Locations:
Search IconSearch

Exercising With Peripheral Artery Disease: Take Steps to Reduce Leg Pain

What to expect from a supervised walking program

Individual running on a treadmill

If you have peripheral artery disease (PAD), you know all about the pain that can come from just a short walk.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

PAD occurs when plaque builds up inside your arteries. Over time, plaque hardens and results in severely restricted blood flow within your legs, causing pain when you walk.

But numerous studies have shown that a form of noninvasive treatment — supervised exercise therapy — can help people with PAD walk farther with less pain.

A simple treatment

Supervised exercise therapy for peripheral artery disease is reimbursed under Medicare. It includes up to 36 exercise sessions supervised by a medical professional over the course of 12 weeks.

“The goal is to enable patients to prolong the amount of time that they are able to walk without experiencing what we call claudication in their legs,” says Erik Van Iterson, PhD, MS, Director of Cardiac Rehabilitation. Claudication is the medical term for discomfort or pain caused by too little blood flow to the leg muscles that you use to walk.

A recent study analyzed 25 clinical trials on supervised exercise therapy and found that total and pain-free walking distances improved for those participating in regular walking. Researchers have also found that supervised exercise therapy for PAD may be just as effective as leg stent treatment.

Walk your way to better mobility

In order to see that kind of improvement, you’ll need to consistently walk to a level of moderate to strong discomfort.

Advertisement

“That feeling of discomfort in your legs when you walk is actually the body’s signal to let you know that blood flow down in the arterial vessels is working its way through the muscle and delivering the intended benefit,” Dr. Van Iterson explains.

In supervised exercise therapy, you’ll likely be recommended to attend three weekly sessions where the general goal over the course of your program is to work toward accumulating up to one hour of walking time on a treadmill. A typical session may look like this:

  1. Walk on a treadmill as long as possible until leg pain reaches three or four on a five-point scale.
  2. Rest until the pain goes away.
  3. Start walking again.
  4. Repeat this pattern for up to 60 minutes.

Dr. Van Iterson notes that the people most likely to benefit from this treatment are those who commit to walking consistently — and not just on the days of supervised exercise therapy.

“That means pretty much every day,” he says. “Yes, you’re only in supervised exercise therapy three days a week, but you really need to be doing similar levels of walking on your own for the other four days.”

Life after exercise therapy

The ultimate goal is to get to the point where you can navigate activities of daily living, like walking to get the mail or going grocery shopping, without being burdened by physical pain caused by PAD.

That may not happen in 12 weeks, and if it doesn’t, that’s OK. Lack of major improvement at the end of 36 supervised exercise therapy sessions doesn’t mean walking therapy is not working. Dr. Van Iterson explains that part of the idea is that exercise therapy will help you establish a baseline of habit, so that you can keep up this type of exercise indefinitely. There is a dose-benefit response to walking therapy, so the more you walk on a consistent and long-term basis, the more likely you are to see a benefit.

If walking therapy does not improve your symptoms, your doctor may recommend other potential treatment options.

Advertisement

Learn more about our editorial process.

Related Articles

salmon avocado lime tacos
December 21, 2020/Heart Health
Choose the Best Diet for Your Peripheral Arterial Disease

Expert advice on different heart-friendly diets

Group of people exercising, doing step-ups on exercise steps
July 29, 2025/Aging Well
Keeping Steady: Balance Exercises To Improve Stability

Building lower body strength is key to staying upright, particularly as you age

Healthcare provider listening to heart of an older patient
July 28, 2025/Heart Health
Understanding the Connection Between Stress and Heart Disease

Chronic stress can trigger palpitations, inflammation, angina and other serious heart issues

Woman taking blood pressure with a cuff at home in kitchen
July 22, 2025/Heart Health
How Stress Is Linked to High Blood Pressure

Daily stressors can increase BP in the moment, as well as contribute to habits that can feed long-term hypertension

Person doing downward dog yoga pose on a mat
July 21, 2025/Exercise & Fitness
Take a ‘Paws’ With Downward Dog

This transitional and restorative yoga pose provides a full-body stretch

People using rowing machines at gym
July 17, 2025/Exercise & Fitness
7 Types of Low-Impact Cardio Workouts

Activities like swimming, cycling and rowing can get your heart pumping without stressing your joints

X-ray of implanted pacemaker
July 11, 2025/Heart Health
How To Know if You Need a Pacemaker

Fainting, heart palpitations and shortness of breath are just a few signs your heart may need help

People in gym doing low-intensity interval training, LIIT, workouts
July 7, 2025/Exercise & Fitness
Ease It Up: Why You Should Consider LIIT Workouts

Low-intensity interval training, or LIIT, offers numerous benefits and less wear and tear

Trending Topics

Person in bed sleeping on their side, covers off
Breathing Problems? Try These Sleep Positions

If you’re feeling short of breath, sleep can be tough — propping yourself up or sleeping on your side may help

A couple looking at skyline, with one person slightly behind the other, head bent down
What Is Anxious Attachment Style — and Do You Have It?

If you fear the unknown or find yourself needing reassurance often, you may identify with this attachment style

Glasses and bottle of yellow-colored prebiotic soda, with mint, lemon and ginger garnish
Are Prebiotic Sodas Good for You?

If you’re looking to boost your gut health, it’s better to get fiber from whole foods

Ad