a.k.a. PAES


If you experience a lot of calf pain during exercise, it could be a sign of Popliteal Artery Entrapment Syndrome (PAES). In this rare vascular disease, compression to the popliteal artery cuts off the blood supply to the lower leg. The short term side effects are usually cramping and pain in the calf, but the long term side effects can be damage to the nerves and muscles in the leg.

PAES is most common among athletes because the most common mechanism of this disease has to do with muscular development. The popliteal artery runs through the knee and behind the calf muscle. For many people, its position is no problem. Some people, however, are born with an abnormal positioning of the popliteal artery, or have an abnormally large calf muscle.

In other cases PAES occurs after rapid muscle gains that put compression on the artery. Young athletes sometimes develop PAES as they work to strengthen their muscles. We often see that the problem surfaces as athletes in their teens or 20s experience muscle gains.

Sports that emphasize the strength and development of the calf muscles are at a particular risk for PAES. These include soccer, rugby, football, and running. We see PAES develop in male athletes more often than female athletes, although it’s possible in all genders.


Since we regularly see cases of PAES in our field, we are trained to differentiate PAES from other lower leg problems. Symptoms of PAES usually include cramping, pain, tingling, or numbness in the calf area, cold feet after exercise, and sometimes swelling. All symptoms are usually worse with exercise.

Learning about your history as an athlete and any past injuries will help us understand the mechanism of the condition. In some cases, using an ultrasound is recommended for confirming the presence of PAES.

Most patients with PAES will need surgery to improve their condition. The surgery is relatively straight forward, with the intention of releasing the popliteal artery from any compression. The majority of patients recover completely from their PAES surgery, with normal blood flow and the disappearance of all related symptoms.

Usually, patients can begin walking right away post-surgery. However, a lot of surgeons will recommend that patients still use physical therapy afterwards to help them return to play comfortable and confidently. Our team at MOTUS has helped numerous athletes recovering from a PAES surgery, and we find that with innovative tools like anti-gravity treadmills and Isokinetic Training, we can make recovery even more rewarding.


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