The Importance of Sitting Out of Bed: Rebuilding Strength and Confidence After a Hospital Stay

Please note: Not all exercises are suitable for everyone. Always follow the advice of your doctor or healthcare professional, particularly following surgery or injury, as some procedures involve specific movement restrictions. Ideally, seek guidance from a physiotherapist before starting, to ensure the exercises are safe and appropriate for you. This blog is intended for general advice, not individual recommendations.

Coming home from hospital can be a relief, but for many people the recovery process is only just beginning. An illness, operation, fall or hospital admission can leave you feeling surprisingly weak, tired and unsteady. Even if you were reasonably independent before going into hospital, you may find that everyday activities such as getting dressed, walking to the bathroom or preparing a meal now take considerably more effort.

It is not unusual for people to spend much of their recovery lying in bed or sitting in the same position for long periods. This is understandable, particularly if you feel nervous about falling, are worried about pain or simply don't have the energy to do very much. However, prolonged inactivity can make it harder to regain your previous strength and independence.

One of the most useful first steps is often a simple one: getting out of bed and spending some time sitting in a comfortable chair each day.

This may not sound like much, particularly if you are used to being active, but for someone who has become very deconditioned it can be an important part of rehabilitation. You do not need to start with long walks or demanding exercises. Sitting out, changing position regularly and introducing gentle seated movements can help you begin to rebuild your tolerance for activity.

What is deconditioning?

Deconditioning describes the loss of physical strength, fitness and functional ability that can happen when we are inactive for a prolonged period. It can affect people of all ages, although older adults and people who are already frail may be particularly vulnerable.

When we spend a lot of time in bed, our muscles are not being used in the same way as they would be when we are sitting, standing or walking. Muscle strength and endurance can decline, joints can become stiff, and even relatively simple movements can begin to feel difficult.

The effects are not limited to the muscles. Prolonged inactivity can also affect breathing, circulation, digestion, balance, confidence and our ability to manage everyday tasks. This can create a cycle in which we become less active because we feel weak, but then become even weaker because we are not moving enough.

A hospital admission can be the starting point for this cycle. Someone who was previously walking independently may return home needing a walking frame, help with transfers or assistance with personal care. The important thing to understand is that recovery is possible, but it often requires a gradual and consistent approach.

Why is sitting out of bed so important?

Getting out of bed changes the demands placed on the body. Instead of remaining in a lying position, your muscles have to work to maintain an upright posture, your trunk becomes more active and your body has to adapt to being upright.

Sitting in a suitable chair is not a replacement for standing and walking, but it can be a valuable stepping stone towards these activities. It also provides several benefits beyond simply getting you out of bed.

1. Helping your breathing and chest

When we lie in bed for long periods, our breathing can become shallower and we may not expand our lungs as effectively as when we are upright. Sitting out allows the chest and rib cage to move more freely and can make it easier to take deeper breaths.

Being upright can also help people manage coughing and clearing secretions from their chest. This is particularly relevant following an illness or respiratory infection, when someone may already have reduced exercise tolerance or feel breathless.

Gentle breathing exercises can be incorporated into the day to encourage controlled breathing and awareness of chest movement. If you have a respiratory condition or have been given specific breathing exercises by your healthcare team, follow their advice.

2. Maintaining core strength and posture

Sitting upright requires the muscles around your abdomen, back and pelvis to work together to support your trunk. These muscles form part of your core and help maintain balance and control when you move.

If you spend most of the day lying down, you have fewer opportunities to practise maintaining an upright position. Over time, this can contribute to poor sitting posture, reduced trunk control and difficulty with everyday activities such as reaching forwards, turning or getting up from a chair.

Sitting out regularly gives you the opportunity to practise these movements in a supported position. Even sitting upright for a short period, with your feet supported and your back well positioned, can be a useful starting point.

3. Supporting digestion and bowel function

Being inactive can contribute to constipation and sluggish bowel function. Movement helps stimulate normal bowel activity, while spending prolonged periods lying down can make it harder to maintain a regular routine.

