The Art of Running With Peripheral Arterial Disease (PAD)

running with peripheral arterial disease
Best running and body movement book I ever read, all based on Feldenkrais, and the experience of a lover of running, Jack Heggie.

So you have peripheral arterial disease (PAD) in your legs (for me it’s mainly lower legs), and you want to return to running, but, (a) your doctor told you not to, (b) it hurts too much, (c) you can’t run like you used to, so why bother? (d) other?

I’ve been struggling with PAD for about four years, but I’ve found that it really is keeping this problem at bay, by growing collaterals and improving my PAD running skills.

running with peripheral arterial disease
Don’t let the road intimidate you. Pick shorter targets, like road signs, as you go along. You’ll be surprised by your progress.

Running with PAD is clearly an art. You have to learn how to work with it, starting with running more from your core and upper body, more than your legs. You can learn this as follows:

(1) Do the exercises described in Jack Heggie’s book, “Running with the Whole Body.” You will learn how to engage your body in the running process, rather than making it a “leg thing.” It will also improve your mobility as you age, due to improved awareness.

(2) Modify your running style, to as close to zero impact as possible, to minimize counter-productive reverse pressure waves up your legs, which impair arterial flow that is drive by systolic pressure waves running down your legs. To do this, you have to start your running as if you are a beginner, and let go of how you ran before PAD struck. I recommend the following steps, (a) water-running without a float aid, for conditioning before you tackle the run on a solid surface, (b) treadmill, gradually increasing distance and pace to stay below the “claudication threshold.” I didn’t hit the road until I could run continuously on the treadmill for one hour without losing claudication-related mechanical function (basically foot slapping), (c) and where the rubber hits the road, the road, which will take discipline and patience to regain the joy of running. If feels great, I promise you. Painful? Sure! But great. Except hills are really tough, tougher than before. As Chris Hauth told me years ago, “Suck it up, Morgan. This is training camp, not complaining camp.”

running with peripheral arterial disease
Make sure you have a good coach! Chris Hauth, of AIMP, spotted my heel strike, and taught me how to pace myself. Thanks, Chris!

(3) Learn how to spare your legs by running from your core and shoulders, rather than your legs. Start with the exercises in Jack Heggie’s book, then do the exercise where you run from your feet, then your knees, then your hips, then your shoulders. Running from my shoulders works for me.

(4) Put up with the pain of reopening your collaterals for the intensely painful first mile or two, knowing it gets better as you run further. When it comes to running with peripheral arterial disease, this is one case where that crazy saying, “No pain, no gain,” turns out to be true.

(5) Don’t run when your running mechanics start to fail, due to poor blood flow – foot slapping. Handle the pain to keep running, but knowing to stop running if you sense loss of function, so as to let the blood flow again, which is painful, sorry, so your muscles work normally again.

(6) Work with the power of Syntropy to fight Entropy. You can ignore this, if you want, it’s just a plug for my book.

PS For triathletes: Running off the bike is really difficult with PAD, and thus becomes part of the training, with lots of short bricks.

Hang in there, and run, as running with peripheral arterial disease is the best PAD therapy there is, in my opinion.

-kev aka FitOldDog

running with peripheral arterial disease
Grey is muscle, white is fat, clear ring around the central white spot (bone marrow) is the femoral bone. Note the loss of both muscle and bone mass in the sedentary guy.


  1. Santiago says

    Hi Kevin. Great blog!
    My name is Santiago, and I’m from Buenos Aires, Argentina.
    I’m 48 years old and was diagnosed with PAD.

    Started with a walking program and noticed that it was really boring, so I’m trying to switch to running. So far so good.
    Last week I ran continuous 3km. for the first time in years, and was able to repeat those 3km for the last 4 days.
    I was really in doubt if I was on the right path trying to run instead of walking, but it feels much better. And I feel I might build up collaterals faster than walking since I really have to walk very fast till I feel my calfs cramping.
    Running, they start to cramp within the first 500m and I’m holding on with the pain for the whole run, but I feel great once I finish.

    Thanks for the inspiration!
    Congrats and keep on!

    • Hi Santiago, sorry for the delayed reply, as I get tied up a lot. Yep! You are right, walking is not enough, as running is much more effective, and difficult. Keep up the great work, -kev

Speak Your Mind


This site uses Akismet to reduce spam. Learn how your comment data is processed.

Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.