The heavy snow expected today and Thursday aren’t only an inconvenience and discomfort. It also can be a particular threat to people with heart disease or orthopedic injuries.

That’s why people at risk are reminded to be careful of heavy lifting when shoveling walkways, and watchful when walking on or near slippery surfaces.

Dr. Eric J. Waffner, a primary care physician with the Buffalo Medical Group, offers simple advice: “Listen to your body, and don’t overdo it.”

“People who aren’t in very good physical condition, or have active heart disease, do have to be quite careful because they don’t know what their physical stamina is, and if they exceed it, they could provoke angina or with enough severe activity, potentially a heart attack or some other vascular injury,” Waffner said.

“They really should take it easy, and not be the ones who jump out to shovel the snow until they know they are in good enough condition. If they’re not sure, they should ask someone else to shovel the walk.”

People who haven’t had a heart episode, but have a variety of risk factors, including smokers, a strong family history of heart disease and high blood pressure are advised to be extra careful. Symptoms to watch for include unexpected chest tightness, shortness of breath and a pain or burning in the chest, shoulder or jaw – sometimes dangerously dismissed as muscular pain from exertion.

How prevalent are snow-removal injuries?

A national study in 2012 found 34,200 people were treated in hospital emergency rooms for snow-removal-related injuries. Most were there due to physical strain, particularly to the lower back, shoulders and knees.

“When it comes to chronic orthopedic pain or injuries, that’s another example of where you need to respect your body and what the signals are telling you,” Waffner said. “When you start to feel a twinge, that could be your back, your leg or your shoulder telling you to stop, which you should probably do at that point.”

The American Heart Association recommends warming up and stretching before shoveling to avoid injury and overtaxing the heart.

Pushing the snow rather than lifting it, and using a smaller shovel, also are advised to reduce the heaviness of the load on the shovel. So is a proper lifting technique, with back straight and reliance on the legs to shoulder the weight. Being hydrated and taking short breaks also are important.

Not that shoveling is all bad. A surgeon general’s report 15 years ago found 15 minutes of snow-shoveling was equivalent to a “moderate amount of physical activity,” which is encouraged on a daily basis.