By Simon Peter Lokomo, MPH — Public Health
Last reviewed: July 2026

How to Get Up After a Fall: A Safe Step-by-Step Guide for Older Adults

Do not rush to stand. Stay still for a minute, then check for injury before moving at all. If you hit your head, or anything hurts sharply when you move it, stay on the floor and call for help, because getting up can turn a manageable injury into a serious one. If you are unhurt, the safest method is to roll onto your side, push up onto hands and knees, crawl to a sturdy chair, and rise from there using your arms and your stronger leg. Practicing this before you ever need it makes a real difference.

Here is the reason this is worth knowing in advance. Research suggests only about half of people who fall without being injured can get themselves back up again, and many end up on the floor for an hour or more. The fall is often not the worst part. What follows can be.

What should you do in the first minute after a fall?

Nothing. That is the honest answer, and it is the hardest advice to follow. The instinct after falling is to scramble upright immediately, partly from embarrassment and partly from shock. That instinct is the problem, because moving fast is how a cracked bone becomes a displaced fracture.

Stay where you are. Breathe. Give it thirty to sixty seconds before you attempt anything, and let the initial jolt of adrenaline settle so you can actually feel what your body is telling you. Adrenaline masks pain for the first minute or two, which is precisely why people stand up on a fractured hip and only realize later.

How do you check for injury before getting up?

Work through your body deliberately, from the head down, before you try to move position.

Did you hit your head? If yes, do not get up, and call for help. This matters more in older adults than most people realize, because bleeding inside the skull can develop slowly over hours. Anyone taking a blood thinner should treat a head impact as an emergency regardless of how well they feel in the moment.

Is there sharp pain anywhere? Move one limb at a time, gently, and stop at the first sign of severe pain. Sharp pain in the hip, thigh, wrist or back can indicate a fracture. Severe pain in a hip, or a leg that looks shortened or turned outward, means stay put and call an ambulance.

Do you feel dizzy, faint, or confused? If the fall happened because you blacked out or felt faint, that is a medical event rather than a trip, and it needs attention before you go anywhere.

The rule that physical therapists give is simple and worth memorising. If something hurts as you move it, stay on the floor and get help. You lose very little by waiting for assistance. You can lose a great deal by standing on a broken bone.

How do you get up after a fall, step by step?

This is the method the NHS and fall prevention specialists recommend. It works by breaking one impossible movement, standing straight up from the floor, into several manageable ones. Take each stage slowly and rest between them if you need to.

1. Roll onto your side. Turn your head first, then your shoulders, then your hips. Rest here for a moment.
2. Push up onto your forearm, then your hand, raising your upper body off the floor.
3. Get onto your hands and knees. Pause again. This position alone can feel like an achievement, and there is no hurry.
4. Crawl to something solid. A sturdy dining chair is ideal. A heavy coffee table, the base of a staircase, or a firm sofa will do. Avoid anything on wheels or anything light enough to tip.
5. Place both hands flat on the seat of the chair, keeping your weight forward over your hands.
6. Bring your stronger leg forward so that foot is flat on the floor, leaving the other knee down. You are now in a half-kneeling position, like a runner on the blocks.
7. Push up through that front foot and both arms together, in one steady movement rather than a jerk.
8. Turn slowly and sit down on the chair.
9. Stay sitting. Rest for several minutes before standing again, and drink some water if you can reach it.

If there is no chair within reach and you have stairs, scoot on your bottom to the bottom step, sit on the lowest one, and use your legs and arms to push yourself up onto a higher step until you can rise.

One thing to note about step 4. Crawling feels undignified, and some people resist it. It is by far the safest way to travel across a floor after a fall, because you cannot fall from hands and knees. Get to something solid before you attempt to stand.

What if you cannot get up?

Then the goal changes completely. It is no longer about standing. It is about getting help and staying as comfortable and warm as possible until it arrives.

Being unable to rise is common and it is not a failure. Prior surgery, a stiff knee, weak arms, or simply not having the strength to push up from the floor all make the standard technique impossible for many people. Age UK is explicit that if a previous injury prevents you from kneeling or pushing up, you should not attempt it.

