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• #1 Popliteal artery entrapment syndrome – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/popliteal-artery-entrapment/symptoms-causes/syc-20465211

  Popliteal artery entrapment syndrome (PAES) is an uncommon condition that affects the main artery behind the knee. […] The main symptom of popliteal artery entrapment syndrome (PAES) is pain or cramping in the back of the lower leg. The pain occurs during exercise and goes away with rest. Other symptoms may include: Cold feet after exercise. Tingling or burning in your calf. Numbness in the calf area. […] If the nearby vein, called the popliteal vein, also becomes trapped by the calf muscle, you may have: A heavy feeling in the leg. Lower leg cramping at night. Swelling in the calf area. Changes in skin color around the calf muscle. Blood clot in the lower leg, called deep vein thrombosis. […] Symptoms typically affect young, otherwise healthy people under age 40. […] Long-term pressure on the popliteal artery can cause the artery to narrow. This is called artery stenosis. It can cause pain and cramping with just slight activity, such as walking. […] In severe cases or when undiagnosed, the nerves and muscles in the leg can become damaged. Blood clots may occur in the lower leg.

• #1

  https://www.orthobullets.com/knee-and-sports/3107/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome is a condition characterized by constriction of the popliteal artery by adjacent muscles, tendons or fibrous tissue. […] Diagnosis can be suspected clinically with diminished pulses with active foot plantar flexion or passive foot dorsiflexion and confirmed with a lower extremity arteriogram. […] Treatment is generally conservative for mild symptoms with vascular surgery indicated for patients with refractory symptoms. […] Patients often report limb swelling as primary complaint. […] Foot numbness and paresthesias also common. […] Tingling sensation of toes following vigorous exercise. […] Calf cramping following even light exercise as the condition worsens. […] Limbs can occasionally be asymptomatic. […] Diminished pulses with active foot plantar flexion or passive foot dorsiflexion. […] Coolness of posterior calf and paresthesias may also be present. […] Most patients eventually require surgery. […] 70-100% of patients are reported to be asymptomatic after surgery.

• #1

  https://drtobycohen.com.au/popliteal-entrapment-syndrome/

  Popliteal artery entrapment syndrome, also known as PAES, is a rare condition in which an abnormally positioned or enlarged calf muscle compresses the popliteal artery, positioned behind the knee. […] Symptoms usually come on over a number of years. The most common symptom is pain or cramping in the back of the lower leg. Calves can go rock hard and then take several days to recover. This pain often recedes when the leg is rested. Other symptoms include: Numbness in the lower leg or calf, Tingling or burning, Cold feet after exercise. […] Typical symptoms of PAES include: Tightness in the calf when walking, Numbness in the foot after exercise, Tender calves, Pins and needles in the feet.

• #1 Popliteal Artery Entrapment Syndrome (PAES): Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17375-popliteal-artery-entrapment-syndrome-paes

  Popliteal artery entrapment syndrome symptoms in your calf and/or foot during exercise may include: […] Symptoms typically go away after three to five minutes of rest. Over time (without treatment), the symptoms tend to happen at shorter distances and take longer to go away. […] Surgery is the preferred treatment for popliteal artery entrapment syndrome because it gives excellent results for most people. More than 90% of people who have the surgery have great improvement in their symptoms afterward. […] If you dont get treatment until after anatomic PAES has damaged your popliteal artery, you could be at risk of always having pain in your legs when you walk. It’s possible to need to have a leg removed. However, this is very rare.

• #1 Recognising and Managing Popliteal Artery Entrapment Syndrome A Concise Overview for Physiotherapists – BJSM blog – social media’s leading SEM voice

  https://blogs.bmj.com/bjsm/2025/04/07/recognising-and-managing-popliteal-artery-entrapment-syndrome-a-concise-overview-for-physiotherapists/

  Ache deep in the calf after exercise/calf loading or prolonged postures. […] Key aggravators: calf-loading exercises, uphill walking, stair climbing, hiking, running, sustained plantarflexion, or prolonged standing. […] In some cases, pressing a car accelerator may also provoke symptoms. […] Long-term recurrence in FPAES may result from fibrosis around the neurovascular bundle. […] Recognising PAES: PAES is an important differential diagnosis for chronic exertional leg pain. It is commonly missed, leading to delays in diagnosis and treatment.

• #1 Popliteal Artery Entrapment Syndrome (PAES) – Physio Plus

  https://physioplus.com.au/popliteal-artery-entrapment-syndrome-paes/

  Popliteal Artery Entrapment Syndrome (PAES) is an obscure cause of exercise induced calf pain. PAES typically affects a young 20-40yo athletic population and is up to 15x more common in males than females. Patients with PAES will typically present with intermittent claudication (posterior calf pain/cramping) and/or paraesthesia during exercise or exertion. The main subjective difference is that PAES is more specifically exacerbated by exercise intensity rather than volume. PAES can present almost instantly under the right circumstances i.e running uphill, repetitive jumping, sprinting. PAES will present sooner than compartment syndrome with a loss of the dorsalis pedis or posterior tibial pulse, symptoms also settle a lot quicker as they settle with the recovery of the athletes heart rate and blood pressure. Early detection and intervention is important as prolonged stenosis of the vessel can cause scarring and atherosclerosis of the inner vessel wall. If left untreated PAES may require invasive procedures to stent the vessel open and can significantly impact an athletes career. Therefore, early detection is key. Standard treatment of PAES involves relocating the medial gastroc head, optimizing the popliteal artery tract. However, botulinum A toxin (botox) injections used locally to the site of constriction in the medial gastroc head has gained traction in recent literature and is showing promising results. The procedure is far less invasive than traditional measures and has been shown to effectively reduce the muscles constriction of the vessel during exercise. Another benefit is that recovery time is significantly reduced, the player can return to sports almost immediately as function and pain allow. Long term management involves educating the patient to avoid excessive training of calves that would promote increased medial calf bulk which would encourage the condition to return. […] Take home, is that this condition is quite RARE. Your exercise induced calf pain is far more likely to be a result of the more common diagnoses, such as compartment syndrome.

