If you're in charge of shoveling this week, be careful. It's a seemingly-simple task: Move the snow from one spot to another. But hospitals and doctors have seen serious injuries, and even fatalities, related to shoveling.

Heart attacks are the ultimate consequence, particularly among those who are not usually that active. But bodily injury is the more common side effect.

After each major snowstorm, the emergency room at CentraState Medical Center in Freehold sees at least one shoveling-related heart attack patient, according to department chair Dr. Jeremy Dayner.

"It's just the overexertion that gets to them," Dayner told New Jersey 101.5. "It can be the day of, or sometimes it'll be a day or two later."

Anyone over the age of 50, or with risk factors related to heart disease, should "think really hard before going out and shoveling," Dayner said.

Shoveling out of a storm like this one, when precipitation could be measured in feet rather than inches, should definitely occur in shifts, according to medical experts. Make a pass after every few inches instead of waiting for the final flake to fall.

On the bright side, 15 minutes of shoveling can actually satisfy the recommended amount of daily exercise.

The tips below were originally provided to New Jersey 101.5 by orthopedic surgeon Sandro LaRocca as part of New Jersey 101.5's sponsored "Local Experts" series earlier this year. LaRocca is the founder of the New Jersey Neck and Back Institute. His contact information is available on the Local Experts page:

Pick out the right shovel: People will shop for snow shovels, some with handles bent at an angle  —  but do these really help if they are used improperly? The short answer is yes, an angled handle aids in providing leverage  —  but don’t have a false sense of security and lift more snow. My concern with ergonomic shovels is that people see it as a way to lift heavier mounds of snow. On the contrary, ergonomically assisted shovels are to aid an already conservative approach. Also, it’s important to keep in mind that any shovel used improperly can result in injury, and when used properly can reduce the risk of injury.

Stretch beforehand: It’s important to loosen up the muscles and get the blood flowing before going outside in the cold. Warm up the arms, legs, back, shoulders, and neck with basic exercises to reduce the risk of injury.

Stay hydrated: Like any other exercise, you will lessen your risk of cramps and spasms by hydrating sufficiently. Drink plenty of fluids throughout the day- before, during, and after shoveling.

Start out early: When shoveling in especially colder temperatures, the snow is more easily removed early on before it hardens and becomes thicker and heavier. Making multiple trips outside to shovel throughout the day may seem like a tiresome process but it is actually much safer and more efficient than making one big strenuous effort to remove all of the snow at the end of the day.

Use the right technique: Various types of snow-shoveling related back injuries occur from overdoing it or not using the right technique, and many post-surgery patients are unaware of what they can and cannot do. Most importantly, keep the elbows tight and close to your torso and hold the shovel close to your body. Be sure not to twist or turn around when throwing the snow- repeated twisting can injure the neck and lumbar vertebrae. Rather, push the snow straight ahead, ideally avoiding lifting it off the ground. If you must throw the snow because of the depth or structure of your driveway, only throw it straight ahead. Throwing snow to the left or right or behind you is a recipe for disaster. Unless you are building a snowman, it’s not advisable to bend and lift large clumps of snow in your arms as it can cause muscles to spasm.

Take your time! Be sure to switch sides when shoveling and take breaks when needed. Most people tend to favor one side when exercising- to avoid overworking the same muscles, switch sides every few minutes.

Afterwards: After shoveling, stretch the muscles again and make sure to rest up. Ice packs, heating pads and over-the-counter analgesics like Naproxen, Ibuprofen and acetaminophen are all helpful if you are experiencing soreness after shoveling. Using analgesics for an aching neck or back for a few days afterwards is fine, but if pain persists after a week you will want to consider seeing a doctor.

Things to consider: If you have had back or heart surgery in the past, it’s best to consider using a snow blower rather than a shovel this season. While very efficient, users should operate snow blowers with caution as they tend to provide a false sense of confidence and can also result in serious back injuries depending on the height and weight of the machine, the angle of the handle, and the amount of snowfall involved. There’s also no shame in asking others for help- ask local kids if they would like to make a few dollars by helping or shoveling entirely. It will save your back and build their character!

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