Sitting upright for meals is also important. It helps you maintain a better eating position, can improve comfort and may reduce problems associated with eating while lying down. For people who have swallowing difficulties, it is particularly important to follow the positioning and swallowing advice provided by their healthcare team.

Getting dressed, sitting out for meals and incorporating small amounts of movement throughout the day can help re-establish a more normal daily routine.

4. Encouraging circulation and movement

When we sit or lie in one position for a long time, the muscles in our legs are relatively inactive. Moving the ankles, knees and hips helps activate the muscles and encourages the normal movement of blood through the lower limbs.

Sitting out provides an opportunity to move your legs more freely and practise simple exercises such as ankle pumps and seated marching.

It is important to remember that sitting still for prolonged periods is not the goal. Regularly changing position, moving your legs and getting up to stand or walk when safe and appropriate are all important parts of recovery. Your healthcare team may also recommend specific measures to reduce your risk of blood clots.

5. Helping maintain blood pressure tolerance

Our bodies have to adapt when we move from lying down to sitting and then standing. After a prolonged period of bed rest, some people may find this transition more difficult and experience dizziness or light-headedness when they first get up.

This can be related to postural hypotension, where blood pressure drops when changing position. Sitting out regularly, when medically appropriate, can provide a gradual opportunity to become accustomed to being upright again.

It is important to take your time when moving from lying to sitting and from sitting to standing. If you feel dizzy, faint or unwell, stop and seek assistance. Do not try to push through these symptoms.

6. Reducing the effects of prolonged pressure

Spending most of the day in bed means that pressure is repeatedly placed on the same areas of the body, particularly around the heels, hips, bottom and lower back. This can increase the risk of pressure damage, especially in people who have fragile skin, poor circulation or reduced sensation.

Changing position and getting out of bed can help vary the areas exposed to pressure. However, sitting in a chair for long periods can also create pressure, particularly around the bottom and heels. It is therefore important to reposition regularly and use any pressure-relieving equipment recommended by your healthcare team.

7. Improving confidence, mood and independence

There is also a psychological benefit to getting out of bed. Spending the day in a bedroom can make it feel as though you are still unwell, and it can become easy to lose track of normal daily routines.

Getting dressed, moving into a chair, sitting in the living room and having a meal at the table can help re-establish a sense of normality. It provides opportunities to interact with family, take part in conversations and feel more involved in everyday life.

For someone who has experienced a fall, getting out of bed can also be an important first step towards rebuilding confidence. You may feel nervous about standing or walking, but beginning with something manageable can help you regain trust in your body.

Start with sitting out — even if it is only for a short time

If you have been spending most of the day in bed, do not feel that you need to sit out for several hours straight away. Start with a manageable period and gradually increase it as your strength and tolerance improve.

Choose a suitable chair that provides good support. Ideally, it should be stable, have armrests and be at a height that makes getting in and out easier. Your feet should be supported, rather than dangling, and you should be able to sit comfortably without sliding forwards.

You might initially aim to sit out for 10–15 minutes, perhaps around breakfast or lunchtime. If this is comfortable, you can gradually increase the time or introduce another period of sitting out later in the day.

The important thing is to build a routine. Sitting out for meals, getting dressed and spending some time in another room are all useful ways of breaking up the day.

If you are unable to transfer safely without help, make sure someone is available to assist you. Your physiotherapist or healthcare team can advise on the safest way to get out of bed and the most appropriate chair or equipment.

Gentle seated exercises to help rebuild strength and mobility

Once you are comfortable sitting out of bed, gentle seated exercises can be introduced to encourage movement and begin rebuilding strength.

The aim is not to exercise to exhaustion. For someone who is very deconditioned, even a small number of repetitions can be worthwhile. You may need to start with just two or three exercises and gradually build up as your tolerance improves.

Try to sit towards the back of a sturdy chair, with your back supported and both feet comfortably on the floor. Take your time and rest between exercises if needed.

