Exercises for gout: safe ways to stay active after a flare

Gout is a type of inflammatory arthritis that often affects the big toes, feet, and knees. It occurs when uric acid — a substance your body normally gets rid of — builds up and crystallizes in the joints. Pain from gout can be quite severe: “Those crystals can lead to pain and may affect range of motion in the affected joints,” says Dominica Sourial, PT, DPT, a Hinge Health physical therapist. 

While a gout flare can feel very painful and be alarming, it’s often manageable. Rest is the key to getting through a gout episode. Engaging in gentle, targeted mobility movements may ease gout pain following a flare. In addition, leading a healthy lifestyle, which includes eating anti-inflammatory foods and staying active, can help prevent these flares, says Dr. Sourial. Easing back into exercise after a flare with low-impact activity can help increase blood to the area and promote healing. Everyone is different, so it’s important to talk to a healthcare provider about the best approach for your needs.  

Read on to learn how movement can help prevent and manage gout symptoms, including exercises recommended by our Hinge Health physical therapists.

Does exercise help gout?

When a gout flare strikes — especially in your foot or knee — even the idea of movement can feel daunting. The pain can be sharp, intense, and make walking or standing difficult. It’s actually not a good idea to exercise during an active flare, Dr. Sourial says. 

Starting with gentle mobility movements after a flare can help break up tightness in the area and reduce inflammation. Skip activities like running or jumping when coming off a gout flare. “High-impact exercises often add stress to already sensitive joints,” Dr. Sourial says.

Instead, focus on low-impact movements. Simple range-of-motion exercises, stretching, or even short walks — if tolerable — can promote blood flow, which helps reduce inflammation and supports healing. Swimming or cycling (if comfortable) are also good options.

At the start of a gout flare, your body may be more sensitive to pain than usual. After the flare subsides, listen to your body and rest if you need to.

Benefits of physical exercise for gout

Exercise is an essential tool for preventing gout. One study found that people with gout ‌who worked out consistently had less inflammation, fewer flares, and reduced pain compared to those who didn’t exercise. Here are a few reasons movement can be so helpful for staving off gout:

• Reduces inflammation. Gout is an inflammatory type of arthritis. During a flare, it may be too painful to exercise. Staying active outside of a flare can pump inflammatory chemicals out of your muscles. “Working out consistently can lower overall inflammation and reduce the chances of another gout flare,” says Dr. Sourial. 

• Decreases risk of conditions linked to gout. Regular exercise can lower the chances of developing conditions like heart disease and type 2 diabetes, which are linked to a higher gout risk.

• Reduces uric acid levels. Gout episodes happen when uric acid builds up in your joints, leading to intense discomfort. Physical activity (outside of a flare) can help reduce these levels in the body, which may prevent painful gout flares. 

• Increases muscle mass. Building muscle through resistance training can play a helpful role in managing gout. Research shows that having more lean muscle mass may support your body’s ability to process and lower uric acid. Strength-based exercise can also support overall joint health and metabolic function, which may reduce the risk of future gout flares.

Gout flares can be very painful, which is why it’s essential to listen to your body. During a flare, you may not be able to exercise at all. If movement feels ok, consider performing the gentle, targeted exercises above. All of these moves can enhance joint mobility, increase strength in supporting muscles, and alleviate pain in both your feet and knees. These exercises can help you move better by breaking up stiffness and rigidity from inflammation linked to gout. “Always adjust or scale back on the above movements if you experience pain,” Dr. Sourial says.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Tips for exercising with gout 

During a gout flare, exercise might not be possible. In some instances, gentle movements can help ease symptoms. Staying active when you’re not in a flare can help reduce the chance of future episodes. Consider these tips to make working out smoother, especially if you are coming off a gout flare.

• Perform warm-ups. Warming up with dynamic movements, such as the ones above, can help prepare your muscles for activity, which can prevent injury and ease pain, Dr. Sourial says. A warm-up routine can also boost blood flow to the tender joint that was affected during a recent gout flare.

• Focus on low-impact activities. After a flare, choose gentle exercises such as swimming, walking, or yoga instead of high-impact movements like running, which can be tougher on your joints — especially when they’re already sensitive from a recent gout episode.

• Exercise other parts of your body. If lower-body joints affected by gout are hurting a lot, you can try focusing on upper body exercises instead, Dr. Sourial says. These may include bent over rows, forward shoulder raises, and shoulder rows.

