I don't think Mark was talking about the rises and falls you do going over coral heads, or over a railing on a ship to the deck beyond. But for example, the wrecks in Nanaimo have a vertical relief of 50 feet or more from the sand to the superstructure; you could go up and down on those wrecks enough to cause yourself some issues. Walls, obviously, would permit even more excursions.
However, those of us who dive caves deal with sawtooth profiles all the time. You simply can't insist that a cave maintain a steady depth, or even that it consistently descend on the way in. I have dived a cave where you go down to 30 for a while, and come up to about 3', before descending to 30 again -- of course, you have to do the whole thing in reverse on exit. Brian Kakuk has written about caves which go from 100 feet to 150, and back up to 100, and back down to 150 -- you either cope with the sawtoothing, or you don't dive the cave.
What we all have to realize is that sawtoothing is not desirable, and if you do it, you have to recognize the parts of your profile which are effectively decompressing the prior segment of the dive, and treat them accordingly.