Jan. 4, 2023 — The winter stolstice passed on Dec. 21, ushering in a season of substantial snow, with thousands of Americans heading out to shovel their driveways in the coming months.
But snow shoveling can be dangerous: One study found it’s responsible for 11,500 serious injuries and almost 100 deaths annually. So before you reach for your shovel, or even your snow blower, familiarize yourself with the risks and take precautions.
How Strenuous Is Shoveling?
Snow shoveling places enormous stress on the heart, says Barry Franklin, PhD, professor of Internal Medicine at the Oakland University William Beaumont School of Medicine in Royal Oak, MI, who became interested in the impact of show shoveling on health early in his career after two close friends died of heart causes after shoveling snow.
A study conducted by Franklin and his colleagues focused on 10 healthy men, aged 35 or younger, who underwent a stress test to assess their heart rate, blood pressure, and fitness level at maximal exertion. On a different day, the same men shoveled snow for 10 minutes while wearing an electrocardiogram (EKG) monitor, blood pressure monitor, and a device to measure energy expenditure.
“We found that the heart rate and blood pressure during snow shoveling were equal to or greater than maximal treadmill testing,” Franklin says. “Couple that with cold temperature, which decreases blood flow to the heart and increases blood pressure, and you’re causing a tremendous demand on the heart.”
Each shovelful of wet snow weighed about 16 pounds, and the men filled their shovels an average of every 5 seconds during the 10-minute period.
“That means close to 2,000 pounds were moved during the 10 minutes, [or] the equivalent weight of a midsize car,” Franklin says.
There are many reasons beyond the strain of heavy lifting that make shoveling so demanding to the heart.
“When you’re shoveling, you’re typically standing still, and your arms are doing all the work. Blood pools in your lower extremities because your legs aren’t moving, so there’s insufficient blood flow back to the heart at a time when the heart needs that oxygenated blood desperately,” Franklin explains.
Breathing cold air causes blood vessels to constrict, which raises blood pressure and limits blood flow.
“When you put all of these factors together, and you add underlying heart disease, you have a ‘perfect storm’ for catastrophic events,” says Franklin.
Who’s at Risk?
Although we usually regard exercise as being good for the heart, physical exertion is a “double-edge sword,” notes Franklin, who is the co-author of the books Take a Load Off Your Heart and Prevent, Halt and Reverse Heart Disease.
“Exercise can be protective to your heart if you’re physically active on a regular basis,” he says. But vigorous, strenuous exercise can trigger a heart attack or sudden cardiac death, especially if you’re not in shape.
And even if you’re in good shape, shoveling can still place you at risk, although your risk is probably lower, he notes. One study suggests that up 85% of U.S. adults over age 50 have plaques in their arteries even if they have no symptoms. Extreme exertion can cause plaque to rupture, leading to a heart attack.
People at highest risk for shoveling-related cardiac events are people over age of 45, people with hidden heart disease or known cardiac problems, people who are typically inactive, are overweight or obese, and people who have one or more cardiac risk factors, such as cigarette smoking, high cholesterol, or diabetes, Franklin says.
Protecting Your Back
Ken Hansraj, MD, an orthopedic spine surgeon at in Poughkeepsie, NY, says that show shoveling affects not only the heart but also the back.
“Lifting and carrying snow places strain on the back, so pushing or sweeping are better than lifting,” Hansraj says. “But if any lifting needs to be done, use a lightweight ergonomic shovel, which has a bend in the middle.”
Don’t lift too much at once, warns Hansraj, who is the author of the book Watch Your Back: Nine Proven Strategies to Reduce Your Neck and Back Pain Without Surgery. Instead, “take small ‘bites,'” he suggests.
He advises people to “move aside small chunks that are light and easy. You’ll get worn out more quickly if you move heavier loads, and the stress on your back and heart will be greater. This might seem slower but before you know it, you’re done.” And be aware of the “quality of the snow. Wet snow weighs more than dry snow, which is more like baby powder and is a pleasure to play with.”
Pace yourself by dividing the task into smaller units.
“You can divide your driveway into regions — the front of the driveway, the east side, the west side, and the back. Take your time clearing the regions and take a break between regions,” suggests Hansraj.
Before, During, and After
Hansraj recommends warming up indoors before going outdoors to shovel.
“Stretch out your neck, back, hamstrings, quadriceps, and Achilles tendon, pull the elbows in front of your chest, and stretch out your shoulders.” He recommends doing 10 squats, 10 pushups, and 30 seconds of planking.
The reason for these preliminary exercises is to “prepare your ‘shock absorbers’ — your thighs and your innermost and outer core,” he explains. “For example, there’s a point when you’re shoveling that you’re squatting and your thighs are engaged, and you want them rather than your back to carry the stress.”
He also recommends deep belly breathing before going outdoors and remaining conscious of your breathing throughout the shoveling.
“If your breath starts to change and become labored, then quit shoveling,” he says.
If you do lift snow, do it carefully, remaining aware of your posture. Keep your head upright, looking up, expand your chest, keep your shoulders behind you, contract your stomach muscles, and tuck your pelvis.
“The further away the shovel is from the body, the more the weight will exert pressure on your spine, so stand close to the shovel,” Hansraj says. Keep your feet spread shoulder-width apart for a strong base of support, and squat, bending your knees while keeping your back straight.
Listen to your body. If you’re getting tired or short of breath, or if you feel changes in your heart rhythm, stop shoveling. Stop if you feel your neck muscles or lower back begin to ache or if you have near misses when taking steps or placing the snow.
Hansraj suggests taking a long, hot shower after shoveling. You may want to do some more stretches while in the shower. If you experience mild muscle aches, you can take an anti-inflammatory medication like ibuprofen or use an over-the-counter cream.
But if you’re having chest pain or pain that goes up to your jaw or down your arms, or any type of difficulty breathing, get medical help because those could be signs of a heart attack.
Additional Safety Tips
- Dress warmly, wearing layers, warm socks, warm gloves, and non-porous high-top shoes. The top layer should be light and breathable. Cover your nose with a scarf so you’re breathing in less cold air.
- Stay hydrated since physical activity can cause dehydration, even in cold weather.
- Don’t let your hat or scarf block your vision, and be sure to check for icy patches and uneven surfaces.
- Don’t throw snow over your shoulder or to the side because the twisting motion can strain the back.
Snow Blowers Have Risks, Too
The American Academy of Orthopedic Surgeons has additional guidance for people using snow blowers.
- Never stick your hands into the snow blower.
- Don’t leave your snow blower unattended when it’s running.
- Add fuel only before starting the snow blower.
- Never add fuel or operate the machine in an enclosed area.
- Don’t touch the engine.
- Don’t remove safety devices, shields, or guards on switches.
- Keep children away from snow blowers.
Franklin suggests sticking a label on your shovel or snow blower, like “Warning: Use of this instrument for snow removal may be hazardous to your health!”
“It will remind you to take adequate precautions before embarking upon snow removal,” he says. And if you’re an older adult, sedentary, or have health issues, “get a neighborhood kid to clear your snow or hire a snowplow service.”