A pow­erful snow­storm begin­ning Friday morning is expected to drop a heavy dose of snow on the Atlantic Coast’s road­ways, dri­ve­ways, and side­walks, the majority of which will be cleared by plows and snow blowers.

But some people will be forced to shovel, a phys­i­cally taxing activity that can strain the lumbar region of the back and even increase the risk of heart attack.

Shov­eling is an aer­obic exer­cise and puts a lot of stress on the heart,” said Alycia Markowski, an asso­ciate clin­ical pro­fessor in the Depart­ment of Phys­ical Therapy who spe­cial­izes in treat­ment for lower back pain. “If you are out of breath, stop and take a break.”

Markowsi plans on doing her fair share of shov­eling this weekend and offered a few easy-​​to-​​follow back injury pre­ven­tion tips and tech­niques for shov­eling heavy snow.

  • Lift with your legs, not your arms
  • Keep a snow-filled shovel close to your body
  • If you throw the snow, turn your feet in the direction you are throwing—do not twist at the waist

If you do suffer a shoveling-​​related back injury, Markowski rec­om­mends treating it with ice, not heat, which increases inflam­ma­tion. If ice does not quell the back pain, try this simple exer­cise: “Lie on your stomach, keep your hips on the ground, and arch your back,” Markowski said. “This takes the stress off the struc­tures that you have stressed.”

But if you’d rather stay inside where its warm and dry—and pain-free—calling the plow guy might just be the best move of all.