Gout on a bike

fex54.0
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Gout on a bike

Postby fex54.0 » 20 Jan 2019, 6:08pm

I am currently suffering from gout for the first time in some 68 years. I think, from what I have heard, that the severity of my attack is low, so there's a blessing to be counted.

It started in my left foot last November and has since declined to about 10 - 20% of what it was, in terms of pain, but has not gone away. The joint in the ball of the foot is where I am affected and bending that joint is uncomfortable and can be painful. It has kept me off my bike, but I am starting to go out again. I find it difficult to put a lot of force through the left foot and I cannot stand on the pedals to go uphill. Changing gear certainly helps but this is not my preferred way of riding; I am a grinder not a spinner. It is also not much use on my single speed bike either. I ride on fairly flat routes anyway, in South Cheshire, and I am now sticking to routes that have no hills that I might consider to be steep. I am also cycling at much reduced speeds, although I was never exactly rapid.

I have also purchased some Shimano A520 pedals in the hope of load spreading over a larger area and used them for first time today. So far there seems little benefit and they are harder to clip into, especially on the affected foot, being one-sided. I am tempted to get some M530s which also have a bigger platform and are double sided; they seem to be available at a reduced price at the moment which helps.

The principal problem, however, seems to be to be the shoes. I have some Shimano MTB shoes with a single Velcro strap. The shoe is quite tight on the affected foot, especially with Seal Skin socks, and I think that this exacerbates the problem. I am thinking of buying a larger pair but these will be loose on the right foot and, if and when the gout goes, loose on both which I do not want. One possible answer is the Shimano SD5 sandal. This has a strap over the front of the foot and it looks like I can adjust the tightness with that. They will also be much easier to get on; I have to use a shoehorn on the left foot and putting the shoe on that foot cannot be done without discomfort.

Does anyone have experience and advice regarding cycling with gout and of the SD5 sandals, especially in cold weather or, indeed, any other helpful suggestions?

I have looked at other threads that consider gout but they do not answer my questions; they seem to consider the medical rather than the cycling aspects. FWIW I have taken Colchicine and am taking Naproxen; the latter seems to have reduced inflammation but the former seemed to have little effect.

Thanks

Cours
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Re: Gout on a bike

Postby Cours » 21 Jan 2019, 8:08pm

As farcas cycling in cold weather my advice with gout is dont! My friend (62) had a very bad case of gout last month and was almost immobile for a fortnight. His GP put it down to winter dietary changes and cycling in low temperatures.

Apple cider vinegar in solution and walnuts are two very effective herbal pain relief treatments for gout, but rest and avoiding temperature extremes is the best remedy.

Tart cherries although expensive have been proven to give immediate relief from gout pain also.

robing
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Re: Gout on a bike

Postby robing » 6 Feb 2019, 9:04am

You need to see your GP and get your gout under control! I first had gout 15 years ago at the age of 35 -family history of it. Like you it's always my big toe joint - left foot so any form of cycling is painful when it's bad. I had recurrent bouts over many years but now *touch wood* my gout is very well controlled with 300mg allopurinol daily.

Your GP probably won't recommend this straight away - indeed you shouldn't start allopurinol when you have a gout attack. To clear up the gout, you need a course of a stronger NSAID - naproxen is a commonly used one. Also I find ibuprofen works for me, but I need a higher dose - 800mg three times daily. But go and see your GP first and get checked out as not everyone can tolerate NSAIDS especially at higher doses.

Keep hydrated, drink plenty of water and avoid sugary drinks.

https://www.nhs.uk/conditions/gout/

go4it
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Re: Gout on a bike

Postby go4it » 23 Apr 2019, 12:59pm

Just info. and maybe help, I am entering my 5th week of Gout, which had turned into an infected foot.
I had not had a bout for over 18 months, oh boy this was off the pain scale, I have had bowel removal in the past and that didn't come close to this.
I have held off having one-a-day Alpurinol (sp) as my 'attacks' have been few and far between and I deemed it unwise.
However I am having second thoughts, has anybody had a similar experience and maybe taking or considering Alpurinol, or any other remedy, any help will be gladly received. Tia

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andrew_s
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Re: Gout on a bike

Postby andrew_s » 23 Apr 2019, 3:07pm

In terms of pedals & footwear, it may be worth considering shoes with a properly rigid carbon sole, in order to avoid flexing the toe joint.
That would be mostly road shoes that are awkward to walk in, but carbon MTB shoes are also available, if not at the cheap end of the range. Some brands also offer an extra wide fitting option in some models (eg Sidi "mega")

SD5 sandals have a reputation of being relatively flexible, so it may be worth seeing if you can find a pair if the (discontinued) SD66 instead.
I don't find sandals much colder than regular shoes. If it's not cold enough to need gloves, you don't need socks. If it is gloves weather, then socks work fine. It's best if they are wind/water resistant though, otherwise spray off the front tyre can be a problem - sealskins or similar, or regular socks with goretex over-socks on top.

