Avoid the Valsalva Maneuver for Equalizing!

[60plus]

Nothing wrong with the valsalva technique. Do it gently and in plenty of time. Its a bit like driving a car with poor cornering technique - brake gently and steadily as you approach the corner, slamming on the brake pedal when you have already entered the corner too fast is the equivalent of poor valsalva technique.

 

[Moerae]

Can @tursiops or anyone calling this "dangerous" give a citation for the level of danger involved in doing it? Not a random anecdote or example, but information sufficient to evaluate the overall risk to the average person.

DAN's documentation just mentions that it's easy to blow too hard and presents some alternatives that "may" be safer (in their own words). That hardly lines up with the tone taken in some of the discussion here.

 

[tursiops]

Can @tursiops or anyone calling this "dangerous" give a citation for the level of danger involved in doing it? Not a random anecdote or example, but information sufficient to evaluate the overall risk to the average person.

DAN's documentation just mentions that it's easy to blow too hard and presents some alternatives that "may" be safer (in their own words). That hardly lines up with the tone taken in some of the discussion here.

Read through the many reports on ScubaBoard from new divers experiencing ear problems after "valsalvaing too hard." It is dangerous (not to life but to your ears) because it is too easy to blow too hard.

 

[scubaozy]

The way I see it, risk of not doing valsalva is probably higher, thus, more dangerous. Only handful of divers master all possible equalization techniques. Most of the beginners will struggle even with simple Toynbee due not being able to swallow in quick succession. I agree valsalva has inherent risk of an injury so it important to teach how hard people should push air into their ears. It is easier to teach doing valsalva right than teaching Frenzel.

 

[Angelo Farina]

It is easier to teach doing valsalva right than teaching Frenzel.

My instructor's point of view...
Whilst teaching Valsalva is simple, traching some other technique is even simpler...
The simplest one is BTV, as it does not require to pinch the nose, or to take any "action". The diver has simply to voluntarily open the tubes, using the proper muscles.
It takes just 5csecond to ask your students to open their tubes. And in my experience it works immediately with approximately 1 over 5 of them...
Of course for the other 4 you need to switch to some other equalization method. But for me BTV is always the first choice, as it is the method I always used since when I was 6...
It has no risks, it is truly simple, and works well if you do not have a cold...
Not teaching it as the first method could be confusing for my students: why should I expect them to pinch their nose, while I am not doing the same?
@Ucarkus, I entirely agree that teaching properly Frenzel is quite difficult. That's (one of) the reason(s) for which here in Italy the Marcante-Odaglia method was developed: much easier than Frenzel, particularly with a reg in your mouth.
I cannot use Frenzel with the mouth open, and many of my students reported the same. In fact here Frenzel is considered an equalization method specific for deep free divers, who keep the mouth closed while diving (keeping the snorkel in mouth is a bad, dangerous practice for deep free diving).

 

[scubaozy]

@Angelo Farina , not everyone can wiggle their ears or move their scalps. I can do it and I do not even know, why. BTV and Frenzel are about isolating and controlling the muscles around soft palate. Only small percentage of people will be able to do it out of the bat as only few people can wiggle their ears. The rest will have to do a lot of practice until they can learn and this is not trivial. If you do not teach valsalva or present it as a dangerous option and rule it out, you already increased the risk of an injury. Valsalva does not require any special muscle control or even much practice. You cannot do Frenzel with open mouth it is because you have not practiced enough and you do not belong to the minority group who developed the skill naturally, that is all.

 

[Angelo Farina]

@Angelo Farina , not everyone can wiggle their ears or move their scalps. I can do it and I do not even know, why. BTV and Frenzel are about isolating and controlling the muscles around soft palate. Only small percentage of people will be able to do it out of the bat as only few people can wiggle their ears. The rest will have to do a lot of practice until they can learn and this is not trivial. If you do not teach valsalva or present it as a dangerous option and rule it out, you already increased the risk of an injury. Valsalva does not require any special muscle control or even much practice. You cannot do Frenzel with open mouth it is because you have not practiced enough and you do not belong to the minority group who developed the skill naturally, that is all.