Seated marching

Sit upright with your back supported and both feet flat on the floor. Slowly lift one knee, lower it and repeat with the other leg. Continue alternating between legs in a slow, controlled marching movement, keeping your body upright throughout.

This encourages movement through the hips and knees and helps activate the muscles in your legs. If lifting your knees is difficult, simply lift each foot a small distance from the floor.

Repeat 10–15 times on each leg.

Seated hip abduction and adduction

Sit tall with both feet flat on the floor. Lift one foot slightly and move it out to the side, then bring it back to the starting position. Repeat with the other leg.

This encourages movement around the hips and helps activate the muscles that support the pelvis and legs. Keep the movement controlled and only move as far as is comfortable.

Repeat 5–10 times.

Seated knee straightening

Sit tall with your back well supported and your whole leg supported by the chair. Slowly straighten one knee and pull your toes towards you. Hold for approximately five seconds, then lower your leg slowly. Repeat on the other side.

This exercise helps maintain movement and strength in the thighs and knees, which are important for standing up and walking.

Repeat 10 times.

Seated ankle pumps

With your feet supported, move your ankles up and down. Pull your toes towards you, then point them gently away. Continue with a steady, comfortable rhythm.

Ankle pumps encourage regular movement of the lower legs and help maintain ankle mobility. They are particularly useful for people who spend long periods sitting.

Repeat 10 times.

Buttock clenches

Sit upright with your feet flat on the floor. Gently squeeze your buttock muscles together, hold for three to five seconds and then relax.

This is a simple way to activate the muscles around the hips without needing to stand or lift your legs.

Repeat 5 times.

Seated arm raises

Sit upright in a chair with your back supported and feet flat on the floor. Slowly raise both arms forwards towards shoulder height, keeping your shoulders relaxed. Lower your arms back down with control.

This encourages upper-body movement and helps maintain shoulder mobility. Only lift your arms as

high as is comfortable.

Repeat 5–10 times.

Seated reaching

Sit upright in a sturdy chair with your back supported and both feet flat on the floor. Reach forwards with one arm towards an object or target placed in front of you, allowing your body to lean forwards slightly. Return to the starting position and repeat. You can also reach in different

directions as comfortable.

This exercise encourages controlled movement through the trunk and helps practise the reaching movements used in everyday activities. Keep both feet on the floor and avoid reaching too far or losing your balance.

Repeat 10 times with each arm.

Seated trunk rotation

Sit upright in a chair with your feet flat on the floor and your arms folded across your chest. Slowly turn your shoulders, head and eyes to one side as far as is comfortable, keeping your hips facing forwards. Hold for three to five seconds, then return to the centre and repeat to the opposite side.

This encourages gentle movement through the trunk and helps maintain the ability to turn and look around.

Repeat 5 times on each side.

Deep breathing

Sit comfortably with your back supported and place your hands on your tummy. Breathe in slowly through your nose, feeling your tummy gently rise under your hands. Breathe out slowly through your mouth and feel your tummy relax back down.

Try to keep your shoulders relaxed and let your tummy do most of the movement. This provides an opportunity to practise slow, controlled breathing while resting between the other exercises.

Repeat 5–10 breaths.

Important safety information

Not all exercises are suitable for everyone. Your individual abilities, medical conditions and stage of recovery will influence which exercises are appropriate for you. Ideally, a physiotherapist should assess you and guide you through a suitable exercise programme.

Always follow the advice and precautions provided by your doctor, surgeon or other healthcare professional. Some orthopaedic procedures, including joint replacements and fracture repairs, may involve specific restrictions on joint movement, weight-bearing or exercise. Check with your healthcare team before starting any exercises if you have recently undergone surgery or sustained an injury.

Start gently, work within your comfort level and do not push through significant pain, dizziness or unusual breathlessness. If you are unsure whether an exercise is safe for you, seek professional advice before continuing.

