When was the last time you sat on the floor? Perhaps you were playing with a grandchild, reaching underneath a piece of furniture, working in the garden, or simply stretching after a workout. Getting down probably didn't require much thought. Getting back up, however, may have been a different experience.
For many adults, especially as they get older, rising from the floor becomes noticeably more difficult. Knees feel less cooperative, legs don't seem to provide the same push, and finding a comfortable way to stand can require several attempts. Some people eventually stop getting down on the floor altogether, not because they can't enjoy activities there, but because they're uncertain about getting back up.
This ability matters for reasons that extend well beyond exercise. According to the Centers for Disease Control and Prevention (CDC), more than 14 million Americans aged 65 and older report falling each year. Falls are the leading cause of injury in this age group, and knowing how to respond after a fall is an important part of maintaining independence.
Getting up from the floor involves several physical abilities working together. It requires strength, mobility, balance, coordination, and the ability to organize a sequence of movements. The encouraging part is that many of these abilities can be improved with appropriate training, even later in life.
Why Does Getting Up From the Floor Become Harder as We Age?
Getting up from the floor often becomes more difficult because of changes in muscle strength, joint mobility, balance, and coordination. These changes can develop gradually, particularly when we spend less time performing movements that involve kneeling, squatting, or transitioning between different positions.
Consider how much of modern life takes place at chair height. We sit at desks, eat at tables, relax on sofas, and exercise using equipment designed to keep us comfortably off the ground.
There is nothing inherently wrong with these arrangements. But they mean we may go weeks or months without practicing the movements needed to lower ourselves to the floor and stand again.
Age-related muscle loss, often called sarcopenia, can make the task more demanding. Reduced strength in the quadriceps and gluteal muscles affects our ability to push upward, while limited hip or ankle mobility can make it difficult to position the legs effectively.
Joint discomfort, previous injuries, changes in balance, and fear of falling may add further complications.
I think it's useful to recognize that difficulty getting up from the floor isn't necessarily a sign of one particular problem. It's often the result of several smaller changes occurring together.
What Does Your Ability to Get Up From the Floor Tell You About Your Health?
The ability to sit down on the floor and rise again provides information about functional strength, flexibility, balance, and coordination. Research has found associations between performance on floor-based movement tests and long-term health outcomes, although these tests cannot predict an individual's lifespan.
One widely discussed assessment is the sitting-rising test. Participants are asked to sit on the floor and return to standing, with their performance scored according to the amount of support they require and, in some versions, their stability.
A 2025 study published in the European Journal of Preventive Cardiology followed 4,282 adults aged 46 to 75 for a median of 12.3 years. Researchers found that participants with lower sitting-rising test scores had higher rates of death from natural and cardiovascular causes during follow-up, even after adjusting for several health and demographic factors.
The findings are interesting, but they require careful interpretation. The study identified an association, not proof that learning to get up without using your hands will extend your life. The participants were also drawn from a particular clinical population, so the findings may not apply equally to everyone.
I would be especially cautious about turning this test into a personal fitness challenge. Someone with arthritis, a previous joint replacement, or a neurological condition may need to use their hands or a stable support. That doesn't make their movement unsuccessful.
From a functional perspective, the important question is whether someone can move between the floor and standing safely, using whatever assistance is appropriate.
Which Muscles Help You Get Up From the Floor?
The quadriceps, gluteal muscles, hip stabilizers, trunk muscles, and upper body all contribute to getting up from the floor. Their relative involvement depends on the movement strategy and whether you use your hands or another support.
The quadriceps help straighten the knees as you rise, while the gluteal muscles provide power through the hips. The muscles around the trunk help maintain control as your center of gravity shifts.
Your shoulders and arms may also play an important role. Pushing against the floor or a stable chair can make the movement more manageable, especially when lower-body strength is limited.
A 2025 study examining floor-to-standing transfers in older adults investigated the joint movements and physical demands involved in different strategies. This type of research helps explain why a person who can stand comfortably from a chair may still struggle to rise from the floor.
The movement requires more than one strong muscle group. It also requires those muscles to work together through a relatively large range of motion.
Can You Improve Your Ability to Get Up From the Floor After 60?
Yes. Older adults can often improve floor-transfer ability through appropriately designed strength training, movement practice, and instruction in different ways of getting up. The amount of improvement depends on individual health, mobility, and existing limitations.
A systematic review published in 2019 examined 41 studies investigating interventions intended to improve floor-rising ability in older adults.
