Never Twist Like This Getting Out of the Car: The Knee-Friendly Way Physical Therapists Teach People Over 65

Sarah Jenkins

Getting out of the car can feel surprisingly awkward after 65, especially when the seat is low.

You reach toward the pavement, plant a foot, and turn toward the open door. It happens almost without thinking.

The gentler approach separates turning from standing, giving you time to arrange your body before you rise.

Here are 11 practical details to remember for your next supermarket trip or visit with the grandchildren.

Number 4 surprises most drivers: the important turn happens while you are still sitting, not halfway out of the car.

Before you begin, give yourself a clear space

Start with the car fully stopped, the parking brake set, and enough room beside you to open the door comfortably.

Look at the ground before moving. A puddle, loose gravel, or a high curb can change where your feet land.

Put your phone away and leave shopping bags inside until you are standing securely. Keep your hands available for support.

Ask whoever is with you to wait rather than hurry you along. Getting out does not need to be one continuous motion.

These are general pointers, not a replacement for instructions given after surgery or for your particular movement needs.

If your clinician has taught you a different transfer, follow that approach. Your car, joints, and balance deserve individual consideration.

1. Notice the twist-and-step move: one foot planted while your body turns

Picture arriving home with something waiting on the stove. You open the door and immediately reach one foot outside.

That shoe grips the pavement while your chest turns toward the driveway. Your other leg remains somewhere beneath the dashboard.

Now your body is turning above a planted foot. That is the movement to notice before it becomes automatic again.

Instead, stay seated while you turn toward the doorway. Save planting your feet and standing for the next part.

Think of it as two separate jobs: face the exit, then get up. You do not need to combine them.

There is no need to scold yourself for an old habit. Simply pause when you notice yourself starting that familiar twist.

2. Slide the seat back before you open the door to give your knees room

With the car safely parked, move the seat backward if its adjustment allows. Make sure nobody behind you gets squeezed.

Extra space between your knees and the dashboard gives you room to arrange your legs before turning toward the doorway.

Use the seat control while you are settled, rather than searching beneath yourself while already halfway out of the car.

Check that the seat has locked into position before shifting your weight. An unexpectedly moving seat is not useful support.

You may also need more door clearance than usual. A neighboring vehicle can make an otherwise familiar movement feel cramped.

Before driving again, restore your seat to a position that lets you operate every control properly and wear your seat belt correctly.

3. Getting in: sit down first, then bring your legs in

The return trip begins with the reverse idea. Rather than stepping into the footwell, turn so your bottom faces the seat.

Back toward it carefully until you can locate the seat behind you. Do not lower yourself toward a seat you cannot judge.

Use a suitable fixed support and lower yourself under control. Mind your head beneath the top of the doorway.

Once your bottom is securely supported, move farther onto the seat as needed. Then turn toward the dashboard with your legs.

This separates sitting from turning, rather than asking you to balance outside while threading a leg into a narrow space.

If you cannot clear the doorway comfortably, stop and reposition. There is no prize for completing the movement without a pause.

4. Turn your whole body as one unit, with your knees and hips together

Here is the surprising part: getting out starts with a seated turn. You face the doorway before asking your legs to support you.

Think of your chest, hips, and knees traveling in the same direction. Your shoulders should not race ahead while your pelvis stays behind.

Bring your legs toward the opening together as comfortably as you can. Avoid planting one foot outside and twisting your body around it.

“Together” means coordinated, not clamped tight. You do not need to squeeze your knees together, hold your breath, or force a sweeping movement.

Small, controlled adjustments are fine. Let your bottom reposition on the seat as your trunk and legs follow, without wrenching against a foot gripping the ground.

Finish sitting toward the open doorway before standing. If moving both legs this way is difficult, a physical therapist can adapt the sequence to your abilities.

5. Scoot toward the front edge of the seat before trying to stand

Once you face the doorway, check where your bottom sits. Deep, bucket-shaped seats can leave you farther back than you realize.

Trying to rise from that hollow may feel like getting out of your softest living-room chair while wearing a winter coat.

Shift toward the doorway-side edge in small movements, keeping enough of your bottom supported. Do not perch on an unstable sliver.

The aim is to find a supported position where your feet can reach the ground and your body can move forward.

Keep clothing clear of the seat controls and door latch. A long coat can bunch underneath you or catch unexpectedly.

If the seat is too high for your feet to reach securely, stop. That vehicle may require an individually taught approach.

You may also like: Why Grandma Kept a Slice of Bread in the Cookie Tin: 6 Old Kitchen Tricks for Keeping Things Soft That Still Work

6. Hold a suitable part of the door frame and seat, not the swinging door

An open door looks substantial, but it moves. Wind, a slope, or your own pressure can change its position unexpectedly.

Look instead for a secure hand position on the fixed door frame and a firm, stationary part of the seat.

Keep your fingers away from hinges, latches, and anywhere the door could close on them. Check your grip before putting weight through it.

Not every piece of trim is a handhold. A loose covering or an awkward overhead reach may not provide useful support.

Ask a companion to keep the door from swinging, rather than assuming the door itself will hold you steady.

If you need considerable arm support, have a therapist check your setup. Pulling hard on whatever is nearest is not a plan.

