I can get out of a chair, so why can’t I get off the floor?

Three moments I’d watch

1. The knee touches down. Does it hurt from pressure on the knee, from bending it, or from trying to slow yourself down?
2. The foot comes underneath you. Can you get it where you want it without having to pull yourself up with your arms?
3. Your weight shifts before you stand. Can you move onto that foot with the amount of support you’re comfortable using?

If the foot comes through more easily and you still feel unsteady as you shift onto it, I’d spend the next check on that weight shift. We can also compare another way up if kneeling or leading with that leg is the part that gives you trouble.

What happens on the way down?

I’d watch you lower toward a firm raised surface first if the floor feels too far away. Do you stop because bending your knee hurts, because you can’t get your foot where you want it, or because the last few inches feel like a drop? Then I’d see what changes with a higher target or a hand on a stable surface. Being able to slow down gives you time to choose where to put your weight before you go any lower.

Does your knee hurt from kneeling, bending, or pushing?

I’d compare three moments: when your knee touches the floor, when it bends deeply, and when you push through that leg to stand. If contact is what bothers you, we could compare it with padding or look for a route that keeps the knee off the floor. If it hurts when you push up, we could try a higher starting point or use hand support to change how much the leg has to do. Then we’d repeat the part that hurt and see what changed.

Can your hips let you put your foot where you need it?

Picture yourself with one knee down and the other foot in front. Can you bring that foot far enough forward to feel ready to stand? Can you turn into a side-sit without having to pull your leg around with your hands? I’d check what your hips allow and whether your ankle lets your shin come forward over your planted foot. Different ways of rising ask for different amounts of motion. One study of older adults also found greater hip and ankle demands in an instructed floor rise than in repeated chair rises.¹

Where do you feel unsteady?

Some people feel fine once they’re standing. It’s the moment they take a hand off the floor or move a foot that feels shaky. I’d look at which transition makes you reach for support and whether a stable handhold gives you enough time to shift your weight. We might practice just that transition at a height where you feel in control before we put the whole movement together.

How many ways can you get up?

Think about playing on the floor when you were younger. When one position got tiring, you might roll onto a hip, put a hand down, or switch which leg you led with. Each change gives one area a break and asks another to do more. In the clinic, we might compare coming up through one knee with a hand on a sturdy chair, turning through a side-sit with hand support, or moving onto a firm raised surface before standing. Each option has its own demands on your knees, hips, hands, and balance. Research has documented several strategies people use to rise from the floor.²

What I’d change, then check again

If a movement restriction seems relevant, I might use gentle hands-on work and then repeat that exact part of the transfer. If the foot comes through more easily but you still feel unsteady when you lift a hand, I’d spend time on that weight shift. We can practice just one part of the transfer first and then see whether you can use it on the way down and back up. Floor-rise training research has used practice of intermediate positions as part of the task.³

References

1. Floor-to-Stand Transfers in Older Adults: Insights into Strategies and Lower Extremity Demands. ↩
2. Alexander et al. Body positions used by healthy and frail older adults to rise from the floor. ↩
3. Alexander et al. Floor-rise strategy training in older adults. ↩
4. NHS. What to do after a fall. ↩