This sign can mean "to be so sick as to be laid up in bed." I'm using a
pained expression to it is assumed that I'm injured or sick. If I used a
"tired" expression, this sign could mean I'm so exhausted or tired as to be
physically wasted and had to be in bed to recuperate.
LAID-OUT sick. (Really ill / bedridden / wasted)


Also see:
SICK