Don't overdo it.

Bend your knees.

Take frequent breaks.

These are just a few words of advice from Alle-Kiski Medical Center physicians to local residents who likely will be breaking out their snow shovels this weekend to deal with the first major storm of the winter.

"Shoveling snow creates a heavy strain on the heart and body; add in bitter cold temperatures, and many people will put themselves at risk of a cardiac event by overdoing it outside," said cardiologist John A. Balacko, M.D., medical director of the Chest Pain Center at Allegheny Valley Hospital in Natrona Heights.

Dr. Balacko noted that blood vessels narrow when it is cold outside, making it more difficult for the heart to pump blood throughout the body. Also, people who are generally sedentary need to know that shoveling snow or pushing a car out of a snowdrift is not the best way to get in shape, he said.

"We need to be more cautious when we are outside during the winter, especially when it's bitter cold," Balacko said.

Other words of advice:

Dress in warm layers.

And if you exercise outdoors in cold weather, temper your workouts.

In addition to being hazardous to the heart, snow shoveling is a repetitive activity that can cause muscle strain to the lower back and shoulders of a person not accustomed to the workload, said Elaine B. Scott, M.D., director of Rehabilitation Services at AKMC.

"Back injuries due to snow shoveling can happen to anyone, not just older adults," Dr. Scott said. "People between the ages of 20 and 50 are generally more likely than older individuals to injure their backs because they may not be aware that they are out of shape."

Some tips for those clearing away the snow:

Lift smaller loads, and remember to bend your knees and lift with your legs instead of your back.

Wait until the afternoon to shovel, if possible. Warmer temperatures are more likely later in the day, and your body has "warmed up" and is more prepared for the strain of shoveling.

Take frequent breaks when shoveling. Stand up straight and walk around to extend the lower back.

"With proper precautions and the correct shoveling techniques, injuries to muscles and joints and a trip to the emergency room can be avoided," Scott said.