• #1 Popliteal Artery Entrapment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441965/

  The hallmark of this disease is a vascular compromise within the popliteal fossa resulting in an insidious, progressive course of exercise intolerance and calf pain with exertion relieved by rest (claudication). […] Patients with PAES primarily present complaining of intermittent pain in the feet and calves that usually occurs after the exercise and vanishes at rest. […] Typically, patients present with the complaints of leg and foot claudication that can be quite severe and disabling. […] Moreover, the physical examinations usually reveal hypertrophy of the calf muscles. […] The prognosis of the PAES entirely relies on its detection time. If PAES is detected and managed early in the course of the disease, the prognosis of the PAES is generally reasonable. However, if the PAES is detected late when extensive arterial damage has already happened, then the patient is at risk of having permanent claudication or even limb. […] If this disorder is undetected, PAES can lead to the popliteal artery stenosis (PAS), popliteal artery thrombosis (PAT), as well as distal arterial thromboembolism (DAT).

• #1 Popliteal artery entrapment syndrome: What to know

  https://www.medicalnewstoday.com/articles/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) is a rare condition affecting the artery in the back of the knee. It causes pain in the lower legs during exercise. […] The symptoms of PAES generally improve after rest. Surgery may also help. […] People with PAES usually report to a doctor with severe and disabling leg and foot pain that gets worse with physical activity but gets better with rest. […] They may also note the following symptoms in the legs and feet: calf pain, numbness, cool, pale skin, pins and needles, prickling, or skin-crawling sensations, swollen calf muscles, reduced or absent pulse in the foot when flexing it inward. […] People with PAES may experience severe pain in their calves and feet during exercise. The pain usually gets better during rest. […] The outlook of PAES improves with early detection and treatment, but if artery damage has occurred, an individual may have permanent pain during movement.

• #1 Popliteal artery entrapment syndrome: What to know

  https://www.medicalnewstoday.com/articles/popliteal-artery-entrapment-syndrome

  Without treatment, people with PAES may require the amputation of a leg. However, this is very rare, as even severe PAES develops slowly. Doctors usually identify and treat PAES long before a person loses a leg. […] PAES occurs due to increased pressure from the calf muscles on a blood vessel that supplies the lower leg.

• #1 Frontiers | Case Report: COVID-19 exacerbates acute lower limb ischemia in patients with popliteal artery entrapment syndrome

  https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1329863/full

  Popliteal artery entrapment syndrome (PAES) is a rare clinical ischemic disease of the lower limbs, mainly caused by various reasons such as popliteal artery compression and stenosis and secondary thrombosis caused by an injury of the vascular endothelium due to exercise and other factors. The main manifestation is progressive motor pain in the lower limbs, and the combination of high-risk factors such as infection and smoking for thrombosis will exacerbate lower limb ischemia. If not diagnosed and treated appropriately, it may lead to disability and even serious consequences, such as amputation. […] During the progression of the disease, there may be multiple factors that accelerate its progression. […] COVID-19 may increase the risk of arteriovenous thrombosis, which may further aggravate the acute ischemia of lower limbs in people with PAES. Thus, these people tend to be given preventive anticoagulant treatment to avoid serious complications such as amputation.

• #1 Popliteal entrapment syndromes – UpToDate

  https://www.uptodate.com/contents/popliteal-entrapment-syndromes

  Popliteal artery entrapment is the most common form, and popliteal artery compression can reduce blood flow to the leg causing ischemic symptoms. Symptoms are usually chronic, but acute ischemia can also occur. […] The overall prevalence of PES is estimated to range from 0.17 to 3.5 percent of the general population. […] Typical atherosclerotic risk factors such as smoking, hypertension, hypercholesterolemia, and diabetes are absent. […] Popliteal entrapment is most common in athletes participating in long-distance running, basketball, football, rugby, soccer, and martial arts.

• #1 Recognising and Managing Popliteal Artery Entrapment Syndrome A Concise Overview for Physiotherapists – BJSM blog – social media’s leading SEM voice

  https://blogs.bmj.com/bjsm/2025/04/07/recognising-and-managing-popliteal-artery-entrapment-syndrome-a-concise-overview-for-physiotherapists/

  Popliteal Artery Entrapment Syndrome (PAES), first described in 1965, involves neuromuscular and ischemic symptoms caused by pathologic impingement of the popliteal artery (PA), with or without the involvement of the popliteal vein, and tibial nerve in the popliteal fossa. […] The median delay in diagnosis is 12 months, with reports of misdiagnosis lasting up to 15 years due to the young age of patients, lack of atherosclerotic risk factors, and similarity to other lower limb conditions. If undiagnosed, it can progress to chronic complications, including arterial occlusion, critical limb ischemia, aneurysm formation, or even amputation. […] PAES typically presents with (typically one of or a combination of the following) calf cramping & tightness/fullness, swelling, paraesthesia into the feet and toes, coldness, or loss of distal pulses with exertion.

• #1 Popliteal Artery Entrapment Syndrome in a Young Baseball Pitcher: A Ca | JPR

  https://www.dovepress.com/popliteal-artery-entrapment-syndrome-in-a-young-baseball-pitcher-a-cas-peer-reviewed-fulltext-article-JPR

  Although PAES is not common and has often been under-diagnosed, it is a very important differential diagnosis of lower limb numbness and pain, especially when young people develop symptoms after exercising and experience intermittent claudication. It is necessary to include this disease in differential diagnosis to implement early diagnosis and ultrasonography is a more cheap and simple method for early detection.

