How to shovel snow without wrecking your back or shoulders

How do snow shoveling injuries actually happen?

The best national picture comes from researchers at Nationwide Children's Hospital, who published their study in the American Journal of Emergency Medicine in 2011. Using emergency department data from 1990 to 2006, they estimated about 11,500 snow shovel injuries and medical emergencies a year.

Watson, Shields and Smith, American Journal of Emergency Medicine, 2011. National Electronic Injury Surveillance System data, 1990 to 2006.

Soft-tissue injuries were the most common diagnosis, at 54.7 percent, and the lower back was the most frequently injured area, at 34.3 percent. Most shoveling injuries, in other words, are strains from the effort itself. The cardiac cases are a separate subject, covered in shoveling and your heart.

The problem has not gone away. AAOS, citing Consumer Product Safety Commission figures, says more than 137,000 people were treated in emergency rooms, doctors' offices and clinics in 2018 for injuries from shoveling or using snowblowers, with sprains and strains of the back and shoulders among the most common.

How should I warm up and pace myself?

The American Academy of Orthopaedic Surgeons (AAOS) treats shoveling as a workout and asks you to warm up your muscles for 10 minutes with light exercise first. Then:

• Start early and go often. AAOS advises clearing snow early and often, starting when there is only a light covering, rather than moving packed, heavy snow later.
• Take deep snow in stages. Never remove deep snow all at once, especially heavy, wet snow. Wet snow weighs far more than powder; see heavy wet snow vs light snow.
• Take frequent breaks, and drink fluids. Shoveling is aerobic work, even in the cold.

What is the right way to move snow?

1. Push it. A pusher-style shovel moves snow without lifting it at all.
2. If you must lift, squat. Legs apart, knees bent, back straight. Lift with your legs, not by bending at the waist.
3. Keep loads small and close. AAOS notes that holding a shovelful with your arms outstretched puts too much weight on your spine.
4. Walk it, do not throw it. Throwing snow over your shoulder or to the side takes a twist that stresses the back. Carry the load to the pile, or turn your whole body with your feet.
5. Spread your hands on the shaft for more leverage.

Does a bent-handle shovel help?

Start with fit. AAOS says to use a shovel that suits your height and strength, and warns against one that is too heavy or too long.

The evidence on bent "ergonomic" shafts is real but modest. In a 2003 lab study of 10 men, published in Applied Ergonomics, a bent shaft cut forward trunk bending from about 49 degrees to 41, and the authors recommended it for that reason. A 2002 study of 12 people found that a bent shaft slowed forward bending of the lower back, but suggested that using more than one design may be needed to ease discomfort in the arms and wrists. Both were short lab tests, and neither tracked injuries. A bent shaft can help; technique matters more.

What about slips and falls?

Slips and falls caused one in five shoveling injuries in the national study. AAOS recommends shoes or boots with slip-resistant soles, and warns against letting a hat or scarf block your view of ice patches and uneven ground. Take short steps on anything that looks wet, and consider strap-on traction; our guide to ice cleats and walking on ice covers what the evidence shows.

When should I stop and get help?

Stop at the first sharp pain rather than finishing the driveway. For back pain afterward, AAOS draws clear lines:

• Seek medical attention right away for weakness in your legs or loss of bladder or bowel control.
• Call your doctor if back pain does not get better within a few weeks, or comes with fever, chills or unexpected weight loss.

If you already have back problems or do not exercise regularly, AAOS advises talking with your doctor before you shovel at all, and it says to stop and seek emergency care for chest pain, shortness of breath or other signs of a heart attack. For a driveway you should not be clearing yourself, residential snow removal is the alternative, and a snowblower only helps if you can run it safely.

This guide is general information, not medical advice. Talk to your doctor about what is safe for you.