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Runners beware: swimmer's ear isn't just for swimmers.

If you run regularly outside through the warm summer months, or find yourself sweating profusely indoors in a warm gym any time of year, you may not be aware that you could be at risk of a condition most of us rarely if ever associate with activities on land: swimmer's ear.

It turns out that the colloquial name for otitis externa is not doing runners many favors, and so here are some facts about this common infection that might help you avoid it.

Trapped moisture is the culprit

Swimmer's ear is a bacterial infection caused by a build-up of moisture in the ear canal. It is most often seen in conjunction with water exposure, but you need not jump in the pool to contract it. Other situations that can trap excess moisture in the ear canal include hearing aid use, use of noise-reducing ear plugs related to the workplace, and--the now ubiquitous, it seems--use of the small, rubberized insertables known as earbuds.

Advances in smartphone technology as well as in compact, often wireless headphone devices (many of them designed for runners, and most of those insertable) have increased the convenience and popularity of running while listening to music, podcasts and audiobooks. Combined with increased sweating in higher temperatures, the peaking popularity of earbud use has caused an uptick in swimmer's ear in runners.

Avoid cotton swabs

The way to help prevent swimmer's ear is to make sure excess moisture is removed from the ear after training. To dry out the ear canal, do not use a cotton swab (Q-Tip). Swabs are for cleaning the grooves in the cartilage around the ear canal; when they are used incorrectly by inserting in the ear canal, they can push ear wax deeper down into the ear, causing an impaction that itself traps moisture, leading to swimmer's ear.

It's better to hold a hairdryer up to your ear for a few seconds, on its lowest setting, gently passing near the ear canal to dry it out. You may also insert two or three drops of rubbing alcohol into the ear canal to help eliminate moisture. No liquid dropped into the ear can go deeper than the eardrum. Assuming that you have an intact eardrum, it's pretty safe to put alcohol drops into the canal. Do note that this is not a home remedy for already-contracted swimmer's ear, but a preventive step.


Home remedies for swimmer's ear, which can (rarely) clear up on its own, include mixing a few drops of rubbing alcohol with white vinegar. The acidity of the vinegar alters the pH of your ear canal, making it a less hospitable place for bacteria to thrive.

But if you do contract swimmer's ear, it's best to see an ENT physician who can administer topical antibiotics into the ear. Occasionally, an oral antibiotic will also be administered.

A painful infection

You can be more prone to getting swimmer's ear depending on the shape and size of your ear. Symptoms of swimmer's ear include:

* a lot of pain in the ear canal

* tenderness of the outer ear: pushing on the flap of cartilage in front of the ear known as the tragus will often illicit a very painful response

* blocked hearing

* a clogged ear sensation

* drainage from the ear

Sometimes the ear canal will be swollen completely shut, requiring a physician to insert a wick to allow the medication to penetrate to the correct depth. After treatment, it's important to avoid activities that would cause moisture build-up in the ear for a few days until the infection is fully healed.

And those unsanitary earbuds?

It's a good idea to clean the rubberized tips of your earbuds with rubbing alcohol regularly. They can develop grime from use, and we are not always so careful about what surfaces we toss them casually down upon after a strenuous workout. However, earbuds themselves are not the reason for the swimmer's ear infection--the cause is bacteria native to the ear canal that thrives in the perfect storm of too much moisture in an already-warm environment.

Personal corresp., Dr. Eugene Chio, Assistant Professor, Department of Otolaryngology, Ohio State Wexner Medical Center, Columbus, OH

Tips For Running On The Beach

Sand provides terrific strength and stamina training for runners, thereby combining one of summer's timeless pleasures with a way to shave seconds off your race time. If you're a coastal runner or are simply planning a beach vacation this year, here are a few things to keep in mind as you opt for the scenic beauty and fresh sea air as the backdrop to some of your runs.

Prepare for increased work

Just how much more challenging is running on sand vs. pavement? In 1998, researchers examining this exact question published their findings in the Journal of Experimental Biology.

