How Safe Is Snow Shoveling at My Age
Down comes the snow, out comes the shovel, and then comes the heart attack. It's a pattern that Stephen Hargarten, M.D., sees all too often.
"After a heavy, wet snowfall, we'll get five to six times the number of heart attack cases that we would on any other typical winter day," says Dr. Hargarten, associate professor of emergency medicine at the Medical College of Wisconsin in Milwaukee.
At least 75,000 heart attacks occur each year during or shortly following strenuous physical exertion. About 1 in every 3 of those heart attacks are deadly, says Murray Mittleman, M.D., a researcher at the Institute for Prevention of Cardiovascular Disease at Beth Israel Deaconess Medical Center West in Boston. Many of these heart attacks and deaths occur among people over age 60 who have been shoveling snow.
"A lot of people think, 'Oh, it's just snow. I can take care of this.' They think of it as just another domestic chore like mowing the lawn," Dr. Hargarten says. "But snow shoveling is a lot more strenuous an activity than power mowing. Shoveling causes changes in blood circulation that are a lot more stressful on the heart."
Those changes in blood flow can be particularly risky for people over age 60 who are sedentary or who are unaware that they have heart disease.
"As you move along in years, you tend to get less exercise, and activities like snow shoveling become more dangerous," Dr. Hargarten says.
A study of 10 sedentary men in Michigan, for instance, found that just 2 minutes of shoveling snow raised heart rates above the limit commonly recommended for safe exercise.
And if you are out of shape, the chances that you will have a heart attack in the hour following a physically draining task like snow shoveling are 53 times greater than that for a person who is physically active, Dr. Mittleman says.
"If you live in an area like Boston where snowfall is inevitable, it is important to get regular exercise throughout the year so that your cardiovascular system will be better prepared to handle the demands of shoveling in the winter," Dr. Mittleman says.
| Blowing That Snow Away Isn't Necessarily Better Snowblowers may make your work easier and put less stress on your heart rate and blood pressure. But even with power assistance, the demands of snow removal can still be too high for inactive people who have heart disease, says Barry Franklin, Ph.D., director of the Cardiac Rehabilitation and Exercise Laboratories at the Beaumont Hospital Rehabilitation and Health Center in Birmingham, Michigan. Plus, these devices may have limited value with extremely deep snowfalls. "In sedentary men manual shoveling increases heart rates up to 175 beats a minute. But using a snowblower can elevate your heart rate to 120 beats a minute, and if you have a heart condition that could still be a real problem," he says. So remember: Before you decide to clear any snow, ask your doctor if it is safe for you to do, Dr. Franklin says. |
How Shoveling Strains Your Heart
When you shovel snow, you tend to hold your breath as you lift, Dr. Hargarten says. That increases pressure in your chest and reduces blood flow to your heart. At the same time, cold air constricts your blood vessels. All of this pushes up your blood pressure and forces the heart to work even harder. If your heart arteries are damaged or partially blocked with plaque, these things can combine to set you up for a heart attack.
Doctors are uncertain if physical exertion like snow shoveling also contributes to the onset of a stroke, Dr. Mittleman says.
So is snow shoveling a good idea if you're older than 60? If you're exercising regularly, you're living a healthy lifestyle that includes low-fat eating, you're getting regular physical exams, and you do not have any signs of heart disease, high blood pressure, or diabetes, you can probably safely do it, Dr. Hargarten says. Otherwise, it is smarter to get someone else to do it for you.
If you choose to shovel, here are some things to consider.
Get an annual checkup. Before the first snow flurries begin to fall in your area, get a physical and ask your doctor if you can shovel snow during the upcoming winter, Dr. Hargarten recommends.
Let morning snow go. If at all possible, avoid shoveling snow immediately after you awaken, Dr. Hargarten says. Most heart attacks occur early in the morning because blood is more prone to clotting after you have been sleeping. Take your time getting around to shoveling. Stretch, take a warm shower. Allow yourself an hour or two before tackling this task.