BrightonRock
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Re: Gout on a bike

Postby BrightonRock » 24 Apr 2019, 8:53am

Is gout still a major issue in these modern times?

go4it
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Re: Gout on a bike

Postby go4it » 25 Apr 2019, 4:17pm

Brighton R
If a 'major issue' is an ailment that can stop you from walking driving sleeping for..(6 weeks in my case) Yes.
I flippantly said to my G.p that every Dr. should try it out to know how bad it is

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NUKe
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Re: Gout on a bike

Postby NUKe » 25 Apr 2019, 4:50pm

I I have had Gout in the past, fortunately other than one attack, it was mild by comparison to yours. In terms of Cycling with it I found ditching the SPD altogether and going for MTB big Flat pedals helped, word of caution the A520 don’t spread the weight anymore than any other SPD , the 530 is a better pedal inthat it has a wide non SPD side.
Shoes the Shimano ones are relatively narrow, but I found the lace-up ones worked for me. Try a slightly larger shoe with a decent toe box. I also found that replacing the insole with a Scholl gel one helped relieve the pain. Sandals are an option I have the Shimano ones , they are very adjustable so you should be able to get them comfortable, but unless you want to wear waterproof socks, I personally don’t want to use them in winter.
NUKe
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landsurfer
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Re: Gout on a bike

Postby landsurfer » 25 Apr 2019, 5:53pm

Explain the effect the Gout has on your ability to cycle / exercise to your GP and ask for a prescription for Alinpurinol .
This is a small tablet, taken daily, that prevents the build up of the deposits on your joints that lead to the inflammation that is so symptomatic of Gout.
It also prevents / delays the onset of Arthritis in all body joints.
I was prescribed the drug after Gout caused me to be unable to cycle or walk without pain for nearly a month, my mother suffered from Arthritis so there was a possibility of genetic effects with myself.

Since being prescribed the drug, nearly 3 years ago, i have had no gout or arithitic symptoms whatsoever... :D
The Road Goes On Forever ...

pete75
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Re: Gout on a bike

Postby pete75 » 25 Apr 2019, 7:50pm

Colchicine gets rid of a gout attack fairly quickly and allopurinol keeps it away.

robing
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Re: Gout on a bike

Postby robing » 25 Apr 2019, 11:53pm

Yep I've been gout free since taking allopurinol 300mg per day.
I always only ever got it in one big toe.

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bigjim
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Re: Gout on a bike

Postby bigjim » 28 Apr 2019, 7:41pm

I've had gout on and off for about 5 years. I don't take regular medication for it. I have been tempted when it was at it's worse though. I can feel it coming on now and take a Naproxin straight away and one a day for two days. seems to stop it in it's tracks. I think it's worth trying to find the trigger. I've changed my diet to keep me in an Alkaline state, but find the trigger, in my case, is red wine or beer. A couple of glasses of red or two pints and the same night the Gout kicks in so for the past few months I've been alcohol free and feel a lot better with no signs of an attack. I also make sure I don't get dehydrated.
I usually suffer pain on the top of my big toe and the side. It's never stopped me cycling during mild attacks, even when I was struggling to walk. I've found SPDs easier than flats as the ball of the foot seemed to be taking all the weight and keeping the pressure off the toe..
Nothing left to prove.

go4it
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Re: Gout on a bike

Postby go4it » 18 May 2019, 9:07am

Thanks for your advice 're Allpurinol You may be interested to know I phoned GP unfortunately I got one who is on their Board/Panel (!) he strongly advised against it(cost cutting me thinks) So I made an appointment to usual Dr. simply stating I would take her advice :(she previously recommended Allpurinol) I am now on a dose of 100mg a day to be reviewed after blood test in 2 week's...watch this space.
Thanks once again for timely advice

Ivor Tingting
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Re: Gout on a bike

Postby Ivor Tingting » 18 May 2019, 1:17pm

Buy two pairs of cycling shoes, one larger size, one smaller. Some hikers have to do this with walking boots if one foot is appreciably larger or smaller than the other and footbeds don't help. More expensive but each foot gets a good fit boot or shoe.
"Zat is ze reel prowoking qwestion Mr Paxman." - Peer Steinbruck, German Finance Minister 31/03/2009.

comfortablynumb
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Re: Gout on a bike

Postby comfortablynumb » 19 May 2019, 10:09am

I am 62 years old, 1.8m tall and 80kg so no lightweight but not over heavy either, rarely drink alcohol and vegetarian for about 30 years so nothing like the stereotypical gout sufferer and used to laugh at my overweight, meat scoffing, wine drinking ex workmate how suffered badly with gout. Last October I had a day out cycling with my mate and probably forgot about hydration and although only October I remember my feet feeling cold. Next morning woke up with gout in my big toe, never a hint of it before. Saw my GP who laughed and said "Ha! welcome to the club" he is a fellow sufferer. I tried keeping my feet warm, bed socks at night etc and keeping well hydrated which helped but had another attack in my other big toe two weeks later.
My GP arranged blood tests which showed a figure of 46 (sorry can't remember the units used) The normal range he reckoned is 23 to 43. Suggested I go straight onto Allopurinol as he says people sometimes leave it too long and the joints can get permanently damaged.
I am now taking 100mg of Allopurinol daily and having no gout or side effects. I've not changed my diet as that was fairly good anyway but I am careful to keep well hydrated. My last blood test showed 40 so not low but back in normal range.
Steve.