The researchers found that resistance training and practicing floor-rising strategies showed promise, although the combined results did not demonstrate a statistically significant improvement across all interventions. Differences between studies made firm conclusions difficult.
Earlier research also found that teaching older adults specific movement strategies improved their ability to complete floor-rising tasks and reduced their perceived difficulty.
These findings reinforce something important about functional movement. Building strength is useful, but practicing how to apply that strength to a particular activity may also be necessary.
If your goal is to get up from the floor more comfortably, exercises such as squats or leg presses may help develop the physical capacity. Eventually, however, you may also need to practice the actual sequence of getting down and standing again.
What Is the Safest Way to Get Up From the Floor?
A common approach involves moving onto your side, transitioning to hands and knees, bringing one foot forward, and using a stable support to assist with standing. However, the safest method depends on your mobility, strength, medical history, and whether you have been injured.
For someone who can safely practice floor transfers, a therapist might teach a sequence that includes rolling onto one side, moving into a hands-and-knees position, approaching a sturdy chair, and gradually moving through a supported kneeling position before standing.
The sequence can be adapted. Some people cannot kneel comfortably, while others have wrist, shoulder, or hip limitations that make particular positions unsuitable.
The important part is learning a method that works for your body rather than trying to reproduce an idealized movement.
A stable chair or another appropriate support can be extremely useful. There is no reason to avoid using your hands simply to make the movement look more athletic.
If you have significant balance problems, osteoporosis with a history of fractures, a recent joint replacement, or other medical concerns, floor-transfer practice should begin with professional guidance.
And if you have actually fallen, don't immediately attempt to stand. First assess whether you're injured. Severe pain, a suspected fracture, a head injury, dizziness, or an inability to move normally are reasons to seek medical assistance rather than attempting an unsupported transfer.
Can Pilates Help You Get Up From the Floor More Easily?
Pilates can help develop several abilities involved in floor transfers, including trunk control, hip strength, coordination, and movement awareness. However, Pilates alone may not provide enough lower-body strengthening or task-specific practice for everyone.
This is one reason I find it useful to connect Pilates exercises with everyday movement goals.
A Pilates session may include exercises that strengthen the hips, improve control of the trunk, or encourage coordinated movement between different parts of the body. These abilities contribute to getting up from the floor.
But the transfer itself also involves changing positions, managing body weight, and sometimes using the arms and legs in ways that aren't practiced during a typical Pilates routine.
Someone who regularly performs mat Pilates may already be comfortable moving close to the ground. Another person may benefit more from standing exercises, supported strengthening, or practicing transitions at an elevated surface before progressing to the floor.
The goal is not to make every person perform the same exercise. It is to identify which physical abilities need attention and choose movements that help develop them.
What Exercises Can Help You Build Floor-Transfer Strength?
Chair stands, supported squats, step-ups, hip strengthening, and appropriate balance exercises can help develop abilities needed for floor transfers. These exercises can be adapted to different fitness levels and gradually progressed.
Chair Stands
Rising from a chair strengthens the legs and practices transferring body weight forward and upward. It can be particularly useful for people who are not yet comfortable practicing near the floor.
Chair height, hand support, and the number of repetitions can be adjusted to match individual ability.
Supported Step-Ups
Stepping onto a low, stable platform challenges the legs to lift body weight while maintaining balance. This develops strength and control that may also be useful during kneeling-to-standing transitions.
The exercise should be performed with suitable support when balance is uncertain.
Hip and Trunk Strengthening
Strengthening the hips and trunk can improve control when changing positions. Exercises may be performed standing, seated, or lying down, depending on the person's needs.
Practicing Position Changes
Once someone has adequate strength and can safely approach the floor, practicing selected parts of a floor transfer may be useful.
This could begin with moving between sitting and standing, progressing to supported half-kneeling, or learning how to reposition the body while using a sturdy surface.
I would rather see someone practice a manageable movement consistently than struggle through a more demanding exercise that leaves them uncomfortable or uncertain.
How Can Occupational Therapy Help With Floor Transfers?
Occupational therapy can help people develop or adapt floor-transfer skills by examining their physical abilities, daily activities, and home environment. The focus is on making the movement useful and safe in situations that matter to the individual.
For example, someone may want to sit on the floor to play with grandchildren. Another person may need to kneel while gardening, while someone else is concerned about what would happen if they fell while home alone.