Lay off the smokes and java. Avoid drinking caffeine or smoking tobacco for at least an hour before and after shoveling. coffee and cigarettes can elevate your blood pressure and pulse rate and increase the risk of a heart attack, Dr. Hargarten says. In addition, smoking elevates your carbon monoxide level, which further compromises the delivery of oxygen to the heart muscle.
Eat lightly. Wolfing down a big meal may seem like a great way to rev yourself up for this exhausting chore, but you may be doing yourself more harm than good, says Barry Franklin, Ph.D., director of the Cardiac Rehabilitation and Exercise Laboratories at the Beaumont Hospital Rehabilitation and Health Center in Birmingham, Michigan. Eating draws blood into the stomach, which means that less blood is circulating to the rest of your body. So if you shovel after eating, you are more apt to strain the heart, he says.
Stretch out. Before you begin shoveling, take 5 minutes to stretch and warm up your muscles, says John Emmett, Ph.D., an exercise physiologist and associate professor of physical education at Eastern Illinois University in Charleston. Stretching will help open up blood vessels and improve circulation to the heart. Try doing 20 to 25 knee bends and other stretching exercises before tackling the white stuff, he suggests. (To learn a warm-up routine, see "Warm Up for Comfort" on page 228.)
Dress in layers. Dress in easily removable layers so that you don't become overheated as you work, Dr. Mittleman suggests. As you shovel, your body will warm up. But you don't want to get too warm, because if you get overheated, your blood vessels will dilate, blood will pool in your legs, and your blood pressure will drop. All of that forces your heart to pump harder and increases your risk of a heart attack. If you start sweating or feeling warm, it's time to shed a layer of clothing, he says.
Find the right tool. The smaller and lighter the shovel blade, the lighter the load you will lift. And the lighter the load, the less strain you will have on your heart and back, says Dr. Emmett. Specially designed snow shovels that have a bend in the handle can lessen the strain on the body even more. These shovels are available at most hardware stores, he says.
Be sure that the shovel is the right height so that you don't have to stoop too much, Dr. Emmett says. Here is one rule of thumb: Grasp the handhold at the end of the shovel with one hand. Place your other hand about 18 inches from the point where the handle meets the blade. If your hands are a little more than a shoulder-width apart, you have the right shovel for you.
Work smart. Start slowly and work your way up to a faster pace, Dr. Emmett says. During the first 5 minutes of shoveling, take half as many scoops as you would when you are going full speed. When you lift the shovel, bend at the knees and lift with your legs. That will put less strain on your arms, back, and heart, Dr. Franklin says.
Try to keep the load as close to your body as possible. Avoid twisting and turning as you work. Instead, shovel in the direction that you want to toss the snow and throw it out straight from the shovel blade, Dr. Emmett suggests. Take a 5-minute break from shoveling every 15 to 20 minutes.
Watch for the warning signs. Immediately phone for an ambulance or go to an emergency room if you feel dizzy, light-headed, or short of breath or if you sense tightness or burning in your chest, arms, or back, Dr. Mittleman says.
"Don't worry about feeling embarrassed about coming into the emergency room for a suspected heart attack. It is better to be embarrassed and safe rather than be sick and dead," Dr. Hargarten says.
Prescription for Prevention
Heart attacks triggered by snow shoveling are quite common, particularly among people over age 60 who don't regularly exercise or who are unaware that they have heart disease. If you live a healthy lifestyle that includes regular physical activity, low-fat eating, and not smoking, you probably can safely shovel snow. If you don't, ask someone else to do it.
Do:
* Get a physical and ask for your doctor's consent before shoveling.
* Dress in layers to prevent overheating.
* Stretch and warm up before shoveling.
* Work smart, not hard. Use the right equipment, start slowly, and take frequent breaks.
* Be on guard for the warning signs of a heart attack, including tightness or pressure in the chest.
Don't:
* Smoke. And don't drink caffeinated beverages such as coffee or overeat for at least 1 hour before or after shoveling.
* Shovel snow within 1 hour of waking in the morning.