Using "force platform and cinematographic analyses," they determined the mechanical work performed by subjects during walking and running on sand and on a hard surface. The researchers used oxygen consumption to also measure the energetic cost of walking and running under the same conditions.

Walking on sand is harder in proportion to walking on pavement than running on sand is to pavement running:

* Sand walking required 1.6 to 2.5 times more mechanical work than walking on a hard surface at the same speed

* Running on sand required only 1.15 times more mechanical work

* Walking on sand required 2.1 to 2.7 times more energy expenditure than walking on a hard surface at the same speed

* Running on sand required 1.6 times more energy expenditure

The authors explain the increase in energy cost as due to two effects: the mechanical work done on the sand, and a decrease in the efficiency of positive work done by the muscles and tendons due to the sand's unpredictable surface.

Beach factors to consider

When choosing where and when to embark on a beach run, it's a good idea to give some thought to the following:

Beach length. Try to find a beach that has at least a mile of uninterrupted shoreline. An unanticipated jetty or cliff around the bend can terminate a run too abruptly.

Beach slant. A too steeply beveled beach surface will make running unpleasant and increase injury risk. The flatter the beach, the better.

Surface condition. Running barefoot on the beach, as a good many if not a majority of beach runners do, means taking into account whether there are excessive seashells, rocks, or (far worse) broken glass or other hazardous debris. If you are venturing into unknown surface conditions, it is worth taking your shoes with you just in case.

Type of sand. Depending on the tide cycle, you may have multiple surfaces to choose from. Soft, dry sand is the hardest to run on because it gives a lot more underfoot than wet sand. Wet, packed sand is what's left behind as the tide recedes. It's much more firm than soft sand. If you're new to beach running, start on the wet sand. If you want to do a soft sand run, get ready for a great workout.

Tidal patterns. Do check the tide chart so that you ensure:

* You get the type of sand you want

* You do not have too narrow of a sand strip to run on (that you'll also be sharing with walkers, swimmers, and sunbathers)

Low tide or a receding tide is the best bet for accommodating the above. Free tide charts by state can be found here:

Physical challenges

Calf and ankle strain. Like hill running, the calf and Achilles bear a lot of the brunt of running on sand. If you choose to go without shoes, do so with caution. You'll have to acclimate quickly to running without an elevated heel, and fatigue can befall you rather quickly if you're new to beach running. Don't push the intensity your first time on the sand. Make it an enjoyable workout. Keep your mileage low and allow yourself a slower, more relaxed pace. And while the ground force impact of running on sand is softer than on pavement, the uncertain surface makes it easier to twist or sprain an ankle.

Bright hot sun. At least 20 minutes before setting out, always lather sunscreen on all of your exposed skin, in generous amounts. You might want to wear a cap and sunglasses are a must.

Physical benefits

Lower body strength. When the sand moves beneath your feet it engages your ankles, arches and calves and causes them to become stronger. Another 1998 study, this time published in the Journal of Strength and Conditioning Research looked at the adaptations from running on sand in high school- and college-aged males as compared both to road runners and controls. After six weeks, calf circumference increased significantly in the sand runners. And while both road running and sand running groups increased in vertical jumping ability and thigh circumference, the sand runners underwent the greatest physiological and performance changes.

Calories burned. In 1992, researchers in Europe found that people who walked or ran on sand burned between 1.2 and 1.8 times more calories per mile, which equates to between 20 and 80 extra calories. This matches what researchers reported six years later, with a 1.6 times energy expenditure on dry sand.

J. Exp. Biol., 1998, Vol. 201, No. 13, pp. 2071-80,

Running Competitor, "Beach Running 101: 7 Tips For Running On Sand," by Ryan Wood, July 16, 2014,

Live Strong, "What Are the Benefits of Running on Wet Sand?" by Betty Holt, March 13, 2014,

J. Strength & Cond. Res., 1998, vol. 12, No. 2,
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Author:Chio, Eugene
Publication:Running & FitNews
Date:May 1, 2015
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