Watching someone fall can be scary, and knowing how to help them get back up safely is a skill every caregiver and family member should have. But here's the thing most people don't realize: helping someone up the wrong way can cause additional injuries to both the person who fell and the person trying to help.
Physical therapists have spent decades refining techniques that minimize injury risk while helping people regain their footing after a fall. These methods aren't just for professionals: they're designed to be learned and practiced by anyone who cares for an older adult or someone with mobility challenges.
This guide breaks down the exact techniques physical therapists recommend, when to use them, and how to practice them before an emergency happens.
Before You Help: When to Call 911 Instead
Not every fall requires a trip to the emergency room, but some situations absolutely do. Before attempting to help someone up, take a moment to assess the situation.
Call 911 immediately if the person who fell:
- Lost consciousness, even briefly
- Hit their head or complains of head, neck, or back pain
- Has visible injuries like bleeding, swelling, or bones that appear misshapen
- Can't move a limb or experiences numbness or tingling
- Complains of severe pain in any area
- Appears confused or disoriented beyond what's normal for them
- Has difficulty breathing or chest pain
If none of these red flags are present, ask the person how they feel. Give them a minute to catch their breath and orient themselves. There's no rush: taking time to assess prevents hasty decisions that could lead to re-injury.
The Assessment: Questions to Ask Before Moving Forward
Once you've determined it's safe to proceed without emergency services, have a brief conversation with the person who fell:
- "Are you hurt anywhere?"
- "Do you feel dizzy or lightheaded?"
- "Do you think you can bear weight on both legs?"
- "Did you trip on something, or did your legs just give out?"
That last question is particularly important. If someone's legs gave out without an obvious obstacle, it might indicate a medical issue that needs attention from their doctor, even if they seem fine now.
If the person feels ready to try getting up and you're physically capable of assisting, you can proceed with one of the two methods physical therapists recommend.
Method One: The Sequential Method (For Getting Up After a Fall)
This is the most common technique used when someone has already fallen and needs to get back to their feet. It progresses logically from lying down to standing, using furniture or walls for support along the way.
Step 1: Roll to Your Side
Starting from a lying position on their back, have the person roll onto their side. They should bend the knee of their top leg and use their arms to help with the roll. Once on their side, they should extend their bottom arm out for stability.
Step 2: Push Up to Side-Sitting
From the side-lying position, the person uses their top arm to push their upper body up while swinging their legs down. They'll end up sitting with both legs pointing in the same direction, knees bent. This is called side-sitting. It's a stable resting position if they need to catch their breath.
Step 3: Move to Hands and Knees
Next, they'll rotate forward onto their hands and knees. This four-point position (also called prone kneeling) is very stable and gives them a chance to rest again if needed.
Step 4: Crawl to a Sturdy Surface
If they're not already near a solid piece of furniture, a stair railing, or a wall, have them crawl to one. The surface needs to be able to support their full weight as they stand up. A lightweight chair or wobbly table won't work.
Step 5: Move to High Kneeling
Using the sturdy surface for support, they'll lift their hands off the ground one at a time and place them on the furniture or wall. Now they're kneeling upright on both knees with their hands supporting them.
Step 6: Half-Kneeling Position
From high kneeling, they'll bring one foot forward so it's flat on the ground. The other knee stays on the floor. They're still holding onto the sturdy surface for balance. This half-kneeling position is the launching point for standing.
Step 7: Push to Standing
Using both their leg strength and the support of the furniture or wall, they'll push up from the half-kneeling position to standing. The leg that's forward does most of the work. Once upright, they should take a moment to stabilize before attempting to walk.
Method Two: The Backward Chaining Method (For Practice and Prevention)
This method flips the script. Instead of teaching someone to get up after they've fallen, it teaches them to get down to the ground safely and then back up again. It's called "backward chaining" because you learn the final steps first, then work backward to the beginning.
Why practice getting down when we're worried about falls? Because building this skill in a controlled environment builds confidence, strength, and muscle memory. If someone does fall, they'll already know the movements needed to get back up.
Step 1: Practice Half-Kneeling
Start standing or sitting next to a sturdy chair. Lower yourself to a half-kneeling position (one foot flat, one knee down) while holding the chair for support. Hold this position for a few seconds, then stand back up. Repeat until this feels comfortable and controlled. You can place a folded towel or cushion under your knee for comfort.
