Is it better to have your legs up or down? The medical pros and cons

September 22, 2025 •

5 min read

According to the Centers for Disease Control and Prevention (CDC), millions of Americans are at risk for health issues like deep vein thrombosis (DVT), which can be exacerbated by poor circulation. Understanding the simple act of elevating your legs can be a powerful tool for improving overall vein health and answering the question: is it better to have your legs up or down?

Quick Summary

It is generally better to have your legs elevated, especially after prolonged periods of sitting or standing, to improve circulation and reduce swelling; gravity assists blood flow back toward the heart, providing relief and promoting vein health. However, for active circulation, keeping your legs in motion (down) is necessary, making it a balanced approach.

Key Points

Leg Elevation is Therapeutic: Raising your legs above heart level is an effective way to use gravity to improve blood flow, reduce swelling, and relieve pressure on your leg veins.
Prolonged 'Legs Down' is Risky: Extended periods of sitting or standing can cause blood to pool in your lower extremities, increasing the risk of varicose veins and deep vein thrombosis (DVT).
Movement is Essential: While elevation is beneficial for rest, keeping your legs down and active is critical for stimulating the calf muscles, which act as a natural pump for circulation.
Balance is Key: The best approach for optimal leg health involves a balance of regular activity and intermittent elevation, rather than committing to just one position.
Correct Elevation Technique: For best results, elevate your legs with proper support, ensuring they are above your heart level for at least 15-30 minutes multiple times a day.
Signs of Poor Circulation: Visible signs like swelling (edema), varicose veins, and skin discoloration can indicate poor circulation exacerbated by prolonged leg-down positions.

The role of gravity in your circulation

Your body's circulatory system constantly works to pump blood against gravity, especially from your lower extremities back to your heart. The veins in your legs contain tiny one-way valves that help push blood upward. However, when you sit or stand for long periods, gravity causes blood and other fluids to pool in your lower legs and feet, putting extra strain on these valves and leading to a range of potential issues. This is why the position of your legs—up or down—can have a significant impact on your health.

The benefits of elevating your legs

Putting your feet up is more than just a relaxing habit; it's a therapeutic practice with multiple health advantages. When you raise your legs above heart level, you leverage gravity to help blood flow back to the heart, which provides significant relief. For optimal results, most experts recommend elevating your legs for 15-30 minutes, three to four times a day, particularly if you have specific circulatory issues.

Reduces swelling (edema): By helping excess fluid drain away from your ankles and feet, elevation can significantly reduce swelling caused by conditions like pregnancy or chronic venous insufficiency.
Relieves pain and pressure: The act of elevating your legs takes pressure off your veins, which can alleviate pain, discomfort, and the feeling of heaviness in your legs. This is particularly helpful for those who spend a lot of time on their feet.
Improves blood flow: By working with gravity instead of against it, you give your venous system a break, improving overall circulation throughout your body.
Aids in injury recovery: Elevating an injured limb is a standard first aid protocol (part of RICE - Rest, Ice, Compression, Elevation) to reduce swelling and inflammation.
Helps prevent blood clots: Promoting better blood flow can reduce the risk of deep vein thrombosis (DVT), a serious condition where a blood clot forms in a deep leg vein.
Promotes relaxation: The physical relief that comes from leg elevation can also have a positive effect on your mental state, reducing stress and helping you wind down after a long day.

The effects of keeping your legs down

While necessary for movement, keeping your legs down for extended periods, especially while sitting or standing stationary, can have detrimental effects on your circulatory system. This is not to say that standing or sitting is inherently bad, but rather that long periods of immobility in this position pose risks.

Blood pooling: Gravity naturally causes blood to pool in your lower extremities when you are upright, placing more pressure on your leg veins and their valves.
Increased risk of vein issues: This continuous pressure can lead to the development or worsening of conditions like varicose veins and spider veins.
Potential for blood clots: For individuals with pre-existing risk factors, prolonged immobility with legs down can increase the risk of DVT.
Soreness and fatigue: Standing for extended periods can tire your leg muscles and joints, causing discomfort and fatigue.
Reduced lymphatic drainage: Poor circulation also affects the lymphatic system, which can lead to fluid buildup and swelling.

A balancing act: When to elevate vs. when to keep legs down

For most people, the ideal approach is a balance between both positions. Movement and activity, where legs are down, are crucial for muscle function and circulation. The calf muscles, in particular, act as a “second heart,” pumping blood back towards the heart. However, regular intervals of leg elevation are key to counteracting the effects of gravity and promoting better circulation.

