Pedal pulses are the rhythmic throbbing felt in arteries of the feet, indicating the circulatory health of the lower extremities. This assessment helps monitor blood flow to the feet and legs. Healthcare professionals frequently check pedal pulses as part of a routine physical examination to evaluate peripheral circulation.
Key Locations for Checking Pedal Pulses
Two primary arteries in the foot are commonly used for checking pedal pulses: the dorsalis pedis and the posterior tibial artery.
The dorsalis pedis artery is located on the top of the foot, running superficially over the bones. To locate it, gently feel between the first and second metatarsal bones, slightly below the ankle, often lateral to the extensor hallucis longus tendon. This artery supplies oxygenated blood to the dorsal side of the foot. It is sometimes absent in a small percentage of healthy individuals.
The posterior tibial artery is found on the inner side of the ankle. You can locate it by feeling behind the medial malleolus, which is the prominent bony bump on the inner ankle. The pulse is typically felt in the groove between the medial malleolus and the Achilles tendon, slightly above the heel. This artery supplies blood to the posterior compartment of the leg and the sole of the foot.
Step-by-Step Guide to Checking Pedal Pulses
Before checking a pedal pulse, ensure the person is in a comfortable, relaxed position, ideally lying down with the foot slightly relaxed. Expose the foot by removing socks and shoes.
To palpate the pulse, use the pads of your index and middle fingers. Avoid using your thumb, as it has its own pulse that could be mistaken for the patient’s. Apply light pressure initially and then gradually increase it until you feel a rhythmic beat. Applying too much pressure can occlude the artery, making the pulse undetectable.
Once positioned, apply light pressure with your index and middle fingers, gradually increasing until you feel a rhythmic beat. Once a pulse is located, note its strength and rhythm, and compare findings between both feet for symmetry.
Interpreting Your Findings
A normal pulse is typically described as strong and regular, indicating adequate blood flow to the feet. This suggests healthy peripheral circulation.
A weak or thready pulse might suggest reduced blood flow to the lower extremities. This can be a sign of conditions such as peripheral artery disease (PAD), where arteries narrow or become blocked, or diabetes-related circulation issues. If a pulse is consistently weak, it may indicate a need for further evaluation.
An absent pulse means the pulse cannot be felt at all. This can be a significant finding, potentially indicating a more pronounced circulatory issue, such as a severe blockage in the arteries. While some healthy individuals may naturally have an impalpable dorsalis pedis pulse, especially if factors like thick skin, edema, or anatomical variations are present, a consistently absent pulse in conjunction with other symptoms warrants attention.
It is important to seek medical attention if you consistently have difficulty finding a pedal pulse, or if a pulse is consistently weak or absent, particularly if accompanied by other symptoms like pain, numbness, tingling, or changes in the color or temperature of the feet. These signs could indicate underlying vascular conditions that require professional assessment and management.