What Happens To My Ears When I Scuba Dive?
What’s the first thing you learn when you start scuba diving? To never hold your breath and how to equalize. The two most important things that can prevent a boat load of problems! Since scuba diving is the best damn thing ever, we need to remember to look after ourselves and our health so that nothing will keep us from diving. Ever. So it is very important to know what can go wrong when you dive and how to prevent them. And if you’re not serious about them, they can keep you out of the water for months. And what a nightmare would that be!
Learning how to prevent serious ear problems is something you learn during your very first confined water session during your Open Water Course (and that is to equalize). Yet even the most experience divers have problems caused by not being able to equalize properly. Oh the irony!
So, let’s talk a little bit about ears, what’s in them, what can go wrong and how to prevent ear problems when scuba diving.
Anatomy of the Ear
In order to understand what actually happens to your ears when you scuba dive, you do need to know a bit about the ear’s anatomy. So let’s have a little biology lesson. Don’t worry, it won’t be like your average boring high school type of a lesson, so don’t you dare stop reading! Reward yourself with a beer after your done. Cool? Let’s move on.
Your ear consists of three sections: The external (or outer) ear, middle ear and inner ear. It looks like something like this:
The outer ear
Take a mirror and look at your ear. That flappy thing? That’s your Auricle or Pinna. It’s job is to direct sound into your ear. Then if you would to put something in your ear (hypothetically, please don’t stick things up your ear) you would be in the External Acoustic Meatus aka the Ear Canal. This connects your outer ear to your middle ear.
When your head is underwater, your ear canal fills with water. What’s stopping it from getting any further is your EARDRUM (fancy word for that is: Tympanic membrane). This is what separates your outer ear from your middle ear.
Needless to say your eardrum is a VERY important lil’ thing. Its job, as mentioned before, is to keep unwanted stuff from getting any further and thus protect the important bits in the middle and inner ear, that control your hearing and balance. We will talk about what happens to your eardrum when you dive in a bit!
Your middle ear is also connected to your Eustachian Tube, which is connected to the back of your nose. When you equalize, you are pushing air into your Eustachian tube, equalizing the dead air space in your middle ear.
Your eardrum also vibrates as sound hits it, which then magnifies and forwards those vibrations to 3 tiny bones called The Ossicles.They then deliver those vibrations to your Oval Window which is what separates your middle ear from your inner ear. The oval window, as well as another tiny window called The Round Window are two of the thinnest membranes in the human body. However, they compensate their size by being some of the most important bits in your ear! Who said that size matters…
Your inner ear is that snail looking bit called The Cochlea (which is actually latin for snail). It is filled with a fluid called the perilymh fluid. As mentioned earlier, the oval and the round window protect the inner ear and keep that fluid inside and also stops anything from going inside.
The eardrum, ossicles and the oval window are all connected. The sound vibration is transferred into the cochlea which then transfers that information in to your brain. That bit is a bit too complicated, so let’s not go there.
What actually happens to your ears when you scuba dive?
We all know pressure increases as we go deeper. That causes your dead airspaces in the ear to shrink. And the decrease of pressure can cause things to rupture. As you descend, the pressure inside your ear causes the eardrum to stretch inwards, as the airspace behind it becomes smaller. If you fail to EQUALIZE, the eardrum will stretch to the point where it will simply rupture. As it ruptures, it lets water into your middle ear and kinda completely defeats the purpose of having an eardrum… You will feel initial pain that is soon relieved as water gets in. Sneaky one. You will however feel how the water gets in and it will feel cold. That’s your queue for a ruptured eardrum. Cold water rushing into your head.
As you ascend, you’re passively equalizing as that extra air pushed into your dead air spaces usually finds its way out on its own. However, if you ascend too fast, your body will not have time to adjust and you might experience a Reverse Squeeze. So everything expands too fast, causing another boat load of problems if you don’t slow down!
Why do Scuba Divers Ascend Slowly?
Scuba diving is a popular activity that is appealing to many, it is also an activity that requires proper training to maintain safety. Each year, approximately 200 people die worldwide as a result of scuba diving accidents. Knowing how to dive correctly is essential.
Scuba divers ascend slowly because ascending too quickly can cause serious injury or death. Slow ascents decrease the risk of decompression illness by allowing the body to eliminate excess nitrogen. Rapid ascents may also cause lung rupture with collapse (pneumothorax) and reverse ear squeeze.
While it may seem like fun to give a firm push from where you are diving or to kick quickly to the surface, the result can be painful and even life-threatening. In this article, you will learn why scuba divers ascend slowly to the surface.
What Happens to Your Body When You Dive?
