The sensation of “blocked ears” following a dive is a common post-dive experience. This uncomfortable feeling stems from two primary mechanisms: water trapped in the external ear canal or a pressure imbalance affecting the middle ear. The middle ear, an air-filled space behind the eardrum, relies on the Eustachian tube to regulate pressure against ambient changes during descent and ascent. When this tube fails, the resulting pressure difference is known as barotrauma, which causes the feeling of fullness or blockage. Understanding the cause is the first step toward safely and effectively resolving the discomfort.
Immediate Techniques to Clear Blockages
For blockages caused by water remaining in the outer ear canal, simple, gravity-assisted methods can often provide immediate relief. Try tilting the head to the side of the affected ear, pulling gently on the earlobe to straighten the canal, and allowing the water to drain out naturally. A gentle application of warmth can also help, such as holding a warm compress against the ear or using a hairdryer set to the lowest heat and speed, held 30 centimeters away, to evaporate the moisture.
To prevent infection, commercial drying drops containing isopropyl alcohol or a homemade solution of one part white vinegar and one part rubbing alcohol can be used. These solutions help displace the water and dry the skin of the ear canal, but they must never be used if there is any suspicion of a perforated eardrum or an existing ear infection. If the blockage is due to pressure, try methods that encourage the Eustachian tube to open, such as chewing gum or yawning, which naturally activate the muscles around the tube opening.
If those simple actions do not work, a very gentle equalization technique may be necessary, such as the Toynbee maneuver (pinching nostrils shut and swallowing). Alternatively, try a very gentle Valsalva maneuver by pinching the nose and lightly blowing air against the closed nostrils, being careful never to use excessive force. Forcing air can create pressure that may worsen the condition, so any maneuver that causes pain should be stopped immediately.
Distinguishing Between Water Trapping and Pressure Effects
The location and quality of the discomfort help determine whether the issue is trapped water in the outer ear or a pressure problem. Water trapping typically results in a muffled sound quality, a tickling sensation, or the feeling of water sloshing back and forth when you move your head. This sensation is limited to the ear canal outside the eardrum.
Conversely, a pressure blockage, or middle ear barotrauma, usually presents as a distinct feeling of deep fullness, severe pressure, or pain. This is accompanied by a significant reduction in hearing, or a “stuffed” sensation, and results from the Eustachian tube being unable to vent the pressure. Barotrauma can also cause temporary dizziness or tinnitus, symptoms that are not typically associated with simple water entrapment.
Recognizing the difference is important because applying water-drying drops to a barotrauma issue will be ineffective, and forcefully attempting to “pop” a pressure-blocked ear can be dangerous. If the discomfort is deep-seated and painful, it is highly likely a middle ear issue, and the focus should shift to very gentle pressure-relieving maneuvers or seeking professional guidance.
Signs That Require Professional Medical Evaluation
While most post-dive ear blockages resolve quickly with home care, certain symptoms indicate a more serious injury that requires prompt medical attention. Severe ear pain that persists for more than a few hours or worsens after 24 to 48 hours indicates that home remedies are insufficient. Any discharge of fluid from the ear canal, especially if it is bloody or clear, suggests a possible rupture of the eardrum and needs immediate assessment.
Furthermore, the sudden onset of vertigo or severe dizziness accompanied by nausea suggests a potential injury to the inner ear. The inner ear controls balance, and damage there, known as inner ear barotrauma, requires quick treatment to prevent permanent hearing loss. Significant or sudden changes in hearing, or the development of persistent, loud ringing (tinnitus), also warrant an urgent consultation with a physician.
Prevention Strategies for Future Dives
Preventing blocked ears requires ensuring optimal Eustachian tube function before and during the dive. Never attempt to dive if you have a cold, sinus infection, or severe allergies, as congestion in the nasal passages will prevent the Eustachian tubes from opening effectively. Proper hydration helps keep the mucous membranes thinner and less swollen.
During descent, the primary technique is to equalize the pressure early and frequently, ideally before any discomfort is felt. Start equalizing at the surface before descending, and continue every few feet of descent rather than waiting until the pressure builds up. If equalization becomes difficult, ascend slightly, try the maneuver again gently, and only continue the descent once the pressure is balanced.
Divers should practice different equalization methods, such as the Frenzel maneuver (using the tongue as a piston) or the Lowry technique. Descending feet-first can also aid equalization, as studies suggest a head-up position requires less force to clear the ears. If you cannot clear your ears after multiple gentle attempts, ending the dive safely is the appropriate action to prevent injury.