Get help any way you can. Use your phone if it is reachable, or press your medical alert button if you wear one. If neither is available, bang on a wall, floor or radiator with your hand or a shoe, since a repeated banging noise carries further through a building than shouting and takes less energy. Shout as well if you think anyone is close enough to hear.

Then make yourself as safe as possible while you wait. If you are on a hard floor and can move, edge toward carpet. Pull down anything you can reach to cover yourself, since lying still on a floor drops your body temperature faster than people expect. Shift your position every half hour or so if you are able, because staying in one position on a hard surface damages skin. Move your arms and legs a little from time to time to keep circulation going.

Falls at night carry the highest risk of a long wait, since nobody is awake to notice, which is one more reason the route from bed to bathroom deserves attention. We cover that specific journey in nighttime bathroom trips and falls.

Falls at night carry the highest risk of a long wait, since nobody is awake to notice, which is one more reason the route from bed to bathroom deserves attention. We cover that specific journey in nighttime bathroom trips and falls.

This is where a worn alert device genuinely proves its worth, and it is also why wearing it matters more than owning it. In one study of older people who fell, roughly 80 percent of those who had a personal alarm did not use it, often because it was in another room. We looked at what these devices can and cannot do in do medical alert systems actually save lives.

How should you help someone else who has fallen?

Do not lift them. This is the single most important instruction for family and carers, and it is regularly ignored with bad results for both people.

Hauling someone off the floor can worsen an injury you have not yet identified, and it injures a startling number of carers, who are often themselves older. A person who cannot get up unaided is not going to become liftable because you love them.

What to do instead:

• Stay calm and get down to their level so you are not talking down at someone who is frightened and on the floor.
• Ask before you touch anything. Did they hit their head? Where does it hurt? Can they move everything?
• If there is any sign of injury, call emergency services and keep them still, warm and company until help comes.
• If they seem unhurt, talk them through the steps above while they do the work themselves. Bring the chair to them. Steady the chair so it cannot slide.
• Stay close and offer a hand for balance as they push up, without taking their weight.
• Get them sitting and resting afterwards, then watch them for the next day or two.

That last point gets overlooked. Symptoms of a head injury or a slow bleed can appear hours later, so any new confusion, drowsiness, vomiting, worsening headache or unusual behaviour after a fall needs urgent medical attention even if they seemed fine at the time.

Should you practice getting up before it happens?

Yes, and this is the most useful thing in this article. There is a formal physical therapy method for teaching it called backward chaining, and it works by breaking the movement into small steps taught in reverse order, starting from standing and working down toward the floor. Because the learner never begins lying flat, it feels far less daunting.

The evidence is encouraging. A systematic review including 446 participants found backward chaining improved older adults’ ability to get up from the floor unaided, increased mobility, and was associated with fewer subsequent falls, with particular benefit after hip fracture. Physical therapy guidelines recommend that older people are taught how to cope with a fall rather than only how to avoid one.

The honest caveat is that the method is not yet widely used in routine practice, study quality varies, and researchers say more work is needed to standardise how it is taught. That is an argument for asking a physical therapist rather than for skipping it.

Ask the doctor for a referral, and ask specifically about learning to get up from the floor. Practice on a carpeted floor with someone present, next to a sturdy chair, and stop if anything hurts. Building leg and arm strength makes the whole thing easier, which is one more reason the exercises in our guide to balance exercises for seniors earn their place.

There is a second benefit worth naming. Knowing you could get up again takes some of the terror out of the possibility of falling, and that fear is itself a serious problem, as we covered in fear of falling.

What the evidence does NOT support

• That you should always help someone up. If injury is possible, getting them up can make it worse, and lifting injures carers too.
• That feeling fine means you are fine. Adrenaline masks pain, and bleeds inside the skull can develop over hours.
• That owning a medical alert is the same as being protected. Around 80 percent of alarm owners in one study did not use it when they fell. It has to be worn.
• That being unable to get up is simply weakness. Roughly half of uninjured fallers cannot rise unaided. It is common, and it is partly a technique problem that can be taught.
• That backward chaining is definitively proven. The findings are promising, but the method is not yet standardised or widely implemented.

When to call emergency services

Call an ambulance rather than attempting to get up if the person hit their head, takes a blood thinner and struck their head, has severe pain, cannot move a limb, has a leg that appears shortened or rotated, lost consciousness, is confused or unusually drowsy, is bleeding heavily, or has been on the floor a long time and is cold.