• #1 Long-Term Results of Surgical Treatment for Popliteal Artery Entrapment Syndrome

  https://www.mdpi.com/2075-4418/14/12/1302

  Repetitive trauma to the popliteal artery from focal impingement results in chronic inflammation, followed by occlusive or aneurysmal formation. However, this type is underestimated because only dynamic maneuvers can detect it. Nevertheless, to avoid the disease progression and associated critical complications, surgeons and physicians should not underestimate a clinical suspicion of such pathology. […] Long-term results of surgical treatment for PAES seem to be very satisfying. Myotomy with or without arterial reconstruction using venous bypass can lead to good patency at 15 years of follow-up.

• #1 Sports Injury Bulletin – Anatomy – Popliteal artery entrapment: a mysterious syndrome

  https://www.sportsinjurybulletin.com/anatomy/popliteal-artery-entrapment-a-mysterious-syndrome

  Therefore, a clinical exam and leg pain are not sufficient to diagnose PAES; there must be evidence of actual vascular occlusion in conjunction with the pain. […] Occlusion found on ultrasound, combined with characteristic pain symptoms, is significant for both anatomical and functional PAES. […] Symptoms of intermittent claudication, even in a young athlete, should always warrant a full exploration of vascular integrity, regardless of compartment pressures. […] In cases of anatomical PAES, surgery is almost always the most effective treatment. […] Results are nearly always positive, with more than 90% of athletes who undergo this type of surgery fully returning to sport within three months. […] Functional PAES may be more difficult to treat effectively. Surgery in these situations appears somewhat less effective, with an average success rate around 80%.

• #1 Popliteal Artery Entrapment Syndrome (PAES) – Motus Physical Therapy

  https://motusspt.com/popliteal-artery-entrapment-syndrome-paes/

  In some cases, PAES can also cause problems with blood flow to the leg, such as claudication (pain with walking) or ulcers. […] Most people with PAES experience a significant improvement in symptoms with treatment. […] However, the condition can recur, particularly if you do not avoid activities that put stress on the popliteal artery.

• #1 Popliteal Artery Entrapment Syndrome (PAES) Causes and Treatments

  https://www.upmc.com/services/heart-vascular/conditions/popliteal-artery-entrapment-syndrome

  PAES tends to affect male athletes under 30, largely runners. It causes symptoms most often during a workout such as pain, numbness, or cramping in the calf. […] PAES symptoms may include: Coolness in the foot and calf. Discoloration of the toes and toenails. Pain, numbness, tiredness, or cramping in the calf during exercise. Swelling in the leg. […] Often, symptoms improve after a few minutes of rest but return during exercise. […] If left untreated, it can cause permanent damage to your popliteal artery, nerves, or muscles. […] In severe cases, permanent muscle or nerve damage can occur due to compression or loss of blood flow to the lower leg. […] After PAES surgery, most people make a full recovery with a low risk of recurrence. Most athletes are able to return to their sport. […] PAES surgery successfully relieves symptoms in more than 90 percent of people. However, if you have damage to your popliteal artery, you may have pain in your legs when you exercise, even after surgery.

• #1 Popliteal Artery Entrapment Syndrome…Is anyone out there? – StudioVeena.Com

  https://www.studioveena.com/discuss/discussion/Popliteal_Artery_Entrapment_SyndromeIs_anyone_out_there_20160902032445/

  I have been suffering from functional Popliteal Artery Entrapment Syndrome (PAES) for close to 5 years. […] I started seeking treatment and a diagnosis for the severe cramping and numbness I had in my lower legs. […] The dangers of no blood flow could lead to damage in my artery, blood clots, and eventually the loss of my legs. […] I suffered severe nerve damage and no longer have feeling over 50% of my lower leg. […] In February I noticed that my legs were actually worse feeling. […] After another angiogram it became evident that I no longer had any blood flow in either leg. […] I am crushed and devastated and will totally go against his AMA. […] The experience enough is damaging and life changing and it is difficult when no one has heard of this or understands what is happening. […] I now have PTSD and panic attacks before every appointment. […] I can barely walk a block without the pain killing me. […] No one understands the excruciating pain that starts to shoot up your legs.

• #1 Popliteal artery entrapment syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Popliteal_artery_entrapment_syndrome

  The popliteal artery entrapment syndrome (PAES) is an uncommon pathology that occurs when the popliteal artery is compressed by the surrounding popliteal fossa myofascial structures. This results in claudication and chronic leg ischemia. Patients with PAES mainly present with intermittent feet and calf pain associated with exercises and relieved with rest. Associated symptoms include numbness, discoloration, pallor, and coolness in the affected lower extremity. Complications of untreated PAES can include stenotic artery degeneration, complete popliteal artery occlusion, distal arterial thromboembolism, or even formation of an aneurysm. Prolonged compression of the popliteal artery can lead to extensive arterial damage and permanent claudication or limb loss. Nonetheless, the course of PAES is often slow and takes time, thus, limbs loss is rarely seen, even in PAES patients.

• #2 Popliteal Artery Entrapment Syndrome | Frankel Cardiovascular Center | Michigan Medicine

  https://www.umcvc.org/conditions-treatments/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) is a rare vascular condition that affects the legs. It occurs when the popliteal artery the dominant source of blood supply to the leg below the knee becomes compressed by a muscle, tendon or band behind the knee. This compression restricts blood flow to the lower leg and can cause damage to the artery over time. […] Patients with PAES typically experience an onset of symptoms associated with exercise, which may include: Aching pain (claudication), numbness or cramping in one or both calves during strenuous exercise (typically occurring within 5 or 10 minutes and subsiding when exercise stops) […] Pain in the lower leg and feet at rest (in patients with advanced PAES). […] In more advanced cases, the compression may cause permanent change to the artery or complete blockage.

