Gout can be an excruciating experience.
Suffering from a flare-up of gout symptoms in your joints—especially the feet—can be enough to put them off doing any type of physical exercise.
But should you walk with gout? Can it help?
The short answer is yes. We’ll be looking at the reasons behind it in this article.
What is gout?
Gout is a type of inflammatory arthritis that’s caused by excess uric acid in the bloodstream. As your body responds to the excess uric acid, crystals will form around the joint, which can be extremely painful.
Gout can affect fingers, wrists, elbows, knees, and ankles. However, it affects one joint at a time and most commonly affects the joint of the big toe. In the foot, it can also affect the ankle and midfoot.
While gout is more likely to affect men, women who are postmenopausal may be more susceptible to a gout flare. Unfortunately, some people may experience gout without any warning, as it appears overnight.
Fortunately, gout is treatable with medication but there is no cure for it.
What causes gout and who is at risk?
Uric acid is a byproduct that’s created when the body breaks down chemicals known as purines. These are found in certain drinks and food. Uric acid dissolves in the blood and passes through your kidneys to exit the body as urine.
Sometimes the body either produces too much uric acid or the kidneys don’t eliminate the uric acid effectively and this leads to uric acid crystals—monosodium urate—to build up in the fluids, tissue, and joints of the body.
These sharp crystals accumulate in and around the joints, which is what causes gout. With that being said, some people who have high uric acid levels may never experience gout.
The following foods and drinks can lead to an increase of uric acid, slow the removal process of uric acid or trigger a gout flare:
- Venison such as deer
- Red meat—both beef and lamb
- Venison and meat gravies
- Seafood and shellfish like lobster, shrimp, anchovies, mussels, and sardines
- High-fat foods such as dairy products and bacon
- Processed foods
- Refined carbohydrates
- Organ meats like liver
- All types of alcohol like liquor, wine, and beer
- Sugary beverages and foods
You may experience a gout flare due to medication, as it can increase the uric acid levels in the body. Even small amounts of pain medication or Aspirin—acetylsalicylic acid—can trigger gout.
If your doctor has prescribed diuretics—chlorothiazide,hydrochlorothiazide, metolazone, furosemide, etc—or water pills to treat conditions like edema or high blood pressure, one of the side effects can be that there’s excess uric acid in the body.
Medication to treat rheumatoid arthritis—like cyclosporine—can trigger gout. Other medications like beta blockers, ACE inhibitors and ARBs—angiotensin II receptor blockers—may cause a gout flare.
With that being said, some people may be at a higher risk of getting gout if they’re overweight or obese, have diabetes or have congestive heart failure. If there’s a family history where members have had gout, then this can increase the risk of experiencing it.
Changes to the ABCG2 gene—ATP-binding cassette family—can lead to having hyperuricemia. This reduces the ability of the protein to release urate in the gut. But a genetic defect with the organic anion transporters—which transports purine derivatives—in the kidney can actually cause the reabsorption of uric acid from the kidney. This increases the levels of uric acid in the blood and will lead to gout.
Age can also be a factor that can trigger gout. Men are more likely to develop gout between the ages of 30 and 50 years. This is due to the fact that men have higher levels of uric acid levels compared to women.
Don’t leave gout untreated as it can lead to long term damage such as kidney problems, irreversible joint damage, and tophi.
Symptoms of gout in the affected joint include:
Gout flares—also known as gout attacks—happen suddenly. You may wake up in the middle of the night as the weight of a blanket or even a sock can be unbearable.
The symptoms can develop quickly from there and are often at their worst within 12 to 24 hours of when you first noticed the discomfort.
Some people may experience intense joint pain that can last for up to 12 hours and you’ll notice that the joint is inflamed and red. It will be tender to the touch—the area will be sensitive to anything that it comes into contact with—and the area around the joint will be warm with a limited range of motion.
The skin around the affected joint will look shiny and as the gout attack starts to settle—about 5 to 7 days later—you may notice that the skin is flaky or that it starts to peel off.
Aside from the long-term damage gout can cause if left untreated, you may find that the gout attacks become more frequent, may last longer and it could spread to other joints in the body.
Why is gout most common in the feet?
Every part of the human body has a different temperature, even though the overall normal body temperature is 98.6° Fahrenheit. The coldest parts of the human body are the feet and toes, as they’re the farthest from the heart.
Gout is most common in the feet, as uric acid will crystallize in cooler temperatures. The temperature of your feet can drop as low as 77° Fahrenheit. This may also be why gout attacks are more common in the colder season, as well as cooler climates.
Over 75% of people who experience gout will find that it develops in the base of the joint of the big toe—metatarsophalangeal joint. While gout may be common in the feet, it can also affect the hands—which are also colder—elbows, and knees.
Can exercise help?
Exercise is not only safe to do when you have gout, but it’s recommended.
It can help to improve gout-related pain and improve your range of motion. Exercising will also help to reduce your overall body weight.
This is important, as research has shown that fat—adipose tissue—not only carries more uric acid than muscle, but that it can produce and secrete uric acid through the enzyme Xanthine oxidase. This means that with obesity there’s an increase in uric acid.
Exercising will help reduce fat—which will decrease the level of uric acid—in the body, as well as reducing weight and pressure on the joints of the body. Coronary artery disease has also been linked to gout and exercise will develop your cardiovascular health, which will reduce high blood pressure.
While you shouldn’t exercise when you have a gout attack, you can start again slowly once the pain and inflammation have eased up. Pay attention to how your body feels during and after exercise, as you may have to adjust the physical activity.
It is always wise to see your doctor before you start any exercise program, especially if you have multiple health problems or if you’re unsure of your health status.
