While I normally do not address the topic of shoveling snow until January, considering recent weather events, I thought it might be valuable to present it sooner. Much has been written about the dangers of snow shoveling for your heart. However, while not fatal, low back pain is the most common injury sustained while shoveling snow. Heart attacks are also more common following wet and heavy snow.

Snow shoveling can place excessive stress on the structures of the spine. When overloaded and overstressed, these structures fail to support the spine properly. The lower back is at great risk of injury when bending forward, twisting, lifting a load, and lifting a load with a long lever. When all these factors are combined simultaneously, as in snow shoveling, the lower back is destined to fail. Low back pain from muscle strain or a herniated disc is very common following excessive snow shoveling.

Snow Shoveling as a Form of Exercise:

• GOOD - For the Young and Healthy – studies show that snow shoveling for 15 minutes is considered moderate physical activity and extreme and vigorous physical activity when performed more than 15 minutes even for young healthy college students.
• BAD – For the Older and Unfit – research clearly shows that there is a significant increase in heart attacks among snow shovelers. If you have any risk factors or medical condition and do not exercise regularly consult your physician.
• Cold Weather – makes this activity even more difficult and physically stressful. Cold air makes breathing more labored and difficult and cold temps create added strain on the body.

People at High Risk of Illness Due to Snow Shoveling:

• History of Heart Attack
• History of Heart Disease
• History of High Blood Pressure or High Cholesterol
• Smokers
• Inactive & Sedentary Lifestyle
• Overweight
• Elderly

10 TIPS FOR SAFE SNOW SHOVELING:

1. MEDICAL CLEARANCE: If you have any medical condition or risk factors consult your physician.
2. PAIN: Stop immediately if you experience any pain. Especially in the chest, left arm, jaw, face, neck, or lower back.
3. ERGONOMICS: Choose a snow shovel that is right for you:
   1. An ergonomic shovel with a curved handle allows you to keep your back straighter or arched when shoveling
   1. An ergonomic shovel with a shorter or adjustable handle length allows you to keep your back straighter and knees bent when shoveling. The right handle length allows you to arch your back 10 degrees with your knees slightly bent when the shovel is on the ground.
   1. A plastic shovel blade is lighter than a metal one and will be better for your spine.
   1. A smaller blade is better than a larger blade. It may take longer but will stress your back less.
4. PUSH: When possible, push the snow. Do not lift it. Lifting is much more stressful on the spine. You can find shovels that are ergonomically designed just for pushing snow.
5. WARM – UP: Be sure your muscles are warm before you start to shovel. Cold and tight muscles are more likely to strain than warm, relaxed muscles. Layer and consider compression shirts or tights can help prevent cold and tight muscles.
6. LEVERAGE: When you grip your shovel, spread your hands at least 12 inches apart. This will improve your leverage and reduce strain on your lower back.
7. TECHNIQUE: Shoveling technique is very important. The American Academy of Orthopaedic Surgeons recommends:
   • Squat with your legs apart, knees bent and back straight.
   • Lift with your legs. Do not bend at the waist.
   • Scoop small amounts of snow into the shovel and walk when you want to dump it.
   • Do not hold the filled shovel with outstretched arms.
   • If snow is deep, remove in piecemeal, a few inches at a time.
   • Rest and repeat as necessary.
   • Move your feet and do not twist your back as you shovel or dump. Never throw snow over your shoulder
8. CAUTION: Be cautious shoveling wet snow. One full shovel can weigh 25 pounds.
   • Shovel wet snow slowly in piecemeal.
9. PACE YOURSELF: Take frequent breaks and stretch your back in the opposite direction of shoveling. For example: 1. Lean backwards and extend your lower back. 2. Pinch your shoulder blades together.
10. TECHNOLOGY:
    • Snow Blower - Use a self-propelled snow blower. It will put much less stress on your lower back than shoveling snow if used correctly. For example, push the blower with your legs and keep your back straight or arched and knees bent.
    • Ergonomic Shovels:
    • 2 Handle Shovels: ErgieShovel or Snow Joe Shovelution
      • Push Shovels: Garant Yukon or Garant Sleigh Shovel
    • Snow Melting Alternatives:
    • www.warmlyyours.com - WarmlyYours - HeatTrak® portable snowmelting system for roofs, gutters, driveways, sidewalks, stairs and handicapped ramps uses electric mats or runners for home or office which can be customized.

Sources: The Colorado Comprehensive Spine Institute; American Academy of Orthopaedic Surgeons 

Visit your doctor regularly and listen to your body.     

