From Floor to Feet:

How to Master Getting Up From the Floor

I want to remain independent as I age. A key to that independence is being able to get up from the floor. Whether you fell accidentally, you intentionally sat down, or you just want to perform floor exercises, it’s an essential skill.

Most of us have seen the commercial with the woman at the bottom of the stairs yelling, “Help! I’ve fallen and I can’t get up!” Regardless of age, anyone can trip and fall and find themselves in a heap. If that happened to you, provided you were not seriously injured, could you get back up? How hard would it be?

You may be saying, “That’s ridiculous, of course I could get back up.” Fair enough, but let’s give it a try, shall we?

The Sit-Down-Stand-Up Test

One way to determine your ability to get up from the floor is the sit-down-stand-up test. Keep in mind that this test is not for everyone. For instance, someone with a sore knee, arthritis, poor balance, or another kind of limitation would have difficulty doing the test with little or no assistance.

Instructions: Lower yourself to the floor sitting with your legs crossed or straight out. Now stand up again. (This may not be an easy movement for many people, so for safety do this with someone next to you.) You also may want to use a yoga mat or a carpeted floor.

To grade your effort, begin with a perfect score of 10 and subtract one point if you do any of the following for support when you both sit and stand:

• use your hand

• use your knee

• use your forearm

• use one hand on the knee or thigh

• use the side of your leg

• lose your balance at any time

For example, if you sat with no problem, but had to use either a hand or a knee to get up, take off one point. If you had to use both hands and both knees, deduct four points (two points each). If you can sit and stand with no assistance, you scored a perfect 10. If you couldn’t get up at all, your score is zero. Ideally, you want a score of eight or higher.

How did you do? Did you need to use your hands or knees? Could you get up at all? I sat down without assistance, but I didn’t have control the last few inches. I deducted a point for that because I should have used my hand to sit down with control. I had to deduct a point for using my hand getting back up.

I scored an 8. My goal is a 9, or ideally a 10; so I have some work to do.

What does this “test” signify? It’s a variation on the classic chair test (where a subject is asked to stand up from a seated position in a chair), which doctors have long used to assess leg strength and lower body fitness in seniors. The more difficult sit-down-stand-up test was designed to provide a window into an older person's ability to function well and remain autonomous. But it's revealing at any age because it calls for flexibility, balance, motor coordination, and, most importantly, ample muscle power relative to body weight.

How to Get Up after a Fall

You should practice this skill regularly. This is a video that shows some examples.

• Roll Onto Your Side. If you’re lying on your back, roll onto your side. Bend the knee that’s on top and use your arm to push yourself up into a seated position. Take a moment to rest and catch your breath before attempting to stand up.

• Get on Your Hands and Knees. If you’re unable to roll onto your side, try getting on your hands and knees. Place your hands on the floor and bring one knee up between your hands. Use your hands and knee to push yourself up into a kneeling position.

• Roll onto Your Stomach. If you can’t use your knees to get up, roll onto your stomach. Get into a pushup position or like you’re going to do a Downward Dog, and use your hands to move back towards your feet. This option and others are demonstrated in the linked video.

• Use a Stable Object for Support. Once you’re in a kneeling position, use a stable object for support, such as a chair or table. Place your hands on the object and use your legs to push yourself up into a standing position. If you don’t have a support object, place your hands on your dominant leg and use that for support to rise. If you can’t do that, scoot across the floor on your bum to reach a support object. Take your time.

If you found it difficult getting up from the floor, you can become stronger and more flexible. If you got up from the floor pretty easily, take steps now to maintain your ability so you can continue to feel confident that if you fall or get down on the floor for any reason, you will be able to get back up.

Simple Exercises to Help You Get Up From the Floor

If you had difficulty getting up from the floor, there are exercises you can do to develop and increase your strength, flexibility, and coordination. This is a simple circuit that can be completed easily almost anywhere and requires no equipment. This routine is intended for new exercisers or for those who are limited in their physical abilities for any reason. Each of these exercises can be done at a more advanced level.

Perform at least one circuit 3 times a week. If you don’t have time to complete the entire circuit at once, fit one or two of the exercises in when you can. I’ve linked to videos showing demonstrations of each exercise. As always, consult with your physician and seek approval when starting a new fitness program.

1. Wall pushups. Stretch your hands against a wall in front of you, about chest height. When your hands make contact with the wall, step back about one or two feet with your body at a 45-degree angle. Begin the exercise by lowering your body toward the wall until your nose is almost touching, and then press your body back up to the starting position in a controlled manner. Perform 10 to 15 repetitions. Wall pushups are a full-body workout. While you may primarily think of them as an upper body exercise, they engage many muscles in the body to stabilize the pushup position and movement.

2. Wall plank. After completing the pushups, bend at the elbows until you are supporting your body weight on your forearms. Maintain a flat back and hold this position for up to 30 seconds while breathing and attempting to keep the muscles in your abdomen tight. Planks primarily work your core muscles and stabilizers.

3. Standing bird dogs. Shift your weight back to your hands, and simultaneously raise your right arm off the wall and left leg off the floor at the same time. Maintain a neutral spinal position taking care not to rotate or twist your spine. You might find it necessary to keep your hands in contact with the wall as they slide up. Continue for 10 repetitions, alternating hands and legs. This strengthens the core, hip, and back muscles; and helps with balance. For an advanced version, don’t use the wall for support.

4. Sit to Stand. Sit in a chair with your feet apart while holding your hands together in front of your chest. (Make sure it’s a stable chair that is not on wheels.) Without using your hands, push through your feet to stand and hold this position. Bend your knees to sit into the chair with control. To make it easier, add a cushion or pillow to make the chair higher. To make it harder, sit down more slowly and use a lower chair. Control is critical to the effectiveness of this exercise. Try to perform the sit to stand 10 times. This strengthens muscles in your thighs, hips, butt, and core. It also improves balance and mobility.

5. Seated Hip Opener (Pigeon Pose). Sit upright in a chair. Cross the right ankle over the left knee. Flex the right foot so that you feel a stretch in the outer hip as well as the right hip glute. Lean forward at your waist slowly and then lean into your right hip so that you feel a more intense stretch. Hold this stretch for approx. 20 to 30 seconds. Switch sides and repeat the process. This stretches the outer hip and glute muscles.

6. Single Leg Balance. Have a chair or other stable surface nearby to hold onto if needed. Lift one leg off the ground, slowly. Maintain your balance while standing on one leg for 30 seconds. Return to the starting position and repeat 5 times. Try to increase the time spent standing on one leg. Perform with opposite leg.

The Sobering Statistics on Falls

According to the U.S. Centers for Disease Control and Prevention and other research:  

• More than one out of four Americans age 65+ falls each year.

• Falls are the leading cause of fatal and nonfatal injuries among older adults. 

• The cost of treating injuries caused by falls is projected to increase to over $101 billion by 2030.

• Falls result in more than 3 million injuries treated in emergency departments annually, including over 800,000 hospitalizations. 

• In 2015, the total cost of non-fatal fall injuries was $50 billion.

• Each year about $754 million is spent on medical costs related to falls.

• For older adults in the U.S., fall death rates went up by 30% from 2007-2016, and researchers predict there will be 7 deadly falls every hour by 2030.

As we age, we become more susceptible to falls and injuries. A fall can result in loss of independence. Falls, with or without injury, carry a heavy quality of life impact. A growing number of older adults fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. The take away: do everything you can to decrease your risk of falling and increase your confidence in your strength and mobility to remain mobile and independent as you get older.