10 Tips to Prevent Ear Injury

The most common injuries in scuba diving are ear injuries.  Pressure increases with depth, and you must be able to "equalize" your body's air spaces to avoid injury.  Equalizing means making the pressure inside your body's air spaces match the surrounding ambient pressure.

HERE ARE 10 TIPS TO PREVENT EAR INJURY

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1. DO NOT DIVE WHEN CONGESTED - If you have a cold or allergies, mucus fills your body's air spaces, making it difficult or impossible to equalize your ears and sinuses.  Air needs to be able to move freely through your ear and sinus air spaces in order to make the pressure inside of your body's air spaces equal to the surrounding pressure.    

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2. ONLY USE MEDICATIONS WITH EXTREME CAUTION -  Some divers like to take a decongestant such as Afrin or Sudafed before a dive.  These medications help to clear up congestion, but if the congestion returns during the dive you may have another problem to contend with - reverse block.  Reverse block can happen if you are ascending and the expanding air cannot be released from your body's air spaces.  Be careful to take decongestants close enough to your dive time so they are effective, but not too early so they do not wear off during your dive.

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3. REDUCE MUCUS BEFORE & DURING THE DIVE - As disgusting as these ideas may sound, they work.  Prior to descending, blow your nose to clear the mucus from your sinuses.  "Hock a loogie" to clear your Eustachian tubes of phlegm.  This will make equalizing easier during your descent.  But mucus may re-accumulate, and you may need to get rid of mucus during the dive, too.  I remove my mask while underwater to blow my nose and clear my air spaces of mucus, and it works for me.  I would only recommend this for divers who are very comfortable removing their mask underwater.   

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4. AVOID SUBSTANCES THAT CAUSE EXCESSIVE MUCUS PRODUCTION -  Consuming milk products, tobacco, and alcohol cause your body to create more mucus.  If you are someone who tends to have trouble equalizing, avoid drinking milk or having other dairy products before a dive.  Smoking and drinking alcohol should always be avoided before and after diving.  Smoking and drinking cause mucus to form, make it harder to equalize, and increase your risk of decompression sickness.

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5. KNOW VARIOUS EQUALIZATION TECHNIQUES - Most divers know the "jaw wiggle" technique, the "swallow" technique, and the "pinch your nose and blow gently" technique.  Relaxing your face and neck muscles while trying to equalize can make a big difference, too.  Relaxing your muscles allows air to move more freely through your air spaces, while tense muscles can prevent equalization from happening.  You can tilt your head to the side to elongate your Eustachian tube, the tube that connects your ears and sinuses to your throat, while trying to equalize.  You can also massage your Eustachian tube to help air pass through for equalization.  This works great if you have one stubborn ear, but can also be used for two stubborn ears if you alternate sides.  You can combine these techniques for even better results.  For more techniques, read Diver Alert Network's The Diver's Complete Guide to the Ear.

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6. ALWAYS DESCEND SLOWLY AND CONTROLLED -  Most divers descend way too quickly, and put themselves at high risk of barotrauma, pressure related injuries.  You should think of your descent like descending a ladder, rung by rung.  Go slowly, equalize every two feet, and be able to stop immediately if your ears do not equalize to the depth of that rung.  If you are having trouble equalizing, go up only two feet (one rung of the ladder).  Going up more than that will cause unnecessary and dramatic pressure changes to your ears that are likely to hurt you.  Many divers are totally unaware of exactly how much they are going up or down.  Looking at your depth gauge, or better yet, your dive computer, can help you make sure you are not going up or down too far or too fast.  

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The best way to assure a slow, controlled descent is to use a descent line and climb up and down that line with your hands while you equalize.  If surface conditions are choppy, remember that you shouldn't let the line jerk you up and down.  Move your arm up and down with the waves, while your body remains at a constant depth.

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7. DESCEND FEET-FIRST -  That will allow air to rise up your Eustachian tubes and mucus to drain down.  If you descend in an inverted position you will probably need to equalize more forcefully, which can lead to ear damage.  Always equalize gently.

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8. EQUALIZE PROACTIVELY -  Try equalizing before your dive to make sure your ears will cooperate.  Some experts say that if you practice equalizing hours before your dive, it will be easier for you to equalize during your dive.  If you are unable to equalize on the surface, you will not be able to equalize underwater - and you should not dive.  If you gently equalize right before you begin your descent (pre-pressurize) it may help you to equalize past those first few feet which are where the pressure change is the most dramatic.  Equalize before you feel any pain or discomfort and never force an equalization.

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9. SWIM SLIGHTLY ABOVE THE GROUP -  If you are having a hard time equalizing but the rest of the group is beginning their dive, you can still stay with the group but at a shallower depth.  This way you won't float away into the deep blue by yourself while trying to equalize, and you will not stop the group from beginning the dive.  Be sure to signal to your dive guide that you are having trouble with your ears and that you will swim above the group.  Take your time equalizing and descending, and only descend to a deeper depth when your ears are ready. 

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10. GET CONTROL OF YOUR BUOYANCY - Good buoyancy control will help you to be in control under the water.  With good buoyancy control you will have slow descents and ascents, be able to stop at any given depth if necessary, and be able to stay at a constant depth.  Divers with poor buoyancy control tend to accidentally float up and sink down many times during a dive, subjecting their ears to unnecessary pressure changes.  Consider signing up for a Peak Performance Buoyancy course with Aqua Action Dive Center or your local dive shop.

Remember these 10 tips next time you go diving, and enjoy a fun and pain-free dive!  To learn more, read Diver Alert Network's Guide to Avoiding Ear & Sinus Injuries in Scuba Diving

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