How to shovel snow without landing in the emergency room

You know, for life’s most essential resource, water knows a hundred ways to kill you if you’re not careful. When it’s not trying to drown you in its pools and coastlines during the summer, it shape-shifts to snow in the winter, piling up emergency room visits for those forced to shovel it.

During the most recent period researched, 11,500 Americans a year went to the hospital with a snow shovel–related emergency. While climate change may take a bite out of that stat, the risk of injury and even heart attack remains high, especially for the 25 percent of us who are physically inactive.

“Studies have found that shoveling snow is as strenuous as a maximum exercise routine where you’re using 80 to 90 percent of your maximum heart rate,” says Dr. Neville Crick PT, DPT, MPA, GCS, director of physical therapy for NYC Health + Hospitals / Bellevue. “The people who are most at risk are those folks who are generally sedentary.”

But those excuses aren’t going to placate your boss when you need to get to work after a storm, so we asked Dr. Crick for tips on shoveling snow safely and effectively.

What Are the Most Common Snow-Shoveling Injuries?

Crick says there are basically two categories into which hospital visits due to snow shoveling typically fall.

Musculoskeletal injuries

“Lower back is usually number one [due to] poor technique,” Crick says. “People have a tendency to say, ‘There’s a ton of snow out here, I have no time, I need to get this done as soon as possible,’ and that’s when you start digging in and twisting.”

A couple of days later, you’re in traction on the couch.

“That’s gonna be followed by shoulder and upper-back issues and then core muscles,” Crick continues. “For example, your obliques (the muscles framing your abdomen) also could be injured with twisting motions.” (More on those in a bit.)

Next come the lower extremities, like your hips, quads, hamstrings, and knees, “and then as far down as your calf muscles and lower legs,” Crick adds.

“The thing about shoveling snow that people often don’t realize is that it’s a total body workout.”

Cardiovascular strain

Which brings us to the heart, an underrated area of concern on which snow shoveling can place outsize demand. In fact, cardiac-related cases accounted for nearly 7 percent of the emergency room visits tracked in the above study.

“We’re talking about folks who have heart disease, people who have different forms of cardiac pathology,” Crick says. “Somebody who’s going to the gym all the time, could it happen to them? Absolutely. But they’re less at risk than folks who are out there just trying to get the job done so they can get to work.”

10 Tips for Injury-Free Snow Shoveling

Following Dr. Crick’s recommendations will make snow shoveling easier—and safer. And you can take that to the snow bank!

1. Warm up first

Crick suggests thinking about shoveling as a form of exercise. As with any exercise, you need to prime the body for activity.

“If you’re going to run a mile, you’re not going to just get out on the track and start running; most people do some form of warm-up. It doesn’t have to be long; it could be like five, 10 minutes.”

Read further below for Dr. Crick’s complete list of warm-up movements designed to address the demands of snow shoveling.

2. Wear slip-resistant footwear

Safe, effective shoveling starts with a stable base, and existential to that are feet that stay where they’re intended. So, in addition to a shoe that’s waterproof and insulated, you’ll want one with deep lugs for traction and ankle support to further prevent sliding.

3. Strike the right stance

Ensuring proper body mechanics is key to injury prevention, making the correct carriage while shoveling snow your top priority. Keep these three cues in mind:

Stand with your feet shoulder-width apart to maintain balance.
Keep your back straight through all movements.
Use your knees and hips—not your back—when lifting.

That last bullet is crucial if you want to prevent back pain and injury.

“We tend to think if we bend at the back that somehow makes [shoveling] easier for us,” Crick says. That’s not the case. Your largest muscles are located in your hips and legs, so use ’em!

Also, when bending your legs, make sure your knees don’t drift forward past your toes.

“That’s a common mistake people tend to make, not only when shoveling, but just in general,” Crick notes. “If you’re bending over, the minute your knees go in front of your toes it significantly increases the compressive forces on them. So, a common thing we say in physical therapy is don’t be afraid to stick your butt out. What you really want is to do a squat.”

4. Push the snow whenever possible

The best way to avoid the strain associated with lifting is not to lift at all. So use your shovel more like a plow as much as you can.

“If the snow is light enough, simply pushing it along makes it a lot easier on your back,” Crick says.

