Overview

Popliteal artery entrapment syndrome (PAES) is a rare vascular disease that affects the legs of some young athletes. When you have this syndrome, the muscle behind your knee compresses your popliteal artery — the main artery that runs from your thigh to your calf.

The attachment of your gastrocnemius muscle to your thigh bone causes compression. When your gastrocnemius muscle contracts during foot plantar flexion (pushing down), your muscle compresses your artery.

During exercise, repetitive compression leads to spasms of your artery. This reduces blood flow. The reduced blood flow leads to a buildup of lactic acid and carbon dioxide in your muscles and nerves, which produces heaviness, achiness, tiredness and sometimes numbness in your calf and foot.

Symptoms typically improve three to five minutes after stopping the exercise. Without treatment, over time, the spasm tends to occur quicker and last longer. Symptoms occur after a shorter distance and it takes longer to recover.

Who does popliteal artery entrapment syndrome affect?

PAES occurs most often in athletes between the ages of 15 and 25 years old, particularly those who take part in activities and sports that involve running. These include:

  • Track.
  • Cross country.
  • Soccer.
  • Lacrosse.
  • Field hockey.

How common is popliteal artery entrapment syndrome?

According to estimates, less than 1% of people have PAES. It’s difficult to know the true number of people who have this condition.

Are there any other conditions that may mimic popliteal artery entrapment syndrome?

Chronic exertional compartment syndrome (CECS) is a much more common condition that’s also an exercise-induced muscle and nerve condition. It causes pain, swelling and sometimes disability in the affected muscles of your legs or arms. Anyone can develop the condition, but it’s more common in young adult runners and athletes who participate in activities that involve repetitive impact.

Some people with popliteal artery entrapment syndrome may also have chronic exertional compartment syndrome. About 5% of people who don’t improve after PAES treatment may find they also have CECS. It’s possible to have both of these conditions at the same time.

Popliteal artery entrapment syndrome (PAES) vs. chronic exertional compartment syndrome (CECS)

To check for PAES, your healthcare provider will get resting leg blood pressures and look for a drop with exercise. To check for CECS, they’ll measure the pressure in the four compartments of your leg before and after exercise. An abnormal rise of the pressure in your calf compartments occurs in CECS.

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Symptoms

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Complications

Blood clots are a dangerous complication of atrial fibrillation (AFib). Blood clots can lead to stroke.
The risk of stroke from AFib increases as you grow older. Other health conditions also may increase the risk of a stroke due to AFib. These conditions include:
  • High blood pressure.
  • Diabetes.
  • Heart failure.
  • Some types of heart valve disease.
Blood thinners are commonly prescribed to prevent blood clots and strokes in people with atrial fibrillation.

Prevention

Healthy lifestyle choices can reduce the risk of heart disease and may prevent atrial fibrillation (AFib). Here are some basic heart-healthy tips:
  • Control high blood pressure, high cholesterol and diabetes.
  • Don't smoke or use tobacco.
  • Eat a diet that's low in salt and saturated fat.
  • Exercise at least 30 minutes a day on most days of the week unless your health care team says not to.
  • Get good sleep. Adults should aim for 7 to 9 hours daily.
  • Maintain a healthy weight.
  • Reduce and manage stress.


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