Peripheral Arterial Disease (PAD) exercise advice.mp4

Wouldn't it be great if we could reverse time to tell ourselves how to live a healthy lifestyle to reduce the likelihood for the onset of a variety of health conditions. I'm not going to be reversing time in this video today though. Hi everyone and welcome to Exercise for Health. I'm Richard and today I'll give you some advice on how to exercise with peripheral arterial disease and in particular if you suffer with claudication. If you're new to this channel we offer tips, advice and exercises each week to help you manage your health condition with physical activity. So go ahead and tap the subscribe button below and the bell icon if you want to be notified of when we upload a new video. Atherosclerosis is a natural process where fatty substances over a long period of time clog and harden the arteries in the body which restricts the blood supply to the muscles and organs. Peripheral arterial disease or peripheral vascular disease is a common condition where the deposits build up in the arteries in the lower extremities. Only about 10% of people with this condition however will experience a mild to severe pain in the legs when they go out for a walk which then subsides after a short rest and this is known as intermittent claudication. It's a bit like having angine in the legs and can feel like an aching or cramping pain in the calves, thighs or buttocks and will be quite debilitating if not treated correctly. Although exercise will trigger the pain it's actually a great way of managing the symptoms in the long term and it's crucial for an improved outlook and quality of life. If left untreated the pain can start to develop even at rest and in severe cases cause damage and tissue loss from the foot. The aim of any exercise program should therefore be to number one improve claudication pain symptoms and two reduce cardiovascular risk factors. For strength flexibility and balance training the standard exercise recommendations for all adults will be appropriate as shown on this infographic. However the aerobic or cardiovascular component will need modifying so let's look at that next. Most people that suffer with intermittent claudication generally get the onset of symptoms when walking, probably the most popular form of aerobic exercise. When the leg muscles work and demand more oxygen and if the supply of oxygen from the blood is restricted then the muscles will begin to produce lactate. This lactic acid although harmless builds up and causes an aching cramping or burning pain in the muscles and results in fatigue. So when exercising the leg muscles it's important that you do sustain an effort level until you reach a three on the zero to four claudication pain scale. This is the point where you feel intense pain but not unbearable pain. When you reach a three on this scale you should stop your leg movement to allow for a short recovery period until the pain fully subsides and then start the exercise again. Although not pleasant it is important you reach this point as this is where you'll obtain the maximum benefit from the exercise. This stop start method will help improve the length of time that you can sustain the activity before reaching the onset of pain and you should adopt this method for any aerobic activity whether it's walking, cycling or climbing stairs and I'll cover some exercises that you can do at home in a moment. However when you've stopped exercising to reduce the leg pain you can continue to exercise the arms to keep the heart rate up and this is where some hand weights will come in useful even if it's the standard household tin of beans. In addition while it might feel intuitive to stretch the muscles where and when you feel the onset of the pain, try not to do this in between your exercises or while you're resting because the muscles will not be able to contract as effectively following a static stretch and when you start the exercise again it can make the symptoms start to feel worse so save any stretches to the end of your exercise routine. If you've had a recent diagnosis of claudication then the first step is to see if you can get referred into a supervised structured group exercise program where a specialist instructor will be able to offer you personalized advice and help you keep track of your progress. This may be as part of a cardiac rehabilitation group as the exercises in this setting will be appropriate for you. If you're exercising alone though and you decide that you prefer to go out for a walk, which is the best form of exercise for this condition and what I'd highly recommend, then you will need to plan your route so that you know whether there are going to be any inclines which will increase the likelihood for the onset of pain, the distance so you know whether you can manage the walk without getting stuck and it's also a good idea to have points along the route where you know that you can sit down if necessary to aid your rest. If you're in the gym then the treadmills will be ideal for you as you'll be able to use it to control the intensity i.e the speed and incline of the walk as well as be able to control the amount of time you walk for and you can intersperse these walking stints with some upper body exercises using other equipment. Just make sure that you don't hold on to the