Ear pain when going upwards?

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ElizaDoolittle

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I've found a problem with my ears when I dive which I'd like to ask you about, since everybody (including my OWD instructor) says it cannot be as I describe it.

Before being certified, my ENT specialist told me I had no problem compensating my ears after testing them with a device that sort of put pressure on them (I really don't know what it did). During my course, I was told that compensating is important when going downwards, but that on returning to the surface, nothing needs to be done, as the pressure is equalized by itself.

I have never felt any pain when going downwards. I'm not sure I'm compensating well, but I'm always told that if it doesn't hurt, it's correct. When I do the Valsava manoeuvre I don't feel anything. When I swallow spit, I feel my ears pop. The problem is that my mouth is usually dry and I don't know how to swallow without gathering spit. However, they tell me that maybe just moving my jaw plays the trick, or that I may be doing the Valsava manoeuvre well even if I don't hear anything. It could be. I had always assumed that compensation done well would make me hear my ears pop, but I admit that may not necessarily be so, as there's no pain.

When I go upwards, my ears start popping as if there were no tomorrow, without my doing anything. I suppose that's right, too... But it hurts. Not much, but there's some pain, or maybe just a strong feeling of discomfort, I cannot tell (this also happens when diving in a 3-metre-deep swimming pool). I start feeling very anxious in case something worse happens. For hours after the dive, I carry on hearing loud pops whenever I swallow, though there's no pain after I've come out of the water.

All my life, my ears have popped when travelling by car in the mountain, and I've always felt it more when going upwards than downwards.

Is this normal? As I said, everybody with whom I've dived tells me that I shouldn't be feeling anything on returning to the surface. Not feeling pain when going downwards has prevented me from getting too worried about this, but I'd like to know whether I'm doing something wrongly.
 

Fin kicker

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It sounds like behaviour similar to a reverse squeeze.
The air pockets throughout your sinus can trap air, or restrict it's flow.
When you ascend, the gas expands and looks for an exit, this could be the popping in your head, that you hear.

I've had sinus issues in the past, usually resulting in blood in my mask, after a painful reverse squeeze.
Diving with Psuedoephedrine (Sp?) can relieve this issue, but check with your diving Dr.

You may also want to preempt this risk, by washing out your sinus with Salt Water, using a sinus bottle or 'Teapot'.

Remember your sinus is connected in your head to your ear channels, and effects pressure inside your head, which impacts balance, and ear or sinus pain caused by Gas (Air) under pressure when you dive.

I'm no Dr, or expert. Just proving my feedback for the last 30 yrs of managing this stuff :)
 

DanBMW

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As stated above, it sounds like a reverse squeeze and it can lead to vertigo, which happened to me a long time ago. As I surfaced on a night dive, I became very dizzy and luckily was near the anchor rope. I focused on it and waited for the vertigo to subside.
 

Duke Dive Medicine

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I've found a problem with my ears when I dive which I'd like to ask you about, since everybody (including my OWD instructor) says it cannot be as I describe it.

Before being certified, my ENT specialist told me I had no problem compensating my ears after testing them with a device that sort of put pressure on them (I really don't know what it did). During my course, I was told that compensating is important when going downwards, but that on returning to the surface, nothing needs to be done, as the pressure is equalized by itself.

I have never felt any pain when going downwards. I'm not sure I'm compensating well, but I'm always told that if it doesn't hurt, it's correct. When I do the Valsava manoeuvre I don't feel anything. When I swallow spit, I feel my ears pop. The problem is that my mouth is usually dry and I don't know how to swallow without gathering spit. However, they tell me that maybe just moving my jaw plays the trick, or that I may be doing the Valsava manoeuvre well even if I don't hear anything. It could be. I had always assumed that compensation done well would make me hear my ears pop, but I admit that may not necessarily be so, as there's no pain.

When I go upwards, my ears start popping as if there were no tomorrow, without my doing anything. I suppose that's right, too... But it hurts. Not much, but there's some pain, or maybe just a strong feeling of discomfort, I cannot tell (this also happens when diving in a 3-metre-deep swimming pool). I start feeling very anxious in case something worse happens. For hours after the dive, I carry on hearing loud pops whenever I swallow, though there's no pain after I've come out of the water.

