Raking leaves: A cautionary tale

My patient, a 54-year-old dentist, was mowing the lawn one recent September when he ran over a nest of yellow jackets, causing them to swarm. He ran to escape but slipped on wet leaves. He fell with his arm outstretched, dislocated his shoulder, and suffered nerve damage. Although it took a year and a half, he ultimately recovered.

While winter may be the season most people consider risky for slips and falls, autumn can be equally dangerous.  Accidents sustained in autumn clean-up work keeps emergency rooms hopping and orthopedists busy until spring. If you're not careful, injuries can occur from cleaning the gutters, operating lawn mowers, raking leaves, and hoisting them into bags.  Falls off ladders, foot injuries from mowers, and low back pain from strenuous twisting and lifting can happen to just about anyone. Fortunately, the majority of these can be prevented by taking some simple preventive measures. The American Academy of Orthopaedic Surgeons recommends the following tips.

To prevent injury from raking, be sure to:

• Warm up for at least 10 minutes with some stretching and light exercise.
• Use a rake that is comfortable for your height and strength. Wear gloves or use rakes with padded handles to prevent blisters.
• Keep your vision free of impediment, like hats or scarves, and beware of large rocks, low branches, tree stumps, or uneven surfaces.
• Vary your movement, alternating your leg and arm positions often. When picking up leaves, bend at the knees, not the waist.
• Wet leaves can be slippery; wear shoes or boots with slip-resistant soles.
• Do not overfill leaf bags, especially if the leaves are wet. To avoid back injury, you should be able to carry bags comfortably.
• Never throw leaves over your shoulder or to the side. The twisting motion required to do so places undue stress on your back.

To avoid lawn mower-related injuries be sure to:

• Make sure the engine is off and cool before you begin any maintenance work or refuel your lawn mower.
• Never use your hands or feet to clear debris from under a lawn mower. Use a stick or broom handle instead. Likewise, never touch the blades with your hands or feet, even if the engine is off. The blade can still move and cause serious injury.
• Never remove safety devices, shields, or guards on switches.
• Do not leave a lawn mower running unattended.
• Wear protective gear like goggles and gloves, boots, and long pants when mowing. Never mow barefoot or in sandals.
• Do not consume alcoholic beverages and mow.

To stay safe on a ladder:

• Inspect the ladder for loose screws, hinges, or rungs. Clean off accumulated mud, dirt, or liquids.
• Make sure all four legs rest on a firm, level surface. Avoid uneven ground or soft, muddy spots.
• Before you climb, be sure all ladder locks and safety braces are engaged.
• Never sit or stand on the top of the ladder or on its pail shelf. These areas were not designed to carry your weight.
• Choose the right ladder for the job. A step stool or utility ladder is good for working at low or medium heights, for jobs such as washing windows. Extension ladders are appropriate for outdoors to reach high places, for when you need to clean gutters or inspect the roof.
• Be aware of your balance. Be careful when moving items off a shelf while you're standing on a ladder. If you have to stretch or lean to reach your work area, it would be safer to climb down and reposition the ladder closer to your work.

—Orly Avitzur, M.D., medical adviser to Consumers Union

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