During exercise, athletes sometimes suffer from pain or cramping in the lower calf. They may also notice tingling, burning or numbness in the calf and cold feet after exercise. While the discomfort usually goes away with rest, these symptoms should not be ignored, says Huiting Tina Chen, M.D., a vascular surgeon with Henry Ford Health.
“This type of pain may be a circulation issue called popliteal artery entrapment syndrome, or PAES,” says Dr. Chen. “It is sometimes called the ‘jogging disease,’ because it is typically found in otherwise healthy men and women around 30 years old who are competitive in running, cycling or soccer.”
It is sometimes misdiagnosed, she says, because the typical person with vascular issues is much older, a smoker or former smoker, and has chronic issues that affect circulation, such as diabetes, kidney disease or heart disease.
PAES occurs when the calf muscle is enlarged or is in an abnormal position that causes it to press on the main artery behind the knee (the popliteal artery). This limits blood flow to the lower leg and foot. In those who have the condition, it is often present at birth and symptoms become more noticeable over time, as intense training increases pressure on the artery.
The calf muscle may compress on either the popliteal artery or the popliteal vein and cause:
- leg heaviness, numbness or swelling
- calf cramping, especially during physical activities
- color changes in the skin
- the formation of blood clots
If left untreated, long-term pressure on the popliteal artery can cause it to narrow, which may result in cramping while walking or engaging in another mild activity. Severe cases may lead to blood clots (called deep vein thrombosis) or popliteal aneurysm (a stretching and thinning in the artery wall that could burst).
How PAES Is Found and Treated
If you are a healthy athlete experiencing calf pain, talk with your primary care provider to get referred to a vascular health specialist. Tests to rule out more common causes may include measuring the blood pressure in your leg, an ultrasound test while you point and flex your foot, or a soft-tissue MRI.
If the PAES diagnosis is confirmed, it can be surgically treated by releasing pressure along the artery. Advanced cases may require an arterial bypass, which is a surgery to re-route blood flow around the compressed area of the popliteal artery.
“Once treated, athletes feel immense relief they haven’t experienced in years,” says Dr. Chen.
To learn about other forms of vascular disease and their treatment, visit henryford.com/vascular.
To find a doctor at Henry Ford, visit henryford.com or call 1-800-436-7936.
Dr. Huiting Tina Chen is board certified in vascular surgery and is experienced in complex, minimally invasive techniques. She sees patients at Henry Ford Vascular Health in Jackson and Mason.
