How to Equalize Pressure When Diving – Tips to Avoid Diver’s Ear

covering ears

Every diver needs to learn how to equalize pressure when diving. Many divers instinctively know how to equalize at the beginning of the dive and make their ears pop in order to clear them, but this method doesn’t always work. Not properly taking care of your ears can ruin a dive. You may have started a dive and things seem to be going well. As you pinch your nose and blow in order to equalize your ears, nothing happens. So, what can you do to equalize pressure when the basic method doesn’t work? Let’s find out.

Equalizing Methods

As a new diver, you have a lot on your plate. Learning how to use new equipment, handling waves and choppy water conditions, and executing the proper dive techniques are the main focus for the beginner, but failing to equalize pressure during a dive can result in major hearing damage or hearing issues, later down the line. Studies have shown that an astonishing eighty-nine percent of divers fail to equalize pressure correctly. Twenty-nine percent of divers stay out of the water for several weeks due to issues caused by equalizing incorrectly. Six percent of divers will get permanent ear damage. Many divers are surprised to learn that permanent ear damage can be caused by incorrectly equalizing their ears at the start of a dive.

The big issue is the way many divers equalize their ears, which is the most common method used. Unfortunately, it’s not the right way to do it. This method is called the Valsalva maneuver. It involves pinching the nostrils and blowing through the nose. This move will result in overpressure in the throat forcing air to the eustachian tubes. During a dive or on a plane it creates that familiar pop in the ears that relieves pressure.

But if it works, why is it considered the wrong way to equalize pressure? It will work fine if you keep the tubes open prior to the pressure change. But if you don’t equalize your ears often or early enough, then the difference in pressure can force soft tissues together, which closes the ends of the tubes. This forces air against the soft tissues and ends up locking them shut.

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Better Methods to Use to Equalize the Ears

The following techniques can be better alternatives to the traditional method.

Tonynbee Maneuver: When your nostrils are blocked or pinched against the mask skirt, swallow. This will pull open the eustachian tubes while the movement of the tongue will compress the air against them.

Lowry Technique: With this technique, you’ll simply pinch your nostrils, blow, and then swallow. This is a combination of the Tonynbee and the Valsalva technique. When you close your nostrils, you have to blow and swallow at the same time in order for it to actually work.

Edmonds Technique: For this method, you’ll pinch your nose, then blow, pushing your jaw forward. While tensing the soft palate and the throat muscles, then pushing the jaw down and forward, do the traditional Valsalva method.

When Should I Equalize?

diver

Most divers think they know when to equalize, but it’s usually a lot more often and sooner than they think. Pro divers recommend equalizing every two feet of descent. However, this is usually too late. At a slow descent, a rate of sixty feet per minute would require an equalization every couple of seconds. Most divers will descend at a significantly faster rate, so they should be constantly equalizing. However, the deeper you go, the less you’ll have to equalize.

Equalizing Tips

  • When you equalize, listen for the pop
  • Before you even set foot onboard, be sure that you hear a click or pop when you swallow, in both of your ears. This will tell you that both of your eustachian tubes are open.
  • Begin equalizing several hours before a dive and start to gently equalize the ears every few seconds. This will work to help minimize the chances of a block during descent. Chewing gum between each dive can also help. When you pre-pressurize at the surface it can help to get you past the crucial first three feet of a descent, when you’re usually busy with clearing your mask or dumping BCD. It can also help to inflate the eustachian tubes, making them slightly larger. The goal here is to pre-pressurize by chewing gum if it seems to help you more than the other methods, or you can try it if you’re looking for a gentler way to pressurize.
  • Air usually rises up to the eustachian tubes, while mucus that’s fluid-like drains downward. Some studies have shown that the Valsalva maneuver requires around fifty percent more force if the driver is positioned head down, compared to head up.
  • Pulling yourself down on a mooring line or anchor can help with controlling the rate of your descent. If you don’t use a line, then your descent rate can accelerate at a much faster rate than you realize. Lines will also help you to stop a descent faster if you feel any pressure. This can stop diver’s ear in its tracks before it has a chance to occur.
  • Make sure you equalize often and try to maintain a slight positive pressure in the ears
  • If your ears begin to hurt, don’t ignore it. If there’s pain this means that the tubes are probably locked down by the change in pressure. The result will be diver’s ear if you don’t resurface immediately. If your ears start to feel uncomfortable only a few feet in the water you can also try to equalize again.
  • Don’t drink alcohol or smoke, because both can irritate the mucus membranes, which will promote more mucus production. This can block the eustachian tubes.
  • Water that gets up your nose can cause some irritation to the mucus membrane, resulting in an increase in production. Because of this, it’s important to keep your mask clear.

What to Do If You Get Diver’s Ear

Diver’s ear, also known as barotrauma, refers to the pain that’s caused by a change in pressure around the ears. This condition causes pain, discomfort, and can have an impact on a person’s hearing. While mild cases can clear up on its own, some people may need to seek medical attention. In severe cases, corrective surgery may be needed.