handrails while you're walking on the treadmill as this will alter the intensity and can cause variations in your overall outcomes. If you have peripheral arterial disease then it's highly likely that you may suffer with other associated cardiovascular conditions. Therefore exercising in a swimming pool may carry more risks than benefits. When you enter an aquatic environment you increase the pressure placed on the heart. Water immersion causes physiological changes to the heart and being in cold water can increase the risk of arrhythmias but even for the claudication symptoms alone you'll see much more benefit from land-based exercises. If you're carrying out exercises at home then here are some examples that are specific to improving the length of time before the onset of leg pain and claudication symptoms. The first one is walking around on the of your feet. This is a great way to stimulate the muscles in the lower leg while walking on a flat surface in a small space. If you find balance is difficult with this then walk normally but place the focus on pushing off from the balls of your feet to lift the heels up. When you find you get to a three on the zero to four claudication pain scale stop and rest until the pain disappears before resuming this exercise or moving on to another one. The next one is step ups. So using a You can start by leading with the right foot to go up first and then the left foot to come down first maybe for about five to ten repetitions before swapping over to the opposite way. This will place emphasis on one side both up and down before swapping over. Try to ensure that you're pushing off the ball of the foot when stepping up and then also ensuring when you come down the first contact should be also through the ball of the foot. As with the other exercises when you reach a three on the zero to four claudication pain scale stop and rest until the pain fully subsides before resuming this exercise or moving on to another one. The next one is calf raises. So starting with the balls of the feet on the edge of a step making sure that you're able to have something nearby to hold on to for balance purposes if you feel that you need it. Drop the heels of the feet towards the floor until you feel tightening in the calves then lift the heels up as high as you can pushing the balls of the feet into the step before slowly lowering back down again. See if you can manage a set of 10 repetitions or continue until you reach that magic number three again on the pain scale. The next one is sit to stand heel lifts. So for this exercise use a chair ideally a dining room chair that's not too low to be able to stand up from. With your feet a shoulder width wide lean the body forwards and drive your hips up and forwards. When you reach an upright position then lift the heels off the ground and then drop them back down slowly return into a seated position before starting again. Aim to do a set of about 10 repetitions until you reach the number three on that pain scale. The last exercise is split squats. For this exercise it's probably worth being near a support like a wall table or chair in case you feel your balance is compromised. Stagger your feet with the front foot flat on the floor and the back foot up on the ball of the foot ensuring that your feet aren't too narrow like being on a tight rope so maintaining a shoulder width. Begin to bend the back knee towards the floor as low as you can manage before pushing through the back foot to straighten the back leg coming back up to an upright position. Again repeat the movement for about five to ten repetitions before swapping sides or until you reach that pain number three on the zero to four scale. This one is particularly tough on the leg muscles so don't worry if you don't go down too low or if you can't manage many repetitions. Don't forget to give yourself enough rest to recover from the pain feeling fully but remember to use this rest time to exercise the upper body muscles if you can. The goal will be to be able to carry out your activities of daily living without triggering the onset of pain. This might also include being able to walk for longer periods without having to stop every few minutes. If you're able to walk for 10 minutes continuously at a steady pace without experiencing any symptoms then you are doing very well and you should try to aim to do 30 minutes in total of walking in a daily exercise routine three to five times a week as this will massively enhance your physical well-being. If you want to do a 10 minute walking at home routine to follow along to and if you feel that you're at that level then click on the pop-up banner above my head to take part in one of my mini mover videos and if you need to stop at any point within the 10 minutes due to the onset of pain you can pause the video and just restart it again when you feel that you're ready. If you found this video informative today please give it a like by clicking the thumbs up button below and share it with friends to help this channel grow so more people can benefit from these videos and remember to stay active, keep moving and I'll see you next week. Thank you for watching. If you enjoyed this video today please give it a thumbs up. You can also click here to subscribe to this channel or click here to watch a recent video. See you soon.