If you have peripheral arterial disease, or PAD, you are likely all too familiar with the leg pain and cramping that is characteristic of this condition. But according to new research from Japan, exercises that strengthen the hips may reduce calf cramps for people with PAD.
In PAD, the arteries that lead to the legs, feet, and sometimes arms, become clogged with fatty deposits, which reduce or block blood flow to the affected areas. Causing symptoms such as cramping, pain, or tiredness in the legs when walking or climbing stairs, the condition affects between 8 million and 12 million Americans, with those who have diabetes more likely to develop PAD than the general population.
The investigators used a three-dimensional motion analysis system to compare the walking patterns of seven people without PAD to 16 people with PAD and an average age of 71 who had moderately blocked leg arteries and pain in one or both of their legs when walking. They found that those with PAD had abnormal gaits; walked more slowly, even when trying to walk quickly; took smaller steps; used their hip flexor muscles less during the push-off phase of each step (when the heel is lifted but the toes are on the ground); and used their ankle flexors more during the push-off phase compared to those without the condition.
Hip flexors are muscles located at the front of the thigh that lift the leg with a pulling motion during the push-off phase of each step, while ankle flexors are located at the back of the calf and lift the leg with a pushing motion. According to the researchers, older people generally have weaker ankle flexors and use their hip flexors more during the push-off phase of walking, but people with PAD use their ankle flexors more to compensate for weakness of the hip flexors. This weakness of the hip flexors may be due to disuse and blood flow restriction to the muscles, they suggest.
So what can be done to strengthen the hip flexors and reduce dependence on the muscles of the calf? The researchers recommend exercises such as raising and holding one knee toward your chest while seated, as well as performing straight-leg lifts while lying on your back, in which one leg is lifted with the knee straight while the other leg remains bent with the foot on the floor. (Click here for a video demonstrating straight-leg lifts.)
“PAD patients should ask for an expert, such as a physical therapist, to evaluate their gate and the strength of their hip flexors and other muscles. Based on the evaluation, a combination of muscle training and walking exercise may increase how far they can walk and reduce their calf pain during walking,” notes study author and doctoral candidate Takaaki Kakihana, PT, MSc.
Until the study is published in a peer-reviewed journal, the findings should be considered preliminary.
For more information, read the article “Strengthening Hip Muscles May Ease Calf Pain From Blood Vessel Disease.” And for more information about dealing with PAD, see the article “Diabetic Leg Pain and Peripheral Arterial Disease.”
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