Strenuous Exercise and Resulting Hearing Loss

by Neil Bauman, Ph.D.

Updated April 10, 2016

Sometimes I get unusual emails. For example, one person recently wrote,

Two days ago my middle-aged boyfriend had a 20 minute hearing loss after having worked out extraordinarily strenuously with his personal trainer. When he mentioned this to his trainer, his trainer told him that one other person, a woman in her 20s had told him the same thing. What’s going on?

Strenuous exercise, whether it is lifting weights, straining to win a foot race, or even a strenuous yoga session can sometimes result in hearing loss. There are a number of causes. I’ll just mention three of them here.

First, strenuous exercise, or a blow to the side of the head, can cause a membrane in your inner ear to rupture, allowing fluid (called perilymph) to leak from either the oval window or the round window into the middle ear cavity. The fancy name for this is perilymphatic fistula. Sometimes these tears heal up by themselves. Other times they require surgery to fix them. Hearing loss from perilymphatic fistulas may be temporary or permanent. Often much, but not all, hearing returns, leaving you with some degree of permanent loss.

Another cause of hearing loss resulting from strenuous exercise is from a condition called Large Vestibular Aqueduct Syndrome (LVAS). In people with LVAS, the increase in intracranial pressure from the exercise sometimes forces the contents of the endolymphatic sac (sandwiched between the brain and the skull) to flow “backwards” to the cochlea where the extra-high ionic content of the endolymph causes problems in the inner ear. The result is hearing loss. To learn more about LVAS, point your browser to https://www.hearinglosshelp.com/articles/lvas.htm.

A third reason for sudden hearing loss after strenuous exercise is a temporary lack of blood flow to the inner ears. A man wrote,

After intense exercise at the gym or when it is really hot outside and I feel exhausted, my left ear gets clogged. When I get that sensation, I normally sit down, lower my head so that it is positioned below my waistline waistline and my ear is unclogged. I am not sure if I’m right but, it might be related to blood to returning to my brain. The frequency is about 10 times annually.

In my reply to this man, I wrote, “You say your ears get ‘clogged’. To me that means the middle ear fills with fluid. I don’t think that is what is happening to you because putting your head down wouldn’t help in that case. It would drain even better if you kept your head erect.

What I think is that you really mean your ear feels “blocked”. The sensations may feel much the same, but the underlying condition is totally different.

If you don’t have adequate blood flow to your inner ears, then they don’t work as well–and you can have some degree of sudden temporary hearing loss. That sudden hearing loss gives you the sensation of your ears being blocked (or else the sound would get in and you’d hear better, wouldn’t it)?

By putting your head down, blood flow returns to your ears and hearing returns–and when that happens the blocked feeling disappears.”