Your ability to sit on the floor and get back up is more important than you may think!

Getting to the ground and back up is a fairly complicated motor skill which can vary in difficulty based on one’s surroundings and physical limitations. There are many ways to accomplish this task involving movements such as squatting, lunging, kneeling, or bending over, and it requires lower body mobility, strength, and stability as well as a certain amount of comfort being on the floor. Not only is one’s ability to get to the floor and back up an important predictor of mortality, but it is also crucial for many activities of daily life as well as for recovery in the event of a fall (de Brito et al., 2012; Wang et al., 2016). Fall risk is a great concern, especially in older adults due to the injuries, disability, and reduction in quality of life that a fall can cause. Many studies have reported that reduced muscle strength in the lower extremities raises the risk of failing (Wang, D. et al., 2016).

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A study by de Brito et al. (2012) scored 2,002 adults ages 51 to 80 years old on their ability to sit down on the floor and get back up. They were scored out of 10 possible points and deductions were made for the use of another body part or the floor for support while getting down or back up. The researchers followed up with the individuals over the next six years, and 159 of the participants died. Every point increase in a person’s test score correlated with a 21% reduction in his or her risk of death in the next six years. While this is a correlation study and evidence of correlation isn’t evidence of causation, the association between movement ability and mortality is hard to ignore.

Try it out now. Start by standing up. Sit down on the floor using your hands or other objects as little as possible. Every time you use something for assistance, subtract one point from five. Stand up from the floor using as little help from hands and objects as possible. Subtract one point from five each time you use hands or objects for assistance. Add your results from getting down (a number out of 5) and getting up (a number out of 5) for your score out of 10. Each point less than 10 increases the probability of death in the next six years by 21%. Are you ok with your score? Keep reading to learn how to improve!

If getting down to the floor and/or up is nearly impossible for you: 

Here are three simple exercise progressions you can work through over the next 6-8 weeks.

  1. Sit to stand
  2. Lowering and raising in a split stance (similar to a lunge)
  3. Step ups

Sit to stand

Select a box or chair that is a comfortable height. Sit down to it and stand back up without using your hands or assistance. Progress to tapping your butt on the box instead of entirely transferring your weight onto it, and gradually lower the box to increase the distance you raise and lower yourself. This increases comfort with getting down to and up from progressively lower seats and strengthens the leg muscles necessary to do so. If you progress to the point where you can lower and raise yourself to a point at more than 90-degrees of knee flexion, progress this exercise to include lying down. In this variation, sit/squat down to the low position, transfer all your weight to the box, and lie all the way down. To reverse the movement, sit up from lying supine and squat up from that position.

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Lowering and raising in a split stance

Slightly lower and raise your body (bending the front and back knees) in a split stance position using TRX straps for support. With practice, increase the distance you lower and raises your body, and then decrease the amount of assistance used to stabilize from two TRX straps to one strap to no assistance. This exercise increases comfort and stability in the split stance position one uses to get up from the ground, and it strengthens the leg muscles which are important for the movement.

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Step ups

Step up to a small platform using one leg. Similar to the other exercises, this will increase leg strength, stability in a single leg stance, and comfort in a movement pattern one can use to get up from the ground. Progress by increasing the repetitions of step ups performed on each leg and the height of the platform you are stepping up to.

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The next step:

Once you can get down to the ground and back up with relative ease, I’d suggest including a Fall Matrix in your workout warm-up once a week.

  1. Start standing. Place one hand on your same-side knee. Lay down, with your back against the floor and stand back up without removing the hand from your knee. Then lay down with your stomach on the floor without removing the hand from your knee, and stand back up. Optional: Lay down with your right side on the floor, and stand back up. Then repeat on the left side.
  2. Repeat these 4 variations touching the other side’s hand to its same-side knee.
  3. Repeat these 4 variations touching one hand to the opposite side knee.
  4. Repeat these 4 variations touching the other side’s hand to its opposite side knee.

Progress these exercises by touching your hand to a body part lower than the knee, for example, place your hand below the knee, on your shin, on your ankle, on your toes.

Like many things with our bodies, if you don’t use it, you lose it. Get on the ground and back up regularly so you don’t lose your ability to!

