Clinically reviewed by What is difficulty standing up
Needing a push, a pull or three attempts to get out of a chair is one of the earliest signs that leg strength has dropped. It is very common in older adults, and it is treatable far more often than families expect.
Standing up uses the big thigh and hip muscles, needs the ankles to bend, and needs blood pressure to hold steady as the body comes upright. Any of those three can be the problem.
If you are reading this about a parent, the useful thing to know is that this is usually not just old age. Weakness from weeks in bed responds to exercise at any age, including in the eighties.
Symptoms you might have
- Pushing down hard on the arms of the chair, or needing a hand from someone
- Rocking forwards several times to build momentum
- Managing a dining chair but not a soft sofa or a low bed
- Pain in the knees or groin as the weight comes on
- Feeling unsteady for the first few steps after standing
- Dizziness or vision greying for a few seconds after standing, which is a blood pressure matter and a doctor's check
- Avoiding going out because chairs elsewhere are too low
- A fall, or a near fall, while getting up
Why it happens
- Loss of thigh and hip muscle with age, which speeds up sharply after any illness
- Weeks in bed or in hospital. Strength is lost within days of lying still
- Knee or hip arthritis, so the movement hurts and gets avoided
- Blood pressure dropping on standing, often related to medicines, which is a doctor's area
- Poor balance and fear of falling, so the weight is never committed forwards
- Low chairs, soft sofas, deep beds and squat toilets, which demand far more strength
- After a stroke, or with Parkinson's disease, both of which have their own pages
- Poor eyesight, bad lighting and slippery floors
When you should see a physiotherapist
Come in as soon as it is noticed, not after the first fall. Strength is easier to rebuild while someone can still stand with help. Families are welcome at the assessment, because most of what makes a difference happens at home: chair height, technique, and someone to count the repetitions.
Go to a doctor if there is dizziness on standing or a blackout. Blood pressure and medicines are theirs to check, and never change a dose yourself.
Go to a hospital immediately if the weakness came on suddenly, if one side is weak, or if the face droops or speech is slurred, which can be a stroke. Go the same day after a fall with hip pain and an inability to stand, or for a joint that is hot, red and swollen with a fever.
Al-Shama Physiotherapy Clinic
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اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
This is mostly a strength problem, and strength responds to training at any age. The programme is simple, specific and repeated often, which is why it works.
- Assessment of leg strength, balance, joint movement and how the person currently stands up
- Exercise therapy, built around sit to stand practice itself, progressed by lowering the chair and reducing hand support
- Hip and thigh strengthening, bridges, straight leg raises, standing hip work and heel raises
- Technique training, feet back, nose over toes, push through the legs and stand in one movement
- Balance training for the first seconds after standing, which is when most falls happen
- Manual therapy for a stiff, painful knee or hip that is limiting the movement
- TENS and electrotherapy for joint pain where it is blocking the exercises
- Home and equipment advice: chair height, bed height, grab rails, a raised toilet seat and a walking aid
Physiotherapy does not prescribe or adjust medicines, and dizziness on standing is referred to a doctor. Surgery has no role unless a joint is severely arthritic, which is a surgeon's decision.
Exercises, and what to avoid
What helps
- Sit to stand from a firm chair, five repetitions, three or four times a day. This is the exercise that fixes the problem
- Heel raises holding the kitchen counter, ten to fifteen at a time
- Sitting knee straightening held five seconds, and bridges lying on the bed
- Standing hip side lifts holding a support, which steady the first steps
What to avoid
- Being lifted under the arms. It is unsafe for both of you and the legs stop working
- Pulling up on a wheeled chair, a walker or a towel rail
- Low sofas, soft beds and squat toilets while strength is being rebuilt
- Standing up fast, especially at night
What you can do at home
Raise the chair. A firm cushion or a block under the back legs often turns an impossible chair into a manageable one, and armrests make a large difference.
Use the technique every time: shuffle to the front of the seat, feet flat and pulled back under the knees, lean the nose over the toes, then push up through the legs.
Count out loud together. Five stands, three times a day, tied to mealtimes so it is not forgotten.
At night, sit on the edge of the bed for a slow count of ten before standing. This alone prevents a lot of falls.
Fix the easy things: a raised toilet seat, grab rails, a working light and closed shoes.
How long it takes
Technique and chair height change things the same day. That is usually the first win.
Strength takes four to twelve weeks of daily practice to make a clear difference, and most families notice something by week three.
After a long hospital stay, allow three to six months to get back to independent standing, because muscle lost in a fortnight takes months to rebuild.
What speeds it up is practice every day, even five stands at a time. What slows it down is being lifted, soft low chairs, and stopping after a little improvement. Fall prevention and balance problems have their own pages.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
کرسی سے اٹھنے میں دشواری اکثر ٹانگوں کی کمزوری سے ہوتی ہے۔ یہ صرف عمر کا مسئلہ نہیں۔ بستر پر کچھ ہفتے گزرنے کے بعد طاقت تیزی سے کم ہوتی ہے، اور ورزش سے واپس آتی ہے۔
بہترین ورزش: کرسی سے اٹھنا بیٹھنا، پانچ دفعہ، دن میں تین چار بار۔ تین ہفتے میں فرق محسوس ہونے لگتا ہے۔
طریقہ: کرسی کے آگے سرک جائیں، پیر گھٹنوں کے نیچے کھینچ لیں، ناک پنجوں کے اوپر لے کر جائیں، پھر ٹانگوں سے زور لگا کر کھڑے ہوں۔ مرض کو بغل سے اٹھا کر نہ اٹھائیں۔
کھڑے ہوتے وقت چکر آئے تو ڈاکٹر سے بلڈ دباؤ اور دوائیاں چیک کروائیں۔ اگر کمزوری اچانک آئے، ایک طرف کام چھوڑ دے، یا زبان لڑکھڑائے، تو فوراً ہسپتال جائیں۔
Roman Urdu
Kursi se uthne mein dushwari aksar taangon ki kamzori se hoti hai. Ye sirf umar ka masla nahi. Bistar par kuch hafte guzarne ke baad taqat tezi se kam hoti hai, aur warzish se wapis aati hai.
Behtareen warzish: kursi se uthna baithna, paanch dafa, din mein teen chaar baar. Teen hafte mein farq mehsoos hone lagta hai.
Tareeqa: kursi ke agay sarak jayen, pair ghutnon ke neeche kheench lein, naak panjon ke oopar lekar jayen, phir taangon se zor laga kar khare hon. Marz ko baghal se utha kar na uthayen.
Khare hote waqt chakkar aaye to doctor se blood pressure aur dawaiyan check karwayen. Agar kamzori achanak aaye, ek taraf kaam chhor de, ya zubaan lardkhaye, to foran hospital jayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
My mother cannot get out of her chair, where do we start?
She feels dizzy every time she stands, what is that?
What chair height is best?
Is a walker a good idea?
How long before her legs get stronger?
Related conditions
- Parkinson's disease physiotherapy
- Osteoporosis and weak bones
- Bed sores, prevention and care
- Balance problems in older people
- Falls and fall prevention