I agree, but it is a matter of priority. To my students I always presented a number of equalization methos, including Valsalva. But the order I always used is:
1) BTV, as this is what I did always use, and I think is the best. 1/5 of the students are done with it.
2) Marcante-Odaglia. A lot of people already use it, mostly thinking it is Valsalva (possibly even you). Some other think it is Frenzel. But it does not have the drawbacks of Valsalva, nor those of pure Frenzel. Let say that another 1/5 of the students can perform easily this method. All the others could (as it is much easier than Frenzel), but it requires doing exercises, so let's leave the remaining 3/5 for now.
3) Toynbee. Swallowing is easy and effective for a small number of students. We can assume a third 1/5 of the students are done immediately with Toynbee.
4) Valsalva. Here we are addressing the remaining 2/5 of students, those with more problems, who cannot manage any of the previous 3 methods without some specific training. Valsalva is simple, and is immediately succesfull for half of these remaining students.
5) the last group of 1/5 of students still have problems equalizing, due to a combination of factors.These include narrow tubes, chronical inflammation (smokers), anxiety, lack of control, etc.
These students are not done in one lesson, they require specific training lasting as much as 10 one-hour lessons in a deep swimming pool. For these students often it is necessary to resort to some of the most advanced techniques, which combine a basic Valsalva with something else (Lowry, for example).
As you see I did not include Frenzel in the list. I think Frenzel is worth to be taught only to deep free divers, no need of Frenzel for scuba divers, who have plenty of time descending slowly and equalizing at will.
In conclusion, Valsalva is one of the many methods available. It should never be the first choice, in my opinion, as several other methods are available, which are both easier and safer for a minority of students.
Valsalva should not be demonised, indeed: it can be the right method for the largest group of students.
But I find barely stupid to ask a student who can succesfully equalise using BTV, Marcante-Odaglia or Toynbee to use Valsalva.
Of course a Valsalva done properly is just marginally more dangerous than other methods, and definitely less dangerous than not getting proper equalization.
So it is just matter of presenting the various methods in a reasonable order, and then let each student to become proficient in the method which works better for him/her, including Valsalva.
What I do not like is presenting Valsalva as the first, better method for everyone.

 

[tursiops]

Of course a Valsalva done properly is just marginally more dangerous than other methods, and definitely less dangerous than not getting proper equalization.
So it is just matter of presenting the various methods in a reasonable order, and then let each student to become proficient in the method which works better for him/her, including Valsalva.
What I do not like is presenting Valsalva as the first, better method for everyone.

I'm happy for all those folks that have posted they've been doing Valsalva for X years with no problem. My cautions are directed toward those new divers who often are taught only Valsalva, and do it poorly, to the point of injuring their ears. They need to know there are alternatives to Valsalva that may work better for them, and which are less prone to problems from poor execution. I cannot clear with Valsava, for example, without blowing excessively hard; I don't think I am unusual.

 

[Angelo Farina]

I'm happy for all those folks that have posted they've been doing Valsalva for X years with no problem. My cautions are directed toward those new divers who often are taught only Valsalva, and do it poorly, to the point of injuring their ears. They need to know there are alternatives to Valsalva that may work better for them, and which are less prone to problems from poor execution. I cannot clear with Valsalva, for example, without blowing excessively hard; I don't think I am unusual.

We are all made slightly different! That's the reason for which so many methods were developed, and everyone should find the best one FOR HIM...
Which can as well be Valsalva for a number of people, but definitely NOT for everyone.
It is not the best one for me, it is not for you, and it appears not to be the best one even for a number of divers who THINK of being using Valsalva (as they are not knowing the mechanics of the other methods - and when you pinch your nose it is Valsalva, isn't it?), but after careful analysis, it results that they are NOT using it, but something else.

 

[Joneill]

I agree, but it is a matter of priority. To my students I always presented a number of equalization methos, including Valsalva. But the order I always used is:
1) BTV, as this is what I did always use, and I think is the best. 1/5 of the students are done with it.
2) Marcante-Odaglia. A lot of people already use it, mostly thinking it is Valsalva (possibly even you). Some other think it is Frenzel. But it does not have the drawbacks of Valsalva, nor those of pure Frenzel. Let say that another 1/5 of the students can perform easily this method. All the others could (as it is much easier than Frenzel), but it requires doing exercises, so let's leave the remaining 3/5 for now.
3) Toynbee. Swallowing is easy and effective for a small number of students. We can assume a third 1/5 of the students are done immediately with Toynbee.
4) Valsalva. Here we are addressing the remaining 2/5 of students, those with more problems, who cannot manage any of the previous 3 methods without some specific training. Valsalva is simple, and is immediately succesfull for half of these remaining students.
5) the last group of 1/5 of students still have problems equalizing, due to a combination of factors.These include narrow tubes, chronical inflammation (smokers), anxiety, lack of control, etc.
These students are not done in one lesson, they require specific training lasting as much as 10 one-hour lessons in a deep swimming pool. For these students often it is necessary to resort to some of the most advanced techniques, which combine a basic Valsalva with something else (Lowry, for example).
As you see I did not include Frenzel in the list. I think Frenzel is worth to be taught only to deep free divers, no need of Frenzel for scuba divers, who have plenty of time descending slowly and equalizing at will.
In conclusion, Valsalva is one of the many methods available. It should never be the first choice, in my opinion, as several other methods are available, which are both easier and safer for a minority of students.
Valsalva should not be demonised, indeed: it can be the right method for the largest group of students.
But I find barely stupid to ask a student who can succesfully equalise using BTV, Marcante-Odaglia or Toynbee to use Valsalva.
Of course a Valsalva done properly is just marginally more dangerous than other methods, and definitely less dangerous than not getting proper equalization.
So it is just matter of presenting the various methods in a reasonable order, and then let each student to become proficient in the method which works better for him/her, including Valsalva.
What I do not like is presenting Valsalva as the first, better method for everyone.

How do you do Marcante-Odaglia? I'm not finding any good resources online that do a good job of clearly demonstrating how to execute this technique?