• #2 Popliteal Artery Entrapment Syndrome (PAES): Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17375-popliteal-artery-entrapment-syndrome-paes

  Popliteal artery entrapment syndrome symptoms in your calf and/or foot during exercise may include: […] Symptoms typically go away after three to five minutes of rest. Over time (without treatment), the symptoms tend to happen at shorter distances and take longer to go away. […] Surgery is the preferred treatment for popliteal artery entrapment syndrome because it gives excellent results for most people. More than 90% of people who have the surgery have great improvement in their symptoms afterward. […] If you dont get treatment until after anatomic PAES has damaged your popliteal artery, you could be at risk of always having pain in your legs when you walk. It’s possible to need to have a leg removed. However, this is very rare.

• #2 Popliteal artery entrapment syndrome // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) is an uncommon condition in which an abnormally positioned or enlarged calf muscle presses on the main artery behind the knee (popliteal artery). The artery becomes trapped, making it harder for blood to flow to the lower leg and foot. […] The main symptom of popliteal artery entrapment syndrome (PAES) is pain or cramping in the back of the lower leg (the calf) that occurs during exercise and goes away with rest. Other signs and symptoms may include: Cold feet after exercise, Tingling or burning in your calf (paresthesia), Numbness in the calf area. […] Symptoms typically affect young, otherwise healthy people under age 40. […] Long-term pressure on the popliteal artery can cause the artery to narrow (stenosis), causing pain and cramping with just slight activity, such as walking. […] The lack of blood flow results in pain and cramping in the back of the lower leg during times of activity.

• #2 Popliteal artery entrapment syndrome | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/popliteal-artery-entrapment-syndrome?content_id=CON-20459610

  Calf pain cramping your style during a workout? Know the symptoms of popliteal artery entrapment syndrome. […] The main symptom of popliteal artery entrapment syndrome (PAES) is pain or cramping in the back of the lower leg. The back of the lower leg is called the calf. The pain occurs during exercise and goes away with rest. Other symptoms may include: […] Cold feet after exercise. […] Tingling or burning in your calf. […] Numbness in the calf area. […] If the nearby vein, called the popliteal vein, also becomes trapped by the calf muscle, you may have: […] A heavy feeling in the leg. […] Lower leg cramping at night. […] Swelling in the calf area. […] Changes in skin color around the calf muscle. […] Blood clot in the lower leg, called deep vein thrombosis. […] Symptoms typically affect young, otherwise healthy people under age 40. […] Long-term pressure on the popliteal artery can cause the artery to narrow. This is called artery stenosis. It can cause pain and cramping with just slight activity, such as walking. […] When the condition is diagnosed and treated early, a full recovery is expected, and symptoms should disappear.

• #2

  https://www.orthobullets.com/knee-and-sports/3107/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome is a condition characterized by constriction of the popliteal artery by adjacent muscles, tendons or fibrous tissue. […] Diagnosis can be suspected clinically with diminished pulses with active foot plantar flexion or passive foot dorsiflexion and confirmed with a lower extremity arteriogram. […] Treatment is generally conservative for mild symptoms with vascular surgery indicated for patients with refractory symptoms. […] Patients often report limb swelling as primary complaint. […] Foot numbness and paresthesias also common. […] Tingling sensation of toes following vigorous exercise. […] Calf cramping following even light exercise as the condition worsens. […] Limbs can occasionally be asymptomatic. […] Diminished pulses with active foot plantar flexion or passive foot dorsiflexion. […] Coolness of posterior calf and paresthesias may also be present. […] Most patients eventually require surgery. […] 70-100% of patients are reported to be asymptomatic after surgery.

• #2

  https://drtobycohen.com.au/popliteal-entrapment-syndrome/

  Popliteal artery entrapment syndrome, also known as PAES, is a rare condition in which an abnormally positioned or enlarged calf muscle compresses the popliteal artery, positioned behind the knee. […] Symptoms usually come on over a number of years. The most common symptom is pain or cramping in the back of the lower leg. Calves can go rock hard and then take several days to recover. This pain often recedes when the leg is rested. Other symptoms include: Numbness in the lower leg or calf, Tingling or burning, Cold feet after exercise. […] Typical symptoms of PAES include: Tightness in the calf when walking, Numbness in the foot after exercise, Tender calves, Pins and needles in the feet.

• #2 Popliteal Artery Entrapment Syndrome (PAES) Causes and Treatments

  https://www.upmc.com/services/heart-vascular/conditions/popliteal-artery-entrapment-syndrome

  PAES tends to affect male athletes under 30, largely runners. It causes symptoms most often during a workout such as pain, numbness, or cramping in the calf. […] PAES symptoms may include: Coolness in the foot and calf. Discoloration of the toes and toenails. Pain, numbness, tiredness, or cramping in the calf during exercise. Swelling in the leg. […] Often, symptoms improve after a few minutes of rest but return during exercise. […] If left untreated, it can cause permanent damage to your popliteal artery, nerves, or muscles. […] In severe cases, permanent muscle or nerve damage can occur due to compression or loss of blood flow to the lower leg. […] After PAES surgery, most people make a full recovery with a low risk of recurrence. Most athletes are able to return to their sport. […] PAES surgery successfully relieves symptoms in more than 90 percent of people. However, if you have damage to your popliteal artery, you may have pain in your legs when you exercise, even after surgery.

