Ear discomfort underwater can significantly detract from the experience, but this pain stems from two distinct biological mechanisms: pressure differences and moisture retention. The most immediate and often sharp pain during descent is caused by the air pressure in the middle ear not matching the surrounding water pressure, a condition known as barotrauma. A separate, delayed type of discomfort comes from water trapped in the outer ear canal, which creates a breeding ground for bacteria and can lead to infection. Understanding these causes allows for targeted preventative action to ensure a comfortable time in the water.
Techniques for Equalizing Ear Pressure
The middle ear is an air-filled cavity separated from the external environment by the eardrum, connecting to the back of the throat via the Eustachian tube. When descending, ambient water pressure increases rapidly, pushing the eardrum inward and causing pain if the pressure inside the middle ear is not raised to match it. Prevention lies in actively opening the Eustachian tube to allow air to pass from the throat into the middle ear space.
The simplest and most common technique is the Valsalva maneuver, which involves pinching the nostrils closed and gently attempting to exhale through the nose. This action forces air from the lungs, increasing pressure in the nasopharynx and pushing the Eustachian tube open. A gentler alternative is the Toynbee maneuver, where a person pinches the nose shut and then swallows. Swallowing helps to open the Eustachian tube by activating the muscles that control it, which can be effective for minor pressure changes.
For those who dive deeper or more frequently, the Frenzel maneuver is often preferred because it avoids using air from the lungs. This technique is performed by closing the vocal cords, pinching the nose, and using the tongue like a piston to compress the air against the back of the throat, pushing air into the middle ear. Regardless of the method used, the practice must be performed early and gently, before any significant pressure or pain is felt. If the ear begins to hurt, ascend slightly until the pressure eases before attempting to equalize again, as forcing an equalization against pain risks injury to the inner ear.
Preventing Water Trapping and Swimmer’s Ear
A different source of ear pain is otitis externa, commonly known as Swimmer’s Ear, which is an infection of the outer ear canal. This condition is caused when water becomes trapped, washing away the protective layer of earwax and raising the pH level of the canal, which allows bacteria to multiply easily. Preventing this involves both physical barriers and proper drying hygiene after leaving the water.
Physical barriers like specialized earplugs or a tight-fitting swimming cap can be used to prevent water from entering the ear canal. Earplugs are particularly effective for surface swimming and showering, but they should be used with caution for diving, as they prevent equalization and can cause outer ear barotrauma. After any water exposure, the immediate goal is to remove all remaining moisture from the ear canal.
One effective drying method is to tilt the head to the side, gently pulling the earlobe in different directions to straighten the canal and encourage water to drain out. The ear can also be dried indirectly by holding a hairdryer on the lowest heat and speed setting several inches away. A simple option for restoring the ear canal’s natural balance is the use of drying drops. These drops often contain equal parts white vinegar and rubbing alcohol; the alcohol absorbs the water and evaporates, and the vinegar’s acidity discourages bacterial growth. Drying drops should never be used if there is any suspicion of a perforated eardrum or if ear tubes are present.
Recognizing Serious Symptoms and When to Seek Medical Attention
While mild discomfort often resolves on its own, certain symptoms indicate a more serious injury, such as a perforated eardrum or inner ear damage, requiring professional medical evaluation. Severe, persistent pain that does not subside shortly after leaving the water is a primary warning sign. Any discharge of fluid, especially if bloody or clear, suggests that the eardrum may have ruptured due to the pressure differential.
A sudden, noticeable loss of hearing or a persistent ringing in the ears may signal a problem that needs attention. The most concerning symptoms are severe dizziness or vertigo, the sensation of spinning or falling. Vertigo, nausea, or vomiting following a water activity can indicate damage to the delicate balance mechanisms of the inner ear.
If pain or any other concerning symptom continues for more than 24 hours, consulting a healthcare provider is recommended. Following an injury, it is important to abstain from any further diving or water activities until a medical professional confirms the ear has fully healed. Ignoring these warning signs can lead to chronic hearing issues or recurrent infections.