I managed to turn my feet and calves into "remote blood pumping stations," by changing the way I use my feet. It's made a real difference to my walking and running (though that is still tough). Not easy at first, but it is working. Took me years to solve this PAD disease plumbing puzzle, based on basic vascular anatomy and physiology. But then, I am a veterinary pathologist, and a pathologist's job is to determine mechanisms of disease. It's what we do! We can't help it! And I want to run marathons again, even though I'm in my 80s. Based on personal experience of the crippling pain of peripheral artery disease (PAD), I created this step-by-step training plan, to help anyone, not just athletes, for whom their physicians and surgeons have done all they can for their lower limb ischemia (impaired blood flow due to blocked arteries). As a veterinary pathologist, researcher, and athlete, suffering severe PAD since 2014, including almost complete blockage of my right popliteal artery, I undertook the task of finding ways to improve blood flow to my calves and feet. PAD was ruining my enjoyment of my sport, Ironman distance triathlons. I researched the issue, testing a range of body movement changes, over a period of eight years, During this time, I've managed to reduce claudication pain and numb feet, during walking and running, including on hills, while slowly improving my athletic performance. The proof of my method? Eight years after my excellent vascular surgeon said there was no more he could do for me, safely, I came in third in my age group, 80-84, in the 2023 World 70.3 Ironman Championships, in Lahti, Finland. I improved blood flow in my calves and feet by converting them to "remote blood pumping stations." Remote from what you might ask? Remote from my heart, which is only one, well two, of the thousands of vascular pumps in your body. Do the work, thinking like an endurance athlete, and I'm sure you'll make progress. If you do try my methods, please give me feedback, as I'm constantly working to find new ways to fight this horrible condition that affects so many, especially those with genetic dyslipidemias (high blood fat), as I do, or with diabetes. I want to get back to running marathons and full Ironman distance. No big request in my early 80s, do you think? Never give up! Kind regards, -kev aka FitOldDog aka Dr. Kevin Thomas Morgan, BVSc, PhD, DipACVP, FRCPath