(Illustration by Jason Raish)

Snow was piled high around Ken Fleit’s Silver Spring home during the 2010 storm that came to be known as Snowmageddon. Banks of it towered on either side of his driveway. He had run out of places to put it as he shoveled hour after hour. He started flinging the stuff over his shoulders when he felt a sharp pain in his neck.

“It felt like a dagger,” Fleit said, “then an electric pain down my arm. I am sure it was from overall fatigue and a breakdown of [of my shoveling] technique.”

Turns out that a small section of disk in his neck had torn off and lodged itself on a nerve. Fleit, a 55-year-old physical therapist, underwent surgery to remove the wayward piece. He said that what happened to him shoveling is pretty unusual and could also have occurred while doing something else. But his is a cautionary tale, a reminder that shoveling snow — or shoveling anything else, for that matter — should not be approached casually.

“The analogy I like to give people is that of the weekend warrior,” said Mehul J. Desai, director of pain medicine and nonoperative spine services at George Washington University Hospital’s outpatient rehabilitation center in the District. “People go at shoveling a little too aggressively. The Washington metro area doesn’t get as much snow as up north. It’s not as common an occurrence, so people are either too exuberant [about shoveling] or avoid it until a lot of snow has piled up.”

Both can cause you pain.

About 11,500 Americans a year check into emergency rooms for injuries sustained while shoveling snow, according to a 17-year study by the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. Two-thirds of them are men. Injuries range from minor strained muscles to hits on the head with a shovel to life-threatening heart problems. (See sidebar.)

If you do feel a twinge in your back or shoulder, it could be as “innocent as a strain,” Desai said. “Injuries run the gambit, from that to a slipped disk.”

Lower backs are the most vulnerable, said David Levin, an orthopedic spine surgeon in Rockville. The muscles that span the spine and help with balance and support often are the soft tissue strained as people lift and twist shovels full of snow, Levin explained. The strain is much like a sprained ankle and heals relatively easily.

A herniated, or slipped, disk is more serious and could be caused by twisting while hoisting snow, Levin said. A damaged disk can press on a nerve, causing pain or tingling from your buttocks to your legs.

“If you have burning pain, tingling in your feet and buttocks, those could be warning signs that there are more major problems,” Desai said. “Or if you have numbness and weakness in your legs, a disk may be injured. That situation needs to be formally evaluated by a physician.”

The key to avoiding any of this, medical experts say, is to pace yourself and tackle shoveling as you would any rigorous exercise: Don’t overdo it the first time out the door. And as with any sport or exercise routine, there are best practices; in the case of shoveling, they include what to wear, how to stand, how to grip the shovel, how to move the snow and what equipment to use. These all can make a difference.

The proper warm-up

●Before you even step outside, warm up your muscles by stretching and performing such simple exercises as heel lifts, leg lifts and leg circles.

Stretch gently, Desai said. “Slowly bend at the waist; don’t be aggressive about it,” Desai said. “If you are going to reach for your toes, hold that for seven to 10 seconds. Or if you are sitting and reaching for your toes, leave your left leg straight and cross right leg over; twist,” and repeat on the other side, for example.

Not everyone agrees that stretching prevents injury, but “if you are used to stretching before and after, do it,” Fleit said.

The proper attire

●Don’t overdress for the cold, but dress warmly enough to avoid getting wet and stiff. Don’t just slip on a jacket, a pair of jeans, a T-shirt and running shoes.

●Wear a hat and shoes or boots with some grip on the bottom to avoid falls. “Lots of people slip on ice,” Fleit said. “You can lose your footing and end up in [my office] with a fractured or sprained ankle.”

The proper stance

●Keep your feet as wide apart as your shoulders “for a good base of support,” Fleit said.

●Grip the shovel with one hand on the top at the handle and the other halfway down the shaft. And do not lean out over your shovel, which puts too much pressure on your back, Levin said.

●Bend your knees, not your back, to scoop up the snow. “By bending our knees and using our legs to lift, we are engaging our most powerful muscle groups: buttocks, thighs,” Desai said. “In the process, we are also protecting our low-back muscles, which are relatively weak. It is possible that this is an evolutionary development, since most animals have stronger hind legs compared to forelegs.”

Wearing a flexible brace can remind you not to bend your back, but it will not prevent you from torqueing your back, which could cause problems, Fleit said.

The art of shoveling

●Take small loads and walk it to where you want the snow to go. Don’t throw it. That’s how Fleit got into trouble during Snowmaggedon. When you start bending and twisting with your back, you risk injury, Desai said.

●Better yet, Fleit said, “snow should be pushed rather than lifted.”

●Don’t wait until the snow stops and try to clear it all at once, said Craig Saur, a manager at Strosnider’s Hardware store in Bethesda, as he pointed out the various types of shovels the store sells.

●Take breaks. Shovel for no more than 15 to 20 minutes at a time. “This is an endurance activity, not a sprint,” Fleit said. “Think of it as though you are going out for a long, slow bike ride.”

When you start perspiring, that is a good time to rest, Desai said. “When you get tired, you start losing your form.”

●Drink enough. “People are often surprised how you get dehydrated when it is cold outside,” Desai explained. “You don’t have to get it done at once. Get the space cleared, and then do the minimum amount to keep it cleared.”

●Hire strong neighborhood teenagers to help.

The proper shovel

●“I think you need three different shovels,” said Fleit, “one to push, one to lift, and you need something to break up ice, something with an edge. One shovel won’t do all that.” And make sure it feels like the right size for you when you hold it.

Desai said to pick a shovel with a stout handle, not a flimsy one. “It is like anything else: Newer is not necessary better,” he said. “Pick what works well for you. In the store, test if it feels good in your hand,” sturdy without being too heavy.

Shovels with ergonomic handles — the ones with an elbow bend in the shaft — may be more comfortable when picking up snow, but Fleit said they don’t work well for tall people. “The length of the shaft matters,” he said. If the shaft is too short because of the elbow bend, it will encourage you to hunch over with your back to move the snow, instead of bending your knees.

Also, while these shovels may be ergonomically superior, he said, often “they put this huge steam shovel on the bottom, so you scoop too much.”

●It’s all in the scoop. Saur, at Strosnider’s, said he prefers aluminum to plastic faces, or scoops. “They’re more durable,” he said. And he likes shovels with a metal edge to cut into ice or crusty snow and one with a shallow scoop. “If a shovel has a deep face, you are more likely to take bigger scoops,” Saur said. Bigger scoops mean heavier loads of snow and more strain on muscles, ligaments and joints.


The Washington area doesn’t get enough snow to justify buying a snowblower, according to Saur. “They are self-propelled, which I think is great,” he said. “But we just don’t get enough snow to warrant the cost. There’s usually not a lot to shovel.”

Still, every year Levin, the spine surgeon, said his practice sees a few hand injuries or amputations from people trying to unclog a jammed snowblower while it is running. “Turn off the snowblower, and never use your hand to clear jams,” he said.

When to stop

If you feel a twinge in your back or shoulder, Desai said, stop shoveling.

Most minor injuries resolve themselves with rest, over-the-counter remedies and applying heat or ice, Desai said. But if the pain is more severe or doesn’t go away with a little rest, you should consult a doctor.

Hambleton is a freelance writer and documentary filmmaker based in Chevy Chase.