SPRINGFIELD — As winter continues in New England, shovels are being put to good use once again. But shoveling sometimes comes with consequences, including suffering a heart attack or putting one’s back out.
“When shoveling snow, an individual experiences an increase in heart rate and blood pressure which increases the need for blood supply to the heart. In those with cardiovascular disease or risk factors, this can be dangerous as it can lead to a heart attack,” said Dr. Seth Gemme, vice chair of Clinical Operations for Emergency Medicine at Baystate Health.
He noted that signs and symptoms of a heart attack include pressure or pain in the chest, arms, or neck; nausea; lightheadedness; sweating or feeling clammy; or unusual fatigue.
According to the National Institutes of Health, each year, snow shoveling results in about 11,500 injuries, including 100 fatalities. Data shows that those deaths are generally caused by heart attacks, with the most common injuries associated with snow removal being sprains and strains. Researchers have also found that those over age 55 are more than four times as likely as younger patients to suffer heart-related problems while shoveling snow, with men twice as likely as women to develop symptoms.
Even for those in good health, learning the proper techniques for shoveling snow can help prevent injuries.
“If you already suffer from low back pain and are not used to strenuous physical activity, then leave the snow shoveling for someone in good health and physical shape,” said Dr. Julio Martinez-Silvestrini, medical director at Baystate Rehabilitation Care.
For those who do shovel, he advised, “take time to stretch your lower back muscles with some gentle exercises before shoveling and consider walking for a few minutes or marching in place. You should also drink plenty of water to avoid dehydration and refrain from any caffeine or nicotine, which are stimulants and may increase your heart rate.”
Martinez-Silvestrini and the American Physical Therapy Assoc. offer the following tips for avoiding back injuries from snow shoveling:
• Lift smaller loads of snow, rather than heavy shovelfuls. Take care to bend your knees and lift with your legs rather than with your back.
• Use a shovel with a handle that lets you keep your back straight while lifting. A short handle will cause you to bend more to lift the load. Using a shovel that’s too long makes the weight at the end heavier.
• Because the spine cannot tolerate twisting as well as it can other movements, it is important to avoid this movement as much as possible. Step in the direction in which you are throwing the snow to prevent the lower back from twisting. This will help avoid the next-day back fatigue experienced by people who shovel snow.
• If possible, push the snow away instead of lifting it.
• Take frequent breaks when shoveling. Stand up straight and walk around periodically to extend the lower back.
• Standing backward-bending exercises will help reverse the excessive forward bending that occurs while shoveling. Stand straight and tall, place your hands toward the back of your hips, and bend backward slightly for several seconds.
Dr. Martinez-Silvestrini noted that there is sometimes confusion over whether to use ice or heat after injuring one’s back. “Apply a cold pack as soon as possible after the injury, and every three to four hours, for up to 20 minutes. After two or three days, you can apply heat for 20 to 30 minutes, three or four times a day, in order to relax your muscles and increase blood flow.”
Unfortunately, for some, not all injuries are simple strains. Baystate Medical Center’s Division of Neurosurgery sees many patients in the wintertime who suffer from herniated discs, which are common to the lower spine. When a disc is herniated or ruptured, it can create pressure against one or more of the spinal nerves, resulting in numbness or pain in the lower extremities, often radiating down the leg. Neurosurgeons also see many spinal fractures when people slip while shoveling snow or chopping ice.
To avoid slipping on ice and snow, doctors recommend buying a pair of shoes or boots with good traction or adding snow and ice safety traction devices to footwear.
If possible, use a snowblower to do the work. If not used correctly, however, even using a snowblower can strain or injure your back if you push or force the equipment to go faster. And using a snowblower may still be too much activity for someone with heart disease. Snow blowers are not light, and it can be heavy to push through a lot of snow.
For some, the best advice may be to leave the shoveling to others by hiring a youngster who wants to make extra money or contracting with a plowing service to clear the driveway and walkways when it snows.
“You know your body better than anyone else,” Gemme said. “If something doesn’t feel right while you’re outdoors shoveling, then stop immediately.”