The CDC recommends that adults do at least 150 minutes of physical activity at a moderate intensity per week, which includes brisk walking (on a treadmill or outside).
For a well-rounded and balanced exercise routine, you want to include the following three components.
Aerobic exercise—also known as cardiovascular activity—should get your heart pumping, elevating your heart rate into your target range. This will improve your cardiovascular health, which can reduce the risk of Type 2 diabetes and heart disease, as well as reduce the risk of both lung and colon cancer.
You’ll also benefit from burning calories—which helps to lose weight—and you’ll find that your endurance is increased, you can control your appetite, you’ll have better sleep, reduced stress levels, and improved mood; all through doing cardio.
Look at adding aerobic exercise to your routine three to four times a week. You can alternate between swimming, brisk walking, or cycling on a stationary bike for 30 minutes. Just make sure to wear high-quality aerobic shoes.
Strength training—also known as resistance training—should be included at least twice a week into your exercise regime. You can use resistance bands, free weights, their own body weight, or even weight machines to build muscle.
As we get older we lose muscle mass. Resistance training helps you to not only build muscle but bone density as well. If you don’t build muscle then this will be replaced with fat, and this can increase your uric acid levels.
Increasing your muscle mass will help with balance and stability, which can reduce your risk of falling. An increase in bone density will reduce fractures and broken bones should you fall and it can reduce your risk of osteoporosis.
You’ll also find that your strength increases, which will help you to remain independent as you go about doing your daily activities.
We need to remain flexible to make our daily activities easier.
These include bending, picking something up, or reaching for an item on a shelf. Adding flexibility to your exercise routine will help you to maintain or increase your full range of movement.
When you improve or increase your flexibility and range of movement, you are reducing your risk of injury like muscle tears from tight muscles. End your workout by stretching slowly and smoothly for 15 minutes every day.
Not only will you be able to move easier, but if you suffer from aches and pains—like lower back pain—stretching can help alleviate the pain as you stretch the tight muscles out.
Easing back into walking and exercise after a gout flare
Once the gout attack and symptoms ease up then you can start to walk again.
But take it easy and pay attention to how your body feels. If you start to feel pain, stop immediately. You may want to use a walking stick or cane to support you if you are going to be walking outdoors, as this will help to reduce the pressure that’s placed on the joints.
Take a shorter walk or reduce the amount of time that you walk for, especially if you’re walking outdoors.
For a low-impact option, you could try walking on an elliptical machine or aqua-walking. The water will provide both resistance and buoyancy, which will reduce the impact on the joints and the warm water can help to alleviate the pain.
If there’s no pain while you’re walking, you can still reduce the distance or the amount of time that you walk for.
Gout can last for up to two weeks and you don’t want to push yourself too hard, as this could prolong the symptoms of gout, especially the inflammation in the joint.
Tips for exercising with gout
1. Choose the right footwear
With gout often affecting the big toe, ankle, and midfoot, it’s important to wear the right shoes.
Look for a shoe that has a wide, spacious toe box, as this will let your toes splay naturally without any pressure points and still have space to accommodate a swollen toe.
The upper of the shoe should be made from soft, stretchy material, as this will stretch with the foot and accommodate swelling without irritating the skin.
The shoe should have a rocker-sole design, guidance technology, or flex grooves that help to propel the foot forward while reducing the stress on the foot. There should be adequate cushioning to protect the affected area and to keep you comfortable while you walk.
Make sure that the shoe provides adequate arch support for your foot shape, as this will help to distribute your body weight evenly without creating pressure points that could aggravate gout.
2. Follow a comfortable walking pace
After your gout attack, start walking slowly, at a pace that you’re comfortable with and that creates the least amount of pressure on your affected foot.
As the symptoms continue to ease up, you can look at increasing your pace so that you can elevate your heart rate.
3. Include other low-impact aerobic exercises
Include low-impact, non-weight bearing aerobic exercises like riding a stationary bike or swimming to your exercise routine. These exercises will not place as much pressure on your joints—ankles, knees, and toes—as you get your heart rate up.
By including different aerobic exercises, you can also work on any muscle imbalances as both swimming and bike riding target both fast and slow twitching muscles.
4. Stretch your affected joint
Only stretch your affected joint when the gout attack has eased up and won’t cause you any pain. Stretching the affected joint will help it to regain flexibility, which will make it easy to move.
You can start by moving your affected joint forwards, backward, and then around. Make sure that you don’t extend beyond the point of pain. Do this five times and then gradually increase the range of movement of the affected toe, as well as the repetitions.
5. Build muscle with strength exercises
If you don’t have access to weights or weight machines, you can use resistance bands to help you build muscle.
To start, you can look at using resistance bands when you do your flexibility exercises. This will make your workout more challenging as you stretch against the force of the band.
When a flare occurs, you can reduce your gout symptoms by:
To help alleviate the pain and inflammation, use an over-the-counter, nonsteroidal anti-inflammatory medication like Advil, Aleve, Ibuprofen or Motrin IB.
If your pain isn’t too severe, you can ice the affected joint using either cold compresses or packs. This will reduce the swelling and alleviate the pain. Try to keep the affected foot elevated above your heart, as this will reduce swelling. This is easier when lying down.
Rest your affected foot as much as you can, as this will reduce the amount of pressure that’s placed on the joint. If you do have to move, try and use a walking stick to help you. This will distribute your weight without placing pressure on the affected joint.
Make sure that you stay hydrated and drink plenty of water, as this will help to keep your uric acid levels normal and prevent an increase in uric acid. Avoid foods and drinks that are high in purines that can increase your uric acid levels.