This condition can be chronic or acute. Scuba diving is typically the cause of diver’s ear, but it can also commonly occur during an airplane take off.

Acute cases of diver’s ear are usually harmless and fairly common. However, if a person with chronic diver’s ear experiences prolonged symptoms, complications can arise. The blockage of the eustachian tubes, which connect the mouth and ear, is a common cause of this condition. These tubes are responsible for maintaining the balance when there’s a change in external pressure. If a blockage occurs, then the difference in pressure outside and inside the middle ear can cause symptoms associated with diver’s ear.

During a landing or take off, the changes in altitude in an airplane can also cause this condition. This is due to the rapid descent or ascent combined with the pressurized cabin. This combination causes an imbalance between the pressure in the outer and middle ear. An altitude change that occurs when going down or up a mountain can cause similar effects.

With diving, the changes in water pressure will affect the tympanic cavity located in the ears. Because of this, it’s crucial to descend slowly when diving, in order to avoid a rapid change in pressure, which can cause an ear injury.

Symptoms of Diver’s Ear

The symptoms of diver’s ear can vary depending on the severity of the condition. A person may initially only feel slight discomfort and pressure inside the ear, however, the condition can progress over time.

When a change in air pressure is responsible for diver’s ear, it will typically go away once the air pressure has normalized and should not continue to cause problems.

However, some people will experience more symptoms when diver’s ear is a result of a blockage in the middle ear or an illness.

If the symptoms worsen and you seek medical attention, your doctor can classify the condition as chronic or acute. Acute cases are very common, whereas chronic cases can occur for a prolonged period of time and can cause complications later on.

With a mild case, a person may experience:

  • Mild hearing loss
  • Difficulty hearing
  • Ears may feel full
  • General discomfort in the ear
  • Other discomfort

With moderate cases and severe cases, if diver’s ear persists and you have not sought treatment, you may experience more symptoms or worsening symptoms, such as:

  • Eardrum injury
  • Bleeding from the ear or ears
  • Fluid leakage
  • Increased pain
  • Intense pressure
  • Moderate hearing loss
  • Severe hearing loss

Duration

With mild cases, diver’s ear will cause symptoms that usually only last for two to five minutes before they clear up. If you have a severe case, then you may need medical attention in order to resolve the underlying cause. Recovery time for this condition depends heavily on the underlying cause and severity.

This condition can lead to a ruptured eardrum, also referred to as tympanic membrane perforation. If this occurs, the healing time can take several months. Ruptured eardrums typically heal spontaneously, however, if this doesn’t happen, surgery may be necessary in order to repair the eardrum.

Medical Attention

For most people, the symptoms will clear up before a person can visit their doctor. However, if the pain is constantly returning or is severe, there is fluid leakage, or bleeding, then an appointment is needed.

Your doctor will ask when the symptoms began in order to see if they relate to changes in water or air pressure. Next, they’ll check for an ear infection and look at the inside of the external ear canal and the eardrum to check for signs of diver’s ear.

If the eardrum looks as if it’s pushed out or in, this will be a major indicator of diver’s ear. A doctor can assess this by applying small bursts of air into the ear to check for blood behind the eardrum or fluid buildup. There may be no physical evidence of ear barotrauma in some cases.

After an exam, a doctor will go over the next steps and the best treatment options available.

Treatment

Gum can help to relieve some of the symptoms associated with diver’s ear.

In many cases, diver’s ear will resolve on its own, after a short period of time, so medical intervention will not be needed.

If problems persist, it should be possible to relieve symptoms by using certain techniques that work to open the eustachian tubes. This will allow air to leave or enter the middle ear. This helps to equalize the pressure.

Techniques include:

  • Sucking on a throat lozenge
  • Using over the counter antihistamines
  • Using over the counter decongestants
  • When diving, stopping a descent at the first sign of discomfort and equalizing your ears can help to prevent further discomfort

Preventing Diver’s Ear

You can reduce your chances of experiencing diver’s ear by:

  • Using an antihistamine, decongestant, or both before diving or other activities in which pressure changes are common. This will include flying in a plane or hiking. When diving, the best way to avoid this condition is slowing down the speed of the descent.
  • Using the right gear, such as a good dry snorkel can also help.
  • Equalizing pressure more often

In most cases, diver’s ear will be benign and will resolve on its own. A person should seek medical attention if any additional symptoms develop, or if the sensation lasts for longer than one hour, or frequently occurs after a dive. After medical treatment, you should not experience any additional complications.

Final Thoughts

Now that you know how to equalize pressure when diving, you can try out the different methods I’ve included here on your next dive. Remember, you also need to equalize your ears more often during a decent, depending on the depth of the descent and the speed. With the methods included here and the safety tips, you’ll have no problem learning have to equalize correctly in order to avoid complications such as diver’s ear and other issues that can occur if you don’t learn how to equalize your ears correctly.