{"id":11549,"date":"2025-04-07T06:00:03","date_gmt":"2025-04-07T05:00:03","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=11549"},"modified":"2026-03-04T09:20:38","modified_gmt":"2026-03-04T08:20:38","slug":"recognising-and-managing-popliteal-artery-entrapment-syndrome-a-concise-overview-for-physiotherapists","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2025\/04\/07\/recognising-and-managing-popliteal-artery-entrapment-syndrome-a-concise-overview-for-physiotherapists\/","title":{"rendered":"Recognising and Managing Popliteal Artery Entrapment Syndrome A Concise Overview for Physiotherapists"},"content":{"rendered":"

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 (1).<\/span> Compression commonly involves the medial head of the gastrocnemius muscle and may be congenital or acquired through muscular hypertrophy (2).<\/span> PAES has an estimated incidence of 0.17% to 3.5%, with approximately 85% of cases affecting males, predominantly athletes under 30 years old (2).<\/span>\u00a0<\/span><\/p>\n

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 (3).<\/span><\/p>\n

Types of PAES<\/h4>\n
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  1. Anatomical PAES<\/b>: Involves a defined anatomical lesion causing compression and occlusion of the popliteal artery. Is typically unilateral in nature (2, 3).<\/span><\/li>\n
  2. Functional PAES (FPAES)<\/b>: Characterised by evidence of PA occlusion without a clear anatomical lesion. Often bilateral, with the medial head of the gastrocnemius muscle contributing to crowding in the popliteal fossa. Functional compression occurs in 30% to 50% of the general population and can affect both trained and untrained individuals (2, 3).<\/span> The plantaris muscle is another overlooked culprit for vascular compression.\u00a0<\/span><\/li>\n<\/ol>\n

    Figure 1. Popliteal Artery Entrapment Classification System (3).<\/strong><\/em><\/p>\n

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    Signs and Symptoms\u00a0<\/span><\/h4>\n

    PAES typically presents with (typically one of or a combination of the following)\u00a0<\/span><\/p>\n

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