Can you recom­mend exer­cises for me as a suf­ferer of ath­er­o­scler­o­sis, which causes me claudica­tion when I walk?

By the time most people dis­cover they have “ath­er­o­scler­o­sis”, the dam­age to their blood ves­sels is already quite ser­i­ous. The arter­ies car­ry­ing oxygen-​rich blood around the body lose their nat­ural spring­i­ness and also become thickened and dam­aged from a build-​up of fatty depos­its on the inside. Blood has less room to flow, and may struggle to carry enough oxy­gen through the smal­ler arter­ies to fuel work­ing muscles.

It takes years for the arter­ies to thicken and harden as a res­ult of factors such as genet­ics, poor diet (too much fatty food), smoking and lack of exer­cise. Most of us remain unaware of these creep­ing unhealthy changes until the dam­age causes some­thing dra­matic: angina pain, a mini-​stroke or even a heart attack.

As yet we have no way of revers­ing ath­er­o­scler­o­sis dam­age, so once you know you have the prob­lem, your main aim should be to pre­vent any fur­ther deteri­or­a­tion, through good diet, med­ic­a­tions if pre­scribed, and exer­cise.

In your case the dam­age is caus­ing prob­lems when you walk. “Claudication” pro­duces an intense leg pain whenever the muscles need more oxy­gen than the arter­ies can deliver. Smokers and dia­bet­ics are more at risk of devel­op­ing claudica­tion (also called “peri­pheral vas­cu­lar dis­ease”).

In other instances it could be the arter­ies to the brain or heart that mal­func­tion. And because ath­er­o­scler­o­sis is so often linked to heart dis­ease, you should always get clear­ance from your GP before start­ing an exer­cise pro­gramme.

Having said that, care­fully con­trolled exer­cise can be a cru­cial tool in help­ing to keep you healthy and on your feet if you have car­di­ovas­cu­lar dis­ease of any kind. Ask your GP to put you for­ward for an “exer­cise refer­ral” scheme, where qual­i­fied train­ers will super­vise your pro­gramme and teach you how to exer­cise safely on your own.

The good news is that with cour­age and per­sever­ance, you should be able to improve your walk­ing quite a lot. The right kind of exer­cise will encour­age your body to get fit­ter in ways that will make walk­ing much more com­fort­able and easier to sus­tain in future.

A qual­i­fied instructor will ask you to walk (out­side or on a tread­mill) until your leg pain comes on, and only stop when you can no longer bear it. After a short rest the pain will go away and you’ll be asked to walk some more, and so on. This is what you may hear doc­tors refer­ring to as “walk­ing through the pain” – and it’s about the only instance in exer­cise train­ing when we ask people to put up with pain. Over time, you should be able to walk farther and faster before the pain comes on. Other strength­en­ing exer­cises to com­ple­ment your walk­ing pro­gramme should make you feel a lot more pos­it­ive about man­aging your arter­ial dis­ease long-​term.