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Combatting Common Ear Problems

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Issues with the ears pose one of the most common and vexing challenges for numerous divers.

Equalisation difficulties can affect divers regardless of their level of experience. These challenges can cause discomfort, stress, undermine the dive experience, and in some cases, deter divers from returning to the water.

Let’s commence at the outset. We are all aware that as we descend, the pressure within the air cavities of our body increases. While pressure does not significantly impact liquids, since about 90% of the human body is comprised of liquids, our attention must be directed towards the air-filled spaces, namely the lungs, sinuses, and ears.

What transpires within our ears during equalisation?

Our ears encompass three principal parts: the outer ear, middle ear, and inner ear. While diving, the outer ear becomes filled with water, thus presenting minimal concerns. The inner ear, housing ear fluids, generally does not pose an issue. However, the middle ear functions as a confined airspace, and heightened pressure during descent triggers discomfort within the eardrum and inner ear’s delicate tissues.

How can we alleviate this discomfort?

The middle ear connects to our nose through the Eustachian tubes. Counteracting the pressure changes while descending merely requires the infusion of air.

The most prevalent method entails pinching your nose and exhaling gently against the pinched nostrils. A distinctive “pop” sound or sensation within the ears confirms successful equalisation and alleviates discomfort. This technique is referred to as the “Valsalva manoeuvre.”

An alternative approach involves pinching your nose while simultaneously swallowing or mimicking a yawn by moving your jaws from side to side. These methods utilise throat muscles to open the Eustachian tubes, diverging from the air pressure exhalation of the Valsalva manoeuvre.

Potential issues during diving While this theory sounds promising, real-world application sometimes falls short. On certain dives, one or both ears might resist equalisation due to various reasons:


This represents the most frequent cause. During a cold, the excess mucus can obstruct the Eustachian tubes, rendering equalisation exceptionally difficult or even impossible. If repeated gentle attempts fail to yield results, it is advisable to postpone the dive until recovery from the cold, when the blockage naturally subsides.

The use of decongestants is discouraged as their effects may dissipate at depth, potentially leading to a reverse block. This occurs when expanding air gets trapped within a diver’s air spaces during ascent, causing substantial pain. In this instance, the pain originates from excessive air within the middle ear, rather than insufficient air.

Although reverse blocks are infrequent, they are perilous. The diver’s ascent becomes agonising, yet limited air and underwater time exacerbate the situation. The prescribed course involves a slow descent followed by a gradual ascent.

Our recommendation is clear: if suffering from a cold that hampers equalisation, it’s best to forgo the dive. Rest assured, the ocean will remain accessible on a subsequent occasion.

Excessive Earwax During a Dive

Surplus earwax in the outer ear can exert pressure on the eardrum. This additional pressure impedes proper equalisation. However, this doesn’t warrant inserting cotton buds into the ears, as this could exacerbate the issue. Consulting a medical professional is prudent. Earwax serves as a natural defense for the ears, and its removal should be guided by a doctor’s expertise.

Patulous Eustachian Tube (PET)
This rare condition involves intermittent, incomplete closure of the Eustachian tube. Similar issues can arise from an unusually narrow tube. Both these conditions necessitate diagnosis and treatment by a specialist.

Nasal polyps, and ear infections can also contribute to ear problems. Medical professionals should diagnose and address these concerns.

Tips & Advice

  • Ensure you are free of cold or congestion before diving.

  • Descend gradually and with control.

  • Utilise a descent line if buoyancy is a challenge.

  • Equalise regularly.

  • Frequent equalisation eases the process.

  • Equalising approximately every metre is recommended, but the key is to act promptly upon sensing pressure.

  • Execute equalisation gently. Forcing the process can harm the ears. Discomfort should not involve pain. If pain arises or ears fail to “pop,” halt the descent and alert your buddy or guide. Ascend a few metres and retry at a leisurely pace.

  • Plan ahead. If you anticipate ear difficulties, inform your buddy and guide. If scuba diving in a group, consider entering the water early to allocate ample time for equalisation. Using a line can assist. Don’t hesitate to request help or communicate with your guide; the more information they possess, the smoother their task becomes.

  • Within a diving group, adhere to tip number 6, allowing around 5 minutes for equalisation. Failure to descend by this point might warrant cancelling the dive, as the rest of the group will be awaiting your readiness. Prolonged attempts at ear equalisation should be avoided. Notify the guide of your decision to ascend; neglecting to do so could trigger an unnecessary emergency search.

  • If chronic ear problems provoke concern about group delays, consider hiring a private guide to alleviate stress. Show consideration for your ears, and consult professionals when in doubt. Ear issues often have straightforward solutions, but consulting a doctor is a safe approach if uncertainty persists.
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