5. Lift more, smaller loads

If you do need to lift, consider scooping more often in smaller amounts as opposed to trying to ladle up the entire driveway in a single bound.

“When it comes to basic body mechanics, high-load repetitive stress will equal musculoskeletal strain or injury. So, if we have low loads and we do something repetitively, it’s gonna decrease the chances of something breaking down,” Crick says.

“While it may take a little extra time, you end up saving your back and your shoulders. My wife still complains that her shoulder hurts from the last couple of years she shoveled snow.”

6. Avoid twisting

The image that snow shoveling most often conjures involves digging and hoisting over alternating shoulders, but that’s a blueprint for bursitis. Rather than rotating your trunk, pivot your entire body for any lateral movements.

“Rotating the oblique and core muscles strains them sometimes when we’re throwing the snow over both shoulders,” Crick says. “If you move as a mechanical unit, it significantly reduces the chances of musculoskeletal injury.”

7. Shovel early and often

You’re going to feel compelled to purchase the largest shovel to move the maximum amount of snow allowable by law. Stop right there.

“Instead of waiting until there are five feet of snow, go out when there are two or three inches, and just go back out there again [later],” Crick advises. “Two inches every four hours is better than eight inches at the end and having to spend two or three hours [shoveling] it with that repetitive high-force stress.”

8. Drink plenty of water

“Muscles perform better when they are hydrated,” Crick advises. “And, believe it or not, more people tend to be dehydrated in the winter than in the summer.”

That’s because when we’re cold, the body decreases blood flow to our extremities to centralize heat at our core. This can disrupt hormonal commands to retain water and trigger thirst, reducing the desire to drink by up to 40 percent and doubly depleting our reserves.

9. Listen to some music

If you have a playlist that gets you amped while exercising, Crick says go for it. Just throw in your earbuds and treat it like any other workout.

“Of course, don’t get too into it where you’re, again, throwing snow over your shoulders and doing all sorts of [ill-advised] things, but make it enjoyable,” Crick adds.

10. Outsource the workload

This is no time to be a hero. It is, however, time those 5- and 7-year-olds of yours started earning their keep. Conscript them and anyone else in your household into helping—as long as they follow the nine previous tips.

“Kids like snow for the most part, so if you have family members, get them out there to help you out. It shouldn’t be just a one-person thing.”

5 Warm-Ups to Do Before Shoveling Snow

Perform each of the following movements before you even think of picking up a snow shovel.

Light march

This simple activity will get blood flowing to working muscles.

Stand with your feet hip-distance apart and your arms at your sides.
Lift your right foot off the ground while simultaneously bending your left elbow as you would when walking.
Switch arms and legs, and continue walking vigorously in place for one to two minutes.

Arm circles

By taking the shoulder joints through a wide range of motion, this movement helps prime them for work.

Stand with your feet hip-distance apart and your arms straight out to your sides at shoulder height.
Keeping your elbows straight, rotate your arms forward, drawing large circles with your hands.
Perform 10 circles then reverse direction, rotating your arms backward for 10 more.

Trunk rotations

This warm-up will ready your core and oblique muscles, which can strain during rotational movements.

Stand with your feet hip-distance apart, your arms out to your sides and your elbows and knees slightly bent.
Keeping your back straight, rotate your torso to your right, pivoting on the ball of your left foot.
Switch direction, rotating your torso to your left and pivoting on your right foot, continuing for 30 to 60 seconds.

Single-leg hamstring stretch

Part of keeping your back limber is keeping your hamstrings pliant.

Stand with your feet staggered, your right foot about a foot in front of your left foot.
Keeping your right heel planted, straighten your right knee and lift your right toes off the ground.
Maintaining a slight bend in your left leg, push your butt backward and hinge forward at your hips, bringing your hands as far down the shin of your right leg as possible.
Hold for 15 to 30 seconds, switch sides and repeat.

Calf raises

The muscles closest to the snow will see the most continuous work. This warm-up will help get them acclimated.

Stand with your feet hip-distance apart, toes facing forward.
Rise as high onto the balls of your feet as you can, squeezing your calf muscles at the top of the movement.
Pause, then—slowly—bring your heels back down to the ground.
Repeat for 30 to 60 seconds.