If you're rushing this holiday season to clean gutters or hang holiday lights, consider Mark Miller's story as a wake-up fall.

In 2015, the St. Paul resident had just climbed to the gutter on his home when the feet on his ladder slipped. Miller came crashing down, suffered hip and shoulder injuries and ultimately saw about $80,000 in medical bills.

"It happened so quickly," Miller said, "you can't even think."

The moral of the story — be careful — fits with safety pitches from federal officials, ladder manufacturers and medical professionals this time of year. Among them: make sure the footing is sound; get the angle right; and get help, especially if you're uneasy with the chore.

"There are a lot more amateur ladder users in the fall, and around Christmastime," said Dr. Paul Lafferty, an orthopedic surgeon at Regions Hospital in St. Paul who treated Miller. "There are a lot of common mistakes that people make."

Last year, emergency departments treated an estimated 256,000 injuries involving ladders and stools, according to the U.S. Consumer Product Safety Commission. It's not clear how many of those injured were cleaning gutters or hanging holiday lights.

A few years ago, the safety commission estimated about 15,000 injuries connected with holiday decorating during November and December 2012, with roughly one-third of the emergency room visits involving falls.

At Hennepin County Medical Center, doctors treat about 80 people per year who are injured in ladder falls, and a comparable number hurt by falling off roofs, said Dr. Jim Miner, the emergency medicine chief at the Minneapolis hospital. His recommendation: Don't work on a ladder alone.

"We really do see a spike right now — right around Thanksgiving," Miner said. "Usually, they're trying to do something quick. … There's no one holding it for them, or they're not paying attention."

Accidents are more common among novice ladder users, Miner said, but pros can fall, too.

Rick Luckow, 51, of St. Francis regularly used a ladder on the job, but fell off while working five years ago. He broke two vertebrae, spent nine days in a hospital, and couldn't go back to work for months.

Luckow remembers nothing from the accident itself, but has dwelled on the root cause ever since. The feet of the ladder slipped, he said, so the accident could have been prevented if he'd asked someone to hold the ladder.

Luckow expects to be on a ladder this holiday season hanging lights but will do so with extreme care.

"We get comfortable and careless: 'It'll be all right, it's just a minute,' he said. "I'm here to tell you, it only takes a second for gravity to win."

At Regions Hospital, doctors treated 141 patients for ladder-related falls between October 2015 and October 2016, said Lafferty, the orthopedic surgeon. Except for a lull in winter, there's a fairly steady number of cases, Lafferty said, although there's a seasonal shift in who gets injured.

Injuries in the spring, summer and fall tend to be concentrated among ladder professionals during the peak work time for tradesmen, he said. As year-end holidays approach, its more likely to be amateurs on ladders as they attend to lights and gutters.

"The more you use a ladder, the more efficient you are, and the better you know your tool and you know how to use it," Lafferty said.

Before going to medical school, Lafferty worked six years as a firefighter, so he received formal training on using a ladder. He expects to be among those up on a ladder hanging lights this holiday season, but won't go too high. He'll also wait for good weather, since he avoids ladder work during wind, rain and ice.

Lafferty estimated that ladder setup is the problem in about 40 percent of cases. The optimal angle for the ladder is about 75 degrees, he said, but some novice users think that's too steep a slope.

For Mark Miller, the St. Paul resident who was injured while cleaning his gutter, the ladder's footing was the problem. On that fateful day in May 2015, Miller situated the ladder on his deck, rather than the ground — a strategy that he hadn't tried before.

At first, everything seemed fine, since the deck itself was low to the ground and Miller was climbing to a first-floor gutter just 8 feet or so off the ground. But the deck surface didn't provide enough friction.

"I couldn't do anything — I just came down with it," he said. "It happened just that quickly."

Miller, 61, wasn't afraid of heights and considered himself somewhere between an amateur and a pro when it came to ladders. Now, he won't even try to clean his gutters.

"I won't take the chance," he said.

Christopher Snowbeck • 612-673-4744

Twitter: @chrissnowbeck