Call for medical advice afterwards even for an apparently minor fall, because a fall is information. It usually has a cause worth finding, whether that is medication, blood pressure, vision, or an infection. Our guide on what to do when a parent keeps falling covers that assessment, and the home safety checklist covers what to change afterwards.

Key takeaways

• Wait a minute before moving, and check for injury before attempting to rise. Adrenaline hides pain.
• If you hit your head or anything hurts sharply, stay on the floor and call for help.
• The safe method is roll to your side, up onto hands and knees, crawl to a sturdy chair, then push up using your arms and stronger leg.
• If you cannot get up, focus on getting help, keeping warm, and shifting position, since a long lie carries real risks of its own.
• Never lift someone off the floor. Talk them through it and steady them instead, and ask a physical therapist about practicing the technique in advance.
• If they cannot get up and are uninjured, call the fire department’s non-emergency line for a lift assist. Then book a medical review, because needing one is associated with worse outcomes over the following two weeks.

Frequently asked questions

How do you get up after a fall?

First check for injury and do not rush. If you are unhurt, roll onto your side, push up onto your forearm and then your hands and knees, crawl to a sturdy chair, place both hands on the seat, bring your stronger foot forward flat on the floor into a half-kneeling position, then push up through that leg and both arms together. Turn, sit down, and rest for several minutes before standing.

Should you help an elderly person up after a fall?

Not by lifting them. Ask first whether they hit their head and whether anything hurts, and if there is any sign of injury, call emergency services and keep them still and warm. If they seem unhurt, bring a sturdy chair to them, steady it, and talk them through getting up themselves while you stay close for balance. Lifting risks worsening an unseen injury and commonly injures the carer.

What should you do if you fall and can’t get up?

Get help however you can, using a phone or medical alert button, or by banging repeatedly on a wall or floor, which carries further than shouting and uses less energy. Then keep warm by pulling down anything within reach, move onto carpet if you can, and change position every half hour or so to protect your skin and circulation while you wait.

Why is lying on the floor after a fall dangerous?

Spending an hour or more on the floor, known as a long lie, brings risks separate from the fall itself, including pressure damage to skin, chest infection, dehydration, low body temperature, and muscle breakdown that can harm the kidneys. Long lies have been linked with serious injury, hospital admission, and moves into long-term care, which is why having a way to call for help matters.

Can you practice getting up from the floor?

Yes, and it is worth doing. Physical therapists teach a method called backward chaining, which breaks the movement into small steps taught in reverse from standing down to the floor, so it feels less daunting. A systematic review found it improved older adults’ ability to rise unaided and was linked with fewer subsequent falls. Ask a doctor for a referral and practice on carpet with someone present.

Can you call the fire department to help someone up after a fall?

Yes, and it is called a lift assist. Use the fire department’s non-emergency number if nobody is injured. Many departments provide it free as a community service and bill only if the person is transported to hospital, though some have introduced fees, so it is worth asking in advance. Importantly, research finds lift assist calls are associated with higher illness and death in the following two weeks, so treat one as a prompt to arrange a medical review rather than an isolated event.

How do you get up from the floor with bad knees or arthritis?

The standard method requires kneeling, which is not possible for everyone. If a previous injury, joint replacement or arthritis prevents kneeling, do not force it. Alternatives include scooting on your bottom to the bottom of a staircase and pushing up step by step, or using a sturdy chair to come up from a side sitting position rather than through a kneel. A physical therapist can work out a method suited to your joints, which is worth doing before you need it.

When should you call an ambulance after a fall?

Call if the person hit their head, takes a blood thinner and struck their head, has severe pain, cannot move a limb, has a leg that looks shortened or turned outward, lost consciousness, is confused or drowsy, is bleeding heavily, or has been on the floor a long time and become cold. Also seek urgent help if confusion, vomiting or worsening headache appears in the hours after a fall.

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HomeAgingGuide.com provides evidence-based information, not medical advice. Simon Peter Lokomo holds an MPH in public health and is not a licensed physician. This guidance cannot account for individual injuries or conditions. If you are in any doubt after a fall, seek medical assessment, and call emergency services if serious injury is suspected.