Step 2: Add High Kneeling
Once half-kneeling feels easy, add the next step. From half-kneel, lower both knees to the ground so you're in a high kneeling position (upright on both knees). Hold it, then reverse back through half-kneel to standing. Only move forward when this progression feels secure.
Step 3: Move to Hands and Knees
From high kneel, lean forward and place your hands on the ground, moving into the hands-and-knees position. Hold it, then reverse back through high kneel, half-kneel, and standing. Practice this progression until it's smooth.
Step 4: Progress to Side-Sitting
From hands and knees, shift your weight to one side and swing your legs around so you're sitting with both legs pointing the same direction. Hold it, then reverse back through all the previous positions. This is getting more challenging, so take your time.
Step 5: Lower to Side-Lying
From side-sitting, slowly lower your upper body down to the floor so you're lying on your side. Hold it, then come all the way back up through every position you've practiced. This requires good core and arm strength.
Step 6: The Full Sequence
Finally, from side-lying, roll carefully onto your back. Hold it, then reverse through every single step back to standing. This is the complete sequence: from lying on your back to standing tall.
The beauty of backward chaining is that you can stop at any step and practice just that portion until it feels manageable. You're not trying to master everything at once.
Safety Tips for Helpers
If you're assisting someone who's fallen, your safety matters too. Back injuries from lifting incorrectly are remarkably common among caregivers.
Never try to lift someone from the ground by yourself unless you're confident in your physical ability to do so safely. Even then, you're usually better off guiding them through the sequential method rather than lifting their full weight.
If you do need to provide physical assistance:
- Bend from your knees, not your waist
- Keep your back straight
- Don't twist while lifting or supporting weight
- Let them do as much of the work as possible
- Use a gait belt if available (a strap that goes around their waist to give you something secure to hold)
Sometimes the best help is verbal guidance and reassurance, not physical lifting. Talk them through each step, encourage them to rest when needed, and remind them there's no rush.
The Importance of Practice
Here's something most people don't think about until it's too late: the middle of an emergency is a terrible time to learn these techniques for the first time. Both the person who fell and the helper will be stressed, possibly scared, and definitely not thinking clearly.
That's why physical therapists strongly encourage practicing these movements before they're needed. If you're caring for someone with mobility issues, spend some time together going through the backward chaining method. Make it a regular activity, like stretching or light exercise.
For the person at risk of falling, this practice builds:
- Muscle memory for the movements
- Strength in the specific muscles needed for each step
- Confidence that they can get up if they do fall
- Reduced fear of falling (which ironically helps prevent falls)
For the caregiver, practice helps you understand what each step looks like and where someone might struggle. You'll be better equipped to offer the right help at the right time.
When to Work with a Physical Therapist
While these techniques can be learned from written instructions, working with a licensed physical therapist offers significant advantages. They can:
- Assess individual mobility limitations and adapt techniques accordingly
- Identify specific muscle weaknesses that need to be addressed
- Teach proper body mechanics to prevent injury
- Create a personalized practice plan based on current fitness level
- Monitor progress and adjust the difficulty as skills improve
If someone has a recent history of falls, has been recently hospitalized, or has conditions affecting balance or strength (like Parkinson's disease, stroke recovery, or severe arthritis), a physical therapist's guidance isn't just helpful: it's essential.
Building Confidence After a Fall
One fall often leads to another, not because of physical limitations, but because of fear. Someone who's fallen becomes afraid of falling again, so they limit their activities, which leads to muscle weakness and balance problems, which makes another fall more likely. It's a vicious cycle.
Learning proper techniques for getting up breaks that cycle. When someone knows they can get themselves up safely, or that their caregiver knows how to help them effectively, that fear loses its power. They're more likely to stay active, maintain their strength, and actually reduce their fall risk over time.
Moving Forward with Confidence
Falls don't have to mean a loss of independence. With the right techniques, practice, and preparation, both older adults and their caregivers can face the possibility of falls with less fear and more practical knowledge.
Start by practicing the backward chaining method when no one is rushed or stressed. Go slowly through each step. Build the skill gradually. And remember that seeking guidance from a physical therapist isn't admitting defeat: it's taking a smart, proactive step toward safer aging.
The best time to learn how to get up after a fall is before one happens. The second best time is right now.
