In May this year, I went for a 3-km open water swim. Thanks to a combination of imperfect technique, waves, and being negatively buoyant I managed to get water up my right frontal sinus.The day after I felt pressure behind my eyebrow and realized there was an infection brewing but I thought “Oh well, that will be gone soon”…

What followed was a brutal 4 month recurring sinus infection and several doctors visits. I was unable to dive more than 5 meters deep in the first month and after that continued to be plagued by equalizing issues.

On one of my prescriptions, my doctor wrote “chronic sinusitis”. The word ‘chronic’ freaked me out and I was afraid my diving was over.

The infection I have has not yet completely gone away. But, thankfully I have been able to clear my sinuses consistently since late September.

In my case, medication did not do much. Some ancient and simple techniques were fortunately quite effective.

This should go without saying… If you think you have an infection, see a physician.

Breathing and rinsing to clear the sinuses

Humming for nitric oxide

We devoted an entire article to nasal nitric oxide a while ago. Here’s what you need to know from that article in two sentences:

The lining of the sinuses generates nitric oxide (NO), which is a very reactive antifungal, antibacterial, and antiviral agent. You can increase the concentration of nitric oxide in your sinuses by humming, which makes your sinuses vibrate.

In a 2006 case of chronically inflamed sinuses a patient was able to get rid of chronic sinusitis in 4 days without additional medication (external link).

Here is how you can hum your sorrows away.

Humming for a sinus infection

• Hum at a low pitch for 15 minutes 4 times per day. You should find the pitch that causes your forehead (the problem area in particular) to vibrate the most. In the article mentioned above the physician prescribed a frequency of roughly 130 hz.

This is 130 hz:

Humming to clear a sinus

If you just need to clear a sinus prior to a freediving session, 5 minutes of humming before a dive might already do the trick.

Again, hum loud so that you make your sinuses vibrate.

Alternate nostril breathing

Alternate nostril breathing is also known as ‘channel cleansing breath’, which is the direct translation from the sanskrit nadi shodhana. It is a simple exercise:

• Close the right nostril, breathe out and in through the left.
• Close the left nostril, breathe out and in through the right.
• Take full deep breaths and only swap sides at the top of the inhale.

You can make this breathing pattern more effective by using a timed inhale and exhale. For example, use a 4-count inhale and a 6-count exhale.

This breathing pattern will help you keep your sinuses clear. However, if you are quite clogged you will benefit more from combining humming with alternate nostril breathing.

Combining humming with alternate nostril breathing

My sinus infection only occurred on one side, and I feel minor pressure behind my right eyebrow every day. In order to make the right sinus vibrate, I hum while doing alternate nostril breathing.

In this case you are sending all the air through only one nostril while humming. This will make your sinuses (on the side of the open nostril) vibrate more and you will produce more nitric oxide as a result.

I hum for about 2 minutes in the morning, all through my right nostril. This allows me to breathe and equalize easily for the rest of day.

Saline rinse

A neti-pot or other tool to rinse your sinuses with salt water can be very helpful. Salt water will loosen mucus and will help drain the sinus. I use a combination of table salt and sodium carbonate. It is best to buy prepackaged sterile salts and use distilled or at least boiled water so that you don’t introduce any pathogens.

Unfortunately a saline rinse is less helpful for the frontal sinuses (behind the eyebrows) than for the Maxillary sinus (next to the nose). As a result it did not help me much with my frontal sinus infection.

However, saline rinses are an effective tool for preventing sinus infections and keeping the nasal passage clear.

Medication to clear the sinuses

In my case, none of these medications truly got at the root problem.The frontal sinus is simply hard to reach no matter whether you use a spray or oral antibiotics.

However, some medication did reduce my symptoms.

Over the counter: medicated nasal spray

Medicated nasal spray, like mucinex, or nasacort will reduce inflammation. Reducing inflammation will in turn reduce swelling in the nasal passage, which in turn might allow mucous to drain.

If you are lucky, the mucous will drain enough for your body to deal with the infection. If you are less lucky, the problem will return as soon as you stop spraying.

The frontal sinus is fairly hard to reach with sprays, but if you spray in the middle of a big inhale through your nose you may clear the passage.

Prescription: steroid nasal spray

Steroids reduce inflammation. A steroid spray can reduce the inflammation in your sinuses enough that your body can deal with the remainder of the infection. At the very least the reduced inflammation might help your sinus to drain more easily.

The first time I went to the doctor for my sinus infection was a few weeks after the infection started (I know, I’m stubborn). I was prescribed a steroid nasal spray.

It was remarkably effective. While using the spray I could dive and I could equalize.

Unfortunately as soon as I stopped using the steroid spray the infection returned… For me, steroid spray treated symptoms, but did not eliminate the cause of my problems.

Prescription: Antibiotics

The second time I was at the doctors office, it was time to bring out the big guns. This was about 6 weeks after the onset of the infection. It had been two weeks since I stopped using the steroid spray and obviously that had no lasting effect.

Take two of prescription medicine: one week of oral antibiotics combined with 4 weeks of steroid nasal spray.

The steroid nasal spray worked in reducing the symptoms. The antibiotics did not make any difference…

If you are unfortunate enough that none of these help or have helped you may need to get a surgery so that your sinus will drain normally again. Let me know what worked for you in the comments!