The Truth About Shoveling Snow

With the snowiest weeks ahead, we thought it would be good to uncover the truth about shoveling snow. Slips and falls, not cardiac catastrophes, are the most commonly seen winter-related injuries - but heart problems account for almost every recorded death in reported studies.

It is quite possible that you have heard about the risks of shoveling snow on the news, or possibly from your doctor, and most likely from your spouse. However, it is very unlikely that anyonw has shown you the proof that it can be deleterious to your cardiac health.

 "It's a dangerous activity. People who are middle aged or older with a history of heart problems simply should not shovel snow," said Barry Franklin, director of Cardiac Rehabilitation and Exercise Laboratories at William Beaumont Hospital in Royal Oak, Mich.

But why? In an ABC News report, Franklin lays it out fairly well explaining that many people may not realize that a shovel full of wet snow can weigh as much as 15 to 16 pounds. So he said that if someone is shoveling snow at a rate of 12 shovelfuls per minute, they will have moved nearly a ton of snow if shoveling their driveway in just 10 minutes.

"So the physical demands are really, really substantial," said Franklin. When you couple that with the cold air that they are breathing, which causes the coronary arteries to constrict, in many respects you've got a perfect storm for heart trouble," said Franklin.

"Being out in the cold, some of the warning signs may be camouflaged," he added.

Cold weather and hard work can mask those symptoms, delaying people's responses and sometimes leading them into more trouble.

"We really encourage people beyond the age of 50 to try to hire a neighborhood kid to do it," he added.

Not everyone is at risk for a heart attack while shoveling, of course and people in cold climates often have "conditioning," according to Dr. Randal Thomas, director of the Mayo Cardiovascular Health Clinic in Rochester, Minn.

Studies published in the Lancet and the American Journal of Cardiology show that the incidence of heart failure goes up in the week after a blizzard. The Lancet study, based on death certificates in eastern Massachusetts after six blizzards from 1974-78, demonstrated that coronary artery disease-related deaths rose by 22 percent during the blizzard week and stayed elevated for the subsequent eight days, suggesting that the effect was related to storm-related activities, like shoveling, rather than the storm itself.

Similarly, the AJC article, based on medical examiner records from three Michigan counties, found that there were more exertion-related sudden cardiac deaths in the weeks during and after blizzards, and that 36 of the 43 total exertion-related deaths occurred during or shortly after snow removal.

Here are some tips from Brigham and Women's Hospital cardiologist, Daniel Forman M.D.,director of Exercise Testing Laboratory and Cardiac Rehabilitation.

Certain individuals should consult their doctor before shoveling snow:

• People who have previously had a heart attack or other cardiovascular disease.
• People with a history of chest pain or angina.
• People with medical histories of high blood pressure, diabetes or high cholesterol levels.
• People who smoke or who have other cardiovascular risk factors.
• People who do not exercise regularly.

For those who wish to shovel snow, follow these general tips to help stay healthy:

• Dress warmly and be sure to protect extremities such as your nose, ears, hands and feet. This is important because cold weather can reduce circulation, aggravating heart disease.
• Stretch your arm and leg muscles as you would before any exercise; this minimizes musculoskeletal injury and strain.
• Also warm up your cardiovascular system with a light activity such as marching in place or walking before shoveling. Warming up is an important means of modifying cardiovascular strain.
• Don’t eat a heavy meal or drink alcohol prior to shoveling (this is not a good way to work off a big meal!). Avoid stimulants such as caffeine or nicotine, which increase heart rate and cause blood vessels to constrict.
• Use a shovel with a small blade. It is safer for your heart as well as your back and joints to lift smaller and more frequent amounts of snow than to haul a few huge shovelfuls. Likewise, it is important to have a shovel that is suited for your height.
• Pace yourself. Start out shoveling slowly, and don’t try to clear the entire area at once.
• Take frequent breaks to give your heart a rest. Use the time off to drink plenty of water and stay hydrated. Also make sure you are eating normally and taking your routine medications. Push the snow rather than lifting and throwing it.
• If you must lift, do it properly. Spread your hands along the handle for more leverage, stand with your feet hip-width apart, and bend at the knees (not at the back).
• Do not twist or throw snow over your shoulder. Scoop in a forward motion and step in the direction you throw the snow to avoid lower back pain the day after shoveling.
• Know the warning signs of a heart attack. Stop immediately and seek emergency medical help if you experience heart attack symptoms such as chest pain, shoulder, neck or arm pain, shortness of breath, dizziness, fainting, sweating or nausea.