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The Best Workout to Manage Symptoms of Peripheral Artery Disease

When your muscles cramp in your legs every time you walk because of peripheral artery disease (PAD), exercising might be the last thing on your mind.

But, exercise may actually be the best thing for you. Studies have shown that exercise can actually improve both symptoms related to as well as the progression of PAD.

Why exercising with PAD can pay off

Peripheral artery disease occurs when plaque—made up of cholesterol and other fatty substances—clogs the blood vessels that lead to the legs and feet. This can cause pain and cramping in your legs when you’re working harder, because the muscles in that area aren’t getting enough blood and oxygen.

It might seem like exercise would only make things worse. But the opposite is true: It can actually improve your circulation as new blood vessels form. This can ease the pain, the National Institute of Health points out.

Walking is especially good for you

Runner exercisingSeveral randomized clinical trials have shown that walking can make a real difference for people with peripheral artery disease, says Emile R. Mohler, III, MD, late Director of Vascular Medicine at Penn Medicine.

“Any other exercise is fine. There’s no limitation in what a person with peripheral artery disease can do,” Dr. Mohler notes. “But the majority of the clinical trials out there support the benefits of walking. That is why we recommend it for our patients.”

For instance, a 2012 study that Dr. Mohler co-authored for the journal Circulation found that patients with PAD who did a six-month supervised treadmill program were able to walk farther than patients who had surgery to restore normal blood flow to their legs. The exercise group also did better than people who didn’t do exercise or surgery.

Dr. Mohler says that other activities, such as bike riding or swimming, haven’t been studied in patients. “We can’t guarantee they will get the same benefits as walking.”

Before trying any exercise, always speak to your doctor.

Dr. Mohler says working with a physical therapist to start a walking program is a good move. And if insurance doesn’t cover physical therapy, there are some alternatives.

“Go to YMCA or get a personal trainer for a few weeks to help you monitor your exercise, if you can,” Dr. Mohler suggests. “Other patients just start walking on the treadmill or around malls or their neighborhood, as part of the exercise program.”

Steps to the best workout for PAD

Dr. Mohler says the key to getting the most out of your walking program—supervised or not—is to follow these steps:

Step 1: Warm up. Stretch your calf and thigh muscles in each leg for 10 to 15 seconds.

Step 2: Start walking. Walk at a fast enough pace for about 5 minutes, even though it may cause some mild pain.

Step 3: Stop and rest. After 5 minutes of mild or moderate pain, stop and rest until the pain goes away.

Step 4: Repeat the walk-and-stop routine several times. During the first two months of your walking program, build up slowly to walking a total of 35 minutes each session, not counting the rest breaks. Keep adding a few minutes until you’re at the goal of walking 50 minutes.

Step 5: Cool down. Finish by walking slowly for 5 minutes. Then, stretch your calf and thigh muscles again.

Step 6: Stick with it. Aim to eventually do 50 minutes of walking, at least 3 to 5 times a week. As that becomes easier, challenge yourself to work harder. You could try walking up hills or stairs, or add an incline to your treadmill routine.

Keep in mind: Peripheral artery disease took years to develop in your legs, and it will take a few months to improve your walking. Dr. Mohler says, “It’s important to be patient with yourself.”

If you think you or a loved one has peripheral artery disease, talk to a Penn Medicine vascular expert about starting a walking program.


In late 2017, Dr. Emile Mohler unfortunately passed away. His accomplishments to the field of vascular medicine and contributions to Penn Medicine were numerous, and his research provided valuable insight and treatment benefits for patients with peripheral artery disease (PAD). Read more about Dr. Mohler’s life and research.

About this Blog

The Penn Heart and Vascular blog provides the latest information on heart disease prevention, nutrition and breakthroughs in cardiovascular care.


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