Health Beat: Why Getting Up Gets Harder—and What to Do About It

Mark McNease

This article was inspired by true events. I was on the floor organizing a kitchen cabinet realized I may never get up again.

There’s a sound many of us make now when we rise from a low couch. It’s somewhere between a grunt and a sigh, and it usually comes with a hand pushing off a knee. If you’ve caught yourself making it, you’re in good company. Getting up from a chair, out of a car, or off the floor is one of the first everyday movements to feel harder with age. The good news: much of that difficulty is reversible.

What’s actually going on

The biggest culprit is muscle loss. Starting around our 30s, we lose muscle mass gradually, and the pace picks up after 60. Doctors call it sarcopenia. Standing up asks a lot of the thighs and hips—the quadriceps and glutes do most of the lifting—and those are the muscles that tend to shrink fastest when we sit more and move less.

Strength isn’t the whole story. Power matters too—the ability to produce force quickly. The fast-twitch muscle fibers responsible for quick bursts decline faster than the slow, steady ones. That’s why you may be able to walk a mile but still struggle to launch yourself out of a deep armchair. Rising is a short, explosive movement, and it’s the explosive part we lose first.

Then there are the joints. Stiff hips, sore knees, and tight ankles limit how far forward you can shift your weight over your feet, which is the key move in standing. Without that forward lean, you’re trying to lift yourself straight up with your arms and thighs, the hardest way to do it.

Balance plays a role as well. The inner ear, eyesight, and the nerves in our feet all feed the brain information about where we are in space, and all three can dull with age. Add a moment of lightheadedness—blood pressure can dip when we stand, especially with certain medications—and it’s no wonder people hesitate.

Finally, there’s fear. After a fall or a near-miss, many of us start avoiding low seats and the floor altogether. Avoidance feels safe, but it speeds up the decline. The less we practice a movement, the harder it gets.

Why the floor matters

Getting down to the floor and back up is more than a party trick. Researchers in Brazil developed a simple sitting-rising test—sit on the floor and stand again using as little support as possible—and found that people who struggled with it had a higher risk of dying over the following years. The test isn’t a verdict; it’s a snapshot of strength, flexibility, and balance working together.

There’s a practical side, too. Many LGBTQ older adults live alone. If you fall, knowing how to get yourself up safely—and having practiced it—can make the difference between an inconvenience and a long wait on the floor.

How to get better at it

Practice sit-to-stands. Sit near the front edge of a sturdy chair, feet flat and slightly behind your knees. Lean forward until your nose is over your toes, then stand. Sit back down slowly—the lowering phase builds strength too. Start with five or ten, once or twice a day. Use your hands at first if you need them; aim to use them less over time.

Add strength training twice a week. Chair squats, step-ups on a low stair, and bridges (lying on your back and lifting your hips) all target the muscles that get you up. Light weights or resistance bands help. You don’t need a gym.

Work on flexibility in the hips and ankles. Gentle stretches, yoga, or tai chi improve the range of motion that lets you shift forward. Tai chi has solid evidence for improving balance and reducing falls.

Practice getting up from the floor—carefully. Place a sturdy chair nearby. From sitting, roll onto your side, then onto your hands and knees. Crawl to the chair, place your hands on the seat, bring one foot forward so you’re half-kneeling, and push up with your front leg. Once it feels easy, try it with less help.

Stand up slowly. If you get dizzy on rising, pause at the edge of the seat, flex your ankles a few times, and give your blood pressure a moment to catch up. Mention the dizziness to your doctor, especially if you take blood pressure medication.

Adjust your surroundings. A higher chair, a firm cushion, or furniture risers can make daily life easier while you build strength. That’s not giving in—it’s working smart.

Ask for help from a professional. A physical therapist can assess what’s holding you back and build a plan around it. Medicare typically covers physical therapy with a doctor’s referral.

The bottom line

Losing the ability to rise easily isn’t a fixed part of aging. It’s largely a use-it-or-lose-it skill, and muscles respond to training at any age—studies have shown strength gains in people in their 80s and 90s. Start small, practice daily, and check with your doctor before starting a new exercise routine, particularly if you have heart, joint, or balance issues.

Next time you get up off the couch, try it without the grunt. Then do it five more times