Why is it getting harder to stand up from a chair, and what helps? Difficulty getting up from a chair is common in older age, usually because of weaker legs, a chair that is too low or soft, or a technique that makes the job harder than it needs to be. The good news is that a better technique, a better chair set-up and a simple sit-to-stand exercise practised regularly can make a real difference for many people.
This guide is for older adults who find standing up a struggle, and the family who help them. For general strength training, see our guide to strength training in your 80s. If the problem is getting up from the floor, read how to get up safely after a fall.
Why standing up gets harder
Standing up from a chair looks simple, but it takes strength, balance and good timing all at once. Several things can get in the way:
- Weaker leg muscles. The big muscles at the front of the thighs and in the buttocks do most of the work. If you have been less active, unwell or in hospital, these muscles can weaken quickly.
- Technique. Many people try to stand by pushing straight up while leaning back. This puts your weight behind your feet, so your legs have to work much harder.
- The chair itself. A low, soft or deep seat lets you sink in, so you start from further down and further back.
- Stiff hips and knees. Arthritis or stiffness can make it hard to bend far enough to get your weight forward.
- Dizziness on standing. Some people feel light-headed as they stand. This can be caused by a drop in blood pressure (called postural hypotension). The NHS explains more about low blood pressure and dizziness when standing.
7 tips for difficulty getting up from a chair
1. Use the "nose over toes" technique
This one change makes standing easier for many people. When your nose comes forward over your toes, your weight moves over your feet, which is where your legs can push best.
Try this: Practise these steps, saying them out loud if it helps:
- Shuffle to the front of the seat.
- Tuck your feet back (see tip 2).
- Put your hands on the armrests.
- Lean forward until your nose is over your toes.
- Push through your heels and hands and stand up tall.
2. Tuck your feet back
Where your feet are matters as much as how strong your legs are. If your feet are out in front of you, you have to travel a long way forward before your weight is over them. With your feet tucked slightly behind your knees, you are already halfway there.
Try this: Before you stand, slide your feet back until your heels are just behind your knees, about hip-width apart, with your feet flat on the floor.
3. Push up from the armrests
Your arms can share the load with your legs. Pushing down through the armrests gives you extra power at the hardest part of the movement, just as your bottom leaves the seat.
Try this: Place your hands on the front part of each armrest, fingers forward. As you lean forward, push down firmly through your hands until your legs take over. If your chair has no arms, use a sturdy chair that does when you practise.
4. Check your chair height, firmness and use chair raisers
The right chair can make standing far easier. As a guide, when you sit with your feet flat on the floor, your hips should be level with or a little higher than your knees. Firm seats and sturdy armrests help too. If your favourite chair is too low, chair raisers (blocks or frames that fit under the legs) or a firm cushion can lift it. An occupational therapist (a health professional who helps people manage everyday tasks) can advise on the right equipment.
Try this: Sit in your usual chair with your feet flat. If your knees are higher than your hips, ask your GP or local council about an occupational therapy assessment, or try a firm cushion as a first step.
5. Don't pull on a walking frame or a person
Pulling on something feels natural, but it pulls you backwards and off balance. A walking frame can tip towards you if you pull on it. Pulling on a family member's hands can put you both at risk.
Try this: Place the walking frame in front of you, but keep your hands on the armrests until you are fully standing. Then move one hand to the frame, followed by the other.
6. Stand, pause, then walk
The first few steps after standing can be the wobbliest. If your blood pressure drops as you stand, you may feel dizzy or wobbly for a few moments. Our guide to dehydration, blood pressure and falls explains why drinking enough also matters.
Try this: Once you are up, stand still and count slowly to ten before you take a step. If you feel dizzy, sit back down straight away.
7. Build strength with a 4-stage sit-to-stand exercise
Practising the movement itself is one of the best ways to get better at it. The NHS lists sit-to-stand among its strength exercises, and Age UK includes it in its guide to functional fitness (exercises based on everyday movements). The NHS recommends that older adults do activities for strength on at least two days a week, as set out in its physical activity guidelines for older adults.
