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Dr. Susan Wainwright, vice chairwoman of the department of physical therapy at University of the Sciences in Philadelphia, warns shoveling snow -- an extremely strenuous activity -- can cause those in poor physical shape and not be prepared for the stress of shoveling snow to sustain muscle pulls, back injuries and strains.

"Snow shoveling can also strain the heart and cause potentially life threatening injuries, such as a heart attack", Wainwright said in a statement. She recommends men and women age 45 and older, especially those who are not physically active or have a history of a heart condition, should have someone shovel snow.

To avoid shoveling injuries Wainwright recommends:

-- Warming up first by jogging in place or running up stairs and stretching.

-- Purchasing an ergonomically correct shovel and use proper shoveling technique. Push the snow instead of lifting it and do not overload the shovel. To lift, bend the knees and lift with the legs and avoid twisting or throwing snow over your shoulder.

-- Take breaks. Take a break every 15 minutes to stand up straight, walk around and drink water to avoid dehydration and overheating.

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