Research Corner - Q&A Gout in Ankle by Tony Reynolds | Date Released : 26 May 2006 0 comments Print Close Question: I have a client who suffers from gout in the ankle. He wants to get fit, so what would you suggest? He is also hypertensive, NIDDM and overweight. Answer: With this many risk factors, you may want to get a full medical clearance from a qualified medical professional before you do much of anything. Gout is ultimately caused by an increased level of uric acid within the body. Rather than being removed by the kidneys and flushed through the urine, it forms needle-like crystals that get deposited either in the connective tissue, the joint space between bones or both. This leads to very painful inflammatory arthritis, which presents as swelling, redness and heat and pain and stiffness in the affected joint. If the gout is actively causing inflammation in the joint, it may not be advisable to exercise that joint. Exercise may actually prolong the inflammation and perpetuate the client’s pain. Typically in this state, efforts should be geared toward resting the joint and reducing the painful inflammation with ice and NSAIDs. You may be able to implement some pool work if a pool is available. Just remember to minimize lower body activity in the water. You can also do some upper body cardio such as an arm ergometer. After the inflammation of the joint has dissipated, you may be able to slowly implement some closed chain exercises to build strength and stability in the joint. Eventually, you may be able to get more aggressive with different types of cardiovascular exercise, but you should not rush the process. Considering the gout and his other risk factors, your focus should probably be on weight reduction. However, you should monitor his weight loss and make sure he is not losing weight too quickly. Rapid weight loss may actually raise the uric acid levels in the blood, which would obviously be counterproductive. Nutritional Considerations You might find that weight reduction through moderately limiting calories may be his most efficient plan of attack. With this individual’s particular list of risk factors, you may want to suggest he work with a registered dietitian. With the addition of the hypertensive and diabetic issues, he should really be monitoring his diet, and this may be somewhat tricky. The use of alcohol and certain foods that are high in purines such as seafood, kidney/liver/heart/gizzard meats, cocoa, peas, spinach, lentils and beverages such as tea and coffee can cause an incidence of gout. You may want to ensure he is staying properly hydrated. Water can help the removal of uric acid and decrease the potential of another flair up. Back to top About the author: Tony Reynolds Tony Reynolds, MS, CSCS, YCS II, is founder and Director of Performance for Progressive Sporting Systems incorporated in Terre Haute, Indiana. Tony graduated from Indiana State University with a Masters Degree in Sport Biomechanics. Since 2006, Tony has worked extensively with professional, college and high school athletes. His resume includes the International Performance Institute in Florida, the Cincinnati Reds, Indiana State University, Rose Hulman Institute of Technology, St Mary of the Woods and numerous high school teams. Currently, Tony is serving on the Executive Counsel and Board of Directors for the International Youth Conditioning Association. Through this position, he serves to manage and help develop the quickly growing organization. Tony is a co-author for the IYCA’s foundational textbook Developmental Essentials and is one of three elite lecturers that present and certify the IYCA’s Level II and III certifications. Tony has helped to design all three levels of the IYCA’s certification exams. Tony is a featured author and sport performance expert for many strength and conditioning resources including SportSpecific.com, Athlete.com, Bodybuilding.com, Completetrackandfield.com and Soccerspecific.com. Additionally, Tony has lectured for Indiana State Univeristy, presented at the Ryan Lee Bootcamp, IYCA Level II seminars and the Annual Midwest Strength, Conditioning & Rehabilitation Symposium. 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