Gradually progressing towards standing and walking

Seated exercises are an excellent starting point, but the longer-term aim will often be to regain the ability to stand, transfer and walk as independently and safely as possible.

When you are ready, and provided your healthcare team has confirmed that it is safe, you can begin to introduce some supported standing activities.

Sit to stand

Sit towards the front of a sturdy chair with your feet hip-width apart and slightly behind your knees. Position your walking aid in front of you if needed, ensuring it is stable and within reach. Lean forwards so your nose comes over your toes, then push through your legs and use the chair arms if required to help you stand. Once steady, place your hands on your walking aid. Reach back for

the chair and slowly lower yourself down with control.

This is an important functional exercise because it practises one of the movements we use repeatedly throughout the day.

Repeat 3–5 times, if safe and appropriate.

Supported standing and marching

Once you are confident standing, you may be able to practise standing at a stable kitchen worktop or using your usual walking aid, with a sturdy chair positioned behind you for safety.

Holding the support, slowly lift one knee and then the other, placing each foot fully back on the floor before changing legs.

Repeat up to 15–20 times, resting whenever necessary.

Standing balance

Standing with your feet hip-width apart while holding a stable worktop can be a useful starting point for balance practice. As your confidence improves, you may progress to bringing your feet closer together, but only with appropriate support and supervision if needed.

Balance exercises should be individually assessed, particularly if you have recently fallen or feel unsteady.

Walking practice

Short periods of walking around your home can help rebuild stamina and confidence. Use your usual walking aid if required and have someone supervise you if this has been recommended.

Start with a short distance, rest when needed and gradually increase the distance over time.

The aim is to make progress without becoming exhausted or putting yourself at unnecessary risk.

How often should you exercise?

A little movement throughout the day is often more manageable than trying to complete one long exercise session.

You could begin with a short seated exercise routine once or twice a day, gradually increasing towards two or three sessions as tolerated. You may find it useful to complete some exercises while sitting out for breakfast or lunch, rather than treating exercise as a separate activity.

Listen to your body and allow time to rest. It is normal to feel that your muscles are working, particularly if you have not exercised for some time, but you should not be pushing yourself to exhaustion.

Stop exercising and seek medical advice if you experience chest pain, dizziness or severe shortness of breath. If an exercise causes pain, stop, check your position and try again only if it feels appropriate. If the pain persists, contact your physiotherapist.

If you have had a recent fracture, operation or other injury, follow any movement restrictions or precautions given by your hospital team. Not every exercise or standing activity will be suitable for everyone.

Small steps can make a big difference

Recovering after a hospital admission, fall or prolonged period of illness can take time. It is easy to become frustrated when activities that were once straightforward now feel difficult. However, progress does not always mean walking further or doing more repetitions. Sometimes it starts with getting dressed, sitting out for a meal or completing a few gentle exercises in a chair.

The most important thing is to avoid spending the entire day in bed if you are medically able to get up. Changing position, sitting upright, moving your arms and legs and gradually increasing activity all help provide opportunities for your body to regain strength and function.

You do not have to do everything at once. Start with what you can manage today and build from there.

How Physio at Home can help

At Physio at Home, we understand that returning home after a hospital stay can be challenging, particularly if you have lost strength, confidence or independence. We provide individualised physiotherapy and rehabilitation in your own home, helping you work towards realistic goals at a pace that is right for you.

For someone who is very deconditioned, rehabilitation may initially involve getting comfortable sitting out of bed, improving sitting balance, introducing gentle seated exercises and practising transfers. As strength and confidence improve, treatment can progress towards standing, balance exercises and walking practice.

We work with people following falls, illness, hospital admissions and periods of reduced mobility, helping them rebuild confidence and make everyday activities more manageable.

If you or a family member has recently come home from hospital and is struggling with mobility, strength or confidence, contact Physio at Home to discuss how we can help.

Physio at Home provides home-based physiotherapy across Mid Cornwall, including Falmouth, Penryn and Truro. More information https://www.physioathome.uk/