Optimal Exercise Program for People with Peripheral Vascular Disease: How to Manage Claudication and Improve Walking Tolerance

Peripheral Vascular Disease (PVD), also known as peripheral arterial occlusive disease, occurs when plaque builds up in the arteries, reducing blood flow to the muscles. It most commonly affects the legs, making everyday activities such as walking painful or difficult.

What is Claudication?

One of the hallmark symptoms of PVD is intermittent claudication. This is pain, cramping, or fatigue in the muscles—most often in the calves—that occurs when walking or exercising and improves with rest.

Claudication happens because the muscles aren’t getting enough oxygen-rich blood during activity. Many people describe it as:

• Calf pain or cramping after walking a short distance

• A heavy or tired feeling in the legs

• Discomfort that eases when you stop and rest

It can feel frustrating or even discouraging, but it’s important to know: exercise is one of the most effective ways to improve claudication symptoms and quality of life.

Treatments for Peripheral Vascular Disease

Treatment for PVD often includes a combination of:

• Lifestyle changes such as quitting smoking and improving diet

• Medications to improve circulation or manage risk factors like cholesterol and blood pressure

• Exercise therapy, which is considered a first-line treatment for claudication

• In severe cases, surgical procedures such as angioplasty or bypass may be needed

For many people, exercise becomes the most powerful tool for managing symptoms and regaining mobility.

The Role of Exercise in Claudication

Research has shown that a structured walking program is one of the most effective treatments for people with peripheral vascular disease and claudication. Here’s why:

• Builds new pathways for blood flow – Walking stimulates the growth of small blood vessels around blockages, helping deliver more oxygen to your muscles.

• Improves how your arteries work – Exercise makes blood vessels better at expanding and supplying blood when your muscles need it.

• Strengthens your muscles – Training teaches your leg muscles to use oxygen more efficiently, so you can walk further before pain sets in.

• Proven results – Clinical studies show that people with claudication who follow a walking program can double or even triple their pain-free walking distance over time.

The American Heart Association, American College of Cardiology, and Society for Vascular Surgery all recommend supervised exercise therapy as a first-line treatment for claudication.

A Treadmill Exercise Program for PVD and Claudication

Here’s a clinically supported program that we have used with countless clients and you can try if you’ve been diagnosed with Peripheral Vascular Disease (always check with your healthcare provider before starting):

1. Set the treadmill at a speed and grade that brings on claudication pain within 3-5 minutes.

• If symptoms start sooner, reduce the workload.

• If symptom onset  takes longer than 5 minutes, increase the speed or incline slightly.

2. Walk until symptoms become moderately intense (usually calf pain or cramping).

3. Stop and rest until symptoms resolve back to baseline.

4. Start walking again at the same pace.

5. Repeat the cycle of walking and resting with the goal of working up to accumulating 30 minutes of walking time (not counting rest breaks).

Over time, this method helps:

• Delay the onset of claudication pain

• Improve endurance

• Enhance circulation in the legs

The key is consistency—aim for 3–5 sessions per week, and progress gradually.

Takeaway

Peripheral Vascular Disease and claudication don’t have to stop you from being active. With the right approach, exercise can be one of the most effective treatments—helping you walk further, manage symptoms, and reclaim your quality of life.

At The Online Exercise Clinic, we specialize in safe, evidence-based exercise programs tailored to people living with chronic health conditions. If you’re looking for support in managing PVD or other cardiovascular challenges, explore our resources or reach out to learn how an exercise physiologist can help you get moving again—safely and confidently.

The information in the blog is provided for informational and educational purposes only and does not constitute medical advice.  The information is not a substitute for professional medical advice, diagnosis, or treatment.  For questions please follow up with your healthcare professional.