Some people are able to stand easily from a seated position but find that their knee is stiff and takes a few steps to loosen up. This is called startup stiffness and is usually a sign of arthritis in the knee. Other people find it difficult to stand up when they have been sitting in a chair or on a couch.
Standing up from a sitting position is quite a complex manoeuvre. You have to have enough movement in your knees to get your feet under the chair, your thigh muscles have to be strong enough to lift your bodyweight, your balance has to be good enough to keep you upright and your arms have to be strong enough to push up on armrests if you have problems with any of the above.
The most common cause of loss of motion in the knee is arthritis. If you are unable to bend your knees beyond ninety degrees of flexion you will not be able to get your feet under the chair to give yourself a biomechanical advantage lifting yourself from the chair. This means that your thigh muscles have to work harder and generally speaking people with arthritic knees tend to have some muscle wasting as well. If you combine this with pain from the arthritis, which also leads to weakness, the result is significant trouble standing from a low chair or couch.
A meniscal tear can also lead to pain and loss of motion which can create difficulty standing from a chair. This tends to respond well to arthroscopic knee surgery whereas the response from keyhole surgery to an arthritic knee is far less predictable.
If you are having trouble then changing your chair combined with a physiotherapy programme may be of benefit to you. Generally speaking higher chairs are easier to get out of than lower chairs.
Always try to sit in a chair with armrests that come all the way to the front of the chair. Armrests help to provide a handhold to push up on when rising from a sitting position. Make sure the chair has strong enough armrests to support your weight and that the legs are stable.
One way of rising from the chair is to:
- Place your hands firmly near the front of the armrests
- Lean forwards away from the back of the chair
- Move your bum near to the edge of the seat
- Make sure your feet are shoulder width apart. Keep your feet in line beneath your knees or slightly tucked under the chair
- Bring your head and shoulders in line above your knees
- Push with both arms until you are standing
The first line of treatment usually involves tablets, injections and physiotherapy with arthroscopic knee surgery and total knee replacement being used when other modalities have failed.