Ear barotraumas are unlikely to occur on ascent. This is because your Eustachian tubes open automatically when pressure in your middle ear exceeds surrounding pressure. However, a condition called reverse block can develop during ascent. In this instance, air in your middle ear is blocked by a closed Eustachian tube, for example if it is filled with mucus. The air trapped expands on ascent, causing pressure and pain in your ears. Reverse block can damage both your eardrum and your inner ear and can cause blackout if the pain makes it difficult for you to reach the surface.

SIGNS AND SYMPTOMS

Symptoms of reverse block are similar to those of inner ear barotrauma:

• vertigo
• disorientation
• nausea
• vomiting
• tinnitus
• impaired hearing (less common)

MANAGING REVERSE BLOCK

If you experience reverse block:

• stop your ascent by holding on to the dive line
• move your lower jaw left and right, and forwards and backwards
• make swallowing movements while extending your bad side
• continue ascending slowly should the blockage persist

AVOIDING REVERSE BLOCK

To avoid barotrauma relating to reverse block, do not freedive when your respiratory tract is inflamed, for example, when you have a cold or ear infection. Also, do not freedive if you take medication. Remember that the effects of any medication are temporary and may diminish during your freedive, leaving you with the same issue but at depth. Reverse block can result.

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