The paradox of Peripheral Artery Disease (PAD) treatment is both cruel and frustrating: the very activity that can heal you—walking—is precisely what causes excruciating pain. During our recent Collateral Nation podcast with Dr. Kevin Morgan, pathologist, PAD warrior, and author of “Fight the Crippling Pain of Peripheral Artery Disease,” we tackled this emotional roller coaster head-on.
As I told our live audience (several of whom were walking while watching!), it’s incredibly hard to motivate yourself to “walk, walk, walk” when you fear the claudication pain that inevitably comes. Yet without pushing through that discomfort, your body can’t build the collateral blood vessels—those natural bypasses—that are essential for improving circulation.
The Fear That Holds You Back
“Your dragon isn’t PAD,” Dr. Morgan explained during our conversation. “Your dragon is fear.”
This insight perfectly captures what I’ve heard from thousands of PAD patients through our Leg Saver hotline. The fear of pain becomes so overwhelming that many avoid the very activity that could save their limbs and restore their quality of life.
I see this fear manifest in multiple ways:
- Fear of the claudication pain itself
- Embarrassment about having to stop and rest in public
- Anxiety about being stranded too far from home
- Worry that the pain signals damage rather than progress
- Frustration when symptoms seem inconsistent or unpredictable
Mike, who joined our live discussion while actively walking outdoors, shared his recent experience: “On Friday, I had to stop after 40 minutes because the claudication pain was something I’d never experienced before. And yet I walk on the treadmill every single day for an hour and 40 minutes without issue.”
This unpredictability creates a psychological whiplash that leaves many patients hesitant to push their boundaries—precisely when they need to most.
The Grief Process: Essential First Step
Before you can effectively manage PAD through exercise, Dr. Morgan believes you must first process your emotional response to the diagnosis and its limitations.
“The biggest problem people have is grieving the past and moving on with what they have,” he explained. “This is step number one of any training program based upon recovering from a serious disease.”
The emotional journey typically follows these stages:
- Shock: The initial disbelief following diagnosis
- Anger: Frustration at your new limitations
- Acceptance: Acknowledging your new reality
- Adaptation: Learning to work within your new constraints
- Growth: Discovering unexpected value in your experience
Dr. Morgan shared his own journey through this process: “When I had my aortic aneurysm, I had no idea it would change my life for the better. It would turn me into a writer, have me writing these things to help people. You’d think it was a disaster. Turned out to be a great gift.”
I’ve seen this transformation countless times within our PAD community. What begins as devastation often evolves into unexpected purpose and connection.
Understanding Good Pain vs. Bad Pain
Once you begin processing grief and facing your fear, the next critical psychological shift involves distinguishing between beneficial discomfort and harmful pain—what Dr. Morgan calls “good pain versus bad pain.”
“You have to know the difference between good pain and bad pain,” he emphasized. “There’s the pain of training, which is what you’re doing to grow collaterals. So you have to push it to the edge, but not be on the edge.”
This distinction is vital because:
- Therapeutic claudication pain triggers the growth of collateral vessels
- Excessive pain can indicate potential tissue damage
- Learning to read your body’s signals prevents injury while maximizing benefits
Dr. Morgan compared PAD to a tightening tourniquet: “People ask what it’s like. I say, imagine someone puts a tourniquet around your leg above the knee and every month they come along and tighten it. But if you grow collaterals, you can slay the dragon.”
Rewriting Your Story: The Power of Narrative
Perhaps the most transformative psychological shift comes when PAD patients change the story they tell themselves about their condition.
“Our lives are defined by the stories we tell ourselves,” Dr. Morgan noted during our conversation. When you first develop PAD, the story often becomes one of limitation, loss, and victimhood.
Mike’s journey exemplifies how this narrative can evolve. “Six months ago, PAD defined me,” he shared. “But now I define PAD.”
This shift—from being defined by PAD to defining your relationship with it—represents the ultimate victory over the emotional roller coaster of this condition.
“I just want people to know that you can live alongside it,” Mike told our audience. “As long as you stay one step ahead of it, don’t let it drag you back. It’s a new story today.”
Strategies That Make Walking Possible
Before diving into specific walking techniques, Dr. Morgan and our PAD warriors shared several psychological approaches that help them overcome the emotional barriers to consistent exercise:
1. Focus on Today, Not Yesterday
“What you could do yesterday is irrelevant,” Dr. Morgan advised. “It’s what you can do today that’s important.”
This daily reset helps prevent discouragement from inconsistent symptoms. When you have difficult days, Dr. Morgan suggests seeing them as messages from your body rather than failures: “Your body’s telling you to back off. You may be pushing too hard. It’s actually a message to you to chill a bit.”
