Gesturing for prostration and bowing is obligatory for the sick person when he is unable to perform actual bowing and prostration.

If he can stand, he should gesture for bowing while standing and gesture for prostration while sitting; inability to fulfill one pillar does not cancel another pillar he is still capable of performing.

The hadith highlights the leniency of the Sacred Law and its freedom from undue hardship: whoever cannot prostrate should not burden himself with finding something to prostrate on. He worships Allah as best he can, for excess and over-scrupulousness have no place in the religion.

It recommends visiting the sick and directing them to what benefits them in their religious and worldly affairs, for “religion is sincere counsel.”

When gesturing, the prostration should be made lower than the bowing in order to distinguish each pillar, because in full health prostration is lower than bowing; each position is therefore granted the degree of humility appropriate to it.