Blocked ears after diving usually come from one of two things: water trapped in the ear canal or a pressure imbalance in the middle ear called barotrauma. The fix depends on which one you’re dealing with, and telling them apart is straightforward once you know what to look for. Most cases resolve on their own or with simple at-home techniques within a few hours to a few days.
Trapped Water vs. Pressure Injury
Water stuck in the outer ear canal feels like a sloshing, muffled sensation, often in just one ear. You can usually feel the water shift when you tilt your head. It’s annoying but not painful, and sounds come through like you’re listening from inside a tunnel. This is essentially swimmer’s ear territory, and it responds to physical draining techniques.
Middle ear barotrauma feels different. The blockage sits deeper, behind the eardrum, where pressure changes during your dive caused the tissue to swell or fluid to accumulate. The hallmarks are a persistent feeling of fullness or pressure (like being underwater even though you’re not), muffled hearing that doesn’t shift when you tilt your head, and sometimes a dull ache. In mild cases, the eardrum is simply retracted inward with some redness. In more significant cases, fluid or even blood can collect behind the drum. These two problems require different approaches, so identifying which one you have saves you time and frustration.
Clearing Trapped Water
If water is sitting in the ear canal, gravity is your best friend. Tilt your affected ear toward the ground and gently pull the earlobe in different directions to straighten the canal. Hold that position for 30 seconds. You can also try lying on your side with the blocked ear facing down on a towel.
A few drops of a homemade drying solution can help evaporate stubborn water. Mix one part white vinegar with one part rubbing alcohol, then pour about one teaspoon (5 milliliters) into the ear. Let it sit for a moment, then tilt your head to drain it out. The alcohol speeds evaporation while the vinegar discourages bacterial growth. Only use this if you’re confident your eardrum is intact. If you had any sharp pain, hearing loss, or bleeding during the dive, skip this step entirely.
A blow dryer on its lowest heat setting, held about a foot from your ear, can also help dry things out. Never insert cotton swabs or anything else into the canal to chase the water. You’ll likely just push it deeper or irritate the skin.
Relieving Middle Ear Pressure
If the problem is pressure-related, you need to coax the narrow tubes connecting your middle ear to your throat (the Eustachian tubes) to open up. Several techniques can do this:
- Swallowing and yawning. Both activate the muscles around the Eustachian tubes. Chewing gum or sucking on hard candy keeps you swallowing repeatedly, which can gradually ease the pressure.
- Valsalva maneuver. Pinch your nostrils shut, close your mouth, and blow gently through your nose. Don’t force it, and don’t sustain pressure for more than five seconds. If it doesn’t work on a gentle attempt, stop. Blowing too hard can make things worse.
- Jaw thrust technique. Tense the muscles at the back of your throat while pushing your jaw forward and down, as if starting a big yawn. This physically pulls the Eustachian tubes open without requiring you to blow against pressure.
- Toynbee maneuver. Pinch your nose and swallow at the same time. This creates a gentle negative pressure that can help equalize the middle ear from the other direction.
Try these techniques gently and repeatedly over the course of a few hours rather than aggressively all at once. The tissues around the Eustachian tubes may be swollen from the dive, and they need time to settle down.
Over-the-Counter Options
If equalization techniques alone aren’t clearing things up, an oral decongestant containing pseudoephedrine can help shrink the swollen tissue around the Eustachian tubes. In studies on air travelers with a history of ear barotrauma, 120 mg of pseudoephedrine reduced the rate of ear discomfort from 62% to 32%. The same mechanism applies after diving. A nasal decongestant spray works similarly by reducing swelling in the nasal passages near the tube openings.
Don’t use nasal spray decongestants for more than three consecutive days, as they can cause rebound congestion that makes the problem worse. An anti-inflammatory pain reliever like ibuprofen can help with any aching and reduce tissue swelling at the same time. Warm compresses held against the affected ear also offer some comfort and may promote drainage.
How Long Recovery Takes
Trapped water typically drains within a few hours, sometimes within minutes using the techniques above. If it hasn’t cleared within a day, the issue is likely something else, such as swelling in the canal that’s holding the water in place.
Mild middle ear barotrauma, where the eardrum is just slightly retracted and red, generally resolves within a few days to a week as the swelling subsides and the Eustachian tubes begin functioning normally again. More significant cases involving fluid buildup behind the eardrum can take two to six weeks to fully clear. During recovery, avoid diving, flying, or anything that subjects your ears to pressure changes. Diving again before the tissue has healed dramatically increases the risk of making things worse.
Signs of a More Serious Injury
Most post-dive ear blockage is mild and self-limiting, but certain symptoms indicate something more significant has happened. A ruptured eardrum can occur during a dive when the pressure difference becomes too great. If the eardrum tears, cold water entering the middle ear triggers intense vertigo and disorientation, sometimes while still underwater. On the surface, signs of a perforation include sharp pain followed by sudden relief, drainage or bleeding from the ear, and noticeable hearing loss.
Inner ear barotrauma is rarer but more serious. The key red flags are:
- Vertigo or dizziness that persists after you’re out of the water
- Significant hearing loss, especially if sounds seem distorted rather than just muffled
- Ringing in the ear (tinnitus) that wasn’t there before the dive
- Drainage or bleeding from the ear canal
- Fever, which suggests infection
Any of these warrants prompt medical evaluation. Inner ear injuries can sometimes involve a tear in the delicate membranes separating the middle and inner ear, and delayed treatment increases the risk of permanent hearing loss.
Preventing Blocked Ears on Future Dives
The most common cause of post-dive ear problems is inadequate equalization during descent. Equalize early and often, starting before you feel pressure, ideally every few feet during descent. If you can’t equalize at any point, stop descending. Pushing through the pressure is how barotrauma happens.
Avoid diving when you’re congested from a cold or allergies. Swollen nasal passages make it physically harder to open the Eustachian tubes, and decongestants taken before a dive can wear off at depth, leaving you unable to equalize during ascent. Make sure your wetsuit hood isn’t fitting so tightly over your ears that it seals off the ear canal, which creates its own pressure pocket. A snug hood without a vent or air gap can cause external ear barotrauma even when your equalization technique is fine.
Descending feet-first rather than head-first also makes equalization easier, since air naturally rises toward the Eustachian tube openings in that position. If you consistently have trouble equalizing despite good technique, it may be worth having an ear, nose, and throat specialist evaluate whether you have anatomically narrow Eustachian tubes or chronic inflammation that could be treated.