2. Create Safe Walking Environments to Reduce Anxiety
Fear of being stranded when pain strikes prevents many patients from walking at all. Dr. Morgan suggests:
“Go around in a circle instead of going away and coming back. I have a one-mile loop outside my house. I’m never more than a half a mile from my house.”
For beginners, he recommends school tracks: “Drive over to a local school and do your workouts on the track. It’s flat, with good surfaces, and your car is always nearby.”
These secure environments reduce anxiety and allow you to focus on the walking itself rather than worst-case scenarios.
3. Help Others to Help Yourself
One of the most powerful motivators Dr. Morgan identified was the satisfaction of helping fellow PAD patients:
“What helps me the most is finding I’ve helped someone else. When someone comes on here and says they did the PAD100 and it helped, you have no idea how that provides me with the confidence to go forward.”
I see this daily in our PAD support communities—those who reach out to help others often find renewed motivation for their own journey.
Walking: Techniques That Work
Once you’ve begun addressing the psychological barriers, it’s time to focus on effective walking techniques specifically designed for PAD patients.
The PAD 100: Transforming Feet into Circulation Pumps
Dr. Morgan’s innovative approach to improving circulation begins with recognizing that “every muscle is a pump” and putting that principle into practice with each step.
“We’ve forgotten how to use our feet,” he explained during our podcast. “Our ancestors used their feet to climb trees, but we stuffed them in shoes and forgot about them. So now it’s time to wake them up.”
His “PAD 100” exercise technique has shown remarkable results for many patients in our community. Mike, who was walking during our live discussion, shared: “Every single morning, I flex my feet, I spread my toes as I bring my feet up, and then I grab them as if I’m grabbing something with my toes as I’m putting them down.”
The technique involves conscious movement with each step:
“When you move your feet, as they come off the ground, you’re spreading your toes, not pointing your toes,” Dr. Morgan clarified. “You have to spread them to help blood flow. And then you grab the ground to contract the muscles on your feet and somewhat in your calves.”
I’ve incorporated this technique into my own walking routine and even got my dad (who recently had hip surgery) to start doing it. Beyond improving circulation, I’ve found that focusing on these toe movements provides a helpful distraction: “When you’re concentrating on something like curling your toes,” I shared during our broadcast, “it passes the time and takes your mind off discomfort because you have something else to focus on.”
Walking Through Pain: Building Your Endurance
Dr. Morgan, who at 82 years old is training for another half Ironman race, emphasized that building endurance with PAD requires a strategic approach:
“It’s a journey, not a destination,” he reminded us. When starting your walking program, he suggests:
- Begin with what you can do today, not what you used to do
- Expect good days and bad days
- Rest when your body signals it needs recovery
- Gradually increase duration rather than intensity
- Use mental distraction techniques during difficult patches
Mike’s journey demonstrates the effectiveness of this patient, persistent approach. Six months ago, he could barely walk ten minutes without pain. During our podcast, he revealed: “I climbed a mountain six weeks ago. I do running. I do one-minute intervals of running. Now on the treadmill, I do an hour and 40 minutes daily.”
The Support System: You Don’t Have to Do This Alone
The journey through PAD’s physical and emotional challenges was never meant to be traveled alone. Our podcast community demonstrates the power of connection in managing this condition.
Dr. Morgan noted that building a support network becomes “increasingly important as you get older. And you know how you build a support network? You be kind to other people. That’s all you have to do and care about other people. And before you know it, they’re caring about you.”
During our broadcast, we witnessed this support in real-time. Marie, watching while having a difficult day herself, sent love to Mike as he shared his story—a small but meaningful gesture of solidarity in the PAD journey.
You can join our PAD support groups at PADsupportGroup.org or WalkingSupportGroup.com
Becoming the Author of Your PAD Story
Dr. Morgan left us with a perspective that I believe every PAD patient should embrace: “You are your best doctor. Your doctor is a tool. Your surgeon is a tool. They’re one of the many tools in your toolbox. The treadmill is a tool. Your partners are a tool. They’re people or things that help you deal with it, but you are your best physician at the end of the day.”
This empowered approach—being an active participant rather than a passive recipient in your care—makes all the difference in managing both the physical and emotional challenges of PAD.
If you’re experiencing symptoms like leg pain, cramping, neuropathy, foot burning, tingling, hair loss on your legs, shiny legs, or cold feet, call our Leg Saver hotline at 1-833-PAD-LEGS. Our team can connect you with resources, including Dr. Morgan’s techniques and our My Steps walking program.
And remember, as we witnessed with Mike’s journey: where you are today with PAD is not where you have to stay. With consistent effort, community support, and the right mindset, you can write a new story—one where PAD is just a chapter, not the whole book.
For more information on PAD management, visit PADhelp.org or check out Dr. Kevin Morgan’s resources at inspirationalselfhelpbooks.com. You can also pick up his latest book, “How To Fight The Crippling Pain of Peripheral Artery Disease” on Amazon.