The snow has already arrived for the season bringing with it a host of injuries – from mild sprains to back injuries to life-threatening heart attacks – seen in Emergency Departments throughout New England like at Baystate Medical Center.

Each year some 30,000 people are treated in hospital emergency rooms and other medical settings from doctor’s offices to clinics for injuries that occurred while exerting themselves over shoveling wet, heavy snow or chopping ice.

“The tremendous upper-body exertion required for shoveling heavy snow, combined with cold temperatures, can set the stage for a heart attack while clearing your driveway or sidewalk. If you have coronary artery disease, or are at risk for it, then don’t lift a shovel this winter,” said Dr. Joseph Schmidt, vice chair, Emergency Department, Baystate Medical Center.

He noted that signs and symptoms of a heart attack include pressure or pain in the chest, arms or neck; nausea; lightheadedness; sweating or feeling clammy; or unusual fatigue.

Even for those in good health, learning the proper techniques for shoveling snow can help prevent injuries.

“If you already suffer from low back pain and are not used to strenuous physical activity, then leave the snow shoveling for someone in good health and physical shape,” said Dr. Julio Martinez-Silvestrini, medical director, Outpatient Physical Medicine and Rehabilitation and Baystate Rehabilitation Care.

“Take time to stretch your lower back muscles with some gentle exercises before shoveling and consider walking for a few minutes or marching in place. You should also drink plenty of water to avoid dehydration and refrain from any caffeine or nicotine, which are stimulants and may increase your heart rate,” he added.

Martinez-Silvestrini and the American Physical Therapy Association offer the following tips for avoiding back injuries from snow shoveling:
• Lift smaller loads of snow, rather than heavy shovelfuls. Take care to bend your knees and lift with your legs rather than with your back.
• Use a shovel with a handle that lets you keep your back straight while lifting. A short handle will cause you to bend more to lift the load. Using a shovel that’s too long makes the weight at the end heavier.
• Because the spine cannot tolerate twisting as well as it can other movements, it is important to avoid this movement as much as possible. Step in the direction in which you are throwing the snow to prevent the lower back from twisting. This will help avoid the “next-day back fatigue” experienced by people who shovel snow.
• If possible, push the snow away instead of lifting it.
• Take frequent breaks when shoveling. Stand up straight and walk around periodically to extend the lower back.
• Standing backward-bending exercises will help reverse the excessive forward bending that occurs while shoveling; stand straight and tall, place your hands toward the back of your hips, and bend backward slightly for several seconds.

Martinez-Silvestrini noted that there is sometimes confusion over whether to use ice or heat after injuring your back.

“Apply a cold pack as soon as possible after the injury every three to four hours for up to 20 minutes. After two or three days, you can apply heat for 20-30 minutes three or four times a day in order to relax your muscles and increase blood flow,” he said.

To avoid slipping on ice and snow, doctors recommend buying yourself a pair of shoes or boots with good traction or adding snow and ice safety traction devices to your footwear.