• Listen to your body. Pain is your body’s way of communicating with you. If you start to feel too much discomfort while being active, that’s a sign to dial back. “Avoid pushing through pain during a gout flare,” says Dr. Sourial. “Try to keep it at a manageable level, around a three out of 10.” 

• Wear supportive shoes. Gout often affects the big toe and foot. Wearing shoes that support your feet during flares is important for managing pain. Choose shoes with good arch support. This can help your foot stay steady during exercise, making it easier and more comfortable to move.

• Stay hydrated. Drinking plenty of water is essential during a workout — no matter if you have gout or not. Sweating from exercise can increase the risk of dehydration, which may elevate uric acid levels in those with gout. Dr. Sourial recommends drinking fluids frequently during gout flares and physical activity to help manage and prevent symptoms.

When to see a doctor about gout

Gout is a medical condition that typically requires care from a healthcare provider — often an internal medicine, family medicine, or rheumatology doctor. Prescription medications are usually needed to prevent future flares and help treat symptoms during a flare.

If you’re not already under a doctor’s care for gout, it’s important to get connected with one. And even if you are, reach out if your symptoms persist or worsen despite self-care steps like gentle movement, hydration, or dietary changes.

Contact a healthcare provider if you’re experiencing:

• Severe or unrelenting pain

• Frequent gout flares

• Significant swelling, redness, or warmth in the joint

• Difficulty moving the affected joint

PT tip: Dial back after a flare 

When you’re coming off a gout flare, it’s important to tune into how your body feels before and during physical activity to prevent residual pain from worsening. There’s a difference between discomfort and pain: “Try not to push past pain,” says Dr. Sourial. 

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Arthritis Foundation. (2020). GOUT. Arthritis.org. https://www.arthritis.org/diseases/gout

2. Gout: Risk Factors, Diagnosis and Treatment. (2009). Gout: Risk Factors, Diagnosis and Treatment. Hospital for Special Surgery. https://www.hss.edu/conditions_gout-risk-factors-diagnosis-treatment.asp 

3. Schlesinger, N., Jablonski, K., Schwarz, E., & Young, N. (2020). AB0933 PHYSICAL ACTIVITY DECREASES PAIN AND INFLAMMATION IN GOUT PATIENTS. Annals of the Rheumatic Diseases, 79(Suppl 1), 1766.1-1767. doi: 10.1136/annrheumdis-2020-eular.490

4. Williams, P. T. (2008). Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men. The American Journal of Clinical Nutrition, 87(5), 1480–1487. doi: 10.1093/ajcn/87.5.1480

5. How Fat Affects Gout. (2020). Arthritis.org. https://www.arthritis.org/health-wellness/about-arthritis/related-conditions/other-diseases/how-fat-affects-gout

6. Pan, A., Teng, G. G., Yuan, J.-M., & Koh, W.-P. (2016). Bidirectional Association between Diabetes and Gout: the Singapore Chinese Health Study. Scientific Reports, 6(1). doi: 10.1038/srep25766

7. Andrés, M. (2023). Gout and Cardiovascular Disease: Mechanisms, Risk Estimations, and the Impact of Therapies. Gout, Urate, and Crystal Deposition Disease, 1(3), 152–166. doi: 10.3390/gucdd1030014

8. Hou, Y., Ma, R., Gao, S., Kaudimba, K. K., Yan, H., Liu, T., & Wang, R. (2021). The Effect of Low and Moderate Exercise on Hyperuricemia: Protocol for a Randomized Controlled Study. Frontiers in Endocrinology, 12(12). doi: 10.3389/fendo.2021.716802

9. Zhou, J., Wang, Y., Lian, F., Chen, D., Qiu, Q., Xu, H., Liang, L., & Yang, X. (2017). Physical exercises and weight loss in obese patients help to improve uric acid. Oncotarget, 8(55), 94893–94899. doi: 10.18632/oncotarget.22046

10. Jablonski, K., Young, N. A., Henry, C., Caution, K., Kalyanasundaram, A., Okafor, I., Harb, P., Schwarz, E., Consiglio, P., Cirimotich, C. M., Bratasz, A., Sarkar, A., Amer, A. O., Jarjour, W. N., & Schlesinger, N. (2020). Physical activity prevents acute inflammation in a gout model by downregulation of TLR2 on circulating neutrophils as well as inhibition of serum CXCL1 and is associated with decreased pain and inflammation in gout patients. PLOS ONE, 15(10), e0237520. doi: 10.1371/journal.pone.0237520