More than 31,000 Americans found themselves braving snowy, icy roads on their way to the emergency room, victims of one of winter's most serious calamities. It's not the flu - it's back injuries caused during snow shoveling! While snow shoveling is a chore and most certainly manual labor, it is also a moderate physically demanding form of exercise. As such, snow shoveling should be approached with the same smart practices employed before any physical bout of strength training or cardiovascular exercise.

Before heading out to clear the driveway or walk outside your home or business, here are some important tips to remember to help keep you out of the ER!

1. Warm-up your body. I'm not just talking about layers of clothing - I'm talking about your muscles. There is a significantly reduced chance for injuries when you warm your muscles before performing strenuous activities. Perform some marching in place or walk for about five minutes on a treadmill before bundling up to begin shoveling.

2. S-T-R-E-T-C-H. Again, in an effort to reduce injury, be sure to stretch those, now warmed, muscles before beginning your shoveling task. Be sure to stretch your legs, chest, shoulders, arms and most importantly - your back!

3. Dress properly from head-to-toe. Most of us know that a considerable amount of body heat is lost through our heads, so be sure to wear a hat before heading outside. What we don't often think about is tread on our boots when we shovel snow. Slips or balance loss on ice are serious enough. When combined with the act of shoveling, it's easy to strain a muscle.

4. Form proper form. Think like a snow plow and not a bull dozer. That is, try to push the snow rather than lifting it. If you must lift the snow, remember to utilize your legs, rather than your back. Scoop small loads of snow and walk to where you want to deposit it, instead of lifting and turning or twisting and throwing the full shovel.

Remember snow shoveling is a cardiovascular activity that causes the heart to pump at a faster rate. Be sure to pace yourself, take frequent breaks and remember to replenish your fluids often with non-caffeine beverages. If you feel chest pain, discomfort or other symptoms of cardiac trauma, stop immediately and seek medical attention.