Getting up out of a chair is a movement that is used in a TON of tests we as physical therapists use to see if someone is at risk of falling in the near future.  It’s a functional task that we use every day, and yet it gets harder for a lot of people as we age.

According to the CDC, 1 in 4 adults over age 65 falls each year, and falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults.  That’s crazy!

This all sounds sounds scary, but there is also a lot of research on fall-prevention programs, and there is a big movement toward preventative care in physical therapy.  Primarily, this means working with community fitness instructors to help improve fall prevention training and include it in fitness models.

That’s why we are so special here at MoveTru and Langford–we have a well-integrated physical therapy, post-rehab, and prevention and fitness model in which our fitness instructors work with physical therapists to develop and modify fitness programs with prevention, wellness AND fitness in mind.

Now that I’ve scared you away from standing or walking at all… (just kidding, hopefully!)

The “sit-to-stand” movement is included in many of the multi-component tests for fall risk, and is a stand-alone (sorry for the pun) test.  There is the 30-second chair stand test, the modified 30-second sit to stand test, the Five-repetition sit-to-stand test, the Timed Up and Go test, and a few others.1

Being able to get up out of a chair multiple times in a row is correlated with a LOWER fall risk.  So today I am going to give you the most common correction I use when helping re-teach how to sit down or stand up: the forward lean.

What happens to our sit-to-stand as we age?

I believe this stems from a fear of falling, and a long-term neglect of our vestibular (inner ear position and movement sense) system.  The vestibular system works to tell us where our head is in space (whether it’s tilted to the side or forward) and whether or not our head is turning or moving (that’s where vertigo comes in–even if you are NOT turning, your vestibular system THINKS you are and you get that horrible spinning sensation.  If you have vertigo, make an appointment with Monet or Anna at Langford).

As we age, we stop doing things like summersaults, cartwheels and hanging by our knees from the monkey bars (I mean, really!).  This means that our vestibular system is only really used to being upright, and then we start getting warning messages when our head is tilted “too far” forward.  Our brain thinks we are close to falling, and so prevents us from leaning forward.  Thus, we start leaning back or staying upright as we sit, and guess what–that is WAY harder than leaning forward to get up or down.

How to fix it?  The FORWARD LEAN.

Now that you know why sitting/standing might be hard (there are other possibiliites, including weakness or pain), let’s try fixing it.

Start from a higher chair or sit on the edge of a tall bed.  It should already be easy to stand from this height, so if it’s not, put a cushion on top of your chosen surface to make it easier.  As you get better, you can lower your chair height until you can get out of any chair in your home, and even the dreaded toilet seat!

Here’s the movement.  Start sitting down.  When you are ready to stand, start the movement by leaning forward so that your chin is IN FRONT of your toes (if this feels scary, just practice the lean for a while without actually standing up).  Next, stand up from that position.  It SHOULD feel much easier than staying upright when you stand.

To sit down, you reverse the movement.  You will bend your knees to start sitting (don’t let yourself rest the backs of your legs on the bed/chair), and focus on keeping your chin in front of your toes until your bottom hits the seat.

Practice this 10 times, then, if it’s easy and comfortable, try it on a slightly lower chair.

I often tell my clients to do 3 repetitions of this movement any time they get up out of a chair, and to focus on leaning forward every time they sit down or stand up.

MoveTru ABQ Langford Physical Therapy Sit to Stand
MoveTru ABQ Langford Physical Therapy Sit to Stand
MoveTru ABQ Langford Physical Therapy Sit to Stand
MoveTru ABQ Langford Physical Therapy Sit to Stand

What if you can’t do this, or if you have pain while trying?

IF YOU HAVE PAIN when trying to get up out of a chair, or if you have fallen in the past year, please contact us at Langford to see what you need to do to see one of our physical therapists.  We can figure out why you’re having pain, treat that, then progress you to getting up and down safely. We will also probably do some of those tests I talked about in the beginning that determine whether you are at risk of falling, and work on all of those aspects of balance that might be hard for you.

IF YOU DON’T HAVE PAIN, but just have a hard time getting up smoothly from a chair or from the floor, contact us at MoveTru or sign up here for a RESTORE class.  These are our gentler classes and the focus is balance and safe transitions from the chair and eventually the floor.  It always sounds just a little boring or benign, but it is actually REALLY fun, so give it a try!  Jason teaches these classes, and works closely with our physical therapists to develop progressions that are safe and effective and fun.

If you want to learn more ways of getting up, or if you can’t get down to the floor or back up, contact us to see if you can get in to see which avenue is right for you: physical therapy or MovNat classes at our MoveTru space.


1. Applebaum EV, Breton D, Feng ZW, et al. Modified 30-second Sit to Stand test predicts falls in a cohort of institutionalized older veterans. Bowen M, ed. PLoS ONE. 2017;12(5):e0176946. doi:10.1371/journal.pone.0176946.

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