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Physio: Snow shoveling hard on shoulders
When we think of snow shoveling and injuries we often think about sore backs.
Shoulders injuries however, are also very common.
In particular the biceps tendon on the shoulder of the arm that holds the top of the shovel is vulnerable. (This would be the right hand of a right handed shoveler.)
The injury usually happens after a person repeatedly drives their shovel into heavy or crusty snow (like the type of snow left at the ends of our driveways by the snow ploughs).
As the shovel jams into the heavy snow, the front of the shoulder absorbs a quick forceful stress.
As this force is applied repeatedly, structures at the front of the shoulder, such as the tendon of the long head of the biceps can become injured.
The biceps is also vulnerable with this movement because it is actively contracting during this movement.
The biceps brachium is the main muscle along the front of your upper arm. It functions to bend the elbow, turn your forearm upward and flex your shoulder in a forward direction.
The combination of these movements is the same action required by the top arm to effectively shovel snow.
It is able to do all these movements because it crosses both the shoulder and elbow joints.
It has two attachments up at the shoulder, the long head tendon and the short head tendon. I most often see the injury to the long head tendon.
When the long head of the biceps is injured, people often complain of an achy pain in the front of their shoulder.
There can be pain felt along a vertical line in the front of the upper arm but often this pain is described as vague and difficult to pin point as the injury may be up high near its attachment.
Movements that require lifting of the arm are usually sore as are less obvious activities such as turning a screwdriver.
The biceps is actually the main muscle involved in screwing a screw in with a manual screwdriver.
The biceps tendon is not the only structure that can injured with this activity. Rotator cuff muscles, ligaments and bursas can also be irritated.
Thankfully, some common shoveling advice can help lessen the risk of injuring any of these structures.
The first key to avoid injuring your shoulder while shoveling is to make sure you only try to move modest amounts of snow in one scoop or plough. This piece of advice will also help protect your back.
The second and what I think is really specific to this injury is to refrain from repeatedly jamming your shovel against hard crusty snow.
If you obsess over getting the entry of your driveway completely clear after a snow plough has passed, like I am, it will take some real self control.
If the snow is really hard and iced over try using a pick to loosen it up first, or just leave it completely.
If you do begin to experience symptoms after shoveling you should rest your shoulder, apply ice for 15 minutes every couple hours the rest of that day and reassess how you feel the next day.
If symptoms persist for more than a couple days you should see your health care professional.
Lastly, please also respect the possibility that your shoulder pain could be related to your heart.
A 2011 study by Queens University reviewing emergency department visits over two winters discovered that seven per cent of all patients diagnosed as having a heart incident such as heart attack reported shoveling snow that day.
If you find yourself feeling short of breath, nauseated, tight in the chest or you are unsure please get yourself to medical attention as soon as possible.
Jay Stone is a co-owner of Sun City Physiotherapy. He works out of the north Glenmore location.