A couple of years ago we had a snowstorm in Buffalo that dropped a ridiculous amount of snow over a two or three day period (Snowvember if you are into the catchy names the news comes up with for storms....).  I kept up with the driveway during the storm, but it was early season heavy wet stuff that the ancient and since retired snow blower couldn't hack.  Had to use the shovel a lot.  When we did the "final" digout, my wife and I were hard at it for some time, and it pretty much polished off my elbows.  The pain kind of comes and goes during the year depending on what I've been doing, but paddling can certainly agitate it.  We haven't had too much snow yet this year, and the elbows have been doing ok.  If we can stay away from Armageddon levels of snow......