Best & Worst Exercises For Gout

Physical activity can help ease gout symptoms…if you choose the right type of exercise. Discover which to embrace and which to avoid. 

Living with gout can be quite challenging, especially during gout attacks. This is why it’s important for individuals suffering from this form of inflammatory arthritis to do what they can to ease symptoms. That’s where specific exercise routines may help.

In this guide, we’ll cover the best and worst exercises for gout and answer frequently asked questions. 

What is gout?  

Gout is a type of arthritis. It occurs when there is a buildup of high serum urate levels in the body, which results in the formation of uric acid crystals in joints (big toes or lower limbs). The body can also make too much urate or remove too little, which would result in inflammation and arthritis of the joint. Gout flare-ups (which manifest as joint pain and swelling) occur in periods and can last for a week or two. 

Benefits of exercise for gout patients 

Reduces inflammation 

One common gout symptom is inflammation in the affected joint. Regular exercise can generally help in the reduction of inflammation, although the specific intensity of the exercise determines how much inflammation is eased. One study found that performing low to moderate-intensity exercise significantly reduces inflammation in comparison to high-intensity exercise…more on this below. 

Reduces immune cell infiltration 

Another benefit of exercise is that it affects the ability of immune cells like neutrophils and macrophages to enter the joint area during inflammation. When patients perform low-intensity exercise, they tend to experience less immune cell infiltration. This is beneficial in managing the inflammation caused by monosodium urate (MSU) crystals, which are needle-shaped crystals composed of uric acid.

Reduces IL-1β levels in joints

IL-1β stands for Interleukin-1 beta and is an inflammatory cytokine, a small protein involved in cell signaling. It is one of the most significant actors in gout-related inflammation. Performing low to moderate-intensity exercises can help reduce IL-1β levels in the joint area during gout flare-ups. Exercise can also influence the production of IL-1β in a way that determines the body’s response to inflammation caused by gout. 

Reduces neutrophil activity and TLR2 expression

TLR2 is a type of protein receptor. It is usually expressed on immune cells and is involved in the development of gout. Low to moderate-intensity exercise helps decrease the level of TLR2 expression on certain immune cells called neutrophils. 

Exercise may also result in fewer neutrophils gathering at the site of inflammation, which is induced by MSU crystals. This is typically due to a molecule called CXCL1, which attracts neutrophils to inflamed areas and is reduced in the blood of patients who exercise at low to moderate intensities. 

Helps with weight loss 

Weight gain and obesity increase the serum uric acid levels in the body and are typical risk factors for an increase in the incidence of gout. So when you exercise, which helps to manage body weight, there may also be a decrease in the risk of gout flare-ups.

Decreases insulin resistance

Exercise also helps with the reduction of insulin resistance, thus reducing the risk of gout flare-ups — although it should be noted that this benefit was experienced when exercise was combined with a low-calorie diet.

Can exercise cause a gout flare-up?

Patients with high physical activity levels may experience fewer gout flare ups and less inflammation/pain compared to those who are not active…but it’s important to focus on low to moderate-intensity exercise.  

Performing high-intensity exercises can actually increase the levels of uric acid in the body, resulting in gout flare-ups.  

What constitutes high intensity? Activities that cause people to reach 76 - 96% of their maximum heart rate. Examples include burpees, sprinting workouts, skipping, higher intensity cycling, and high intensity interval training (HIIT). 

6 types of exercises recommended for people with gout 

1. Walking
   Brisk walking is a low-impact exercise that can easily be incorporated into a daily routine. It’s easy to do, can be done anywhere, and generally requires no financial investment. You can choose to begin with shorter distances and gradually increase your distance over time to boost mobility and fitness. 
   
   
2. Swimming and water sports
   Water aerobics (e.g., swimming, water walking) are great for people living with gout since the buoyancy of the water reduces the impact on joints.
   
   
3. Cycling
   Cycling is an aerobic exercise that helps in the strengthening of the leg muscles (lower limbs). It does this without putting too much stress on the joints which is why, for the management of gout, individuals can try outdoor or stationary cycling.  
   
   
4. Pilates
   Pilates is a low-impact physical exercise. Like other forms of activity, it can help with weight loss to reduce the possibility of a flare-up. 
   
   
5. Tai chi
   This gentle, low-impact type of exercise is great for people with gout. It involves the use of slow, flowing movements, making it quite gentle on joints and beneficial for flexibility, coordination and balance. 
   
   
6. Yoga 
   Yoga is a great flexibility experience for those with gout. In addition to flexibility, it can help with mobility, strength, and balance. Research has shown that it can also help improve pain levels for people living with gout. 

Exercises to avoid if you have gout 

If you have gout, you should avoid high-intensity exercise which can increase uric acid levels. Examples include:

1. Burpees
   Burpees involve a push up and leap in the air. Since it engages all muscles in the body, it can be too much work for the joints. 
   
   
2. High knees 
   Although high knees help strengthen leg muscles, they are too intense for the joints and can result in an increase of uric acid levels. 
   
   
3. Lunge jumps
   This form of physical activity entails jumping high in the air and switching to your second foot ahead before you land. 
   
   
4. Jumping jacks 
   This is another full body exercise that isn’t gentle on the lower limbs of the body. Although it doesn’t require any equipment, walking is a far better alternative. 
   
   
5. Rope jumping 
   This is also known as skipping. While it’s fun and easy to perform for the average person, it’s not fun on the joints of individuals with gout.