• #2 Popliteal Artery Entrapment Syndrome (PAES) – Physio Plus

  https://physioplus.com.au/popliteal-artery-entrapment-syndrome-paes/

  Popliteal Artery Entrapment Syndrome (PAES) is an obscure cause of exercise induced calf pain. PAES typically affects a young 20-40yo athletic population and is up to 15x more common in males than females. Patients with PAES will typically present with intermittent claudication (posterior calf pain/cramping) and/or paraesthesia during exercise or exertion. The main subjective difference is that PAES is more specifically exacerbated by exercise intensity rather than volume. PAES can present almost instantly under the right circumstances i.e running uphill, repetitive jumping, sprinting. PAES will present sooner than compartment syndrome with a loss of the dorsalis pedis or posterior tibial pulse, symptoms also settle a lot quicker as they settle with the recovery of the athletes heart rate and blood pressure. Early detection and intervention is important as prolonged stenosis of the vessel can cause scarring and atherosclerosis of the inner vessel wall. If left untreated PAES may require invasive procedures to stent the vessel open and can significantly impact an athletes career. Therefore, early detection is key. Standard treatment of PAES involves relocating the medial gastroc head, optimizing the popliteal artery tract. However, botulinum A toxin (botox) injections used locally to the site of constriction in the medial gastroc head has gained traction in recent literature and is showing promising results. The procedure is far less invasive than traditional measures and has been shown to effectively reduce the muscles constriction of the vessel during exercise. Another benefit is that recovery time is significantly reduced, the player can return to sports almost immediately as function and pain allow. Long term management involves educating the patient to avoid excessive training of calves that would promote increased medial calf bulk which would encourage the condition to return. […] Take home, is that this condition is quite RARE. Your exercise induced calf pain is far more likely to be a result of the more common diagnoses, such as compartment syndrome.

• #2 Popliteal artery entrapment syndrome – Bradshaw – Cardiovascular Diagnosis and Therapy

  https://cdt.amegroups.org/article/view/46396/html

  Popliteal artery entrapment syndrome (PAES) is an uncommon cause of lower extremity exertional claudication due to external compression of vascular structures in the popliteal fossa. […] Typical presentation of unilateral or bilateral, intermittent claudication in the feet and calves specifically after exercise and relieved by rest in a young person should prompt further evaluation. Early diagnosis and intervention is essential for preventing thromboembolic complication and in worst cases limb loss. […] Symptoms of PAES arise from the compression of the neurovascular bundle within the popliteal fossa by the surrounding musculotendinous structures. […] The most common symptoms are intermittent claudication and pain in the feet and calves after exercise. Additionally, paresthesia, cramps, coldness, and blanching may occur, typically with an acute onset after exertion. Symptoms resolve with rest or change in position.

• #2 Popliteal Entrapment – The Vascular Institute of Birmingham

  https://new-legs.com/services/popliteal-entrapment/

  Patients with PAES have history of aching pain, numbness, and tiredness or cramping in the calf when they exercise. The symptoms typically go away in three to five minutes of resting.

• #2 Popliteal Artery Entrapment Syndrome (PAES) – Vejthani Hospital | JCI Accredited International Hospital in Bangkok, Thailand.

  https://www.vejthani.com/diseases-conditions/popliteal-artery-entrapment-syndrome-paes/

  Popliteal artery entrapment syndrome (PAES) is a rare condition that occurs when the popliteal artery, the main artery running from the thigh to the calf, is compressed by an enlarged or improperly positioned calf muscle behind the knee. […] Repetitive compression during exercise can cause spasms in your arteries, which can reduce blood flow. As a result, lactic acid and carbon dioxide can build up in your muscles and nerves, leading to sensations of fatigue, achiness, heaviness, and, in some cases, numbness in your calf and foot. […] After stopping the exercise, the symptoms usually show improvement within three to five minutes. However, if left untreated, the spasm tends to happen more quickly and persist for a longer duration over time. The symptoms also tend to occur after covering a shorter distance, and the recovery time increases.

• #2 Mayo Clinic Health Library – Popliteal artery entrapment syndrome | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20459610

  The main symptom of popliteal artery entrapment syndrome (PAES) is pain or cramping in the back of the lower leg. The pain occurs during exercise and goes away with rest. Other symptoms may include: […] Symptoms typically affect young, otherwise healthy people under age 40. […] Long-term pressure on the popliteal artery can cause the artery to narrow. This is called artery stenosis. It can cause pain and cramping with just slight activity, such as walking. […] When the condition is diagnosed and treated early, a full recovery is expected, and symptoms should disappear.

• #2 Recognising and Managing Popliteal Artery Entrapment Syndrome A Concise Overview for Physiotherapists – BJSM blog – social media’s leading SEM voice

  https://blogs.bmj.com/bjsm/2025/04/07/recognising-and-managing-popliteal-artery-entrapment-syndrome-a-concise-overview-for-physiotherapists/

  Popliteal Artery Entrapment Syndrome (PAES), first described in 1965, involves neuromuscular and ischemic symptoms caused by pathologic impingement of the popliteal artery (PA), with or without the involvement of the popliteal vein, and tibial nerve in the popliteal fossa. […] The median delay in diagnosis is 12 months, with reports of misdiagnosis lasting up to 15 years due to the young age of patients, lack of atherosclerotic risk factors, and similarity to other lower limb conditions. If undiagnosed, it can progress to chronic complications, including arterial occlusion, critical limb ischemia, aneurysm formation, or even amputation. […] PAES typically presents with (typically one of or a combination of the following) calf cramping & tightness/fullness, swelling, paraesthesia into the feet and toes, coldness, or loss of distal pulses with exertion.