Aside from ensuring you have the proper gear for scuba diving, the ascent is one of the most critical parts of scuba diving that does not leave much room for error. Your body has several physiological reactions when your scuba dive. Among these are build up of nitrogen in tissues due to breathing pressurized air and changes in volume of air pockets in body due to pressure difference from the surface.
These natural effects of breathing compressed air at depth can result in unintended consequences under certain conditions. Two of the most common ailments experienced by scuba divers are decompression illness and squeezes. A more rare event called a pneumothorax (sudden rupture of lung lining with air leak and lung collapse) can also occur. Each of these is due to sudden changes in pressurization of the body. (Source: American Family Physician)
As you dive down, the pressure of the water increases dramatically. The pressure increase depends on whether the water is freshwater or saltwater. As you descend into the water, the air in your body is significantly compressed. As depth increases, each breath from your air tank includes more air volume to offset the higher external pressure. When you ascend, the air expands because pressure decreases. (Source: Abyss Ocean World)
If you have ever been at the bottom of a swimming pool, you have likely felt the pressure in your ears and lungs. This pressure is magnified during a dive. The scuba gear you wear helps to offset the pressurization effects on the air you are breathing; however, the changes on your body are still apparent and need to be kept in mind throughout the dive.
It is also a common misconception that the gear helps your body not to be “crushed” by the water pressure. This is not true. The gear helps you to stay warm and protected while monitoring the amount of air and time you have left for your dive.
A couple of dangerous situations that can happen during a dive are:
- Crushed by water pressure: Descending into the ocean or any body of water for that matter will exert an increased pressure on your body. As you descend, the pressure increases and forces the air out of your lungs, thereby causing them to cave in. (Source: Sciencing) This doesn’t occur anywhere near recreational scuba diving depths. This is avoidable by not holding your breath at depth. Your regulator will supply you with the correct volume and pressure of air to prevent this, unless you’re thinking about trying to dive to the Titanic! (Spoiler-you can’t.)
- Squeezes: One common problem that can occur during descent is called a squeeze. This occurs when the pressure changes and affects both your mask area and inner ears. There is extreme pain associated with this ailment, but it usually heals on its own with time. Learn to properly equalize on descent, and ascend slowly to allow pressure to decrease before you feel pain.
When the squeezes occur, the pressure causes your face mask to suction against your face. If you have ever experienced a suction cup on your skin, you likely know how much it pulls at your skin. The face mask pulls at the skin around your eyes, which can cause bruising to occur. In a severe situation, blood vessels in your eyes may even be impacted. (Source: Ocean Scuba)
You avoid ear squeezes by equalizing as you descend. You avoid mask squeezes by exhaling a small amount of air through your nose as external pressure builds. If you experience ear pain on ascent, descend to the point where the pain goes away, and try swallowing your saliva a couple of times. You can gently equalize to open your Eustachian tubes, but don’t add much air or you magnify the problem. You can also try rolling sideways to reposition the trapped air.
This is called a reverse squeeze, and it is miserable if you ascend all to the surface without trying to correct it first. Only one of us has ever experienced this, but she felt bad for 24 hours with severe pain for the first 6 hours.
Why is it Vital to Ascend Slowly?
A scuba tank contains compressed air, not oxygen as commonly believed. Air contains 71% nitrogen, which is inert and goes unnoticed when breathing at the surface. But inhaling it under pressure results in a gradual build up of excess nitrogen in various tissues of the body.
One of the most critical moments during a dive is the ascent to the surface. This is the part of the dive that requires careful calculation and patience. If a diver ascends or comes to the surface too quickly, they may face serious consequences, one of which is decompression illness, often referred to as the bends.
- Bends (decompression sickness): The bends occur when the excess nitrogen in tissues expands too rapidly for your body to eliminate it. This excess nitrogen can form bubbles in joints, many different tissues, and the blood stream. Bubbles in blood vessels can be carried to vital organs and cut off the blood supply. Heart attacks, strokes and death can occur.
The bends affect many parts of your body. Typically, when a diver is suffering from the bends, they will notice weakness or numbness in the arms and legs, dizziness, vomiting, or even losing consciousness. This is a medical condition that needs to be treated by a physician, as it can affect your entire circulatory system, including your heart. (Source: E-Medicine Health)
The current world record for the deepest dive ever is held by Ahmad Gabr. In 2014, Gabr took 12 minutes to descend to 1090 feet, backed by a team tracking him and helping him switch tanks when needed as I describe here.
Some have wondered if you can scuba dive to the Titanic. The decompression time is essentially incalculable but would likely be months. But the diver would die from nitrogen exposure and external pressure well before reaching 12,500.
Reverse Ear Squeezes
If the diver ascend too quickly, the air pressure in the middle ear will cause the ear drum to bulge outwards. This is called a reverse squeeze, and it is very painful. My daughter experienced this in Bonaire and had to skip the next few dives.
