Equalizing, equalization, ear clearing, popping your ears…you may have heard it many different ways but it all refers to the same: the equalization (rendering equal) of the pressure in the sinuses and middle-ear with the ambient pressure. Though this happens naturally and involuntarily in more than one situation, yawning and swallowing, for example, this is a basic skill that divers must learn to do on command.
Keep reading this guide to discover what is the best technique for YOU.
Did you know that 89% of divers have problems with their equalizing technique?
The effects of inadequate equalizing can range from transitory pain and simple cases of swimmer’s ear to the serious and lasting damage of barotrauma. According to a survey made by DIVE.in magazine, 29% of divers had to stay out of the water for weeks or even months, due to problems caused by bad equalizing. Moreover, 6.3% of the surveyed divers have gotten permanent ear damage due to problems with their equalization.
But don’t despair! This doesn’t mean you are destined to have an ear-related injury if you are a scuba diver. It just means that the general knowledge regarding equalization is erroneous or simply not well-rounded. The purpose of this guide is to clear all misconceptions to help you understand how your ears work in response to pressure ant the best ways to protect them while scuba diving.
How does natural equalization work?
It’s time for a little anatomy lesson! Your middle ears are hollow spaces filled with air, connected to the outside world only by the Eustachian tubes that extend to the back of your throat. Each Eustachian tube is “closed” with a one-way valve located at its lower end called “Eustachian cushion”. The purpose of this valve is to regulate the entrance of air and prevent contaminants in your nose from migrating up to your middle ears.
What happens when you are equalizing is that you are opening up those valves, allowing higher-pressure air from your throat to go through the tubes and up to your middle ears.
Though you may not be aware of it, your body naturally equalizes your ears every day when you swallow. As explained in Divers Alert Network, oxygen is constantly absorbed by the tissues of your middle ear, lowering the air pressure in those spaces. When you swallow, your soft palate muscles pull your Eustachian tubes open, allowing air to rush from your throat to your middle ears and equalize the pressure. That’s the faint “pop” or “click” you hear about every other swallow.
However, when you’re scuba diving you are subjecting your ears to much greater and faster pressure changes than the ones they are designed to deal with.
Techniques to equalize ears
Of course, no reputable dive center or dive instructor would EVER let you dive without making sure you know at least one equalization technique. Whether you are getting your PADI certification or SDI, NAUI…it makes no difference. All scuba diving agencies and organizations will teach you how to equalize ear pressure from the get-go.
The method most divers learn is, for obvious reasons, also the most universally used one: pinching your nostrils and blowing through your nose. We are talking about the Valsalva maneuver. Does it work? Yes, usually. Is it the best method? Well…let’s just remember those previous statistics, shall we? Almost 9 out of 10 divers have problems with their equalization!
So yeah, there’s definitely an issue with the most common way of equalizing.
The Valsalva maneuver
Equalizing with the Valsalva maneuver consists of pinching your nostrils (or closing them against your mask skirt) and blowing through your nose. The resulting excess pressure on your throat usually pushes air through your Eustachian tubes, opening the valves and thus equalizing your ears. Pretty nifty, right? So what’s the problem?
Well, one problem with this maneuver is that it doesn’t engage the actual muscles that open the tubes. This means that if you don’t equalize early enough or often enough, your tubes will already be locked by the pressure differential, which will force the soft tissues of your tubes together…and there’s nothing this technique can do about that. Forcing air against these soft tissues just locks them shut.
To make things worse, it’s incredibly easy to blow too hard. Blowing with excessive force during a Valsalva maneuver can rupture the round and oval windows of the inner ear. This is made even worse if you have a blocked nose because this will raise your internal fluid pressure, affecting your inner ear fluid.
Other equalization methods
The safest clearing methods use the muscles of the throat to open the tubes, unlike the Valsalva which just forces the air through the tubes. The following are 5 widespread methods that actually use your throat muscles, resulting in a safer, cleaner equalization.
Pinch your nose + swallow
Swallowing pulls open the Eustachian tubes while the movement of the tongue, with the nose closed, compresses air which passes through the tubes to the middle ear. This is an especially good technique if equalization is needed during ascent.
Pinch your nose + blow + swallow
Think Valsalva maneuver meets the Toynbee maneuver.
Pinch your nose + blow + push your jaw forward
While tensing the soft palate (the soft tissue at the back of the roof of the mouth) and throat muscles and pushing the jaw forward and down, do a Valsalva maneuver.
Pinch your nose + make the sound of the letter “k”
This engages the rear part of the tongue and throat muscles. Close the nostrils, and close the back of the throat as if straining to lift a weight. Then make the sound of the letter “K.” This pushes the back of the tongue upward, compressing air into the openings of the Eustachian tubes.
Voluntary tubal opening
Tense your throat + push your jaw forward
Tense the muscles of the soft palate and the throat while you try yawning or wiggling your jaw. This requires a lot of practice, but some divers can learn to control those muscles and hold their tubes open for continuous equalization. Up to 30 percent of divers can successfully master this technique.
Please remember that respiratory tract infections, allergies, cigarette smoking or a deviated nasal septum can compromise equalization. When used correctly, these techniques are effective in healthy subjects. Don’t feel disheartened if you can’t properly perform these equalizing methods at first. Remember that practice makes perfect! Try practicing in front of a mirror so you’ll be able to see your throat muscles engaging. Just be patient and be safe.
Happy diving and ear popping!