After 55: not longer runs, not heavy weights – the simple sit‑to‑stand test geriatricians now use as a daily fitness check

I was halfway through yet another article about “How to stay fit over 50” when my hips started quietly protesting from the sofa. The advice was all the usual suspects: more steps, longer runs, heavier weights. Great if your knees still trust you and your back behaves. Less great if stairs already feel like a negotiation.

A few weeks later, in a very ordinary NHS clinic room that smelled faintly of hand gel and carpet cleaner, a geriatrician did something that shifted the whole picture. She did not ask how many 5k runs I’d done, or whether I lifted. She pointed to the plastic chair in the corner.

“Humour me,” she said. “Arms folded, feet flat. Stand up. Sit down. Repeat.”

No treadmill. No dumbbells. Just that simple wobble between seat and standing. She watched as if it were a full medical drama. And in a way, it was.

The day “fitness” turned into “can you get off the chair?”

The test took less than a minute. I felt faintly silly. This was something toddlers master before they can say “snack”. Yet by stand number eight my thighs were murmuring, and by twelve I was thinking about my balance in a way I hadn’t for years.

She timed me, counted under her breath, then smiled.

“This,” she said, tapping the chair, “is the move that keeps people in their own homes. I care less about how far you can run, more about how safely you can stand.”

It landed harder than any step-count lecture. Because she was not talking about being “sporty”. She was talking about whether Future Me could get off the loo, out of bed, up from the floor if I tripped over a stray shoe. The stuff that decides if you feel independent, or a bit trapped.

That’s when the humble sit‑to‑stand test stopped being a rehab thing in my head and started being a daily check-in.

What geriatricians quietly watch: how you rise

Doctors who work with older adults have a few deceptively simple checks they rely on. Grip strength. Walking speed. And how you get out of a chair.

Standing up from sitting is sneaky. It looks basic, but it asks a lot from your body at once:

• Legs and hips have to generate power.
• Core muscles and back have to stabilise you.
• Ankles and feet have to balance the sudden shift.
• Blood pressure has to adjust fast enough that you don’t go woozy.

If any one of those systems is flagging, it often shows up in the way you stand. You rock forwards three times before you commit. You push hard on the armrests. Your knees drift inwards. You pause at the top, eyes a bit distant, as your blood catches up.

In geriatric clinics, the sit‑to‑stand is a quiet crystal ball: it hints at fall risk, future mobility and how resilient you are after illness.

The good news? Unlike your date of birth, this number is trainable. Done well, the very movement that tests you is the one that keeps you stronger.

The sit‑to‑stand test in plain English

There are two main versions used in clinics. You can do either at home with a safe, sturdy chair.

Option 1: The 30‑second chair stand

This checks how many good‑quality stands you can do in half a minute.

1. Use a firm chair without wheels, roughly knee height, pushed back against a wall.
2. Sit tall, feet flat, hip‑width apart. Cross your arms over your chest, hands on opposite shoulders.
3. Start a 30‑second timer.
4. Stand up fully, then sit back down with control. That is one repetition.
5. Count how many full stands you manage before the timer beeps.

If you need to use your hands to push off, still count it, but make a note. That detail matters more than whether you reach a magic number on day one.

Option 2: The five‑times sit‑to‑stand

This one looks at speed rather than volume.

1. Same chair set‑up: stable, against a wall.
2. Same start position: arms folded, feet flat.
3. Start a timer as you rise.
4. Stand up and sit down five times in a row as fast as you can safely manage, without flopping.
5. Stop the timer when you stand up fully for the fifth time.

You now have a simple snapshot: how many, or how fast. No step counter required.

Why this one move predicts so much

Standing up sounds too ordinary to be meaningful, yet research keeps circling back to it. People who perform poorly on sit‑to‑stand tests are more likely to:

• Struggle with everyday tasks (stairs, shopping, getting out of low chairs).
• Lose confidence walking outdoors.
• Be at higher risk of falls and fractures.
• Recover more slowly after surgery or illness.

It is essentially a proxy for leg strength, balance and what doctors call “functional reserve”: the spare capacity your body has to cope when life throws you flu, a broken bone or a hospital stay.

Past 55, you do not need a marathon time. You need trustworthy legs and a nervous system that can coordinate them quickly.

Better sit‑to‑stand scores are linked to lower mortality risk in older groups. Not because the chair itself is magical, but because the systems it tests are ones you rely on dozens of times a day.

Turn it into a daily check‑in, not a punishment

A test only helps if you repeat it enough to notice trends. That does not mean a grim boot‑camp every morning.

Think of it like brushing your teeth: small, regular, and boring in the best possible way.

• Pick a regular chair you already use – the kitchen one, not the saggy sofa.
• Attach the habit to something you always do: kettle on, news headlines, midday cuppa.
• Do one “mini‑test” most days: 5–10 controlled stands, not all‑out speed.
• Once a week, do a proper count or time and jot it somewhere: notebook, Notes app, calendar square.

Your goal is not heroic numbers. Your goal is noticing if the stairs feel easier, if train seats feel less like deep wells, if your weekly count edges gently upwards rather than down.