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

There is a very good chance that the cold temps and snow will return soon! Winter in NEPA can be the perfect opportunity to try something new. For example, for those who enjoy running or walking you can continue to do so in the winter, with a few adjustments. Equipment, such as treaded sneakers, allows you to run or walk in the snow. Snow shoes are a great way to hike and walk in the snow while cross country skiing simulates running in the snow. But, in the last few years, another outdoor activity has become a winter sport; mountain biking in the snow has become popular.

Many mountain biking enthusiasts in NEPA enjoy 7-8 months of trail riding at our beautiful state parks. Now, with a few modifications, mountain bikers can continue year round. In fact, the adventure in the snow may be an exciting new experience. If winter biking is not your thing, maybe winter walking, running, snow shoeing or cross-country skiing will suit you better.   

The physical and psychological benefits of outdoor activities are many: each season brings its own unique beauty, and winter is no different. Most will not have to abandon outdoor activities, but some adjustments in equipment, clothing, and food are necessary for each season and the temperature changes that it brings.

Mountain Biking in the Snow

While recommended, it is not necessary to purchase a bike specifically for mountain biking in the snow. With a few simple modifications and adjustments, you can prepare a regular mountain bike for winter use.

Modify The Bike Shocks

• Shock Pressure Adjustments for Temperature Changes

In addition to rocks and stumps, winter biking offers the challenges of snow banks and ice chunks. The air pressure in your shock system will be affected by temperature. Additional air pressure will be required to improve shock absorption and in extreme cases, using less viscous oil will be required.

Modify The Tires

Pressure - lower the air pressure in the tires 5-10 psi lower than normally used in the summer to improve traction.

Treads – Just as with winter car tires, a larger tire with more volume and large, widely space knobs will improve traction. Some special winter tires offer studs for improved performance on the ice.

Brakes

Disc Brakes – that are self-cleaning and mounted away from the snow are best for winter biking. However, brakes should be examined and cleaned intermittently for snow and ice accumulation.

Pedals

Platform Pedals – allow the rider to quickly plant the foot for balance when sliding.

Clothing

It is important to layer clothing. Use DryTech or UnderArmor type materials (headgear, gloves, shirts and pants) to allow sweat to breath away from the skin to the next layer of clothing. Use a facemask to cover your mouth and nose to prevent frost bite and warm air before it enters the lungs. Chemical hand and toe warmers are great. Try winter running or walking shoes as described below.

Walking or Running in the Snow

There are running shoes specifically designed for use in wet, cold and sloppy winter conditions. These “winterized” running shoes, which can also be used for walking, offer waterproofing, sealed seams, gaiter collars to keep out snow and slop, slip resistant fabric, anti-roll stability features, anti-microbal material and aggressive tread patterns for traction on slippery surfaces. Some shoe recommendations for both winter walkers and runners include:

. Some shoe recommendations for winter runners and walkers from The Runner’s World Magazine include:

For winter walkers, walking or trekking poles will improve balance and safety when briskly walking in winter conditions. I am a strong proponent of using these tools. They are lightweight, adjustable, and collapsible. Some examples are: Black Diamond^R Trail Explorer 3 Trekking Poles - $59.99 andMountainsmith^R FX Lite Trekking Poles - $35.09. For an inexpensive alternative, an old pair of ski poles will work just fine.

Snow Shoeing and Cross-Country Skiing

These activities should also be considered as a viable option for the winter walker and runner. These are great cross-training alternatives with tremendous aerobic benefits.

Snowshoes work by distributing your weight over a larger surface area so your foot does not sink completely into the snow. Commonly used by fur traders, trappers and forest rangers, snow shoeing has become very popular among many outdoor exercise enthusiasts. It is relatively safe and inexpensive. Some snowshoes include the Tubbs Flex TRK - $169. (REI) and Redfeather Hike - $149.00 (Cabelas).Boots and poles are also required, but ski or trekking poles along with hiking boots or winter running shoes can be used.

Cross country skiing has also gained tremendous popularity among winter outdoor exercise enthusiasts. It is a cross between running and skiing in which the participant propels through a snow-covered trail by pushing and gliding with a running or fast-walking motion. Some examples of equipment packages that include boots, pole, bindings and skis are Alpina Sports Tour – no wax for $229.00 and Rossignol XT from LL Bean at $224.00.

Many of the area’s state parks, such as Lackawanna and Promised Land, offer wonderful trails for winter walking, hiking, running, snow shoeing, cross-country skiing and biking.

For the more casual walker in need of protection from the snow and ice, it may be treacherous just to walk the dog or go to the bank, post-office or grocery store. Consider traction devices that easily slip on and off your shoes or boots such as Stabilicers^R (cleats-type device) or Yaktrax^R (chain-type device).  

Visit your doctor regularly and listen to your body.     

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” every Monday.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

For all of Dr. Mackarey's articles: visit our healthcare forum