16 February 2010

Shoveling snow? Protect your back and your heart

From Denny: This winter season, aptly nicknamed Snowmageddon by President Obama, has been a doozie all across the country. Snow and ice bedevil driving on the roads and walking to our own mailboxes. After a snow storm people get out and shovel this heavy, wetter snow and it ends up causing tens of thousands of shoulder and back injuries every year in the United States. Several hundred heart attacks also occur.

Doctors saw over 70,000 shovel-related injuries serious enough to trigger a doctor's visit in 2008, according to the Consumer Products Safety Commission. Shoveling snow isn't a daily activity for most people and the exertion, very cold weather and then slippery surfaces makes for a deadly combination.

Snow shoveling "is one of the most high-intensity exercises you can do," says Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital, in New York City. "You're using all your major muscle groups."

Here are some tips for thoughtful precautions for your back - and your heart since this is an aerobic activity - during and after shoveling snow.

Let's deal with the main issue: back pain

Lower back strain is the usual suspect, leading the top of the list for snow shovelers. "That's when a muscle gets over-tensioned and tightens. If it over-tightens, it's almost like a spasm and that gets very painful," according to Dr. Henry Goitz, an orthopedic surgeon at Henry Ford Hospital, in Detroit, Michigan, and a spokesman for the American Academy of Orthopaedic Surgeons.

Herniated disk is the second most common injury during snow season, says Dr. Victor Khabie, the co-chief of orthopedic surgery at Northern Westchester Hospital, in Mount Kisco, New York. What's a herniated disk you ask? The common term it's known as is a "slipped disk." That's when one of the soft disks between the vertebrae of your spine decides to get out of position and then complains of its displacement by pushing on a nerve, causing severe pain.

How can you tell how severe is the disk injury? It's a bad sign, says Dr. Khabie, when that back pain also radiates down your leg. "That may mean you have ruptured or herniated a disk."

Sedentary lifestyle

Sedentary people and frigid weather are a recipe for back injuries. "The shoveling tends to be done by people who are not otherwise in good shape," says Dr. Richard Pomerantz, a professor of medicine in cardiology at the University of Rochester Medical Center, in Rochester, New York. "Sometimes a potato chip is the heaviest thing they've lifted for a while."

Ice lurking under the top layer of snow is dangerous

People can "experience very bad fractures from slipping on the hidden ice frozen under the snow," advises Dr. Evalina L. Burger, a vice chair and associate professor of orthopedics at the University of Colorado, in Denver, Colorado. "The worst thing is a fall," she says. "It's not just old people who fall."

Heart attacks

Heart attacks that occur during shoveling snow do tend to be rare. Doctors believe it is the combination of heavy exertion and cold weather. Why is this so? Both the aerobic, and weight-lifting component, especially years when heavy, wet snow occurs, can raise your blood pressure. All this combines to quickly increase the load upon the heart when the heart is not accustomed to it.

By increasing the load to the heart in cold weather when your arteries and vessels tend to constrict which causes the relative blood supply to go down at a time when your heart requires more. It's a case of supply and demand - the demand is too high for the supply available. Sometimes, a heart attack will occur when the heart is too stressed.

Guess what else contributes to a possible heart attack? We have hormones that are released during cold weather and when exercising that can cause built up plaques - those ugly fatty deposits that line artery walls - to rupture, causing either dangerous blood clots or heart attacks.

The time of day for snow shoveling is important to your heart

Most people get out there early in the morning and start shoveling. It's not a good idea, according to a 1996 study in the American Journal of Cardiology. Did you know that the early morning is when the risk for heart attack is higher? So, pick a better time of the day when your heart is ready.

Snow Shovelers Smart Rules

1. The obvious: stay in good physical shape year round.

2. Take the exercise slow by warming up to it. Do some stretching exercises, especially the hamstrings, before you go out and tackle the snow. Some core-strengthening exercises are wise as well like mini sit-ups, crunches which work and warm those lower back muscles to stretch.

3. The ant eating the elephant philosophy works well in this situation. You have to be methodical and deliberate if you want to avoid serious injury. Only shovel small amounts of snow, especially if it's heavy snow, for 5 or 10 minutes at a time, especially if you are not used to exercising or have experienced a back issue in the past. The key is to go back inside where it's warm and do some more stretching exercises for another 10 minutes to help your muscles.

4. Watch your shoveling form as closely as you watch how you weight lift at the gym. Proper technique is smart to avoid injury. It's advised to push the shovel full of snow instead of lifting it. When you go to lift the shovel, go into a knee squat with your back arched as if you are looking upward at the sky. Whatever you do, please don't bend from the waist as that puts incredible pressure on your lower back.

So, how do you handle the technique of disposing of the snow off your shovel? Keep the shovel close to your body and squat with your legs. Let your legs do the work instead of your back.

Make sure you walk over to the dumping area instead of thinking it's OK to just lean over and fling or throw the snow. Rotating or twisting your body increases risk of terrible back injury, unless, of course, you want a herniated disk to happen.

5. Pick a well-designed ergonomic shovel as your tool for the job. Properly designed tools are worth the money as they take the stress off your back. A shovel with a bent handle will give you a better angle where you don't have to go down as far or go all the way back up. Read that as less work.

6. Another way to protect against injury or strained muscles is to layer up with warm clothing. Getting too cold will tighten up your muscles. That's why you want to exercise first before going out and follow up with layers of warm clothing to keep in the heat on those muscles so they will perform better.

7. Make sure you wear snow boots that have good traction treads on them. If your feet slip it can throw off your balance, maybe land you on some ice that can cause a fracture. In the long run, it's less expensive to invest in good quality winter foot wear than spend a lot more at the doctor's office fixing a bad injury.

As far as foot wear goes, in the coldest parts of the country, you might want to keep handy a few essentials like a set of spikes in your car. They only take a couple of minutes to put on and sure beats six weeks off from work if you end up injured.

8. Most of all just practice simple common sense, especially if you are out of shape or elderly. Outsource the job to a neighborhood teenager who is in shape. It's worth the small amount of money.

Considerations before shoveling snow:

history of heart disease
history of back injuries
history of diabetes
history of high blood pressure

9. Before the snow melts this season, file these tips away, tied to your snow shovel for when next year's snow storm hits you will be ready with your game face on! :)

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