Use a sturdy chair with arms, placed against a wall so it can't slide. Have someone nearby the first few times. Move slowly, with control, both up and down.
- Stage 1: Higher seat, hands on armrests. Add a firm cushion to raise the seat. Stand up and sit down slowly 5 times.
- Stage 2: Higher seat, lighter hands. Use the same height, but push less through your arms. Aim for 5 to 10 times.
- Stage 3: Standard chair, hands on armrests. Remove the cushion. Aim for 5 to 10 times.
- Stage 4: Standard chair, arms crossed. Cross your arms over your chest and stand without using your hands. Aim for 5 to 10 times.
Only move to the next stage when the current one feels steady and comfortable on two separate days. Stop if you feel pain, dizziness or unsteadiness.
Try this: Choose the stage that feels safe today, and do one set at a regular time, such as before lunch, at least two days a week.
How family can help safely
The most important rule is: never lift someone under the arms. It can injure their shoulders and your back, and it doesn't teach their body how to do the movement.
Instead, be a coach rather than a crane:
- Give simple cues. "Bottom forward, feet back, hands down, nose over toes, and push." Using the same words each time helps.
- Count them in. A steady "one, two, three, stand" helps with timing.
- Stand to the side, not in front. This leaves room for them to lean forward. Rest a hand lightly on their back or hip to guide and reassure.
- Give them time. Let them pause once standing.
- Ask for training. If your relative needs a lot of help, a physiotherapist or occupational therapist can show you safe ways to help in your own home.
Caring is hard work, so look after yourself too. Our guide to caring for a loved one at home has tips on protecting your back and sharing the load.
Warning signs: when to stop and get advice
Stop practising and sit down if you feel unwell, dizzy, short of breath or in pain.
Call 999 if someone:
- has chest pain or tightness
- faints and doesn't come round quickly
- has sudden weakness on one side, a drooping face or slurred speech (possible signs of a stroke)
- is struggling to breathe
Contact your GP or call NHS 111 if:
- you often feel dizzy, light-headed or close to fainting when you stand up
- standing has become much harder over a few days or weeks, without a clear reason
- you have new confusion, a high temperature or feel generally unwell
- you have had a fall, even if you don't seem hurt
Some medicines can make dizziness on standing more likely. Ask your GP or pharmacist for a medicines review, and don't stop or change any medicine without advice. The NHS has more on preventing falls, including strength and balance work.
When a physiotherapy assessment helps
It may be worth seeing a physiotherapist if:
- you can only stand up from certain chairs, or need several attempts
- you have stopped going out because getting up is too hard
- a family member now helps you stand most of the time
- you have had a fall or a near miss
- you are not sure which stage of the exercise is safe for you
A physiotherapist can check your strength, balance and technique, and look at your chairs, bed and toilet to see what is making standing difficult. At Rehalign, we offer home visits across the West Midlands, including Birmingham, Solihull, Walsall, Wolverhampton, Coventry, Dudley and Telford. That way we can practise with the chair you actually use.
Frequently Asked Questions
Common reasons include weaker thigh and buttock muscles, stiff hips or knees, and chairs that are too low or soft. Technique matters too: leaning back and pushing straight up makes the legs work much harder. Some people also feel dizzy as they stand because of a drop in blood pressure. A physiotherapist can help work out which of these is the main problem.
A simple sit-to-stand from a sturdy chair with arms is one of the most useful exercises. Start from a slightly raised seat, using your hands, and stand up and sit down slowly. As it gets easier, use your arms less, then try a standard height chair. Stop if you feel pain or dizziness, and have someone nearby at first.
As a guide, when sitting with feet flat on the floor, the hips should be level with or slightly higher than the knees. A firm seat and sturdy armrests also make standing easier. Chair raisers or a firm cushion can lift a low chair. An occupational therapist can advise on the right height and equipment for each person.
Never lift them under the arms, as this can hurt their shoulders and your back. Instead, remind them to shuffle forward, tuck their feet back, push on the armrests and lean forward with their nose over their toes. Stand to the side, count them in and let them pause once standing. A physiotherapist can show you safe techniques at home.