• #2 Popliteal Artery Entrapment Syndrome – MD Searchlight

  https://mdsearchlight.com/health/popliteal-artery-entrapment-syndrome/

  The prognosis for Popliteal Artery Entrapment Syndrome (PAES) largely depends on the timing of its discovery. If PAES is found and addressed early, the general outlook is usually positive. However, if PAES is discovered too late, after significant damage to the arteries has occurred, the patient may be at risk of persistent leg pain or even limb loss. […] Nonetheless, the loss of a limb in patients with PAES is extremely uncommon, even in severe cases, because the blockage of the artery tends to develop slowly over time.

• #2 Popliteal entrapment syndromes – UpToDate

  https://www.uptodate.com/contents/popliteal-entrapment-syndromes

  Popliteal artery entrapment is the most common form, and popliteal artery compression can reduce blood flow to the leg causing ischemic symptoms. Symptoms are usually chronic, but acute ischemia can also occur. […] The overall prevalence of PES is estimated to range from 0.17 to 3.5 percent of the general population. […] Typical atherosclerotic risk factors such as smoking, hypertension, hypercholesterolemia, and diabetes are absent. […] Popliteal entrapment is most common in athletes participating in long-distance running, basketball, football, rugby, soccer, and martial arts.

• #2

  https://journals.lww.com/cjsportsmed/fulltext/2022/09000/double_major_for_slashing__management_of_blunt.29.aspx

  Popliteal artery entrapment syndrome (PAES) is a rare condition that produces calf claudication in young patients. […] If undiagnosed, PAES can lead to acute ischemia and a threatened limb as a result of complete arterial occlusion or embolism. […] Most patients present with intermittent calf claudication that is relieved completely by rest, some present with chronic limb ischemia and occasionally acute pain after thrombus formation in an aneurysm. […] Popliteal artery entrapment syndrome must be suspected in all young patients with calf claudication, and appropriate diagnostic imaging must be undertaken after a full history and physical is completed. […] The patient’s symptoms only developed after the initial slash to the unprotected popliteal fossa. […] It is unclear whether the popliteal fossa trauma injured the popliteal artery or facilitated further effects of the developing PAES.

• #2 Popliteal Artery Entrapment Syndrome – A brief overview for Physiotherapists

  https://www.linkedin.com/pulse/popliteal-artery-entrapment-syndrome-brief-overview-angus-shaw

  Typically presents with calf cramping and swelling, paraesthesia, coldness, pins and needles, and or loss of distal pulses with exertion. […] An ache in the posterior compartment of the calf post-exercise or after prolonged postures can also be present. […] If left undiagnosed, progressive popliteal artery injury can occur and chronic sequelae including: arterial occlusion and critical limb ischemia, post-stenotic dilatation or aneurysm formation, amputation. […] The median delay before diagnosis of PAES has been reported as 12 months. Reports of misdiagnosis and inappropriate management for up to 15 years. […] It is suggested that long-term recurrence in patients with functional PAES may be secondary to fibrosis around the neurovascular bundle.

• #2 Popliteal Artery Entrapment Syndrome: Symptoms & Causes | Qwark

  https://qwarkhealth.com/conditions/popliteal-artery-entrapment-syndrome

  The typical prognosis for popliteal artery entrapment syndrome (PAES) is generally good if the diagnosis is made early and appropriate treatment is provided. However, if left untreated, it can lead to long-term complications, including artery damage and thrombosis. […] Early diagnosis and treatment of PAES have a significant impact on the long-term prognosis of the condition. Early diagnosis leads to prompt treatment, which prevents the progression of the disease and minimizes the risk of complications. Delayed diagnosis and treatment can lead to permanent damage to the artery, resulting in a poorer long-term prognosis. […] Potential long-term complications and limitations associated with PAES include chronic pain, muscle weakness, arterial narrowing, and claudication. In severe cases, it can also lead to arterial occlusion, aneurysm, and limb loss.

• #2 Popliteal artery entrapment syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/popliteal-artery-entrapment/diagnosis-treatment/drc-20465225

  To diagnose popliteal artery entrapment syndrome (PAES), the health team checks you and asks questions about your symptoms and health history. […] If popliteal artery entrapment syndrome (PAES) symptoms significantly affect everyday or athletic activities, surgery may be suggested. Surgery is the only way to fix the calf muscle and free the trapped artery. […] When the condition is diagnosed and treated early, a full recovery is expected, and symptoms should disappear.

• #2 Sports Injury Bulletin – Anatomy – Popliteal artery entrapment: a mysterious syndrome

  https://www.sportsinjurybulletin.com/anatomy/popliteal-artery-entrapment-a-mysterious-syndrome

  Therefore, a clinical exam and leg pain are not sufficient to diagnose PAES; there must be evidence of actual vascular occlusion in conjunction with the pain. […] Occlusion found on ultrasound, combined with characteristic pain symptoms, is significant for both anatomical and functional PAES. […] Symptoms of intermittent claudication, even in a young athlete, should always warrant a full exploration of vascular integrity, regardless of compartment pressures. […] In cases of anatomical PAES, surgery is almost always the most effective treatment. […] Results are nearly always positive, with more than 90% of athletes who undergo this type of surgery fully returning to sport within three months. […] Functional PAES may be more difficult to treat effectively. Surgery in these situations appears somewhat less effective, with an average success rate around 80%.

• #2 Popliteal Artery Entrapment Syndrome – Sports Medicine Review

  https://www.sportsmedreview.com/blog/popliteal-artery-entrapment-syndrome/

  Conversely, in patients with functional popliteal artery entrapment syndrome, vascular injury is virtually never seen, and surgical intervention is for symptom relief. […] When the compression has been a chronic issue, the patient is at risk for associated vascular injury, which may require repair secondary to intimal injury and fibrosis with stenosis. […] In summary, popliteal artery entrapment syndrome (PAES) is a rare, but underdiagnosed, condition that closely mimics other disorders in active, young individuals. […] Long term popliteal artery entrapment syndrome can lead to damage to the regional vasculature.

