Why do I get clogged ears when I exercise?
Ear fullness or the plugged sensation that many people report with physical activity is commonly referred to as “Eustachian Tube Dysfunction” (ETD) this means that the inner ear is not able to equalize pressure. The middle ear is a hollow space that is periodically vented when the Eustachian tube opens. This tube is opened or ventilated when a person yawns, chews, or even talks; just like when flying in an airplane and you yawn to equalize the pressure and resolve that ear fullness or associated pain.
For some people, this associated fullness is merely bothersome, and for others, it can cause significant pain and discomfort. Unfortunately for those people, it can become more bothersome with physical activity because with exercise comes increased blood flow to the mucosal lining of the nose and throat. This increased flow of blood is important for humidification and warming of air prior to it entering the lungs. As that mucosal lining becomes engorged with blood flow it can cause the Eustachian tube to close off hindering the middle ear’s ability to equalize pressure. Other irritants can cause this lining to swell, such as pollution, cigarette smoke, or even allergens (dust, pollen, molds, or even animal dander).
How do I fix my clogged ears?
Typically, conservative treatment is very effective at reducing the incidence and the intensity of ETD, it can be as simple as increasing hydration with exercise or periodically leaning the head back and yawning while running, or for others the act of chewing gum with exercise resolves the issue. Some people respond well to a nasal saline washes with a neti pot prior to exercise. If conservative treatments are ineffective, a trial of a nasal decongestant spray for up to 3 days (Afrin or oxymetazoline) may improve clogged ears. Decongestants work by causing the blood vessels to constrict in the nasal mucosa reducing the inflammatory process. However, nasal decongestants should not be used long-term, or on a daily basis. Runners can use them prior to a race or a longer training run when they know the clogged ears sensation will be more bothersome. A lot of providers will also have patients begin the use of a topical nasal steroid spray (Flonase- being one of the most common), steroids are used to reduce the inflammatory process and can be used long term as an effective way to control ETD. They do require ~ 7 days of consistent use to become effective, so if you get to this point, you should continue to use the nasal steroids for at least 2 weeks to determine effectiveness.
If there is a significant hearing loss involved, or your clogged ears do not resolve spontaneously shortly after stopping, or if your symptoms do not resolve with the mentioned treatments further evaluation should be sought, typically by an ENT (ear, nose and throat doctor).
Scott Summers is a Family Nurse Practitioner that specializes in Ear Nose and Throat. Scott is an avid trail runner and alpinist with several ascents in the Tetons and Mt. Rainier