PORTSMOUTH – Shoveling snow is a New England way of life, but for many people, that sudden surge of activity can be dangerous.

There is risk of bodily injury and the potential for a heart attack if people do not approach this task carefully.

“Shoveling snow is a vigorous activity,” said Dr. Peter Dourdoufis, Chief of the Portsmouth Regional Hospital Cardiology Department. “Then there is the cold air exposure. This can cause the arteries or the bronchioles to constrict. That results in a reduction of blood flow and puts added strain on the heart. The rise in adrenaline adds to the increased risk for clotting or a heart attack.”

“Shoveling is a weird recipe for risk, especially for those who are at an increased risk because of pre-existing conditions,” said Dourdoufis. “People who are sedentary most of the time, who are overweight, who are smokers or already at risk for hypertension who suddenly go out to shovel two feet of snow off their driveway need to be mindful. People who have already had a cardiac event must be extra cautious.”

Injury is another danger. Dr. Ashton Stanton of Core Physiatry is a spine specialist. He said the sudden burst of activity represented by shoveling, especially when done by a person who is not physically fit, is the cause of many injuries.

“You are often working against your footing, on slippery ground,” said Stanton. “You may fall. You are using your body like a lever, like the shovel. Throwing snow away from your body means you are likely using wide swings and increasing the torque on your arms and shoulders. It is better if you try to keep the shovel closer to your body. Take smaller shovelfuls of the snow and reduce the strain. It might take a little longer, but it is worthwhile.”

Stanton said they see a significant increase in spinal injuries during the winter months.

“If a person is overweight, we will see greater episodes of injury to the back,” said Stanton. “People will experience back pain because of the synergistic effect on the lumbar spine. People do not understand the increased risk to their elbows, the added tendinitis caused by shoveling.”

Even using a snowblower to clear the driveway poses risk. Stanton said he had a patient who he had treated for back pain return to the center because he lost a couple of fingers trying to clear his snowblower.

Snowmobile injuries are the main winter injury that Dr. Jessica Peelman, who is a hand surgeon at the Center for Orthopedics and Movement at Exeter Hospital, sees.

“What generally has happened is that the person’s snowmobile has gotten jammed,” said Peelman. “The person shuts off the machine and then either uses a stick, or their hand to clear it. They think it’s safe because they shut off the engine but, once the blockage has been cleared, there can be some residual torque left over and the blade spins, resulting in the injury which can be the loss of fingers.”

Peelman said most snowmobiles come with a tool to use in the event of a blockage. She said people should be sure to use that, and to make sure the machine is truly stopped before putting their hands anywhere near it.

“I also see people who develop tennis elbow symptoms,” said Peelman. “People need to take breaks, to not overdue this activity.”

Dourdoufis said his best advice is to get someone else to do the shoveling for you. Realizing that might not be possible, he said to approach the activity wisely.

“If you must shovel, cover up well, with a scarf over your mouth to keep out the worst of the cold air,” said Dourdoufis. “Warm up your muscles before you go out. Avoid a heavy meal and alcohol before you go out to shovel.”

Using a smaller shovel, or just taking smaller bites of the snow can help. Dourdoufis said take breaks, particularly if feeling tired.

“After you finish, do not just go inside and plop in a chair,” said Dourdoufis. “Walk around a bit. Cool down. And, if your doctor told you not to shovel – don’t.”