• #2 Popliteal Artery Entrapment Syndrome (PAES) – Motus Physical Therapy

  https://motusspt.com/popliteal-artery-entrapment-syndrome-paes-2/

  In some cases, PAES can also cause problems with blood flow to the leg, such as claudication (pain with walking) or ulcers. […] Most people with PAES experience a significant improvement in symptoms with treatment. […] However, the condition can recur, particularly if you do not avoid activities that put stress on the popliteal artery. […] In some cases, surgery may be required to relieve persistent symptoms.

• #2 Popliteal Artery Entrapment Syndrome: Symptoms and Management

  https://www.medicoverhospitals.in/diseases/popliteal-artery-entrapment-syndrome/

  Popliteal Artery Entrapment Syndrome (PAES) is a rare vascular condition that predominantly affects young athletes. This compression can lead to compromised blood flow and present a variety of symptoms that may significantly impact an individual’s mobility and quality of life. The symptoms of PAES can be quite variable, largely depending on the severity and type of entrapment. Common symptoms include: […] Intermittent Claudication: Pain or cramping in the calf during physical activity, which subsides with rest. […] Paresthesia: A tingling or numb sensation in the lower leg. […] Swelling: Occurs due to the accumulation of blood or lymphatic fluid. […] Coldness or Pallor: In the lower leg or foot, indicative of reduced blood flow. […] Muscle Weakness: Particularly after exercise. If you experience persistent lower leg pain or other symptoms consistent with PAES, it is imperative to consult a healthcare professional for a thorough evaluation. Delayed diagnosis and treatment can lead to irreversible damage to the artery and surrounding tissues. With appropriate treatment, the prognosis for PAES is generally favorable. Surgical intervention, in particular, has a high success rate in alleviating symptoms and preventing recurrence. Recovery involves a period of rehabilitation, during which patients gradually return to their usual level of activity under the guidance of healthcare professionals.

• #2 Popliteal Artery Entrapment Syndrome in a Young Baseball Pitcher: A Ca | JPR

  https://www.dovepress.com/popliteal-artery-entrapment-syndrome-in-a-young-baseball-pitcher-a-cas-peer-reviewed-fulltext-article-JPR

  Although PAES is not common and has often been under-diagnosed, it is a very important differential diagnosis of lower limb numbness and pain, especially when young people develop symptoms after exercising and experience intermittent claudication. It is necessary to include this disease in differential diagnosis to implement early diagnosis and ultrasonography is a more cheap and simple method for early detection.

• #3 Popliteal Artery Entrapment Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441965/

  The hallmark of this disease is a vascular compromise within the popliteal fossa resulting in an insidious, progressive course of exercise intolerance and calf pain with exertion relieved by rest (claudication). […] Patients with PAES primarily present complaining of intermittent pain in the feet and calves that usually occurs after the exercise and vanishes at rest. […] Typically, patients present with the complaints of leg and foot claudication that can be quite severe and disabling. […] Moreover, the physical examinations usually reveal hypertrophy of the calf muscles. […] The prognosis of the PAES entirely relies on its detection time. If PAES is detected and managed early in the course of the disease, the prognosis of the PAES is generally reasonable. However, if the PAES is detected late when extensive arterial damage has already happened, then the patient is at risk of having permanent claudication or even limb. […] If this disorder is undetected, PAES can lead to the popliteal artery stenosis (PAS), popliteal artery thrombosis (PAT), as well as distal arterial thromboembolism (DAT).

• #3 Popliteal artery entrapment syndrome: What to know

  https://www.medicalnewstoday.com/articles/popliteal-artery-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) is a rare condition affecting the artery in the back of the knee. It causes pain in the lower legs during exercise. […] The symptoms of PAES generally improve after rest. Surgery may also help. […] People with PAES usually report to a doctor with severe and disabling leg and foot pain that gets worse with physical activity but gets better with rest. […] They may also note the following symptoms in the legs and feet: calf pain, numbness, cool, pale skin, pins and needles, prickling, or skin-crawling sensations, swollen calf muscles, reduced or absent pulse in the foot when flexing it inward. […] People with PAES may experience severe pain in their calves and feet during exercise. The pain usually gets better during rest. […] The outlook of PAES improves with early detection and treatment, but if artery damage has occurred, an individual may have permanent pain during movement.

• #3 Popliteal artery entrapment syndrome – Bradshaw – Cardiovascular Diagnosis and Therapy

  https://cdt.amegroups.org/article/view/46396/html

  As the disease progresses, vascular injury induces remodeling that can lead to leg swelling, aching rest pain, and fatigue. […] If compressive vascular damage is not corrected early, especially in patients with hypercoagulable risk factors, arterial occlusion and thromboembolism may occur presenting with the hallmark signs of acute limb ischemia. […] While PAES is an uncommon cause of exertional claudication, the presentation of symptoms in a young, otherwise healthy individual should prompt timely diagnostic workup. Early surgical treatment before vascular injury and remodeling occur provides for superior outcomes.

• #3 Circulation Clinic | Popliteal entrapment syndrome

  https://www.circulationclinic.com/popliteal-entrapment-syndrome

  Popliteal artery entrapment syndrome (PAES) is an important albeit relatively uncommon circulatory disease that affects the legs of young adults causing leg pain during exercise. […] Compression of the popliteal artery restricts blood flow to the lower leg leading to pain in the affected calf that is typically relieved with rest claudication. Involvement of the popliteal vein may cause skin discolouration, swelling and ulceration in the ankle region. Occasionally, adjacent nerves may be irritated causing numbness and/or pins and needles in the calf/foot. […] Repeated compression of the popliteal artery may damage the artery with the development of a permanent stricture or blockage. If this occurs, formal reconstruction of the artery will be necessary in order to relieve symptoms in addition to correction of abnormal muscle anatomy.

