a big enough deal that, when a law clerk friend got a standing desk, someone from her HR department coached her through her transition. And when you think about it, it makes a lot of sense. As Chris Blattman, a Columbia University professor whose blog post on standing desks inspired my conversion, observes, you spend most of the 24 hours in a day either at your desk or on your bed.

That’s a lot of time. I’d been propping myself against a few pieces of furniture in the exact same way for more than a decade. Yet I only spent about two weeks standing in the morning—at home—and sitting in the afternoon before I switched over completely. Suddenly standing most of the day was perhaps the biggest shakeup of that routine since I started working on a computer every day. In my rush to abandon sitting, that hadn’t occur to me, though—nor had the fact that when I gave my body so little time to adjust, things were liable to swell.

2. Many people at “standing desks” are actually using “sit-stand desks”—meaning they’re still spending plenty of time seated.

In an unscientific survey of friends, colleagues, colleagues’ friends, and online reviews, there was really only one consistent finding: almost everyone who’s talking about their “standing desk” is actually using what’s called a “sit-stand desk” (or, less often but more confusingly, a “stand-up desk”). And once I knew to look for it, I realized that almost every article with “standing desk” in the headline was actually talking about sit-stand desks.

The sit-stand distinction gets drowned out by all the pro-standing, anti-sitting mania. But it’s still a critical one.

These desks allow you to adjust the height of your computer, either electronically or manually. This feature is appealing because many people seem to like doing email or talking on the phone while standing, but struggle to write or do more focused tasks unless they’re sitting.

Of course, these preferences vary by person, occupation, and day, making it hard to generalize how much time the average sit-stand desk user is spending in a chair. But if one of the leading studies of sit-stand desk habits is representative, people using sit-stand desks spend two hours a day, on average, standing in lieu of sitting. Not that much, in other words.

If these happy sit-standers were, like me, spending around 12 hours rooted in front of their computers, disrupted only by snacking and bathroom breaks, maybe more people would know about the cankle problem.

3. Certain workplace barriers make sit-stand desks way more common.

Standing desk models like the one I have at work (see photo) are a heck of a lot cheaper than sit-stand desks (usually a couple hundred bucks versus $1,000 to $4,000 for a sit-stand desk). So why are proper standing desk users in the minority?

When workplaces like Google, Facebook, Boeing, Intel, Apple, or GlaxoSmithKline get a critical mass of requests, it makes sense to do an office-wide overhaul. They’ve got deep pockets and, in addition to slashing the bureaucracy of managing different desk requests, they’re probably ordering in enough bulk to command a big discount. Plus, if you’re going to pay for moving fees, you might as well invest in top-of-the-line product.

But it’s harder to request a $3,000 desk when everyone else in your office is content with sitting. Not only does it mean asking for an expensive perk, it’s also likely means disrupting the whole office infrastructure. And for HR, there’s also the precedent to consider. So great is the standing-desk mystique, once one person gets a desk, lots of other employees either want one too—which can get expensive fast—or resent the person who got the special treatment (the Wall Street Journal calls this ”standing desk envy“).

That’s less of a barrier if you’re high enough up in the company to justify a big expense budget and have your own office. I suspect that most people with the office clout to request a fancy new desk in the first place are able to justify the purchase of a sit-stand desk.

4. Many of the people singing the praises of standing desks are men—who can get away with comfy shoes at work more easily than women.

Men’s dress shoes aren’t known for being comfortable. But compared with women’s, at least men’s tend to be flatter and, often, cushier. This means that for women working in all but the most casual offices, looking professional means strolling through the workday on rigid, unforgiving soles—a recipe for cankle-causing blood-pooling. Unsurprisingly, shoe strategy came up quickly in nearly all of the conversations I had with female standing-desk converts. Those with standing-only desks have invested in office Crocs or other comfy footwear to don at their standing desks on days when it’s appropriate; the sit-stand crew said they avoided standing on days where they had to look spiffy. Perhaps those strategies are enough to promote blood flow. Anecdotally, the biggest take-up of standing desks is in Silicon Valley, where less than a quarter of the workers are women.

5. I assumed the general zeal for “standing desks” meant it was okay to stand all day. I was wrong.

“Your experience is not too surprising,” said Dr. Hidde van der Ploeg, an expert on occupational health at the VU University Medical Center in Amsterdam, when I asked him about my cankles. Though sitting too much is harmful, long periods of standing are not particularly healthy either. “[S]tanding all day is not the solution,” said van der Ploeg, “but finding a comfortable balance between sitting, standing and moving around.”

This was news to me. I’d assumed that all the people who love their standing desks spent most of their time actually, you know, standing. And they’re not. It might be better, on balance, to stand instead rather than sit all day (or it might not). But if you sit like a statue, it turns out, you’re going to stand like one too—creating a host of new health problems.

Dr. van der Ploeg’s assessment was also hard for a borderline workaholic to hear. I could blame my standing-related pain on not having a sit-stand desk (the sit-stand models colleagues have gotten aren’t sturdy enough to support an iMac). Or I could request a pricier model and see what happens. But the truth is I have cankles for the same reason I had back problems: I work too many hours.

To sit or stand?

My jerry-built home standing desk.
My jerry-built home standing desk.
Image: Quartz

The hunch that the so-called standing desk craze is really a sit-stand desk craze for Hush Puppie-wearers with superior work-life balance is a little discouraging. But cankles or none, I’m still resisting the chair. Here’s why:

  • I find standing makes me tackle tasks more deliberately, slicing up work into “armchair breaks” (reading, writing outlines) and really only rooting myself in front of my desk when I need to write and handle email (which is still most of my time, alas).
  • Somehow, standing has made me way more aware of my posture than ever before, even when sitting.
  • I’m more focused, largely because I’m less stymied by the urge to multitask or goof around on the internet.
  • I also find myself leaving the office earlier. My standing desk is just awkward enough that I never want to stand around killing time. Instead of noodling around with an idea for endless hours, I now find myself identifying the endpoint of tasks, approaching work the same way I might go to the ATM, or give a speech.

Even when the cankles made it hard to put shoes on, I never considered going back to sitting. Marveling at their bloat, the most that ever occurred to me was that if they looked that gross, it was probably time to go home. And that’s something that in 15 years of stabbing, throbbing, and assorted excruciation that came with sitting, had never crossed my mind.