Can I still swim train with cap and earplugs if I have a perforated eardrum from a middle ear infection?

Controverisal. There is constant back and forth between the experts on this very issue, and no consensus has been reached yet. My practice is if you are on appropriate therapy for the infection, including topical drops like ciprodex, then you can safely swim in clean water (no rivers or lakes). It is essential, however, that you follow up closely with doctor to make sure the ear and perforation has healed.