“In dwelling, live close to the ground” – Ancient Chinese philosopher Lao-tzu

For most of human history our ancestors spent their days and nights living close to the ground. They deep squatted to gather, prepare, and eat food, to toilet, and to rest, and at night they slept on the ground. Today, in many parts of the world such as in India and other countries in Asia, people make it a daily ritual to squat down to the floor with ease to pray, eat, socialize, and sleep. This is evidence that our bodies are well adapted to these positions and have been for a very long time. These people experience healthier joints, less back pain, and greater ease of movement and walking, which also makes them less susceptible to falling.

Americans share the same physiology as floor-living cultures, but with our sedentary habits we have lost much of our mobility to deep squat or easily get down to the ground, simply because we fail to practice doing it. For example, Muslims have a daily prayer practice called Salah that requires a “dynamic flow of squatting, kneeling, and bending” while on the floor. This religious practice is done at certain times during the day and throughout a person’s lifetime, and it generally leads to better joint health as they age. Yoga is another ancient spiritual practice done mostly on the ground that requires a person to hold a variety of poses that can improve flexibility and muscle strength. As the muscles around your joints are strengthened, there is less stress and strain on those joints.

Each transition of squatting down to the ground and back up to standing loads your hip, knee, and ankle joints. These joints contain synovial fluid which is squeezed out when you flex and compress your joints to full range of motion (ROM). For example, at the end range of a deep squat, “the knee flexes up to 150° and the joint forces are as high as 4 times the body weight”! Since synovial fluid is essential for cartilage health, the deep squat might be the most effective method of loading your joints. If we never flex our hips and knees past 90 degrees while seated, our joints start to degenerate. Consequently, we have higher incidence of knee and hip osteoarthritis and joint replacements than cultures or people who practice sitting or sleeping on the floor. As the saying goes, use it or lose it!

In Okinawa, Japan where one of the world’s longest-living populations live, furniture is kept to a minimum in their homes so it’s customary to sit and sleep on the floor. Seiza is a Japanese traditional floor sitting style where a person’s knees are folded fully flexed beneath them. Transitioning from sitting on the floor to standing, multiple times per day, strengthens the core muscles and works the balance. “Research has demonstrated that fall risk in the elderly that sit or sleep on the ground is almost 20% lower than their western (chair sitting and raised bed sleeping) cohorts.” One of the reasons for this difference is the practice and development of strength and mobility from getting down and up off the ground. Studies also show that the “ability to sit and rise from the floor without support” correlates with a longer life expectancy.

Developmental movements that are paramount to getting you upright and walking start in infancy and on the ground: rolling, crawling, kneeling and deep squatting, which eventually lead to standing, walking, stepping and running. If those ground movements are vital in getting you upright and walking – the most essential of all human movements – then when is it okay to lose the ability to get down and up off the ground as adults? Based on the research and health benefits of floor-living, compared to the deleterious effects on our bodies from a sedentary lifestyle, I hope it’s apparent that it’s not okay to lose your ability to get down and up off the ground.