Elevating your legs correctly

To reap the maximum benefits of leg elevation, it's important to do it correctly.

Position: Lie down on your back. Use pillows, cushions, or a wedge to prop your legs up.
Height: Your feet and legs should be elevated above the level of your heart to let gravity work effectively.
Support: Ensure your legs are comfortably supported along their entire length, not just propped up on your ankles, as this can impede blood flow.
Angle: Keep a slight, natural bend in your knees rather than locking them straight, which could strain the joint.
Duration: Aim for 15-30 minute sessions, several times throughout the day.

A popular and effective variation is the "Legs Up the Wall" pose, or Viparita Karani in yoga. In this position, you lie on your back with your legs resting vertically against a wall. This provides a great way to fully relax while promoting drainage.

Comparison table: Up vs. Down


Aspect	Legs Up (Elevated)	Legs Down (Normal Activity)
Primary Function	Rest, drainage, pressure relief	Movement, muscular pump activation
Gravity's Role	Works with gravity to aid venous return	Works against gravity; causes fluid pooling
Impact on Swelling	Reduces edema by draining pooled fluid	Can increase swelling over long periods of immobility
Best for Conditions like...	Varicose veins, venous insufficiency, post-injury swelling	Healthy circulation from active muscle use
Use Case	Resting after a long day, injury recovery, long-distance travel breaks	Daily activity, exercise, walking, standing
Correct Posture	Supported above heart level, slight knee bend	Balanced posture, frequent movement

Complementary practices

In addition to regular leg elevation, several other practices can enhance your circulatory health.

Stay active: Regular movement, such as walking or cycling, helps strengthen the calf muscles that pump blood back to the heart.
Wear compression stockings: These garments apply pressure to your legs to help improve blood flow and reduce swelling.
Avoid prolonged immobility: If your job requires long periods of sitting or standing, take regular breaks to stretch and move around.
Stay hydrated: Proper hydration is essential for maintaining healthy blood volume and preventing blood from becoming too thick.
Manage weight: Maintaining a healthy weight reduces the overall pressure on your veins and circulatory system.

Conclusion: The right answer is a balance

The question "Is it better to have your legs up or down?" doesn't have a single answer, but rather points to the importance of balancing both positions. While keeping your legs down is necessary for daily activities and exercise, regular leg elevation is a simple yet powerful therapeutic technique. Using gravity to your advantage, especially after long periods of being on your feet or sitting, helps reduce swelling, relieve pressure, and improve overall circulatory health. By incorporating regular leg elevation into your routine alongside an active lifestyle, you can significantly enhance your comfort and long-term vein health. For persistent issues, it is always recommended to consult with a healthcare professional, especially a vein specialist.

For more detailed information on cardiovascular health, visit the American Heart Association at https://www.heart.org/.

Frequently Asked Questions

For many people, yes. Sleeping with your legs slightly elevated above your heart can help improve blood flow, reduce pressure on your veins, and minimize nighttime swelling. A wedge pillow or a stack of pillows can help achieve the correct position.

For therapeutic purposes, such as reducing swelling, elevating your legs for 15 to 30 minutes, three to four times a day, is often recommended. For general relaxation, even shorter periods of elevation can be beneficial.

Yes, elevating your legs can temporarily relieve symptoms of varicose veins by reducing swelling and pressure. It helps pooled blood drain back toward the heart, giving the veins a break from working against gravity.

The most effective method is to lie on your back and raise your legs above the level of your heart using pillows or a cushion. This can be done on a bed, couch, or even against a wall in a 'Legs Up the Wall' yoga pose.

Staying sedentary with your legs down for prolonged periods can lead to poor circulation, blood pooling, increased risk of deep vein thrombosis (DVT), swelling, muscle weakening, and joint stiffness.

Yes, elevating your legs after a long flight is highly beneficial. It helps reverse the effects of prolonged sitting in a confined space, reducing swelling and discomfort and improving blood flow.

You should see a doctor if you experience persistent swelling, unexplained pain, changes in skin color, or suspect a blood clot. While elevation provides relief, it's not a substitute for medical diagnosis or treatment for underlying health conditions.

While generally safe, elevating your legs for excessively long, continuous periods without changing position could lead to discomfort or pressure on nerves, especially if not properly supported. For most purposes, periodic elevation is sufficient.