- ReverseEar squeezes: As you descend, the pressure on your eardrums increases. Divers offset that by adding air to the part of the ear behind the eardrum; the middle ear. This is connected to your throat by a small tube (Eustacian tube). Divers can force air through it during descent by closing mouth and nose and trying to exhale. On ascent, this air has to naturally move back through to your throat as it expands.
You can try to fix this by descending slightly until the pain disappears, and then swallow a few times to open the Eustachian tube. If this doesn’t work, you can tilt head with the painful side down and try again. Or go a little deeper and try both.
As a last resort, descend a little further very carefully equalizing to reopen the tube. Then ascend even more slowly with the affect ear tilted up. Keep in mind your dive time, depth, air supply and dive profiles for the day as you do this.
Rupture of lung with air leak (pneumothorax)
The lungs are constantly changing pressure with each breath. They are also the most affected part of the body when external environmental pressures change, such as when ascending to great heights or diving to different depths. Since water is denser than air, pressure changes in the body occur in much shorter distances. At 33 feet, the body experiences twice the pressure felt at the surface.
- Pneumothorax: Another potentially life-threatening complication from a rapid descent. The lungs are lined by a thin layer of tissue connect their walls to the chest wall. This layer moves with breathing. If pressure in the lungs suddenly increases, a hole can develop in this layer, allowing air to leak from lung. This occurs in chest injuries, sudden pressure change environments and sometimes without any cause at all.
When a pneumothorax occurs on the surface, the effects can range from nothing at all to severe breathing problems and cardiac arrest. The hole that forms can allow air to build up between layers such that the lung is compressed. Or it may continue to leak causing the hole to enlarge and the lung to collapse away from the chest wall. This means it won’t expand when you try to breath.
If it occurs suddenly underwater due to rapidly increasing pressure, the effects are magnified quite a bit. Once it has occurred, it requires emergency treatment, preferably by trained doctors or EMTs in an ambulance or hospital. There are cases where lives have been saved by inserting a small sharp needle into the chest to allow re-expansion. But if done incorrectly, it leads to greater collapse and worsening condition.
When a pneumothorax occurs or is suspected, the diver needs to continue ascent as safely as possible, preferably with assistance, and then get immediate medical attention. In the image below, you see that the right lung has ruptured and pulled away from the side wall of the chest. The dark area represents air in the lining of the lung, while the collapsing lung is whiter because it doesn’t have enough air to expand it.
An example of pneumothorax from the author’s personal case files. Not a diving injury.
How Do You Ascend Safely?
When a diver begins their ascent, it needs to be carefully planned and executed. It is recommended that an ascent take place in two different stages that are carefully timed and monitored by the diver.
|Stage 1 of the Ascent (Decompression Stop)||During this stage of the ascent, the goal of the diver is to reach a safe ascent zone. This means they are ascending from a deep dive location and will need to stabilize halfway to the surface. This decompression stop allows the body to reacclimate to the changing pressure gradually. It is recommended that a diver not ascend more quickly than 30 feet per minute. (Source: Scuba Diving) If you have been on an extremely deep dive, you may have more than one stopping point before reaching the surface.|
|Stage 2 of the Ascent||This is the final stage of the ascent and a time to be extra cautious. It may be tempting to rush to the surface when you can see it just above you; however, you need to continue a slow and steady ascent. It is crucial to slowly release air pressure during this final phase of the ascent to ensure you are correctly depressurizing.|
How Do You Track Your Ascent?
Most scuba divers use a dive computer to track their dive times and frequency and decompression status. The dive computer provides the diver with information regarding the time left for a safe dive as well as the depth they have reached.
Determination of safety stops, time between dives, time spent at each depth, required surface break, and more are tracked. (Source: Oyster Diving) The safety of your ascent will be dependent upon the tools you use as well as the communication you have with your dive partner. Your depth gauge and dive watch or computer are used in tandem. If you aren’t using a computer, then you will rely on manual dive tables to track these things.
The entire time a diver is making the ascent to the surface, they should consult their dive computer as well as their diving partner to ensure they are ascending at a safe rate and leaving enough time for the dive to be completed safely.
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Any of the following dive computers should be a good choice for for most people:
Each of these options has fantastic reviews, but if you are uncertain about the brand, style, or type, it would be recommended to seek the help of a professional diver. When purchasing a dive computer, you can plan to spend between $200 – $1,500. Do not fall into the trap of thinking more expensive is better because that may not always be the case. Instead, enlist the help of a professional to guide you.
Why Can Snorkelers Ascend Quickly?
