Ears & Diving: Equalize the Right Way

Ears & Diving: Equalize the Right Way

No more bad dives because of your ears!

Every diver needs to equalize ear pressure at the beginning of a dive. Many instinctively  know how to make their ears pop to clear them. It doesn’t always work though.

Together with DAN Southern Africa & DAN Europe we have created this extensive graphic about what happens to your ears when scuba diving. You’ll learn how to equalize your ears the right way.

Grab this graphic totally free to show on your own site – just copy this code and insert it on your site:

<img src=”https://www.divein.com/wp-content/uploads/image-archive/img/ears-and-diving.jpg” alt=”How ocean pollution affects humans ” border=”0″ />Don’t let your ears ruin your dives – Graphic by the team at <a href=”https://www.divein.com/diving/diving-ears/”>DIVEIN.com</a>

Don’t let your ears ruin your dives

You’ve just started your first dive of the day. Everything is going great! You pinch your nose and blow to equalize your ears, but nothing happens. You try again, but same issue.

Your ears starts to hurt…you try again but it’s the same.

So what now?

Accent and end the dive or push on?


It’s time to learn how to equalise the right way!

According to a survey* we did, we discovered that:

  • 89% of divers don’t equalize the correct way
  • 29% of divers had to stay out of the water for weeks or months due to problems caused by equalizing
  • 6.3% of divers have gotten permanent ear damage due to problems equalizing ear pressure

That’s right, you might be Equalizing the wrong way!

The real issue is that the way most of us thought to equalize ears, which happens to be the most common method, is the wrong way to do it.

It’s the Valsalva Maneuver: Pinch your nostrils and blow through your nose. The resulting overpressure in your throat usually forces air up your Eustachian tubes. In a airplane or during a dive it can create the familiar pop in your ears and relieve pressure.

How come it works if it’s the wrong way? It works perfectly fine as long as you keep the tubes open ahead of the pressure changes. However, if you do not equalize your ears early or often enough, the pressure differential can force the soft tissues together, closing the ends of the tubes. Forcing air against these soft tissues just locks them shut.

5 Better ways to Equalize Your Ears

1. Toynbee Maneuver – Pinch Your Nose and Swallow

With your nostrils pinched or blocked against your mask skirt, swallow. Swallowing pulls open your Eustachian tubes while the movement of your tongue, with your nose closed, compresses air against them.

2. Lowry Technique – Pinch Your Nose, Blow and Swallow

A combination of Valsalva and Toynbee: while closing your nostrils, blow and swallow at the same time.

3. Edmonds Technique – Pinch Your Nose and Blow and Push Your Jaw Forward

While tensing the soft palate (the soft tissue at the back of the roof of your mouth) and throat muscles and pushing the jaw forward and down, do a Valsalva maneuver.

4. Frenzel Maneuver – Pinch Your Nose and Make the Sound of the Letter “K”

Close your nostrils, and close the back of your throat as if straining to lift a weight. Then make the sound of the letter “K.” This forces the back of your tongue upward, compressing air against the openings of your Eustachian tubes.

5. Voluntary Tubal Opening – Tense Your Throat and Push Your Jaw Forward

Tense the muscles of the soft palate and the throat while pushing the jaw forward and down as if starting to yawn. These muscles pull the Eustachian tubes open. This requires a lot of practice, but some divers can learn to control those muscles and hold their tubes open for continuous equalization.

When to Equalize

Sooner, and more often, than you might think. Most recommend equalizing every two feet (.6 meters) of descent, but often that’s too late. At a fairly slow descent rate of 60 ft (18.288 m) per minute, that’s an equalization every two seconds. Many divers descend much faster and should be equalizing constantly.

The good news: as you go deeper, you’ll have to equalize less often!

10 Quick tips to make equalizing easier

1. Listen for the “pop”

Before you even board the boat, make sure that when you swallow you hear a “pop” or “click” in both ears. This tells you both Eustachian tubes are open.

2. Start early

Several hours before your dive, begin gently equalizing your ears every few minutes. “This has great value and is said to help reduce the chances of a block early on descent,” says Dr. Ernest S. Campbell, webmaster of “Diving Medicine Online.” “Chewing gum between dives seems to help,” adds Dr. Campbell.

3. Equalize at the surface

“Pre-pressurizing” at the surface helps get you past the critical first few feet of descent, where you’re often busy with dumping your BCD and clearing your mask. It may also inflate your Eustachian tubes so they are slightly bigger. The guide here is to pre-pressurize only if it seems to help you and to pressurize gently.

4. Descend feet first

Air tends to rise up your Eustachian tubes, and fluid-like mucus tends to drain downward. Studies have shown a Valsalva maneuver requires 50 percent more force when you’re in a head-down position than head-up.

5. Look up

Extending your neck tends to open your Eustachian tubes.