All my life, my ears have popped when travelling by car in the mountain, and I've always felt it more when going upwards than downwards.

Is this normal? As I said, everybody with whom I've dived tells me that I shouldn't be feeling anything on returning to the surface. Not feeling pain when going downwards has prevented me from getting too worried about this, but I'd like to know whether I'm doing something wrongly.
Hi @ElizaDoolittle ,

That's interesting, most of the time people report difficulty equalizing their ears on descent, not ascent. The anatomy of the Eustachian tube, which is the small passage that connects the middle ear to the back of the throat, is such that air passes more easily from the middle ear space to the throat than the other way around. A couple of questions: how easy is it for you to equalize on descent, and do you have any kind of condition that would irritate the mucous membranes in your head, like environmental allergies?

Best regards,
DDM
 
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ElizaDoolittle

ElizaDoolittle

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Thanks everybody for your answers!

Don't ascend too quick. Equalize on the way up.

How should I do it? I remember hearing that doing the Valsava manoeuvre while ascending is not right. If I'm not wrong, it increases the pressure in your throat so as to open the Eustachian tubes, which are kept closed because of the increase in the pressure caused by the water. If I do it during the ascent, wouldn't I be contributing even more to "bending" my eardrums outwards?


Hi @ElizaDoolittle ,

That's interesting, most of the time people report difficulty equalizing their ears on descent, not ascent. The anatomy of the Eustachian tube, which is the small passage that connects the middle ear to the back of the throat, is such that air passes more easily from the middle ear space to the throat than the other way around. A couple of questions: how easy is it for you to equalize on descent, and do you have any kind of condition that would irritate the mucous membranes in your head, like environmental allergies?

Best regards,
DDM

As I said, I'm not sure I'm equalising well on descent. If I manage to swallow (which is not often), I hear the pop and I feel reassured I've just compensated well. If I can swallow, I equalise very easily. But it's very hard for me to gather spit and, as I said, I cannot swallow dry. When I start getting uptight because I cannot gather spit, that's when I do the Valsava manoeuvre. But doing it, I've never heard any pop, so I don't know whether I've equalised or not. The lack of pain seems to indicate I have, but I don't know.

I have no condition of the type you mention, as far as I know (at least, no allergy, I know that for sure). But what I have is a tendency to have a very slightly blocked nose when I wake up in the morning. Is that an irritation of the mucous membranes?
 

Andrewey

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When you start to feel that pain/popping when surfacing, do you continue surfacing or do you stop/descend and try to equalize before resuming?
 
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ElizaDoolittle

ElizaDoolittle

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When you start to feel that pain/popping when surfacing, do you continue surfacing or do you stop/descend and try to equalize before resuming?

I usually carry on going upwards slowly. I haven't dived many times since I was certified, and it's always with my instructor (who organises short dive trips). Since he claims it's impossible that I may have equalising problems while going upwards, and I think he may feel impatient waiting for me while I struggle with it, I don't insist on going even more slowly than he has told us to go. When I hear my ears start popping wildly, I suppose that's what makes the pain not too strong, as I assume it means my ears are compensating in some way, though not well enough, or it wouldn't hurt at all. But I can't deny I feel very worried while all of this is going on. In fact, I was on the verge of not getting certified, because my instructor said I sort of kicked in a weird and anxious way when going to the surface. My last OWD dive was a bit of a disaster, as I was worried about my ears from the very beginning, but, apparently well enough to be certified.

When I travel by car in the mountains and I swallow, my ears pop without problem, no matter whether I'm ascending or descending, so does this mean that if manage to swallow while going to the surface I would equalise well? The problem is my anxiety makes my mouth even drier.

Should I go downwards a bit, equalise as usual when descending (swallowing, if I can, or doing the Valsava manoeuvre if I can't), and start going upwards again as soon as I do it? As I said, I think I shouldn't do Valsava while going to the surface, should I?
 

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