Different ways to equalize your ears

[Thalassamania]

I thought most folks were familiar with this, but then I can see this may just be something that just the commercial and research divers know about. It's one of the first things that you master with most full face masks (esp. Band Masks) or Helmets. There are equipment supported methods for those who can't not manage the, "use the force Luke" approach to ear clearing. Here are two:

One is to wear a loose set of nose plugs. Gentle exhalation will go past, but more forceful exhalation will raise the pressure in the pharynx and equalize (you MUST stay well ahead of the need, even the slightest edema around the Eustachian tubes will prevent this.).

Another approach (the one I use for those days that I can't "use the force") is to glue a small (1/2 x 1 inch) neoprene nose block in the nose pocket of my mask. Mask squeeze helps since it seals my nose against the block, and when I exhale through my nose my ears first clear and then my mask equalizes.

Sometimes I need to block my nose more strongly, then I push my nose (well ... the nose pocket of the mask) against something (forearm, instrument housing, back of my hand, etc.) to close off my nostrils and equalize.


Stay ahead of the need to equalize, try and keep slight positive pressure in your pharynx all the way down.

 

[JcoldwaterIL]

very interesting. I was wondering about this the other day actually. I have never been able to do the jaw wiggle thing to equalize and didn't understand how it was done with a full face mask. The nose plugs sound like they may be useful for a standard mask too since I find it kind of a hassle to hold onto a line, watch my guages and clear my nose all at once. but where do you buy nose plugs?

 

[Thalassamania]

very interesting. I was wondering about this the other day actually. I have never been able to do the jaw wiggle thing to equalize and didn't understand how it was done with a full face mask. The nose plugs sound like they may be useful for a standard mask too since I find it kind of a hassle to hold onto a line, watch my guages and clear my nose all at once. but where do you buy nose plugs?

Nose plugs are the "U" shaped thing with the neck strap (remove the strap) that you can get at any sporting goods or pool store.

 

[Thalassamania]

There are at least two "hands-free" methods of equalizing:

• The Frenzel Maneuver uses the tongue as a piston to force air back into the throat and increase pressure in the Eustachian Tubes.
• The Toynbee Maneuver involves yawning and/or swallowing to increase air pressure in the back of the throat (and by extension, the Eustachian Tubes).

The problem with these from a "teaching" standpoint is that it's impossible to demonstrate the mechanics of what to do, like you can with propulsion techniques and air sharing exercises. You can explain what you are doing, but there's really no way to show it - either the student "gets it", or they don't.

I am actually fairly adept at both of these, but I still occasionally use the Valsalva Maneuver - usually during rapid descents, when I can't keep up with changing ambient pressure any other way.

Since Thalassamania was the one who raised the issue of teaching alternative equalization techniques, and he identifies himself as a "Scuba Instructor", I'd be interested to hear how he himself teaches this to his own students. Note that this is a serious question - I'm sure a lot of us would like to know how to do it better (or possibly at all ).

We teach a mild version of the valsalva whereby the student maintains a slight pressure over ambient in the pharynx during the entire descent. We introduce, by description, Toynbee and encourage students to work with it a bit, especially Toynbee with a waggling of the jaw, stretching of the neck by moving the head from side to side and a strong swallow. We do not really bother with Frenzel since it too requires blocking the nose, but some students stumble onto it themselves.

I’d estimate that over the course of the 13 week course we have perhaps a 50% success rate with non-valsalva methods. Since our divers usually have their hands full, it is critical for them to have a way to clear their ears without using their hands, so the nose-clip or nose block with valsalva usually become the method of choice.

 

[dumpsterDiver]

http://www.liquivision.ca/liquivisiondownloads.html

Scroll down to the Frenzel Fattah Equilizing workshop which is a free download (pdf) that is probably the ultimate guide to equalizing. If I had more discipline, I would reallly try to learn all this stuff..

 

[TSandM]

How do you keep pressure over ambient in the pharynx while breathing? I can't wrap my brain around this concept.

 

[Thalassamania]

http://www.liquivision.ca/liquivisiondownloads.html

Scroll down to the Frenzel Fattah Equilizing workshop which is a free download (pdf) that is probably the ultimate guide to equalizing. If I had more discipline, I would reallly try to learn all this stuff..

It's really good, thanks. That made me look arround a bit and I found andother worth looking at: PREVENTION OF MIDDLE EAR BAROTRAUMA, Edmund Kay, MD

 

[Thalassamania]

How do you keep pressure over ambient in the pharynx while breathing? I can't wrap my brain around this concept.

Lynne, your such a purist.<G> You're right, clearly you can not maintain positive pressure while engaging in a negative pressure event (inhaling). So on descent you do it cyclically. Inhale, exhale gently through your nose, your ears clear, then your mask equalizes, continue to exhale through your nose (maybe look up and get rid of that little dribble of water that was bothering you), slow your descent and inhale. As you Docs say, "repeat as needed." Really staying on top of it is only critical in the first 30 feet or so, because as you know, the frequency that you need to clear with respect to depth change drops off rather rapidly with greater depth. I've found that the real key is religiously staying ahead of the need to clear thus preventing any shift of fluid to the tissues surrounding the Eustachian tubes. While it's not true for everyone, I feel a slight mask squeeze need before I need to clear my ears and that makes it all very easy. Like most every thing in diving you have to play with it and make it your own.