These situations involve different demands.
An occupational therapist can help identify the movements involved, recommend appropriate strategies, and explore environmental adaptations.
Someone who enjoys gardening might benefit from a raised garden bed or a sturdy kneeling bench. A person who struggles with floor-level activities may need to reorganize storage areas to reduce unnecessary bending or kneeling.
For someone concerned about falling, the assessment might also include access to a phone or personal emergency response system and a plan for obtaining assistance.
Occupational therapy doesn't necessarily mean eliminating floor-level activities. It means finding ways to participate in them with an appropriate level of safety and independence.
What Should You Do if You Fall and Cannot Get Up?
If you fall and cannot get up safely, call for assistance rather than repeatedly attempting movements that could worsen an injury. If you suspect a serious injury, have significant pain, or feel unwell, emergency medical evaluation may be necessary.
This is an important distinction between practicing floor transfers and responding to an actual fall.
During a supervised exercise session, the environment is controlled, and help is available. An unexpected fall may involve injury, disorientation, dizziness, or an awkward position.
If you're unable to stand, use a phone or personal alert device if available. If you can move without increasing pain, you may be able to reposition yourself somewhere safer or more comfortable while waiting for help.
People who live alone may benefit from developing a fall-response plan in advance. This might include keeping a charged phone accessible, arranging regular check-ins, or considering an emergency alert system.
Learning how to get up from the floor can be valuable, but knowing when not to attempt it is equally important.
How Often Should You Practice Getting Up From the Floor?
There is no universally established frequency for floor-transfer practice. The appropriate schedule depends on your physical abilities, medical conditions, and whether you're working on strength, movement technique, or confidence.
For some people, floor transfers can be incorporated into an existing exercise program. Others may need several weeks of strengthening and balance training before attempting a complete transfer.
A therapist can help determine whether practicing the full movement is appropriate or whether it makes more sense to work on individual components.
Progress doesn't have to mean getting up faster or using fewer supports. It may mean moving with less discomfort, feeling more confident about the sequence, or being able to complete an activity that previously seemed inaccessible.
I encourage people to think about consistency and quality rather than speed. The purpose is to build a useful skill, not to pass a performance test.
Why Is Getting Up From the Floor Important for Independence?
Being able to move safely between the floor and standing can support independence, confidence, and participation in everyday activities. It also gives people another practical skill to draw on if they unexpectedly find themselves on the ground.
For some people, the greatest benefit is being able to return to activities they've gradually abandoned. Sitting on the floor with a pet, playing with children, stretching, gardening, or working on a project may all become more accessible when getting back up feels manageable.
For others, the benefit is knowing they have practiced a movement that could be useful in an unexpected situation.
At Banyan & Nomad, I believe functional movement deserves as much attention as traditional measures of fitness. Strength, flexibility, and balance matter, but their value becomes especially clear when they help us navigate ordinary life.
Getting up from the floor may seem like a small skill until it becomes difficult. With appropriate assessment, strength training, movement practice, and adaptations when needed, it is a skill many people can continue developing throughout their lives.
With mindfulness,
Elena
References and Further Reading
CDC, Older Adult Falls Data
https://www.cdc.gov/falls/data-research/CDC, Facts About Older Adult Falls
https://www.cdc.gov/falls/data-research/facts-stats/Sitting-Rising Test Scores Predict Natural and Cardiovascular Causes of Deaths in Middle-Aged and Older Men and Women (2025)
https://pubmed.ncbi.nlm.nih.gov/40569873/Ability to Sit and Rise From the Floor as a Predictor of All-Cause Mortality (2012)
https://pubmed.ncbi.nlm.nih.gov/23242910/Are Interventions Effective in Improving the Ability of Older Adults to Rise From the Floor Independently? A Mixed Method Systematic Review
https://pubmed.ncbi.nlm.nih.gov/30512983/Floor-Rise Strategy Training in Older Adults
https://pubmed.ncbi.nlm.nih.gov/12366625/Floor-to-Stand Transfers in Older Adults: Insights Into Strategies and Lower Extremity Demands (2025)
https://pubmed.ncbi.nlm.nih.gov/40981289/Reliability and Validity of the Floor Transfer Test as a Measure of Readiness for Independent Living Among Older Adults
https://doi.org/10.1519/JPT.0000000000000142American Occupational Therapy Association, What Is Occupational Therapy?
https://www.aota.org/about/what-is-ot