Full Potential PT. Tips On Safely Shoveling Snow



January 2020

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Health & Fitness

January 2020

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As I sit andwrite this article the temperature is a balmy 55 degrees on December 29th, but I realize with the way the weather can change in Michigan we can have snow tomorrow. Actually, shoveling snow can be fairly good exercise if one keeps a few principles in mind. My wife is always asking why don’t you get a snow blower, but I actually feel it is good exercise and find it enjoyable as long as I do not let the snow accumulate too much before taking action. In any case, here are a few tips for you folks who still shovel. 1. Know your ability. First and foremost, each of you are different so know your body and what problems you have had. Someone who is 55 years old hasmuchmore to consider that someonewho is 24when they are going to go out and shovel the driveway. Someone with a history of back pain, disc problems, etc. needs to approach the shoveling with a little more smarts. The old axiom ‘strain the brain and not the back” gets more relevant as we get older. So, if you are older or have a history of back, neck or shoulder problems, do some of your exercises first. You know, those one’s stuck in the drawer we gave you in PT. But seriously, loosen up a bit. 2. Know your snow. Some snow is very dense and heavy. So, it is much harder tomove. If that is the case, much better to shovel twice with half the weight and strain. If you have a lot of snow on the driveway or walkway, it is much easier to push snow a shorter distance. So, shovel the width and not the length. Sometimes with a driveway, one might have to split it in haves and go left and right with half the snow or even a ¼ of the distance at a time. The body is much better at handling lighter more repetitive loads v. heavy less repetitive. The heavier the snow the more you should consider this principle. This is all common sense but keeping the lighter and more repetitive concept in mind has saved me a few times. 3. Pushing snow is much easier than lifting and throwing. When pushing snow, one can engage your core rather easily if you have been trained on this. (if not, this is a good skill to learn, we do that). Keep your abs tight as you push so the loads stay balanced and do not concentrate on your lower back. If you have to lift snow and throw it, try to throw it straight ahead and not twist. If you have to turn and throw it, move your feet to change directions and not twist your back. If you have to pick up snow or the pushing get hard, exhale as you do so. Really helpful. Why? Because it recruits your abdominals and they protect your back. Weight lifters do this, snow is weight and the same principle applies. I always tell my patients, “ex with ex”, exhale with exertion. Practice exhaling as you exert and your body will eventually automate and do it without you having to remember. What is that called - a good ergonomic skill that serves to balance the stresses away from the lower back. 4. Watch for unsmooth surfaces. As you’re pushing snow, be careful you do not catch a rise in the concrete and strain your shoulder or back. Typically if

you’re right handed, your right hand will be on the handle and that sudden force jamming into your right shoulder is the stuff a strain is made from, or even worse a bicep tendon tear. 5. And speaking of tears. Many rotator cuff tears occur when someone falls. So, make sure your foot wear has goodgrip to it whenout on slick surfaces. If you’re heading towork and need to shovel first, shoveling snowwith leather soled shoes is asking for trouble as far as slipping and landing hard. 6. Don’t let it freeze. It is a lot easier to shovel snow before someone has walked or driven on it causing it to freeze and stick to the surface. 7. Take a break if there is a lot to do. That snow is not going anywhere, muscles get tired. And when they get tired no one is home to protect the joints. Muscle serves to not only move objects but it protects our joints as well and fatigue sets us up for tightness, possible strain and joint stress. A simple rest break can be all you need. After you finish shoveling, you’re a dozen times better off doing a few stretches for your hips and back before sitting down to relax which will just allow the muscles to stiffen up further (Don’t know how to do that? We can teach you). Muscles recover much betterwith a few light stretches after doing something like shovelingwhere the stresses land heavily on the back mostly due to number 8 just below. 8. Weight xDistance. Avoid the heavy shovels. Metal shovels last longer but can be much heavier and combined with the weight of the snowmake for a heavy strain. A light, quality plastic shovel will last at least a few years and help your back do the same. Remember, if you’re lifting 10 lbs. of snow with a 4-foot long handled shovel, that is 40 lbs. of stress to your back, neck or shoulders. If it is the really wet kind of snow, that weight adds up fast. Divide or reduce the load and conquer. “Strain the brain not the back.” Yes, I know, I am like a broken record but saving yourself from a strain is ¾ mental. 9. Almost last but not least. A snowblower may be what you need with a large area or if you are getting to a point where manually doing this just does not make sense anymore due to the possibility for injury or other health concerns. 10. We are your friendly neighborhood PT clinic. If you’re heading into snow season and your back, shoulders, or neck are already not doing well, then consider getting a consultation to see if we can help you. Don’t add insult to injury, that is not using your brain!

