Solid Tips on Preventing Swimmer's Ear

To water sport participants such as swimmers and water polo players, the pain of swimmer's ear can not just ruin good times in the water but also put a damper on regular life activities.

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Known in medical circles as Otitis Externa, swimmer's ear results from infection and inflammation of the external canal of the ear often due to prolonged exposure to moisture (such as in pools). Typical symptoms include pain and discharge from the outer ear along with difficulty chewing due to local swelling in front of the ear.

Once in full bloom, antibiotic and anti-inflammatory ear drops are often used for treatment, though in some instances oral pain medicines or antibiotics are needed for more severe cases. Many athletes will need a minimum of 2-3 days out of the water before being able to return.

To prevent the pain and disruption caused by swimmer's ear, follow these important tips:

• Regularly use of 2 drops of preventative ear drops in both ear canals after each and every water exposure. The combination of rubbing alcohol (isopropyl alcohol) and acetic acid (vinegar) can be purchased over-the-counter as premixed solutions or can be made at home with a 50:50 mixture of the rubbing alcohol and vinegar. 
• Don't be over-aggressive with cleaning out wax from the ear canals. Sufficient wax is the friend of a swimmer as a lack of wax in the ear canals increases the risk of infection, especially if small abrasions are left after vigorous attempts at wax removal.
• Dry out those ear canals after swimming. Tilt the head toward each shoulder to try and allow water drainage from the ear canals. Using a hair dryer at lowest settings can also help dry out the canals (just don't get too close for concerns over excessive heat or risk of hearing damage).
• Careful with metal earrings that could sensitize the ear to higher risk of infection. If possible, remove any piercings before swimming, especially in cases of recurrent swimmer's ear infections.

Can ear plugs or tighter swim caps help reduce swimmer's ear infections?

The use of hypoallergenic ear plugs with our without tight swim caps to reduce the risk of initial or recurrent infections is controversial. No substantial evidence exists to support strongly recommending plug or caps as absolute preventative devices.

Best to use the above prevention tips to reduce the risk of missing out on favorite water sport activities!

Resource: Pediatric Sports Medicine: Essentials for Office Evaluation (Koutures and Wong eds), SLACK Publishing, 2013

NCAA says No to Padded Cap Use in Water Polo

Intrigued by the recent announcement from the NCAA Playing Rules Oversight Committee prohibiting the use of padded caps underneath water polo caps. The committee based its decision on the fact that, according to the NCAA Sports Science Institute, no scientific evidence supports the notion that padded headgear helps prevent concussions.

Have been asked several times by patients and families about using soft, padded caps or helmets to reduce potential for concussion in contact/collision sports such as soccer, water polo and volleyball. 

While I commend the intent of trying to reduce injury risk, have been hesitant to endorse any product that doesn't have solid science to support use, or one that while appearing to reduce risk, might actually increase such risk.

Soft headgear or padded helmets have not been consistently shown to reduce the rotational forces about the brain that are thought to be primary contributors to concussive injuries. 

How could they actually increase concussion risk?

• By wearing a this supposed protective gear, an athlete may opt to play more aggressively or even base a return to at-risk activity, but not receive a true aspect of risk reduction by wearing the device.
• My biggest concern- and this is from living in the real world and hearing talk like this straight from the athletes themselves- "I see someone wearing a helmet, it looks like a target."  Who really wants to be putting themselves at risk without proper backup?

In the final analysis, until we obtain better information, I think this NCAA directive appropriately takes pressure off families and eliminates the discussion about "requiring" helmets as a criteria for returning or continuing to play.