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I apply an endurance training approach to building collaterals, to carry blood around blocked arteries in my legs. The worst affected are the popliteal arteries, especially on the right, leading to severe calf claudication and numb feet when I attempt to run. Running is the best way to both build collaterals and to keep them open, but it's not easy. This has worked for me since 2014, but it took a while to develop the techniques need to improve blood flow to my feet. The approach I developed, based on my clinical and body movement training, and as a life-long athlete, include spreading my toes, engaging the muscles in my feet, and using a whole body approach to walking and running. Other aspects of this work are detailed in my little book, "How to Fight the Crippling Pain of Peripheral Arterial Disease." I'm still doing Ironman at age 81. It's not easy, but you do meet the nicest people at the back of the pack. I managed to finish third in my age group, 80-84, in the 2023 World 70.1 Ironman Championships, in Lahti, Finland. PAD made it particularly tough, but I'm still enjoying my sport, which helps me to keep my feet. Never give up. Kindest regards, Kevin Thomas Morgan BVSc, PhD, DipACVP, FRCPath.