Snorkeling is much different than scuba diving because it involves swimming at the surface of the water. They inhale air at surface pressure, and as they descend the air is compressed. When they ascend, it expands only back to the original volume taken in before descent. Therefore, snorkelers do not need to worry about the speed of their ascent. Snorkelers aren’t taking in pressurized air that can expand on ascent or release higher amounts of nitrogen into the tissues.
Scuba diving is a favorite activity for many people around the world. While fun and exciting, it requires thorough training to execute a safe and successful dive. The two bookends to a successful dive are the descent and ascent. By following safety precautions and ascending slowly with dive stops along the way, you will ensure an enjoyable – and safe – dive.
How to Make a Controlled Scuba Dive Descent – Beginners
Descending for a scuba diver means there is a system of rules. Correct conduct and procedures need to be followed in order to avoid or eliminate problems like equalizing your ears due to changing ambient pressures. It’s important to learn how to make a controlled scuba dive descent.
Most of the time you make your dive entrance into the water from a dive boat. With some air in your BCD (Buoyancy Control Device) you take a giant stride jump or a back roll into the water. Once you’re in the water, you give the ok signal to the boat crew. NOW THE FUN BEGINS…
I want you to have this great sinking experience and it begins with having the right amount of weight so I’ll show you how to do this and descend the right way. There’s an awesome video for you too.
CORRECT WEIGHT, CONTROLLED BUOYANCY
Controlled buoyancy is the key when you’re scuba diving and descending is no different. Many divers seem to be either overweight or too light. Being overweight can cause you to descend too quickly forcing you to add more air into your BCD. Being too light-weighted will mean not being able to stay down to the depth of your dive group which can cause potential problems when ascending and doing a safety stop.
It’s better to correct the number of weights you need BEFORE you descend. This is a simple procedure to do in shallow water or in the pool.
1) The regulator in your mouth. Put the regulator in your mouth and inhale normally at the surface.
2) Hold your breath. Release all the air out of your BCD using the dump valve or pushing the BCD delator button. It’s ok to hold your breath here because you’re at the surface of the water.
3) Float at eye level. If you are properly weighted you should be floating at eye level holding a normal breath
4) Release your air slowly, Make sure you slowly breathe out. This will make you sink slowly. Remember feet first… vertical body position. There is no need to kick with your fins and no arms flailing. Adjust your weights accordingly.
The point is to not sink fast as it will cause you great pain or injury in your ears.
5) Some divers prefer to carry 2 to 3 extra pounds of weight .9/1.5 kg. Near the end of a dive, the air in your tank is less because of your consumption, making you a little lighter as you start your slow ascent to do your safety stop near the 15’/5m point.
Great! Now that you have the correct amount of weights, you are now ready to prepare to descend.
1) Prepare to descend
At this point, you are already in the water, at the surface.
- Signal to make sure you’re ok with your dive buddy. Your buddy acknowledges the same.
- Orientate yourself at the surface and below.
- Switch your snorkel to your regulator.
- Check your time.
- Prepare to equalize your ears.
- Check to see if your dive buddy is ready to descend. Use your hand signal to descend and get the acknowledgment back.
- Using your left hand raise your BCD inflator/deflator button over your head. Equalize your ears.
Slow Controlled Descent, Happy Ears
If you’re a new diver and want a more controlled descent, oftentimes a dive boat will have a line at the stern which you and your buddy can surface swim to this dive shot line. The shot is the weight and it’s attached to the line which is attached to a buoy. Holding onto this will give you stability as you slowly descend.
The line is also excellent to do your safety stop during your ascent.
GOAL – A SLOW DESCENT WHILE EQUALIZING YOUR EARS!
1) Begin your slow descent. There are 2 ways you can start releasing the air in your BCD. The first is to depress the deflate button which you are still holding above your head with your left hand, the second method is to vent by using the dump valve with your right hand.
My preferred method is to depress the deflate button because that’s the way I was taught years ago AND I can also inflate if I do go down too quickly which would cause immense pain in my ears.
2) Exhale fully. This will initiate the process of descending because you won’t have any air in your lungs so you won’t be buoyant.
3) Breath deeply, continuously and slowly.
4) Equalize your ears early. To release the pressure inside your ears, begin the equalization process at about every 2 feet until you’re down to about 15’/4.5m. If the pressure remains, signal to your buddy that you are experiencing pain in your ears. Slowly ascend a couple of feet and keep equalizing until the pressure is released, then continue to slowly descend to your desired depth.
5) Give the Ok signal to your buddy that you are fine.
That’s it. Now you can be in a neutral buoyancy position and enjoy your dives watching all the underwater fauna life.
Are you ready to give this a try? You might already know all this but this is an excellent refresher in case you’re not a frequent diver.
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Thanks for reading and if you have any stories you would like to share on your experiences of descending or have any questions or comments, it would be awesome to hear from you.
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