Let’s start with back pain. Be mindful if the snow is wet and heavy or light and fluffy. Get a shovel that you push like a plow. Try not to lift the snow, but if you do, bend at the knees and lift in small amounts. If it’s wet and heavy, half the shovel is more than enough. Be sure your muscles are warmed up before you start to shovel. Do some stretching before you head outside. Cold, tight muscles are more likely to cause a sprain or strain. Most importantly, snow shoveling is a perfect storm for a cardiac event. As you shovel, the exertion causes you to breathe harder through your mouth instead of your nose. This brings cold air into your body which may result in spasms in the blood vessels around your heart. Because shoveling is exercise, your heart needs more blood to pump to keep up with demand. And here’s the crux of the problem: The spasming vessels can become so narrowed from the cold that they can’t meet demand, especially if there’s any pre-existing blockage due to coronary artery disease which sets the conditions for a heart attack. Pace yourself, take it slow and easy with the snow shovel and don’t overdo it!