If you have peripheral artery disease (PAD) and deal with leg pain and cramping, it's understandable that you'd want to avoid anything that triggers discomfort, like walking. But (ironically enough) exercising your legs may actually help improve your PAD symptoms in the long run.
"Exercise is a great way to alleviate the symptoms by making you stronger and improving the circulation into the muscles that are affected by the arteries," says David Nieves, DPT, co-owner of Evolving Gate Physical Therapy, a New York-based clinic that treats orthopedic and neurological disorders, including issues associated with PAD.
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In fact, a December 2018 study in Circulation found that regular exercise improves functioning, walking ability and overall quality of life in people with PAD.
"Essentially, the whole point of any exercise routine is to increase strength and circulation," Nieves says. "And by doing this, we allow the muscles to respond in a more timely fashion to the demands imposed by your functional activities."
Below, Nieves shares five exercises to help you manage your PAD symptoms and live a more functional life. Start with about 8 to 10 reps per exercise but feel free to ease off if you're not able to complete the moves with good form.
1. Leg Extension
- Sit on a sturdy chair with your back straight.
- Place your hands on the sides of the chair or hold onto the edges for stability.
- Lift your left leg up while keeping it extended and parallel to the floor, and straighten your knee as much as possible without locking it out.
- Slowly lower your leg back to the starting position, maintaining control.
- Repeat the movement with the opposite leg.
This exercise helps increase blood flow to your quadriceps (front thigh muscles), which are a major supporter of your body when you're walking, Nieves says.
2. Ankle Pumps
- Sit on a sturdy chair with your back straight.
- Place your hands on the sides of the chair or hold onto the edges for stability.
- Flex your ankles, pulling your toes towards your body as far as comfortable, holding the flexed position for a few seconds to stretch your calves.
- Slowly point your toes away from your body, pointing them downwards. Hold the pointed position for a few seconds, feeling a stretch in the front of your ankles and shins.
Ankle pumps are great because they improve blood flow to the calves and shins, Nieves says.
3. Sit to Stand
- Sit on a sturdy chair with your feet flat on the floor, shoulder-width apart.
- Position your feet slightly ahead of your knees and place your hands on the armrests of the chair or on the sides of the seat for support.
- Use your leg muscles to push yourself up into a standing position, straightening your hips and knees.
- Sit back down by slightly bending your knees and hips while keeping your back straight.
- Slowly lower yourself back onto the chair.
Tip
To make this move more advanced, try an air squat. Squats can improve blood flow to your lower extremities and increase quad, gluteal and hamstring strength, Nieves says. "All of these are important components in your ability to walk."
4. Calf Raise
- Stand upright with your feet shoulder-width apart, toes facing forward.
- Slowly rise up onto the balls of your feet, lifting your heels off the ground.
- Hold the raised position for a few seconds to engage the calf muscles.
- Lower your heels back down to the starting position, allowing your feet to fully touch the ground.
Tip
Calf raises help increase the strength and blow flow in your lower leg muscles, which are important for our ability to push off the ground when we walk. If you struggle with balance, try holding onto the back of the chair, counter, or table to better stabilize yourself, Nieves says.
5. Toe Raises
- Stand with your toes facing forward.
- Keep your heels on the ground and raise your toes off the ground.
- Hold the raised position for a second or two.
- Slowly lower your toes back down so that they're fully touching the ground.
Tip
Like with calf raises, you can hold onto a chair or wall to stabilize yourself while doing toe raises. This exercise helps strengthen your anterior tibialis, or shin. Weak shins can lead to shin splints and pain as well as lack of stability when walking, Nieves says.
4 Tips for Exercising With PAD
1. Start Slow
Don't rush through these exercises for the sake of doing them — taking your time will result in the most benefits. "Actually do them in such a way that you create some sort of response in your body," Nieves says.
You'll want to perform these exercises slowly and in a deliberate manner, trying to maintain that mind-muscle connection and focusing on contracting your muscles and holding the stretch when you can.
2. Try to Challenge Yourself
You don't want to exercise through the pain, but you should still push yourself a little. "Pain tends to indicate injury, and in the worst case, it could indicate lack of circulation in a specific muscle," Nieves says.
"We don't recommend working out through the pain, but you do have to impose some sort of demand on yourself in order to achieve benefit from exercise." For the most part, you can exercise through discomfort but don't want to exercise through pain.
Warning
Before you try any new exercises, it's best to consult a medical professional. If you experience any sharp pain while you try these moves, stop what you're doing and speak with your doctor.
3. Rest Between Sets
Always take some time to rest between sets, especially if you experience discomfort during your workout. "If you have pain and cramping, you might have pushed yourself too hard. So you're going to need a longer rest to get to the point where you don't feel that pain or cramping anymore," says Nieves.
On the other hand, if you feel absolutely no effect from the exercise you did, you might want to cut down your interval of rest periods and consider increasing the amount of repetitions.
"Typically, I may let somebody rests from 30 to 60 seconds between a set of exercises," Nieves says. "It all depends on your physical conditioning, what you're used to, and how hard you can push yourself."
4. Keep a Routine
The key to reaping long-term benefits from these exercises is to keep doing them. Whether you do these exercises daily or every other day, it's important to make time in your day to fit these into your routine.
But that doesn't mean you have to do all your exercises in one shot. If you can't do all the moves in a half hour, break down the routine into two 15-minute sessions. In either case, listen to your body — and if you're not sure, talk with your physical therapist or doctor about how often you should do these exercises.
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