Every winter, around 30,000 people are treated for injuries that happened while shoveling snow or removing ice manually. The types of injuries sustained include sprains and strains, particularly in the back and shoulders, as well as lacerations and finger amputations.

Even worse, every time there is more than a dusting of snow and the temperature drops below freezing, the death rate from heart attacks goes up, as much as three times among men 35 to 49 years old. One of the main causes of this increase is snow shoveling.

Clearly, taking proper safety measures while shoveling snow is important. The following tips can help keep you safe from the first snow of the season to the final shoveling of the year.

For your heart:

• If you are in a high risk group for heart attack, you may want to talk to your doctor before you take on the task of shoveling snow. Those at the highest risk for a heart attack during physical exertion include anyone who has previously had a heart attack or who has heart disease, people with high blood pressure or high cholesterol levels, and people who lead a sedentary lifestyle.
• Avoid consuming caffeine (coffee, cola) or nicotine before beginning. These stimulants may increase your heart rate and cause your blood vessels to constrict, placing extra stress on the heart.
• Drink plenty of water while you are working. Dehydration occurs frequently while working in the cold because people tend to sweat a lot while wearing warm winter clothes. The air can also be very dry, even when there is snow on the ground.
• Dress in layers so you can remove layers as needed if you get hot.
• Start slowly and pace yourself, taking breaks when needed. When it is cold, people often try to hurry to get the job done, but that only increases the risk of injury or heart attack.
• If you experience shortness of breath, chest pain, or tingling in your arms, neck, or jaw, it may be a sign of a heart attack: stop working and call 911 immediately.

To avoid injury:

• Warm up your muscles for 10 minutes before shoveling by stretching out or walking in place. Warm muscles take longer to tire and are also less likely to be injured.
• Use a shovel that is appropriate for your height and strength. While a larger blade allows you to move more show at once, it also puts more strain on your body and makes your heart work harder.
• Try to push the snow instead of lifting it. If you must lift, protect yourself from back injuries by lifting correctly. Squat with your legs apart, knees bent, and back straight. Lift with your legs and tighten your stomach muscles as you lift the snow. Do not bend at the waist. Do not hold a shovelful of snow with your arms outstretched as this puts too much weight on your spine.
• Avoid twisting movements. Do not throw the snow over your shoulder or to the side, as this requires a twisting motion that stresses your back. If you need to move the snow to one side, reposition your feet to face the direction the snow will be going.
• Stand with your feet about shoulder-width apart for balance and keep the shovel close to your body. If it is icy, be especially careful when shifting your weight around quickly, such as when tossing snow from your shovel into a pile
• Listen to your body. Stop if you feel pain.

For more information on heart attack, see the Healia Health Guide for Heart Disease.

_{Sources: American Academy of Orthopedic Surgeons, 2007 http://orthoinfo.aaos.org/topic.cfm?topic=A00060; North Dakota State University, 1999 http://www.ext.nodak.edu/snow.htm}

_{Photo: bcmom, Flickr, Creative Commons}