Peripheral arterial disease
Caused by narrowing or blockage of the arteries in the limbs, peripheral arterial disease usually causes restriction of blood supply to the legs, with intermittent pain in the lower legs during exercise or walking the result. This is known as claudication and is due to a lack of oxygen and nutrients getting to the muscles.
In extreme cases, known as acute limb ischaemia, the blood supply is completely blocked and amputation may be necessary. Around 20 per cent of people aged over 60 have some degree of peripheral arterial disease with about one in 12,000 developing acute limb ischaemia per year. Smoking is by far the biggest risk factor, with diabetes, high blood pressure and high cholesterol also contributing. The mainstay of treatment for PAD is medication to reduce cholesterol, thin the blood and control blood pressure. Regular exercise, including cycling, has a major supporting role. Mark McCarthy, keen cyclist and vascular surgeon, says: “The act of cycling improves blood flow to the legs, which can lead to increased walking distances in some groups of patients with intermittent claudication.”
Research has shown that regular endurance exercise can actually increase the diameter of the femoral artery – the main blood supply to the legs.
If surgical treatment is required, an angioplasty may be carried out. This involves opening up the blocked vessels with a special balloon, passed through the artery via a small cut in the groin. According to Mark, cycling can help in rehabilitation from this procedure and improve results. “Walking is recommended immediately following angioplasty, but after about a week, cycling can be commenced. By improving the blood flow to the legs, this will help maintain the effectiveness of the angioplasty in the long term, and help to keep it open.” If you suffer from PAD and are thinking about taking up cycling, Mark has this advice: “If you are new to cycling I would recommend purchasing a hybrid bike with ordinary pedals, and an easy gear ratio to get you up occasional hills. Try short distances first, and build up the distance and time you spend on the bike. I would also recommend taking a phone with you in case you find yourself stranded. Keep well hydrated and take a snack with you.”