injury prevention


Extreme Shoveling: Make Loads Even Smaller, And Other Tips From Spine Expert

Energy efficiency specialist David Adamian shovels a sidewalk in Cambridge, Mass. (Robin Lubbock/WBUR)

Energy efficiency specialist David Adamian shovels a sidewalk in Cambridge, Mass. (Robin Lubbock/WBUR)

My back aches just thinking about it: An additional foot of snow, possibly followed by rain in some areas to add more weight to each shovel-full. This is back-blowing territory, made all the more perilous by the need for speed, to shovel out before night’s chill coats every snowy crenellation with ice.

So for back-saving tips, I turned to an expert: Dr. Carol Hartigan, a physiatrist and the medical director of the Spine Center and Spine Rehabilitation Program at New England Baptist Hospital. My personal takeaway: Smaller shovel-loads. Even smaller than you think you need. Slow down. Bit by bit. And if you possibly can, avoid the whole thing: Outsource. Borrow a snowblower. Or at least share the labor. Ignore all this wisdom at your own risk — the risk of weeks of misery. Our conversation, edited:

First, what’s at stake: What are the most common shoveling injuries you see?

We basically see strains: People who’ve been shoveling, sweeping, clearing snow, breaking up ice, cleaning off the car. Usually it’s the low back but it can also be the neck and the mid-back.

And the worst?

Really just severe, acute back strain: Pulling, stretching, tearing of the muscles and the capsules around the joint and the ligaments causes release of chemicals that irritate the nerves and trigger inflammation and that gets to be a vicious cycle that feeds on itself, and then the muscles tense up and spasm, and then the blood doesn’t flow, and then we get cautious and guarded — those things happen. And there’s no easy way out of that — that’s a situation that has to run its course. It can take a day or two, a week or two, it can take up to eight weeks to resolve.

I really can’t think of any ergonomic way to do that [lift a shovel full of snow four feet high.] I really can’t.

– Dr. Carol Hartigan

In terms of prevention, what do you most wish people knew?

• Snowblowers do help! Having a plow shovel the driveway, for people who are older, is not a bad idea if that’s an option. If people are shoveling themselves, using the right shovel — like a back shovel that has a curved handle — can minimize the back bending.

• Using your legs is a good idea.

• Turn with the snow to throw it, and try not to throw it really far away from the body — keep the shovel close to the body.

• Don’t try to shovel deep snow — like with the 24 inches we had last week — the whole entire depth of the snow at a time. Just do a few inches at a time.

• Split the job up with your family members. Don’t let one person do it.

• Pace yourself.  Do a little, go inside, come back an hour later, as opposed to doing it all at once.

And specifically for today — it looks like it’s going to be extreme shoveling, trying to put another foot of snow on top of walls that are already three or four feet high. What do you advise?

There’s no way around it being a very difficult and challenging situation. We’re going to have to make our driveways a little less wide. Find new spots to put the snow. We want to be very careful to have on shoes with a good tread so we don’t slip — we see injuries when people slip and fall and land on their butt and get a compression fracture. So we don’t want people slipping on the ice. But there’s no two ways about it — it’s going to be a difficult snowstorm  today.

What about the weight of the snow, with rain coming in some areas to make it heavier? Is there any rule of thumb about how heavy a shovel-full you should lift?

It’s better to do more lifts of less heavy shovel loads than trying to do it as quickly as possible with the least amount of maneuvers. It’s very personal to each of us. We’re different sized people. We don’t want it to be super heavy, we want it to be like a medium intensity challenge.

And the height problem? If you have to lift snow up higher to get it onto a pile, does that pose special risks? Continue reading

JAMA: ‘Silencing The Science On Gun Research’

"Non-Violence sculpture by  Carl Fredrik Reuterswärd )Wikimedia Commons)

“Non-Violence” sculpture by Carl Fredrik Reuterswärd (Wikimedia Commons)

The prestigious Journal of the American Medical Association has just published a disturbing account of how research into understanding and stopping gun violence has been quashed by politically motivated defunding.

The author, Dr. Arthur L. Kellermann, points out that our experience with car accidents and other injuries shows that the insights gained from research can save lives — many lives. But……

Read the full piece here, including:

The nation might be in a better position to act if medical and public health researchers had continued to study these issues as diligently as some of us did between 1985 and 1997. But in 1996, pro-gun members of Congress mounted an all-out effort to eliminate the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC). Although they failed to defund the center, the House of Representatives removed $2.6 million from the CDC’s budget—precisely the amount the agency had spent on firearm injury research the previous year. Funding was restored in joint conference committee, but the money was earmarked for traumatic brain injury. The effect was sharply reduced support for firearm injury research.

To ensure that the CDC and its grantees got the message, the following language was added to the final appropriation: “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.”4

And it concludes: Continue reading

Caution, NPR Listeners: Reported Injuries While Walking With Headphones Triple

Please forgive this preaching, but I think I speak for all my WBUR colleagues when I say: We love our listeners and do not want our podcasts and mobile apps to hurt you. So please pay attention — and that is the point, paying attention! — to a new study that finds that reports of serious injuries in pedestrians wearing headphones have tripled in the last several years.

The victims tended to be in urban areas, under 30 and male, and about half were struck by trains. The authors of the paper in the journal “Injury Prevention” — titled “Headphone use and pedestrian injury and death in the United States: 2004-2011 — mined their data from injury databases and even Google, and came up with a total of 116 vehicle accidents, 70% of them fatal.

My speculation is that, say, an On Point segment on physics might be especially perilous.

They found that in three-quarters of the cases, witnesses reported that the victims were wearing headphones, and in about one-quarter, they said a horn or other warning had sounded before the collision.

From the press release:

“The authors say that distraction and sensory deprivation, whereby the wearer is unable to hear any external sounds, are the most likely causes. Distraction caused by the use of electronic devices has been coined ‘inattentional blindness,’ which essentially lowers the resources the brain devotes to external stimuli, they write. Continue reading