How to Equalize your Ears While Scuba Diving

Learning the Why and How’s of Equalization During Scuba Diving

Being underwater – be it through snorkeling, free diving or scuba diving – is a wonderful way to enjoy a completely different world to our land one. But by exploring this new world, our bodies are exposed to physiological changes created thanks to the difference between air and water.

Your Ears and the Underwater World

Your body is filled with “dead air spaces.” One of these dead air spaces is the air space within our middle ear. The middle ear is sealed by the eardrum and connected to the outer world by the Eustachian tubes running at the back of your throat.

In normal everyday conditions, when the outside pressure is normal, the Eustachian tubes are closed. But as we descend in water, for instance, during a dive, the pressure of the surrounding water is higher than what we are used to on land. This causes the water to press against the eardrum bending it inward. To adapt our ears to this pressure difference, and restore the lost volume we must compensate by sending air into the inner ear through the normally closed Eustachian tube.

A Guide on Equalization Methods

If you’ve been down to the bottom of a deep pool, flown in an airplane or driven to the top of a high mountain – the feeling of increased or decreased ear pressure will be a feeling that is familiar to you. This feeling is very similar when it comes to snorkeling, freediving and scuba diving.

There are several different ways people decide to equalize. Most involve some combination of exhaling, swallowing or nose pinching. Although each technique is slightly different, no one method is superior to the other. At the end of the day, it is important to pick the one that works best for you.

“Valsalva” Method

The Valsalva method is one of the most common methods that involves exhaling gently against a closed airway. The slight over-pressurization in the throat forces air up into the Eustachian tubes. To do the Valsalva method, a person simply pinches the nose and gently blows into it, with an emphasis on GENTLE. Blowing too forcefully can lead to barotrauma.

Toynbee Manoeuvre

Another equalizing technique is the Toynbee Manoeuvre. To undertake this method first the nose is pinched close then the equalizer swallows. Swallowing encourages the muscles of the throat to open the Eustachian tubes. This method can sometimes feel more natural and experienced divers might even get to the point where all they need to do is swallow.

Frenzel Maneuver

The Frenzel maneuver requires the person to close off the vocal cords. This is done by simulating lifting a heavyweight. With the vocal cords closed the nostrils are pinched shut and the person tries to make a “K” sound. The combination of the movement of the tongue paired with the plugged nose compresses air upwards against the tubes.

Lowry Technique

The Lowry technique is very similar to the Valsalva and Toynbee methods. It requires the person to pinch closed their nostrils, apply pressure by gently exhaling and swallowing.

Edmonds Technique

The Edmonds technique combines either the Valsalva or Frenzel maneuver with a jaw thrust/head tile. To do this a person selects the aforementioned method and tags on moving their jaw from side to side or forwards and backward. If this isn’t preferred they can also rotate their head up and down

What Happens When you Don’t Equalize

While descending into the water column, the pressure of the surrounding environment increases. If we don’t equalize, this pressure pushes on the eardrum causing pain inside the ear. If we fail to stop or slow our descent this pressure could lead to a middle ear squeeze (blood and fluid forced into the middle ear) and/or a Tympanic Membrane Rupture (also known as a perforated eardrum).

This is why it is important to understand equalization. Never continue the dive if you find yourself unable to equalize your ears.

Common Ear Equalization Problems When Diving

1. Waiting too long

The most common ear-related issue divers face is waiting too long to equalize, and then struggling. Waiting too long to equalize often leads to pain and pressure in the middle ear. The best scuba diving practice is to equalize early and often.

Most dive pros agree that every 2 feet (or half a meter) is a good rule of thumb. As you go deeper, you may find you need to equalize less often. But, you’ll still need to compensate for pressure if you change depths during your dive.

2. Not pinching off both nostrils properly

In order to equalize, it’s important to apply equal pressure to both sides of your ears. This can be done by fully pinching off the nose and attempting one of the methods outlined above. Wearing a mask that fits well also helps.

When you are shopping for a mask, be sure that the nose pocket fits closely. Too much space around your nose makes it more difficult to grasp.

3. Diving with sinus pressure or congestion

Any mucus or blockage in the sinus cavity or Eustachian tube can prevent proper equalization while scuba diving. Failure to equalize can lead to intense pressure, pain, and even barotrauma.

Diving with sinus issues or congestion is never a good idea. If you suffer from seasonal allergies or are prone to sinus problems, discuss them with your doctor before diving.

Tips and Tricks for Equalization

There are a handful of ways to equalize and as long as you find a technique that works well for you, it doesn’t matter how you get there.

• Practice at the surface: Ease your nerves and Eustachian tubes into dealing with pressure changes by practicing at the surface. If you can’t add pressure to your middle ears on land, you won’t be able to underwater. Adopt either of the above techniques and work on it at the surface or in a pool until you feel adequate. You should feel the “pop” or “click” of equalization.
• Blow up a balloon: I’m not one to encourage single-use plastic, but in this case, inflating a birthday balloon 10 times prior to heading in the water really helps get those Eustachian tubes open and ready for changes in pressure.
• Chew gum: Some scuba divers find that chewing bubble gum prior to diving and during their surface interval helps. The movement of the jaw can stretch the Eustachian tube, making it easier to open.
• Lookup: While it is important to know where you are descending and what you are descending onto, extending your neck up helps open and stretch the Eustachian tubes. Looking down can cause a kink or fold in the tube, blocking the passage of air.

• Go down feet first: Air rises from an area with more pressure to an area with the least pressure. This is also true in your Eustachian tubes – air moves up and hence going down in an upright position helps reduce the risk of encountering problems while equalizing.
• Equalize early and often: A great rule of thumb when considering equalization is to do it early and often. The earlier and more frequently a person equalizes, the less likely you will be to run into issues. Even if you don’t feel any pressure, you should continue to block and blow throughout your descent.
• Know and care for your body: At the end of the day, you know your body best. You should never try to push through discomfort to continue your dive. If you are feeling ill or have a sinus cold don’t try scuba diving, free diving or snorkeling. This will wreak havoc on your inner ears. For those who still have trouble equalizing, avoid mucus-forming foods such as dairy products prior to dive day. It is also advisable not to consume tobacco and alcohol as these substances irritate mucus membranes which clog up Eustachian tubes.
• Use a line: Decent lines help control how quickly you go up or down in the water. A free descent or descent without a line can lead to a rapid change in depth. Holding onto a line helps with equalizing and can allow you to stop or pause if there is uncomfortable pressure in your ears.


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Equalizing – An Important Skill

Your body is a well-tuned machine when it comes to life on land, however, it is not designed to thrive in an underwater environment. In scuba diving, snorkeling and free diving our ears struggle to maintain a balanced pressure. The deeper we go the more the pressure increases. To be able to enjoy these activities we must learn to equalize.

What is your favourite way to equalize your inner ear? Have you ever had to cancel a dive because you were unable to equalize?

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