Rig the set‑up so your body feels safe

If it has been a while since you did anything that felt like exercise, safety matters more than enthusiasm.

• Choose a solid chair with a straight back and no wheels.
• Place it against a wall so it cannot slide.
• Wear flat, grippy shoes, or go barefoot on a non‑slip surface.
• Have a sturdy surface nearby (worktop, table) that you can lightly touch if you wobble.

Start small. If ten repetitions in 30 seconds sounds like Everest, aim for three slow stands with plenty of rest. If crossing your arms feels unstable, let your fingertips hover on your thighs until your confidence grows.

Pain is a signal, not a character test. Mild muscle effort is fine. Sharp joint pain, chest discomfort, or feeling faint are your cue to stop and talk to a professional.

A rough feel for “where you are” (not a diagnosis)

These ranges are very approximate and based on common clinical benchmarks. They are not strict cut‑offs and they do not replace medical advice, but they give a flavour of what geriatric teams look for.

30‑second chair stand – ballpark numbers

Age band	“Doing OK” (approx. stands)	“Worth asking for advice”*
55–64	11–17+	Fewer than ~8
65–74	10–16+	Fewer than ~7
75–84	9–14+	Fewer than ~6

*Especially if you also feel unsteady, get tired very quickly, or have had a recent fall.

Remember: using your hands to push, needing to pause, or feeling wobbly can matter as much as the number. Write down how it felt, not just what you scored.

Let the test double as your training

Here is the elegant part: you do not need a separate workout plan if the test itself becomes your mini‑exercise.

A simple pattern that suits many people after 55:

• Most days:
  1–3 sets of 5 slow, controlled stands from your chair. Rest 30–60 seconds between sets. Breathe out as you stand; do not rush.

• Once a week:
  Do the 30‑second or five‑times test and write it down. Treat it like blood pressure – a data point, not a verdict.

As it gets easier:

• Lower yourself more slowly to build control.
• Pause for a one‑second “hover” just before your bottom touches the seat.
• Try crossing your arms fully if you used your hands before.

Your thighs may grumble. Your brain often feels quietly proud.

Listening to your body: when to be cautious

Some people should check with a GP, physiotherapist or nurse before they start pushing this test, especially if you:

• Have had a recent hip, knee or back operation.
• Get chest pain, severe breathlessness or dizziness with minimal effort.
• Have unstable blood pressure or heart rhythm issues.
• Have had a fall in the last few months and feel anxious on your feet.

Even then, a modified version – higher chair, hands allowed, fewer repetitions – is often part of rehab, not forbidden. The key is tailoring it rather than copying a chart from the internet and hoping for the best.

The aim is to build trust in your legs, not to scare yourself with a number you saw on a poster.

The quiet side‑effects you notice first

A fortnight into doing chair stands while the kettle boiled, something subtle shifted. I stopped pushing off my thighs when I got out of the car. Cinema seats felt less like traps. Stairs at the station were still stairs, but my brain wasn’t narrating every step.

People often report:

• Less “grab the furniture” when they first stand up.
• Easier toilet transfers – crude, but life‑changing.
• More confidence stepping off kerbs or buses.
• A small, tangible sense that ageing is not just passive decline.

It is not glamorous. There is no medal. But the dividend shows up every time you stand to answer the door.

Try it tonight

Pick a time you are naturally pottering – after the washing‑up, during the adverts, while the tea steeps.

1. Set up a safe chair against a wall.
2. Do a gentle warm‑up: march on the spot for 30 seconds, roll your shoulders, wiggle your ankles.
3. Try one round of sit‑to‑stands: as many as feel comfortably challenging in 30 seconds, even if that is only three.
4. Note the number and, more importantly, how steady you felt.

Tomorrow or the day after, do it again. Stack the tiny data points until you can see a line rather than a dot.

You do not have to become a gym person. You just have to keep the everyday move of standing up honest, practiced and yours.

FAQ:

• How often should I do the sit‑to‑stand test?
  Most people over 55 do well with a gentle version most days (5–10 stands) and a “proper” timed or counted test once a week. The aim is consistency, not exhaustion.
• What if I need to use my hands to push off?
  That is still useful information. Start where you are: allow your hands, do fewer repetitions, and gradually try to let your legs do a bit more of the work. Over time, many people can progress to lighter hand support or arms folded.
• My knees hurt when I stand up – should I skip this?
  Mild muscular effort is normal; sharp joint pain is not. Try a slightly higher chair, slower movements and fewer repetitions. If pain persists or worsens, speak to a GP or physiotherapist before continuing.
• Is this enough exercise on its own?
  Sit‑to‑stand covers leg strength and some balance, which are crucial for independence. For broader health, it helps to add regular walking and some upper‑body and balance work, but chair stands are a powerful foundation.
• What if my numbers suddenly drop?
  If you notice a clear, unexplained decline over a few weeks – especially with new breathlessness, dizziness or unsteadiness – contact your GP. A change in your sit‑to‑stand can be an early sign that something else needs checking.