As humans we are designed to be stand; not just stand occasionally but spend most of our days standing. Over the last several years the media has been littered with articles discussing the negative effects of prolonged sitting and the benefits of standing. Standing desks and terminals now have a presence in the workplace, so why are we still asking our patients to sit. Ongoing studies have continued to investigate the cost of prolonged sitting of our patients and how the benefit of standing may reduce the cost of ongoing healthcare needs. Despite this ongoing research the basis of standing insurance coverage of standing devices continues to be a challenge. In this course we will review the benefits of standing both medical and functional, the ongoing cost of sitting, and how to decipher the current portfolio of standing devices and how to justify them.