The Dive Otter

Your Ears - Tip Top Shape

[ Circle H Scuba ]
Of all the potential problems that affect divers, ear problems are not only the most common but also the most likely to keep divers out of the water. If you don't take care of your ears, they will either end that day's dive plan or even worse, end your dive career. There are primarily two factors that affect ears during diving:

Water

The second most common problem for divers is known as "Swimmer's Ear". It occurs when there has been a loss of protective wax, water-logging of the skin and minor trauma like scratching/digging in the ear with a cotton swab. This allows bacteria to invade the skin.
How do you know if you have swimmer's ear? Oh...you'll know. If you tug or pull on your ear, it will hurt.

Advice: Stop using cotton swabs! Yes..I know it feels good. Stop. Particularly the day(s) before a dive. You think you are "cleaning" your ear, when you are actually "damaging" your ear.
Prevention: Use ear drops containing vinegar. Often referred to as "ear beer". It replaces the acidic/antiseptic properties of natural ear wax.
Cure: A visit to your doctor for antibiotics

STOP DIGGING IN YOUR EAR WITH STUFF! INCLUDING YOUR FINGERS!

Pressure

The most common problem for divers is trauma to the middle ear, typically via a pressure injury. ~65% of divers will suffer from this injury at least once in their diving career. The middle ear is effectively under a vacuum which is broken ("equalized") by yawning, swallowing or chewing. You will feel the first signs of pressure at less than 5ft of water. After as little as an additional 3 feet it could be impossible to equalize, even with a forceful attempt. DON'T SCREW AROUND WITH EQUALIZATION!

What it might feel like... You are unable to equalize your ears and the pressure keeps building and you keep descending. Then all of a sudden there is a release of the pressure and you're relieved that it has been resolved. You might feel a slosh of water enter your ear and if it's cold water...a spot of dizziness which resolves itself quickly. You can now continue your dive. Yeah! Except.....your middle ear is now full of water and you have about 2-5 hours before severe pain slams you hard.

Advice That Sucks: "Don't blow too hard!"
Good Advice: (For Valsalva - pinch nose/blow) "Don't blow for more than 5 seconds"
Better Advice: Use Toynbee method of pinching the nose and swallowing instead of blowing. It is more gentle/subtle and works as well as Valsalva. Go ahead and try the Toynbee method right now...close your mouth, pinch your nose and swallow. You should feel your ears actually block / over pressure. You just did it correctly.

How often should I equalize when descending? Constant. No seriously...DAN recommends attempting to equalize EVERY FOOT of descent.

I can't get my ears to equalize...now what? Stop your descent! Signal to your buddy Move up a few feet and try again. DO NOT CONTINUE DESCENT

Dizziness vs Vertigo

They are not the same.
Either one of these symptoms should result in prompt professional medical advice. (eg. not your dive buddy)

What about my Sinuses?

Pressure and pain is not restricted to the ears. You can feel pressure and have difficulty equalizing the sinus cavities too. This is why you should NEVER dive with a sinus infection or a cold/flu or anything that disrupts air flow between your nose and mouth. There are NO effective/safe equalization techniques for the sinus cavities.

If you feel pain above the eyebrows, upper teeth or cheeks, between or behind the eyes...immediately abort the dive!

I'll just take a preventative decongestant

Sudafed is known in diving circles as "scubafed". Though it can help certain divers or certain situations, it should NEVER be used routinely and NEVER used in an attempt to overcome a known congested situation such as having a cold or otherwise unable to clear their sinuses. Yes...many divers pop a decongestant before every dive because "nothing bad has happened before" (normalization of deviance)...that does not make it prudent or wise for you as well.

Advice: If you think you need it for the next dive - consider not diving instead