SHOVELING SNOW: TIPS TO AVOID BACK PAIN

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SHOVELING SNOW TIPS TO AVOID BACK PAIN
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Its that time of year again when we escape into
the beauty of watching those first flakes
fall.  But it is also when ER visits go up due
to injuries and heart attacks from the snow
cleanup.   Shoveling is a strenuous activity.
The dangerous combinations of cold temperatures,
slippery ice, and physical exertion cause
numerous mishaps, including heart and low back
injuries.   Each year about 11,500 people in
the United States are treated in emergency rooms
for injuries related to snow shoveling. On
average, 100 of those injuries are fatal,
generally heart attacks.  Understanding the
mechanisms that lead to an injury aids in
establishing prevention strategies. Low backs
strains and heart attacks can occur while
shoveling because most people are not in shape
for the difficult activity of removing heavy snow
and ice. Below we will outline why shoveling can
cause stress on your low back and what you can do
to minimize any ill effects of shoveling.
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Mechanics of shoveling snow Shoveling requires
repetitive bending, heavy lifting, and twisting.
Isolated, each of these can cause an injury to
your low back. When you combine all three, it is
a recipe for disaster. When you understand the
mechanics of injury, you can avoid and remedy the
big culprits. Bending forward is an everyday
activity. Problems occur when you consistently
bend forward more than you bend backward.
Slouched sitting places the same posterior stress
on your back as bending. Stiffness getting up
after prolonged sitting and difficulty
straightening up after repetitive bending
are warning signs. Once you take a few steps and
stand straight, this posterior stress on your
spine eliminates because you are no longer bent
forward. But if you continue to place the same
posterior pressure on your back by remaining in a
slouched position or continue to bend
repetitively, this stress will cause damage. The
body is supposed to move and be in different
positions. Problems arise when you continue to
place the same strain on your back without moving
in the opposite direction.
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Anatomy Discs are the protective shock absorber
between the bones in your back. The inside or
nucleus consists mainly of water. Sitting
slouched for a long time places anterior pressure
on the disc nucleus, pushing it backward. Over
time the displacement of the nucleus will cause
tears, allowing the center of the disc to move
even more posteriorly. You will not notice
anything until you try to straighten up. This
displacement of the nucleus causes stiffness when
you change the spinal position because it is out
of place. You feel better once you take a few
steps because the walking motion places the
opposite pressure on the nucleus, pushing it back
to its central position. But over time, the
nucleus may not be centered all the way and will
stay a bit posterior. It then only takes a little
bit more pressure or a twist while lifting a
shovel of snow to throw your back out!  You will
have no pain until the tear in the disc reaches
the innervated outer layer. Nerves innervate only
the very outer layer of the disc, leaving the
majority of the disc with no nerve innervation
and no pain sensation. Similar to your nail
when you rip your nail there is no pain unless
the tear reaches the innervated nailbed. But
there will be stiffness when you try to move out
of the damaging position, and this is your early
warning sign!
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• Prevention
• Know your limitations and get help when you need
  it.  If you are out of shape or have other
  conditions, take it easy. 
• Heart attacks can occur when there is a sudden
  increase in workload, and the heart cannot handle
  this requirement.
• Know your surroundings.  Ice leads to slips and
  falls. Wear shoes with treads and throw down salt
  or sand to help create foot traction.
• Be prepared with the proper tools and
  clothing.  Wear layers of clothes that you can
  remove as your core temperature increases when
  working. Use a shovel that is ergonomically
  correct and lightweight.
• Warm-Up If you will do the heavy lifting and
  repetitive bending, make sure you are ready.
  Warm-up with back extensions. If you cannot do a
  full extension (cobra), do a set of ten to help
  increase your flexibility. The loss of extension
  range of motion is most often from prolonged
  sitting.
• Mechanics When shoveling, push rather than throw
  and avoid twisting and throwing over your
  shoulder as this leads to a greater rate of
  injury. 

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• 6. Stand with your feet about shoulder-width
  apart to maintain balance. 
• 7. Try to keep the shovel close to your body. 
• 8. Bend at the kneesnot the waist or back. 
• 9. Tighten your stomach muscles as you lift the
  snow to help maintain your spine in a neutral
  position.
• 10. Lift with your legsnot your back. 
• 11. Avoid twisting your body. 
• 12. Push or dump the snow in front of you. 
• 13. Take breaks when you start to feel back
  stiffness and drink plenty of water to stay
  hydrated.  Perform standing back extensions
  whenever you take a break or have any stiffness. 
• 14. Avoid sitting slouched after vigorous
  activity for 24 hours, as the slouched position
  will place your spine in the same flexed posture
  as bending forward.
• If you do sustain a low back injury,
  please schedule with one of our specilaists who
  will evaluate to determine the root cause of your
  pain and educate you in a self-treatment program.
• At any hint of shortness of breath or chest pain,
  stop shoveling immediately and, if symptoms
  persist, seek medical attention. 

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