Reverse squeeze

[AbyssalPlains]

It seems the pain is due to the eardrum being restricted from bulging outwards (as it naturally does due to the pressure relief during an ascent). .

This is actually not the case. The eardrum should never bulge, neither inward nor outward. If it does, something is wrong.

 

[Hank49]

This is actually not the case. The eardrum should never bulge, neither inward nor outward. If it does, something is wrong.

If it's not the eardrum bulging, or bending...or whatever, in or out, what is the cause of the pain?

I had a reverse block, related to, as TS&M stated, a pre existing sinus congestion. I was pretty deep with I felt the first pain as I started ascending and knew what it was. I took my reg out so I could pinch my lips tightly together, descended about 2 meters, pinched my nose and sucked in until it popped. After that I ascended slowly without incident.

 

[Lee Taylor]

If it's not the eardrum bulging, or bending...or whatever, in or out, what is the cause of the pain?

I had a reverse block, related to, as TS&M stated, a pre existing sinus congestion. I was pretty deep with I felt the first pain as I started ascending and knew what it was. I took my reg out so I could pinch my lips tightly together, descended about 2 meters, pinched my nose and sucked in until it popped. After that I ascended slowly without incident.

Thank you Hank. This is very helpful. This is what I suspected. A "reverse squeeze" is addressed by "sucking in" as opposed to blowing out. The reg has to be removed for obvious reasons.

 

[Lee Taylor]

Reverse block is identical in cause to a normal block except it happens when the pressure inside is higher than outside (ie on an ascent). It can still cause identical ruptures and damage. Big issue with a reverse block is you have to come up sometime. If its a normal block on descent you just abort - with a reverse eventually due to gas you HAVE to come up and potentially damage your ear.

As a side note you mention "released my grasp on the dive line" - are you really relying on holding onto a rope or line to ascend or do a stop? A rope should be a guide and nothing more, buoyancy should be controlled and managed without having to hold onto anything.

Thanks for the response and information. In regards to holding the dive line: In this situation if you did not hold the dive line, the current that was running would traverse you sideways into open ocean and away from the boat for the duration of your deco.

 

[drewdude]

I too suffered from reverse squeezes. My problem was in the sinus areas above me eyes. I had a couple of dives in cold water that reaallllyyyy hurt on ascent. It was always around the 20-10' range coming up. I had surgery last May and the doc did some real work. Dove last week for the first time, and no pain. Part of the problem was that some of my sinus passages/cavities were narrow. He opened them up. I would recommend a trip to an ENT doc. Might be an easy fix.

 

[TSandM]

BTW, the eardrum does bulge, or suck inward. It's a very flexible and delicate membrane, and it moves in response to pressure changes. We see bulging eardrums in kids with middle ear infections, when the fluid builds up in the ear. That is painful, just as a reverse block in the ear is.

 

[Sas]

I have dived a few times with a bit of congestion, took Sudafed but obviously it wore off during the dive as I have had two reverse squeezes. The first time took me by surprise so I didn't know what to do, my nose kind of 'exploded' would be the word I would use... blood everywhere (but I didn't notice that until the surface - freaked my buddies out tho) and the pain was really really quite bad.

Second time I felt one coming on and I managed to reduce the effects somewhat by taking out my regulator and wriggling my jaw around, swallowing, and rubbing my face, and pinching my nose and trying to breathe in and out. And I also took the ascent very very slow. Still had a severe nose bleed but wasn't nearly as painful as the first time.

 

[vladimir]

I had a reverse block in the Truk Lagoon. As others have said, the combination of decongestant and aggressive clearing on the way down was probably to blame. To further complicate the situation, I was diving solo and ~35 meters deep when I found I couldn't ascend without intense ear pain, no matter how gradually I tried. As my gas dwindled and I pondered the predicament I was in I realized there were no good choices--not ascending was clearly not an option and ascending was only slightly more appealing, it seemed. My big fear was that my ear drum would "blow" and the resultant vertigo would cause me to lose control of my ascent. (I'm not sure this is what would happen, but it seemed like a logical concern at the time.) I found the mooring line, steeled myself for the ear pain, and began a slow hand-over-hand ascent. I wanted to have the line in my hand while I waited for any vertigo to pass. I was greeted with the satisfying squealing sounds of opening eustachian tubes fairly early in the ascent, but not before screaming into my regulator a bit.

 

[Deefstes]

I had a reverse block in the Truk Lagoon. As others have said, the combination of decongestant and aggressive clearing on the way down were probably to blame. To further complicate the situation, I was diving solo and ~35 meters deep when I found I couldn't ascend without intense ear pain, no matter how gradually I tried. As my gas dwindled and I pondered the predicament I was in I realized there were no good choices--not ascending was clearly not an option and ascending was only slightly more appealing, it seemed. My big fear was that my ear drum would "blow" and the resultant vertigo would cause me to lose control of my ascent. (I'm not sure this is what would happen, but it seemed like a logical concern at the time.) I found the mooring line, steeled myself for the ear pain, and began a slow hand-over-hand ascent. I wanted to have the line in my hand while I waited for any vertigo to pass. I was greeted with the satisfying squealing sounds of opening eustachian tubes fairly early in the ascent, but not before screaming into my regulator a bit.

Now see, that's exactly what terrifies me. It's a relief to know that it's uncommon but I can't help to imagine scenarios as this one by Vladimir. Glad you're OK though. Thanks for all the tips everybody.

 

[friscuba]

I had a reverse block one time several years ago when I was teaching a lot and diving every day I had off for fun. I'd had a 2 second vertigo episode about 4 days earlier, so I should have known something was up. I got the block and it was pretty bad, ended up at the ENT in the next day or two, turned out I had a pretty good fungal infection going on at the time that probabaly contributed greatly. The ENT hooked me up to some kind of suction tool with a fiber optic so he could see what he was vacumning and it was a great quick relief, but the pain was around for several days. I was out of the water for a few weeks, on anti-biotics and steroids and other good stuff.

I hadn't learn the massage the jaw/neck below the ears to hopefully release the eustacean tube trick at that time, so I can't say for certain if that might help on a reverse squeeze. Some people find it helps on clearing and it wouldn't surprise me if it's a good option on a reverse since that's where the excess air is supposed to go.

It's uncommon enough that if you avoid diving with congestion it's probably not something you should worry about.