Shoveling snow without hurting your back, or your heart.

The first real snowfall of the winter in St. Charles County brings the same wave of calls: a back that seized halfway down the driveway, a shoulder that has not been right since, a neighbor who had to stop and catch their breath. Shoveling is heavy, repetitive, bent-over lifting done in the cold, usually by people who have not lifted anything that heavy since last winter.

A little preparation changes the odds a lot. Here is how to shovel without hurting your back, and the signs that mean the problem is your heart, not your muscles.

Why does shoveling snow hurt your back?

A national study of emergency room visits estimated about 11,500 snow-shovel injuries a year in the United States. Just over half were strains from the effort itself, and the lower back was the part of the body most often hurt.

The job stacks the odds against your back:

• Heavy loads, far from the body. A full shovel of wet snow can weigh well over ten pounds, held at the end of a long handle, which multiplies the load on your low back.
• Bending and twisting together. Scooping, then turning to throw the snow over your shoulder, is the combination backs like least.
• Cold, stiff muscles and no warm-up. Our article on cold weather and your joints explains why the first few minutes in the cold feel worse.
• Doing it all at once, because the driveway has to be clear before work.

Snow shoveling and your heart

Every winter, shoveling also sends people to the emergency room with heart problems. In the same national study, heart-related emergencies were a small share of shoveling visits, but they accounted for every death. A large study from Quebec found that heavy snowfalls were followed by more heart attack admissions and deaths among men.

The reasons are straightforward: shoveling is heavy work done in short bursts, often first thing in the morning, while cold air tightens blood vessels. The American Heart Association advises people with heart disease, or with risk factors such as high blood pressure, diabetes or smoking, to talk with their doctor before shoveling, and to pace themselves if they do.

Stop and call 911 for chest pain, pressure or tightness, pain that spreads to the arm, jaw or back, unusual shortness of breath, sweating, nausea or lightheadedness while you shovel. Do not wait to see whether it passes.

A sore back after shoveling tells you to change how you shovel. Chest pressure while shoveling tells you to stop and call 911. Know which one you are feeling.

Protect your back: how to shovel snow safely

1. Warm up for five minutes. March in place, swing your arms, and do a few gentle hip hinges and back bends before you step outside.
2. Push, don’t lift, where you can. Pushing snow to the side of the drive with the shovel low is far easier on your back than scooping and throwing.
3. Take small loads. Half a shovel, more often. With deep snow, take the top layer first, then the bottom.
4. Hinge at the hips and bend your knees. Keep the load close to your body, one hand near the blade, and lift with your legs.
5. Turn your feet, not your back. Walk the snow to where it is going instead of twisting to throw it over your shoulder.
6. Switch sides every few minutes, so one side of your back is not doing all the work.
7. Pace it and break it up. Rest every 10 to 15 minutes, and in a long snowfall, clear it in two or three rounds rather than all at the end.
8. Watch your footing. Salt or sand as you go, and wear boots with grip. A fall onto your backside is how many tailbone injuries start.

Many of the same habits apply in the fall; our guide to yard work without back pain covers raking and lifting bags.

What to do if you hurt your back shoveling

Stop for the day. Most shoveling strains are muscle and settle within days to a couple of weeks. Keep moving gently with short walks rather than lying in bed, use heat for the ache, and see pain on one side of the lower back if it has settled into one side, which shoveling often causes.

Get it assessed if it is not easing after a week or two, or if the pain travels down a leg. See a physician the same day or the next for new weakness in a leg. Go to the emergency room for numbness in the groin or inner thighs, new trouble controlling your bladder or bowels, or weakness in both legs.

What a visit here looks like

For a back strained while shoveling, Dr. Andersen checks which movements provoke it, which joints have stiffened and which muscles are guarding, and screens the nerves to the legs. Care usually combines precision spinal adjustments, soft-tissue work and two or three exercises to get you moving normally again, plus a few changes to how you shovel so the next snowfall does not undo it.

How long does a back strained from shoveling take to heal?

Most shoveling strains improve noticeably within a few days and settle within two to three weeks with gentle movement. A back that has been strained before, or one that was already stiff, can take longer, and how quickly varies from person to person. If every snowfall brings the same injury, it is worth working on hip and trunk strength before winter rather than after.