Ready to dive in? Ear check for scuba diving

Diving into the underwater world is an exhilarating adventure that offers a unique blend of freedom and exploration. However, scuba diving is not without its challenges. One of the most significant hurdles divers encounter is equalizing ear pressure. Mastering this essential technique can mean the difference between a pleasurable dive and an uncomfortable experience. Every month I receive a few patients in my clinic for a pre- scuba diving ear check, so in this article, I will examine ear checks for scuba diving, and effective strategies to equalize ear pressure and help you enjoy every moment of your diving journey.

Ear check before scuba diving

When you dive underwater, the pressure surrounding you increases rapidly. For every 10 meters (about 33 feet) you descend, the water pressure increases by approximately one atmosphere (1 ATA).

Let's take a look at the below anatomy of the ear and see what happens when you descend into the water:

• Outer ear - As the water pressure increases, the water movement in the outer ear may move the earwax in the ear canal deep and stick it to your ear drum. So it makes sense to make sure that your ear canal is clean from any blockage of ear wax. In a worst-case scenario, the ear wax may expand due to exposure to seawater and act as a piston in the ear canal, passing on the increase of the pressure to the eardrum. So you can imagine that the first step in preparing your ears for scuba diving is to ensure they are clean.

• Middle Ear - Your middle ear is connected to the top of your throat through a small tube called the Eustachian tube. The Eustachian tube has two roles, a. to equalize the pressure in your middle ear, and b. to drain the fluid or infection material that may have built up in the middle ear. If you have had a cold, soar throat, sinus infection, cough or any inflammation neck and up you may have experienced a runny nose followed by feeling mucus flowing at the back of your throat that you don't have much control over. This mucus could block your Eustachian tube on one or both sides. The symptoms include a feeling that your ear is blocked, or when you swallow your saliva you hear popping or crackling in your ear. A clean and open Eustachian tube is vital in equalizing the pressure in the middle ear while scuba diving. Please see this article on how you can clean and manage the blockage of your Eustachian tubes.

• Inner ear—The inner ear is not mechanically or hydraulically connected to its surroundings, so there is nothing to clean or check in it.

  
  

How to protect your ear canal from a fungal infection before scuba diving

If you head on to a vacation in warm places or plan a scuba diving you may want to consider a few simple steps to protect your ears from picking a fungal infection.

1. Ear wax removal - Ensure that there is no ear wax buildup before you begin your vacation. Even a 50% ear wax buildup can trap water in your ear. A warm and dark environment in your ear canal is a perfect environment for a fungal infection to form and grow.

2. Swimmers ear spray - A thin layer of earwax in your ear canal is the best natural protection for your ear canal. However, the ear canals of some people do not create much ear wax. Or you wish to double down on ear protection before scuba diving then you can try protection sprays. There are ear swimmer sprays that are ticker than olive oil so when sprayed they create a sealed protection in the ear canal that stays for a few hours. Here is one by Earol.

   
   

How to clean your ear after scuba diving

It is a good habit to wash your ears after each dive. Gently rinsing the ears with fresh water after each dive may help. A more strict approach to cleaning your ear after scuba diving is to gently rinse with warm water, dry thoroughly, and consider using a solution of equal parts white vinegar and rubbing alcohol to help prevent a swimmer's ear or fungal infection.

The importance of equalizing while scuba diving

Equalizing ear pressure is crucial for several reasons:

1. It allows for a more comfortable descent and ascent. When equalization is done correctly, you can focus on enjoying the amazing marine life around you rather than worrying about ear pain.

2. It prevents possible injuries, such as ruptured eardrums or inner ear complications. According to a study, roughly 10% of divers report issues related to pressure equalization.

   
   

To maximize comfort during your dives, it's essential to equalize every few feet as you descend. Staying attuned to your body's signals will enhance your diving experience.

How to equalize ear pressure while scuba diving

1. Valsalva Maneuver

The Valsalva manoeuvre is among the most widely used methods by divers to equalize ear pressure. Here’s how to perform it effectively:

1. Pinch your nose closed

2. Close your mouth

3. Gently blow against your closed nostrils while keeping your mouth shut

   
   

This method pushes air into the Eustachian tubes, helping to equalize the pressure in your ears.

2. Toynbee Maneuver

The Toynbee manoeuvre offers a gentle alternative. Follow these steps:

1. Pinch your nose closed

2. Swallow while keeping your nose pinched

   
   

This action helps open the Eustachian tubes, allowing for a more gradual equalization than the Valsalva manoeuvre.

3. Frenzel Maneuver

For advanced divers, the Frenzel manoeuvre may be beneficial:

1. Pinch your nose

2. Close your throat as if getting ready to swallow

3. Use your tongue to push air into your nasal passage

   
   

This technique is particularly useful if standard methods are ineffective.

4. Using Jaw Movements

Sometimes, simple actions with your jaw can assist with equalization. While descending, try to:

1. Yawn widely

2. Chew gum or suck on hard candies

   
   

These movements can help naturally open your Eustachian tubes, making the process easier.

When to equalize while scuba diving

Knowing when to equalize is just as important as knowing how. Divers should begin equalizing before they feel any discomfort in their ears. It is advisable to equalize every few feet during descent, stop to assess your comfort level if you feel any pain, and never rush through the process.

On ascent, equalizing is typically unnecessary since pressure decreases. However, if you start feeling discomfort, repeat your chosen equalization technique.

Common mistakes to avoid in equalizing pressure while scuba diving

To maximize safety and comfort, be aware of common pitfalls:

• Forcing equalization: Do not attempt to force the process. If it does not work immediately, wait a moment and try again gently

• Ignoring discomfort: If you experience pain, stop your descent and relax. If needed, ascend slightly before trying to equalize again

• Descending too quickly: A controlled descent allows time for natural equalization, reducing the risk of injury

  
  

Practising and being aware of these mistakes can lead to a much safer diving experience.

To make equalizing ear pressure as stress-free as possible, consider the following recommendations:

• Stay relaxed: Tension can hinder your ability to equalize effectively. Remaining calm allows you to better focus on the techniques.

• Use a dive buddy: For beginners, diving alongside an experienced partner can provide guidance and support

• Practice on dry land: Familiarizing yourself with equalization techniques on land can help make them easier when you are underwater

  
  

Happy diving!

Disclaimer: The information provided in this article is intended for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment. Reliance on the information provided on this blog is solely at your own risk.

References and additional readings

• Eustachian tube dysfunction and how to manage it

• PADI website

• Ear equalization while diving