Surfers and kayakers spend a lot of time in cold water. In Colorado, high flows mean that the river water you’re surfing was snowmelt only hours or days before it’s flowing under your board. In most of North America, the biggest ocean swells arrive when they’re powered by winter storms. And wetsuit and drysuit technology has done nothing but improve, allowing us to comfortably surf colder and colder water. But heading into colder and colder water has its pitfalls, namely exostosis.

It’s Not Pretty

Exostosis (from the Greek, “new bone”) is a product of cold water’s contact with your ear canals. The skin in your ear canal is some of the thinnest skin in your body – think tissue paper. Cold water stimulates a layer under the skin called the periosteum to trigger new bone growth into your ear canal.

The problem is that your ear canal is doing perfectly fine as it is, without any stupid extra bones growing in it. The bone growth itself isn’t so much of a problem as what the bone growth then causes. If it continues unchecked, the bone growth has the effect of narrowing your ear canal, making it more likely that water, bacteria, and other nasties get stuck deep within your ear, triggering deep ear infections that can be crippling. Wax and sloughing skin can also get trapped in the narrow opening. As a result of the narrowing and infections, it can even lead to hearing loss, either temporary or permanent. While there are some over-the-counter treatments, when the condition gets advanced you’re looking at surgery.

It takes a fair amount of exposure for things to get serious – think ten years or so of spending time in cold water. Usually when the growths start they are asymptomatic, but things develop from having a little tougher time clearing your ears to small aches to full on head-splitting ear infections. Hopefully your river surfing career will last at least ten years. So it’s worth taking preventative measures now, at least if they’re straightforward. Fortunately, they are. And they’re cheap.

Preventing the Problem

Good news: this doesn’t take rocket science to prevent. It’s as simple as wearing earplugs. The earplugs don’t even need to completely seal your ears from water; simply keeping your ears from getting flushed with cold water seems to be enough (kind of like a wetsuit; doesn’t keep you dry, but it protects you from repeated exposure to cold water).

You can get fancy and visit an audiologist for custom-fit earplugs, and I’ve heard a lot of people recommend Doc’s Earplugs (Amazon link). I’ve even had good luck with the drugstore “Christmas Tree”-looking earplugs, like these. Glue them onto the string that comes with them and you can thread it through your helmet (you’re wearing a helmet right?), so you don’t lose them. Avoid the foam plugs; you don’t want hunks of wet foam in your ear.

Wearing a neoprene hood in cold water also helps, though not as much as the earplugs.

As the saying goes, an ounce of prevention is worth a pound of cure. With earplugs you’ll be able to surf cold water (and the peak of Colorado runoff) without fear of clogged ears, infection, or worse.