7. Set both feet flat on the ground, about hip-width apart, before you rise

Once you face outward, place both feet on firm ground. Aim for a comfortable stance about the width of your hips.

Look down briefly to check your shoes. One foot may have landed on a curb while the other remains on the road.

Your feet need a dependable surface, not matching appearances. If the ground is uneven, reconsider the parking position before proceeding.

Avoid starting upward with one foot still tucked inside the car. Finish arranging your feet while the seat supports you.

Choose footwear that stays securely on your feet. A loose heel or sliding slipper adds something else to manage at the doorway.

If you cannot establish a steady stance, ask for help. Do not turn a difficult parking spot into a balancing challenge.

8. Lean “nose over toes” and stand with your legs, using your arms for support

“Nose over toes” is a simple reminder to bring your upper body forward before rising. It is not an exact measurement.

From your supported sitting position, lean forward comfortably so your weight moves toward your feet rather than staying behind them.

Then press through your feet and straighten up in a controlled movement. Let your hands assist from suitable, fixed supports.

You do not have to make this an arms-free exercise. The point is to avoid hauling yourself upward from something unreliable.

Check your head clearance as you rise. Low door openings can be easy to forget when you are concentrating on your feet.

If standing requires repeated rocking, a powerful yank, or another person pulling your arms, stop and seek an individually taught method.

9. A smooth plastic bag on a cloth seat can make turning easier

Cloth upholstery can catch against clothing when you try to turn. That friction is why a simple plastic bag sometimes gets suggested.

A smooth bag beneath your bottom may allow easier seated turning. But it also creates a surface that can slide unexpectedly.

Ask a physical therapist whether this makes sense for you, particularly if controlling your seated position is already difficult.

It is not something to try hurriedly in a crowded parking lot. You need to understand placement, control, and removal first.

Remove the bag once positioned for travel, before the car moves. Do not leave loose plastic near pedals or foot controls.

If it makes you feel slippery or insecure, do not use it. A household shortcut should never become another thing to struggle against.

10. Pause once you are standing before taking your first step

Reaching an upright position is not the signal to hurry away. Give yourself a moment to find your balance outside the car.

Keep appropriate support available while you check how you feel. Look toward your route before reaching for shopping or turning around.

If you use a cane or walker, have it positioned as your therapist has taught you, rather than beyond comfortable reach.

Tell your companion to leave the bags alone for a moment. You can deal with the groceries after you are settled.

If you feel lightheaded, do not walk it off. Return to a safe supported position if possible and ask for help.

Once you feel steady, begin walking without pivoting sharply on a planted foot. Use small steps to change your direction.

11. Ask a physical therapist for a car-transfer lesson when the routine feels difficult

You do not have to wait until getting out becomes impossible. Repeated struggling is enough reason to ask for practical instruction.

Mention exactly which part is difficult: turning on the seat, clearing the doorway, reaching the ground, or rising to stand.

Describe your actual vehicle, too. A low sedan, tall pickup, and deep passenger seat present very different arrangements for your body.

Ask whether the therapist can observe a transfer in your car. Seeing the setup can reveal details a conversation misses.

Bring your usual walking aid, and include anyone who regularly helps you. They need to learn where to stand and how to assist.

A useful lesson ends with a method you understand and can repeat, including what to do when the parking space is awkward.

Make the sequence familiar before your next busy outing

Choose an unhurried occasion to review the sequence, with someone nearby if needed. Avoid practicing alone when you already feel unsteady.

Keep the reminder simple: make room, turn while seated, arrange your feet, rise, and pause. You need not memorize every paragraph.

Say the stages quietly if that helps. Familiar words can keep you from rushing straight from opening the door to standing.

Ask family members for patience rather than a tug on your arm. Explain that you are setting yourself up before moving.

Keep bags, umbrellas, and the grandchildren’s belongings out of the doorway until you have finished. One task at a time is enough.

Some days or vehicles may require more assistance. Adjusting the plan is sensible, not a failure to remember what you learned.

When to talk to your doctor

Talk with your doctor about recurring knee pain, swelling, catching, or giving way, especially when these interfere with ordinary outings.

Repeated lightheadedness when standing also deserves attention. Describe when it happens and whether it occurs outside the car as well.

Seek prompt medical assessment for sudden severe pain, a hot swollen joint, or an inability to bear weight after an injury.

If you faint or develop chest pain or severe breathlessness, seek emergency help. Do not attempt to drive yourself for care.

After surgery, follow your clinical team’s movement restrictions. Ask them to explain how those instructions apply to your particular car.

A transfer lesson can address how you move, but new or worsening symptoms need their own assessment rather than another household workaround.

Take the calmer approach into your next outing

Your next trip does not need a dramatic new routine. Give yourself room, finish turning before standing, and leave the bags until afterward.

Back home, enjoy another familiar idea: Why Grandma Kept a Slice of Bread in the Cookie Tin: 6 Old Kitchen Tricks for Keeping Things Soft That Still Work.

Or head into the kitchen with It’s a Big Mistake to Boil Green Beans in Plain Water: The 2-Step Trick Older Cooks Used to Keep Them Bright and Crisp.

Small everyday habits can make a difference after 60 – take a look at kitchen-table slouching habits doctors say are worth avoiding and what sitting on your wallet may do to your back.