SHOVELING SNOW - TIPS TO AVOID BACK PAIN
                     SHOVELING 
SNOW: TIPS TO 
AVOID BACK 
PAIN
http://www.virtualphysicaltherapists.com/
It’s 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.
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.
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!
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. 
 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 knees—not 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 legs—not 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. 
VIRTUAL 
PHYSICAL 
THERAPISTS
[email protected]
HTTP://WWW.VIRTUALPHYSICALTHERAPISTS.COM/
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