The Benefits of Exercise for Peripheral Arterial Disease Relief

Best Exercises for Peripheral Artery Disease
Written by Maureen Salamon
5 min read
Long walks around his hilly Pittsburgh neighborhood turned scary for Jagdish Bhatnagar when his left calf started hurting so badly, he had to rest on the side of the road. Diagnosed in early 2021 with peripheral artery disease (PAD), the 83-year-old retired medical physicist knew blocked blood vessels in his leg were causing his severe cramps.
But Bhatnagar didn’t have surgery or take medications for his condition. Instead, he takes part in a supervised exercise therapy (SET) program that helps him push past his pain on a treadmill three times a week while being monitored by a nurse or other medical professional.
Since Medicare’s 2017 decision to cover SET, this PAD treatment has slowly caught on across the U.S. Studies show SET can help people like him walk longer and more comfortably.
“I feel I’m getting rejuvenated with this exercise,” Bhatnagar says. “Before, I felt like a sick person. But now, I feel I’m becoming healthy.”
Treadmill walking, the main form of exercise therapy included in SET programs, is the gold standard for improving PAD’s main symptom, called claudication. Claudication is the pain and cramping in the calf, thigh, or buttocks that happens while you walk because too little oxygen reaches your leg muscles.
“Basically, walking improves the way muscles use oxygen or helps develop more blood vessels to increase the supply of oxygen,” says Mark Jordan, a senior clinical exercise physiologist who leads SET sessions at the University of Pittsburgh Medical Center in Pennsylvania. Translation: It improves circulation to the leg.
A typical SET program includes up to 36 sessions over 12 weeks, each lasting 30-60 minutes.
You first take a walking test to measure how long and fast you can walk until you feel pain in your leg. Your team will then tailor SET sessions to your abilities, blending periods of walking and resting based on your symptoms. As you improve, your therapist will adjust your treadmill settings to increase speed, steepness, and time walking, Jordan says.
“We use a 1 to 5 pain scale for patients to rate their pain while walking,” he says. “Once they reach 4, we have them stop and sit down. They wait for their pain to go away, then go again. They continue doing that several times until they’ve been walking for a total of 60 minutes.”
Some SET programs blend in other forms of exercise. These can include an ergometer — a bike you pedal with your arms — as well as a stationary bike, rowing machine, and arm and leg weights. SET programs also educate you about the disease itself and about healthy eating to improve your risks. (Some SET programs include a nutritionist on the medical team.)
“Really, any movement has been shown to be beneficial,” says vascular surgeon Oliver Aalami, MD,
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