All our best for a smooth snow season,

The Full Potential staff.



belt? If you have substantially different in motion right to left then this is often a sign of the shoulder getting tight and causing pressure and often causing pain in the front of the shoulder. 4. Can you reach across the front of your chest and grab your opposite shoulder? Does that create front shoulder pain or pressure? Tightness in the back of the shoulder causes a lot of front shoulder pain and the answer is in loosening these muscles to reduce the pressure/pain it causes in the front. 5. How do your muscles perform? Can you grab a gallon of milk (8 lbs.) or water easily and lift it out of the fridge to the table? Do you hike the shoulder blade when doing that and cause the neck to get tight? Did you know that weak shoulders can contribute to ongoing neck problems? 6. Can you go out and do light work like washing windows, washing your car or even pushing up out of a chair without pain then or later? 7. Can you sleep on your shoulder for extended periods? Does your shoulder prevent you from getting a good night’s sleep? Some people go buy an expensive new mattress thinking it’s the bed when in fact it is muscles and joints that are under stress. (see short article on beds and pain in this issue). If several of these tests are positive, you have mechanical stress/pressure under the inflammatory pain which is a perpetuating factor in why you are not getting better. You should seriously consider getting a consult and see how we can help you or just talk to your doctor for a referral. Physical therapy treats the mechanical source of your pain and when that is improved the basis for low grade inflammatory agitation is reduced and critical space is restored. You will then move with greater ease and comfort. Yes, you still have your degenerative osteoarthritis but it’s not stopping you now or it is just less of a factor. Arthritis is a gray word; it is not a black or white situation. You can have mild to severe arthritis. For those of youwho havemild tomedium joint changes there is a lot PT can do for you and a consult would clear up a lot of your questions. I hope this article helps you to understand why it is important to know the difference between mechanical basis for pain and an inflammatory basis, sound knowledge is so important with so many opinions on how or where to get help. It’s a new year and the future is more enjoyable with a body that can meet your expectations. Make up your mind this month to get the help you need to live the life you want, that would be a good New Year’s goal.

There is a lot of attention on the word arthritis and how it is responsible for someone’s pain. You have pain in your back or shoulder and it is ongoing and giving it time is not the answer. You see your doctor; they take an x-ray and see some arthritis and the conclusion is this is why you hurt. Arthritis can be painful but to say that 100%of someone’s pain is due to arthritis is not always the whole story. The bigger culprit in why you hurt, especially pain that came on for no particular reason, maybe slowly crept into your body and decided not to leave, is pressure. Yes, pressure. Excessive pressure on a joint surface or concentrated pressure on a portion of a joint surface is not comfortable and if this happens to be in a joint with some arthritic change then the effects of pressure are even worse. Loss of space due to pressure is a very common occurrence as one gets older and handling the source of pressure is key to having some control over pain. Ongoing pressure and friction can create low grade inflammation but is the inflammation really the source of the problem? Behind the inflammation ismechanical stress or pressure and that iswhere you can do something about your pain beside medicate and curtail your activity. If you have been dealing with somemusculoskeletal pain issue for months then you’remore than likely dealing withmore of amechanical pain source versus an inflammatory source. Inflammation typically goes through a healing cycle in four to six weeks, having pain for months is not fully in alignment with the healing cycle for inflammation andmedicating is not the full answer, although it might be helpful temporarily. But who just wants temporary relief and is dependent on unnecessary medication? Handling the source for the mechanical pain is the long-term answer that actually resolves the source of pain and pressure. Let’s take your shoulder as an example. Here are a few tests to show you if you’re having mechanical stress under your “arthritis pain.” Some of these tests are easier to see the differences when standing in front of a mirror. 1. When you raise your arm in front or out to the side overhead, do you get pain in the middle of the range? Especially if you move quickly. Try different angles. This is a test for impingement which is a pressure type of pain and requires an improvement in how the shoulder muscles steer the shoulder bones. 2. Is one shoulder’s motion much less than the other when raising your arms over head? You can have tightness in your shoulder, the shoulder blade or in your ribs and trunk muscles that can contribute to this loss of motion.

Vincent Hanneken, PT

3. Can you put your hand up your back easily like when putting on a bra or



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Relieve Your Pain Try these simple exercises before and after shoveling! Exercise Essentials

Relieves Back Pain

Relieves Back Pain

THORACIC ROTATION Lying on your back with your knees bent, gently move your knees side-to-side.



Always consult your physical therapist or physician before starting exercises you are unsure of doing.

PIRIFORMIS STRETCH While lying on your back and leg crossed on top of your opposite knee, hold your knee with your opposite hand and bring your knee up and over across your midline towards your opposite shoulder for a stretch felt in the buttock.

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