The Medical Minute: Don't leave common sense out in the cold

By John Messmer, M.D.
Penn State Milton S. Hershey Medical Center

Although it’s not winter yet, snow is here and many of us have already been faced with the task of clearing our sidewalks and driveways of white stuff. It’s no exaggeration to say it’s real work to shovel snow. For our hearts, it’s like jogging a 12-minute mile -- not a competitive speed, but stressful if you have heart disease and are not used to that much exercise. If the air is very cold, the stress level is even higher.

If we do it improperly, our backs aren’t designed to handle the kind of lifting associated with snow-shoveling. As we get past our 30s, our spinal discs become more brittle and subject to injury. It’s easy to slip a disc in the pursuit of a clear sidewalk. Snow blowers can help save our backs but their powerful blades can take off a finger or hand if we don’t use them carefully.

Icy patches can result in falls with injuries to hips, backs, arms and legs. Cold air can cause frostbite and hypothermia. If these warnings haven’t convinced you to move down south, you might want to review some tips for getting through the winter without injury.

If you don’t exercise regularly, check with your doctor to determine if you can tolerate the stress of shoveling snow. Warm up by doing light exercise before attempting to shovel. Have a light breakfast -- you will need some nutrition to do the work but a heavy meal and vigorous exercise can compete for your circulation and lead to stomach cramps. Take your time -- you don’t have to do it all at once. If you begin to feel tired, stop and rest. If you develop chest pressure, call 911.

Lift small amounts of snow and keep your shovel close to your body rather than in front with your arms extended, particularly with heavy or deep snow. Try to bend the knees while keeping your back straight, scoop some snow, and stand up lifting with your knees, not by straightening your spine. Carry the snow to where you want to pile it or throw it forward. Throwing to the side or twisting to throw snow puts extreme stress on your spinal discs and can rupture one. Try to minimize bending at the waist.

If you use a snow blower, never put your hands or feet into it. If there is a clog, don’t just disengage the auger, shut off the engine and wait a minute until all movement stops, then use only a wooden or plastic device to unclog the blades.

Drink plenty of warm liquids to maintain hydration and body heat and be sure to dress appropriately. Since shoveling is hard work, you will need to dress with lighter clothing than if you were not working. Layers help you to stay warm until you develop some body heat, then an outer layer may be removed. Keep your ears and fingers covered to protect against frostbite.

Wear insulated boots to protect your feet from the cold if you will be walking in the snow. Slip resistant soles will reduce your risk of falls. Once the snow is removed, use salt, sand or gravel on icy patches to reduce the chance of slipping.

If you do hurt your back, rest for a day or two but no more. Recovery is quicker with early movement but don’t resume lifting until the pain is resolving. Apply ice to the painful area off and on for the first day or two then use heat for 15-20 minutes at a time. Allow the skin to cool before continuing to use heat. Most people can use Tylenol, ibuprofen (Advil and others) or naproxen (Aleve and others) for pain. If your back hurts severely after a couple days’ rest, check with your doctor. If you already have a disc problem, avoid lifting snow at all if possible.

Snow covered fields and trees present a pretty picture around Christmas time. With a few precautions, you can enjoy the winter wonderland instead of treating your aching back.