An ear infection (otitis media) involves inflammation and fluid buildup in the middle ear, usually caused by a viral or bacterial infection following a cold. Although maintaining a fitness routine is desirable, physical activity is generally discouraged due to physiological risks. The decision to exercise depends on the severity of symptoms and the specific activity planned.
Physical Consequences of Exertion
Physical exertion aggravates a compromised middle ear. Exercise increases heart rate and systemic blood pressure, which increases blood flow and pressure within the head and ear. This heightened pressure intensifies inflammation and fluid buildup behind the eardrum, causing greater discomfort.
Strenuous activities involving breath-holding or straining can trigger the Valsalva maneuver, raising pressure in the chest and head. This pressure transfers to the middle ear, exacerbating pain or causing fullness. If the infection has spread to the inner ear, the vestibular system (which controls balance) is affected. Exertion further destabilizes this system, provoking severe dizziness or vertigo, creating a safety hazard.
The inner ear requires a stable environment, and pressure changes from intense activity can be detrimental. Increased pressure stresses the eardrum and the round or oval windows separating the middle and inner ear. If a fever is present, exercise is risky because it elevates body temperature further, increasing stress and the risk of dehydration.
Activities to Modify or Avoid
Certain physical activities must be modified or avoided to prevent complications. High-impact movements, such as running, jumping, or intense aerobics, create a jarring motion that shakes the fluid within the middle ear. This agitation often increases pain and worsens symptoms like pressure or headache.
Activities involving significant pressure changes pose a risk. Heavy weightlifting or powerlifting, which require straining or breath-holding, should be stopped. Straining creates intense intracranial pressure, potentially leading to inner ear injury. Similarly, yoga inversions or activities where the head is below the heart increase pressure in the head and ear.
Water exposure is prohibited, especially if eardrum perforation or drainage is present. Swimming, diving, and submerging the head introduce the risk of contaminated water entering the middle ear, potentially causing a secondary bacterial infection. Even with an intact eardrum, the pressure from diving or deep water is painful and dangerous.
Safe Return to Exercise
A safe return to exercise should only occur once all acute symptoms have resolved. The individual must be fever-free for at least 24 hours without fever-reducing medication. Ear pain and feelings of fullness must have completely subsided before considering physical activity.
Balance issues or vertigo must be entirely absent, as residual dizziness can lead to falls and injury. When resuming activity, start with low-intensity, low-impact exercise, such as a gentle walk or light stretching, to gauge tolerance. Gradually increase the duration and intensity over several days, monitoring for any recurrence of ear discomfort or pressure.