Gout is a painful inflammatory condition that is associated with overindulgence of foods like red meat, shellfish, and alcohol. In medieval times, gout was associated with nobility because of the cost of such a diet. This gave it the nickname “the disease of kings (1).”

Today, gout is an issue that affects many people in developed countries. Recent studies point to an increase in the incidence of gout worldwide (2).

The diet of kings is now readily available to most people in developed countries. Modern conveniences have made most humans less physically active.

Both of these factors contribute to the obesity epidemic which is associated with an increased incidence of gout. Consequently, there is a correlation between gout and issues such as heart disease, kidney disease, and atrial fibrillation (1).

Gout is often recommended for exercise. Knowing what gout is, when to exercise and what types of exercise to perform are important factors.

Guidelines for exercising with gout are offered in this article.

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Gout is a type of arthritis caused by excessive levels of uric acid in the body.

Uric acid is a normally occurring substance in the body that is excreted by the kidneys in urine. But if there is too much of it, uric acid crystals can collect in the joints, causing intense pain, redness, and swelling in the joints, tendons, and surrounding tissues (usually in the lower extremities) (2).

If untreated, gout can cause irreversible joint damage, chronic pain issues, as well as joint deformity. In addition, people are less inclined to move when in pain, and this leads to increased issues with lack of mobility, muscles weakness, and stiffness of the joints (2).

Gout is associated with obesity and weight gain, especially when levels of visceral fat are high (3). This risk increases with age. In addition, gout risk increases with eating purine-rich foods such as meat and seafood (4, 5).

Heavy alcohol intake, as well as consuming high levels of sugary drinks, increase the risk of a gout flare up (4).

Since gout is associated with obesity and weight gain, then weight loss is one good way to manage and control gout. Some methods are better than others, however. For instance, a keto diet is not recommended for those with gout, as ketosis can elevate uric acid levels in the body (4).

Recent research suggests physical activity of low to moderate intensity can have a positive effect on serum acid levels, whereas strenuous activity may exacerbate them (4). Therefore, moderate exercise and dietary modifications can help to manage uric acid levels and prevent flare ups from gout (6, 7).

Summary

Gout is caused by high levels of uric acid in the body. crystals are deposited in the joints, tendons, and surrounding tissues. It is associated with being overweight.

It is best to avoid exercising during a gout attack. If the gout pain is in one of the joints in your lower body, you should rest, apply ice, and elevate the legs.

The inflammatory process is at its worst during an acute episode of gout. Increased movement at joints that are painful can cause inflammation. Weight-bearing activities such as standing and walking can be painful during a flare up.

Therefore, immediate treatment for gout flare ups require managing the inflammation and lowering uric acid levels. Your doctor may prescribe anti-inflammatory medications (NSAID’s) and uric acid-reducing drugs such as Allopurinol to take after the gout attack has resolved (8).

Limiting strenuous exercise at the painful joints can be helpful in reducing inflammation. However, non weight-bearing, low-intensity exercise that doesn’t increase pain may be possible, and may help reduce inflammation (9).

In general, people with gout who maintain a regular routine of low- to moderate-intensity exercise have a better prognosis than those who are sedentary or those who exercise at high intensities (9). This is true before, during, and after a flare up.

Summary

Listen to your body and work with your doctor to manage gout flares. Rest and do not exercise during a gout attack. In between gout flares up, low to moderate intensity exercise may help reduce inflammation.

Exercise has a protective effect when it comes to living with gout. Not only does it decrease uric acid levels in the blood, but some research has found that consistent exercise can extend lifespan by 4–6 years in people who have elevated uric acid levels (10).

Since weight gain and obesity increase uric acid levels, then reversing these issues will also decrease the risk of an acute gout flare up (4). What’s more, exercise has been shown to reduce inflammation (11).

Exercise also decreases insulin resistance, which also increases the risk of a gout flare up. This in conjunction with a low-calorie eating plan have been shown to be the most effective non-drug related interventions to decrease gout symptoms (4).

Strength and flexibility can be restored for people with gout after an acute flare up, if they exercise.

Pain decreases your activity level, and when the body is not moving much, your joints can stiffen and become less flexible. A recent clinical review showed exercise modalities can be beneficial for restoring your ability after the immobility of a gout flare up (12).

Additionally, another study found that people with gout who exercised regularly were less likely to develop tophi, or the bulbous-looking joints that result from uric acid crystal buildup (13).

Summary

People with gout may benefit from exercise. It can help with a number of things, including reducing uric acid levels, inflammation, and even extending lifespan.

Taking your time is the main thing to remember when you get back into exercise after a gout flare up. If you were running before the flare up, you should start with low to mid intensity exercises such as walking or cycling.

It is a good idea to limit exercises that place a lot of impact on the joint such as skipping rope and plyometric jumps.

It is better to avoid high intensity exercises as this can increase uric acid levels in the body that can cause another flare up of gout. High intensity exercise includes activities that put a person at 76–96% of their maximum heart rate, such as sprinting workouts, high intensity interval training (HIIT), and higher intensity cycling (2, 4, 14).

Summary

After a gout flare up, start exercising at a lower intensity. The exercises that you choose should not have a big impact on the joint. Increasing intensity while avoiding high intensity exercise is what you should do.

Exercises that work the body’s cardiovascular system are best for managing uric acid levels and help to manage body weight (4). Examples of these types of exercises include walking, cycling, and swimming.

If someone has had multiple flare ups from gout, they may experience permanent arthritic changes in the joint. This can limit the range of motion.

Lower impact exercises such as swimming and water aerobics that involve buoyancy can help the joints.

In addition, general flexibility exercises can be helpful as well. Exercises such as yoga can be beneficial for maintaining mobility. In fact, one research study showed that yoga can help improve pain levels with gout (12).

Strength training has been shown to be helpful in managing other conditions such as osteoarthritis and rheumatoid arthritis, but little research has been done regarding strength training and gout (15).

Nevertheless, lower extremity strength often decreases in those managing gout. Therefore, strength training especially for the lower extremities can be helpful to add to your exercise plan (16).

Summary

Cardiovascular exercises are best for uric acid levels. You may need to do lower impact exercises to manage joint pain. Flexibility exercises can help restore motion. Maintaining strength in the lower limbs is important.

  • Start slowly with an exercise program, but be consistent. The current exercise guidelines are to perform at least 150 minutes of moderate intensity exercise per week. This is a good place to start for maintaining weight and cardiovascular health (17).
  • During and immediately after a gout flare up, avoid high intensity exercise. This can increase the levels of uric acid.
  • Remember to stay hydrated. Dehydration has been associated with increases in uric acid levels. This means drinking water and avoiding sugary drinks high in fructose, which is also linked to higher uric acid levels (4, 18)
  • If you are having difficulty with gout or exercising, you should consult your physician. He may recommend physical therapy.
  • When focusing on weight loss, it is best to use exercise in conjunction with diet to lose weight gradually. Abrupt weight loss can be associated with increased uric acid levels (4).

Summary

Start slowly with exercise. High intensity exercise is not advisable. Lose weight gradually by drinking water and eating less. If you are having difficulty controlling gout, you should consult your physician.

“Moderate intensity exercise is important for gout management. It can help to keep body weight in check. It is important to take a break after a flare up. Choose exercises that don’t make you feel worse, but allow you to move.”

It is possible to improve your symptoms with gout, increase your lifespan, and decrease your risk of flare ups by exercising a little bit every day.