• #3 Popliteal artery entrapment syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Popliteal_artery_entrapment_syndrome

  The popliteal artery entrapment syndrome (PAES) is an uncommon pathology that occurs when the popliteal artery is compressed by the surrounding popliteal fossa myofascial structures. This results in claudication and chronic leg ischemia. Patients with PAES mainly present with intermittent feet and calf pain associated with exercises and relieved with rest. Associated symptoms include numbness, discoloration, pallor, and coolness in the affected lower extremity. Complications of untreated PAES can include stenotic artery degeneration, complete popliteal artery occlusion, distal arterial thromboembolism, or even formation of an aneurysm. Prolonged compression of the popliteal artery can lead to extensive arterial damage and permanent claudication or limb loss. Nonetheless, the course of PAES is often slow and takes time, thus, limbs loss is rarely seen, even in PAES patients.

• #3 Frontiers | Case Report: COVID-19 exacerbates acute lower limb ischemia in patients with popliteal artery entrapment syndrome

  https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1329863/full

  Popliteal artery entrapment syndrome (PAES) is a rare clinical ischemic disease of the lower limbs, mainly caused by various reasons such as popliteal artery compression and stenosis and secondary thrombosis caused by an injury of the vascular endothelium due to exercise and other factors. The main manifestation is progressive motor pain in the lower limbs, and the combination of high-risk factors such as infection and smoking for thrombosis will exacerbate lower limb ischemia. If not diagnosed and treated appropriately, it may lead to disability and even serious consequences, such as amputation. […] During the progression of the disease, there may be multiple factors that accelerate its progression. […] COVID-19 may increase the risk of arteriovenous thrombosis, which may further aggravate the acute ischemia of lower limbs in people with PAES. Thus, these people tend to be given preventive anticoagulant treatment to avoid serious complications such as amputation.

• #3 Popliteal Artery Entrapment Syndrome (PAES) — The Physio Lab

  http://www.thephysiolab.com/news/2025/3/7/popliteal-artery-entrapment-syndrome-paes

  The goal of surgical treatment is to restore normal blood flow to the affected leg, reduce occlusion and prevent further damage to the artery. […] Popliteal Artery Entrapment Syndrome is a rare but potentially serious condition that can cause significant leg pain, weakness, impairment to athletic performance and, in severe cases, permanent damage to the popliteal artery. Early diagnosis and appropriate treatment, whether surgical or conservative, is crucial in managing this condition.

• #3 Popliteal Artery Entrapment Syndrome (PAES) – Vejthani Hospital | JCI Accredited International Hospital in Bangkok, Thailand.

  https://www.vejthani.com/diseases-conditions/popliteal-artery-entrapment-syndrome-paes/

  PAES typically presents with discomfort or cramping in the posterior lower leg (calf) that arises during physical activity and subsides after a period of rest. Additional warning signs and symptoms could be: The calf has numbness, The feet feels cold after exercise, Paresthesia, characterized by a tingling or burning sensation in the calf muscle. […] In case the calf muscle entraps the popliteal vein nearby, the symptoms you may experience include: The leg feels heavy, Cramps of the lower legs in the evening, Swollen or discolored calf, The lower leg has clots of blood, also called Deep Vein Thrombosis (DVT). […] Leg pain symptoms generally tend to impact individuals who are under the age of 40 and in good health. It is advisable to seek medical attention from your doctor if you experience any type of leg pain, particularly if you experience cramping in your calf or foot during physical activity that subsides after rest.

• #3 Popliteal Artery Entrapment Syndrome: Symptoms and Management

  https://www.medicoverhospitals.in/diseases/popliteal-artery-entrapment-syndrome/

  Popliteal Artery Entrapment Syndrome (PAES) is a rare vascular condition that predominantly affects young athletes. This compression can lead to compromised blood flow and present a variety of symptoms that may significantly impact an individual’s mobility and quality of life. The symptoms of PAES can be quite variable, largely depending on the severity and type of entrapment. Common symptoms include: […] Intermittent Claudication: Pain or cramping in the calf during physical activity, which subsides with rest. […] Paresthesia: A tingling or numb sensation in the lower leg. […] Swelling: Occurs due to the accumulation of blood or lymphatic fluid. […] Coldness or Pallor: In the lower leg or foot, indicative of reduced blood flow. […] Muscle Weakness: Particularly after exercise. If you experience persistent lower leg pain or other symptoms consistent with PAES, it is imperative to consult a healthcare professional for a thorough evaluation. Delayed diagnosis and treatment can lead to irreversible damage to the artery and surrounding tissues. With appropriate treatment, the prognosis for PAES is generally favorable. Surgical intervention, in particular, has a high success rate in alleviating symptoms and preventing recurrence. Recovery involves a period of rehabilitation, during which patients gradually return to their usual level of activity under the guidance of healthcare professionals.

• #3 Type 2 popliteal artery entrapment syndrome: a case report – Turkish Journal of Thoracic and Cardiovascular Surgery

  https://tgkdc.dergisi.org/text.php?lang=en&id=1681

  The definitive diagnostic tool for this syndrome is an MRI. […] Poplitial artery entrapment syndrome usually progresses along with vascular disease until final vessel occlusion with a subsequent ischemic limb event. […] Therefore, all anatomic entrapments of the popliteal artery should be repaired surgically independent of the symptoms it causes. […] It is a rare cause of lower extremity claudication and should always be kept in mind when approaching a patient with claudication with no other obvious causes.

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