6. Use a descent line

Pulling yourself down an anchor or mooring line helps control your descent rate  more accurately. Without a line, your descent rate will probably accelerate much more than you realize. A line also helps you stop your descent quickly if you feel pressure, before barotrauma has a chance to occur.

7. Stay ahead

Equalize often, trying to maintain a slight positive pressure in your middle ears.

8. Stop if it hurts

Don’t try to push through pain. Your Eustachian tubes are probably locked shut by pressure differential, and the only result will be barotrauma. If your ears begin to hurt, ascend a few feet and try equalizing again.

9. Avoid tobacco and alcohol

Both tobacco smoke and alcohol irritate your mucus membranes, promoting more mucus that can block your Eustachian tubes.

10. Keep your mask clear

Water up your nose can irritate your mucus membranes, which then produce more of the stuff that clogs.

Learning to equalize while diving is something we can take for granted. Our ears are full of amazing components that need to be treated properly. If you experience any issues with your ears before diving, talk to some professionals. Or ask your doctor. Ask him about barotraumatics.

Any questions about equalizing? Or do you have any useful habits? Share them below.

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Reply to 

Wow, your content is very amazing. You are truly dedicated to what you do.

Love the infographic, and it’s new to me to equalize this way.

Reply to 

Again, only the ENT doctor with experience in barotraumatics can give you specific advice, since it entails knowing your personal reaction to this medication or another. As to the dangers of compressed air remaining in the inner ear space, there’s not much chance on that. The eustachian tube is rarely clogged itself, in most cases the blockage occurs in the mouth/nose/sinus area and blocks the air entering the tube(s). If the air is forced into the inner ear, it will likely be able to escape naturally as one ascends to the lesser pressure area.
I’d avoid experimenting and relying upon the internet advice, and I’d never take any medication for short-term effect. Your health is way too important to risk. It is my most serious suggestion that you go see a specialist for dive-related problematics (not just any ENT doctor!), and get a thorough examination. No two people have same organisms, so there’s no universal solution for the same problem.

Torben Lonne
Torben Lonne
Reply to  Torben Lonne

Hi Brenda,

It will help in most cases. The big issue you can encounter is that it works on the way down, but that the effects of the Sudafed will wear off while you dive and you can risk a reversed block. This is when the air is trapped inside your ear and can escape through your eustachian tube. As you can imagine, the can lead to some very serious ear damage as I’ll keep you from ascending. And if you haven’t solved this by the time you’re low on air, you’ll have to just go up.

I’d strongly suggest you talk to a medically trained person before using this, and make sure you know the consequences.

Reply to  Torben Lonne

It was suggested to me by another diver, that a short-acting dose of Sudafed might help with equalization. What are your thoughts?

Reply to 

Lori, you should have an examination of your whole ENT tract thoroughly checked and by someone who understands barotraumatics. Your description of problems appear like there is some trouble related with your inner ear where, as you know, your balance center resides. Maybe the pressure difference affects in some way your sense of balance (mechanically or hydraulically?), which in turn gives you vertigos while the pressure changes. The theory could be confirmed if you have similar problems during air travel, though not so pronounced as in diving.
That’s also what andro-barometric vertigo means, translating as human (andro-) pressure-changing (barometric) vertigo …
I hope your problem is not unsolvable, since it’s a difficult location for surgical corrective action, should such be required.
I hope I’m wrong, and it proves to be something simpler to get rid of (blood pressure related?)
Dive Safely!

Reply to 

I would love to hear from you experts out there. I’ve been diving since the 90’s and I just developed an issue since 2015. On my first few dives of my trip I will equalize well but on my ascend, I begin to experience vertigo and motion sickness. I become disoriented; I hold onto my buddy’s arm for a slow ascend then motion sick rest of the day. I’ve even has a sinus squeeze, too. The doctors on Bonaire said I had andro-barometic vertigo but they speak dutch. The doctors here in the states don’t understand that diagnosis. I have an appointment with an ENT before my nest trip to Bonaire so wish me luck in them giving me suggestions. Have you heard of what I’m experiencing and do you have a diagnosis/ idea on how to prevent this?

Brian @ Drysuitdive.com
Brian @ Drysuitdive.com
Reply to 

I had a DM suck on a lifesaver or piece of hard candy while descending; he claimed that was a great way to clear your ears. I’ve tried it once with gum, seemed to work pretty well. It was a bit uncomfortable having something in my mouth while underwater but I think I could get used to it.

Ted Bennitt
Ted Bennitt
Reply to 

Sometimes my one ear clears but the other doesn’t, so continued efforts to clear produce unequal pressure in the cleared ear resulting in pain, and the risk of damage. I’ve discovered that I can avoid this problem by closing off the cleared ear while I equalize the other ear. I do this by pressing on the tragus (the bit in front of the ear-hole) of the cleared ear with my finger to produce a small positive pressure which prevents the tympanic membrane from bulging outwards.

It works for me; maybe it can help others with this problem?

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