References
de Brito, L. B., Ricardo, D. R., de Araujo, D. S., Ramos, P. S., Myers, J., & de Araujo, C. G. (2012). Ability to sit and rise from the ground as a predictor of all-cause mortality. European Journal of Preventive Cardiology. doi: 10.1177/2047487312471759
Wang, D., Zhang, J., Sun, Y., Zhu, W., Tian, S., & Liu, Y. (2016). Evaluating the fall risk among elderly population by choice step reaction test. Clinical Interventions in Aging, 11, 1075-1082. doi: 10.2147/CIA.S106606
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Why it’s important to expand your movement comfort zone!

Clark (1995) theorizes that there is a positive correlation between one’s motor skillfulness and daily activity level. This is important because of the rising obesity- and inactivity-related diseases in our society and the decreases in activity among everyone from children to adults. Low self-efficacy toward movement abilities and diminishing movement comfort zones play a role in these decreasing activity levels, and I believe it is our job as coaches and trainers to increase clients’ self-efficacy and movement comfort zones.

Self-efficacy is a person’s perception of his or her ability to successfully complete a certain task, and individuals tend to avoid tasks where their self-efficacy is low (Jongen et al., 2016). Based on this, Clark’s theory correlating motor skillfulness and one’s activity level isn’t too much of a stretch. People who don’t believe they can do activities are less likely to do them, but why don’t people believe they can do activities?

I think one reason people have low self-efficacy toward movement is that with less and less movement over time, movement comfort zones get smaller and smaller. Many adults spend a majority of their lives moving from chair to chair, and other movements aren’t practiced so they become less comfortable. Getting down to the floor and back up, for example, is something that rarely happens for many. This movement becomes out of their comfort zone, avoided, and soon enough, they can’t get down to the floor (or up from it).  As the old adage goes, “if you don’t use it, you lose it,” and this applies to movement skill as well.

Dan John is a well-known strength coach who strongly advocates that everyone get down to the floor and back up 25 times a day to increase comfort on the floor and movement ability and as prevention for falls or fall-related injuries. He mentions research that showed people who had difficulty getting down to the floor and back up were five times more likely to die in the next six years than the participants who did the task with ease (Barwick, 2012; Barreto de Brito et al., 2012). Using these patterns on a regular basis is the best way to increase one’s comfort with them.

I also observe limited movement comfort zones in many kids, especially those who don’t regularly participate in sports or other exercise-based activities. Their movement comfort zones aren’t challenged, they don’t expand, and through their lives, these kids avoid more and more activities because they lack the self-efficacy to participate. One thing I do with the kids I coach is push the boundaries of their movement comfort zones. We crawl, roll, and tumble, practice handstands, climb cargo nets, and traverse monkey bars. I integrate this idealogy with adult clients and in my own life as well. I think the best way to increase movement self-efficacy and comfort zones is through repetitive practice of activities out of one’s comfort zone. This expands one’s comfort zone and provides experience-based evidence about how skillfulness in many movements can be easily obtained with practice.

References

Barreto de Brito, L. B., Ricardo, D. R., Soares de Araujo, D. S. M., Ramos, P. S., Myers, J., Soares de Araujo, C. G. (2012). Ability to sit and rise from the floor as a predictor of all-cause mortality. European Journal of Preventive Cardiology, 0(00), 1-7.

Barwick, T. (2012). Can you do this? Simple sitting test predicts longevity. NBC News. Retrieved from: http://vitals.nbcnews.com/_news/2012/12/13/15870881-can-you-do-this-simple-sitting-test-predicts-longevity

Clark, J. E. (1995). On becoming skillful: Patterns and constraints. Research Quarterly for Exercise and Sport, 66(3), 173-183.

Jongen, P. J., Heerings, M., Ruimschotel, R., Hussaarts, A., Duyverman, L., van der Zande, A., & … Visser, L. H. (2016). Intensive social cognitive treatment (can do treatment) with participation of support partners in persons with relapsing remitting Multiple Sclerosis: Observation of improved self-efficacy, quality of life, anxiety and depression 1 year later. BMC Research Notes, 91-8. doi:10.1186/s13104-016-2173-5