Probably the hardest thing for most new divers to get used to when they first start going underwater is clearing their ears.
What Parts of a Diver’s Ear Are Effected by Pressure?:
To understand how ear equalization works, divers must first learn some basic ear anatomy.
The Outer Ear is open to the environment and is filled with air (or water) from the surroundings. The outer ear experiences the same pressure as the outside environment.
The Middle Ear is not open to the environment. In fact, the middle ear is almost completely air-tight. The only way air can move in and out of the middle ear is through a thin tube called the Eustachian tube.
The Eustachian Tube connects your ears to your nose and throat. When the Eustachian tube is open, air can flow from your nose and throat into your ears. However, the Eustachian tube is normally closed, trapping air in the middle ear.
The Eardrum is a thin tissue that separates the outer ear and the middle ear
Why Do Divers Have to Equalize Their Ears?
Water pressure increases the deeper a diver goes. Since the outer ear is affected by the pressure of the surrounding environment, the pressure in the outer ear increases as a diver descends. However, the middle ear is sealed so the pressure in the middle ear does not change. If a diver descends without equalizing his ears, the increased pressure in the outer ear relative to the middle ear flexes the eardrum inwards. The discomfort felt as the eardrum bends inwards is called a squeeze.
A Diver must equalize the air pressure in his middle ear with the pressure in his outer ear or he risks a ear barotrauma or even rupturing his ear drum.
How Do Divers Equalize Their Ears?
To equalize the air pressure in his middle ear during descent, a diver must manually open his Eustachian tube to allow high pressure air to fill the middle ear. This is easier than it sounds. Divers can equalize their ears using any of the following techniques.
This is the method most divers learn. Pinch your nose and gently blow through your nose. The resulting overpressure in your throat usually forces air up your Eustachian tubes.
With your nose pinched, swallow. Swallowing pulls open your Eustachian tubes while the movement of your tongue, with your nose closed, compresses air against them.
A combination of Valsalva and Toynbee. While closing your nose, blow and swallow at the same time.
How Often Should Divers Equalize Their Ears on Descent?
The answer varies from diver to diver. The general rule is that a diver should equalize his ears before he feels pain or discomfort. Most divers equalize their ears every few meters while descending. Keep in mind if a divers ascends a little bit, he will have to re-equalize his ears as he descends again. A diver cannot over-equalize his ears, so when in doubt, equalize!
Do Divers Have to Equalize Their Ears on Ascent?
Usually, divers do not have to manually equalize their ears as they ascend. As the water pressure decreases on ascent, the pressure in the middle ear becomes greater than the pressure in the outer ear. The extra air pressure usually leaks out the Eustachian tube automatically.
If a diver’s ears do not equalize automatically as he is ascending, he may experience discomfort in his ears as the eardrum bends outwards. A diver experiencing a reverse block may feel discomfort sometimes accompanied by a feeling of dizziness..
Reverse blocks are common when the Eustachian tube is inflamed, or when a diver is congested. Keep in mind that a reverse block is caused by too much air pressure in the middle ear, so attempting a Valsalva Maneuver (or similar equalization technique for descents) will only make the problem worse because it adds more air pressure to the already over-full middle ear.
What Should a Diver Do If He Has Equalization Problems?
If a diver has equalization problems, either on ascent or descent, he should immediately establish neutral buoyancy so that he does not descend or ascend inadvertently. Any further depth change could exacerbate the problem. The diver should signal to his buddy that he has a problem with his ears, and attempt one of the following techniques. Remember never to equalize forcefully.
• For Equalization Problems on Descent
- Take a few seconds to relax and focus on your breathing.
- Gently try a different equalization technique, such as swallowing
- Look up to stretch open your Eustachian tubes and gently try to equalize.
- Ascend a few feet and try to equalize again.
- If nothing works, slowly ascend to the surface, relax for a few minutes, blow your nose and clear your throat, and then try again.
• For Equalization Problems on Ascent
- Open your Eustachian tubes by swallowing or wiggling your jaw.
- Try the Toynbee Maneuver pinch your nose closed and swallow.
- Descend a few feet and wait for the pressure to equalize on its own.
Some Conditions make it Difficult to Equalize:
If congestion obstructs your Eustachian tubes, you might have more trouble equalizing your ears. Thus, if you have a cold, you might find it impossible to equalize your ears. Don’t allow cold medicine or an hour of reduced congestion to lull you into false security. Even if you experience easy equalization on the descent, your congestion might return during the dive. You could then experience the “reverse squeeze,” in which you have trouble clearing your ears as you return to the surface.
Eardrum pain, can occur if you jump into the water from a boat or dock and slap your ear against the surface of the water as you enter. If you make overly violent attempts to clear your ears to compensate for pressure changes, you can also cause eardrum pain. Don’t try to force your ears to clear. If, after gentle attempts to clear your ears, your ears remain blocked, consider aborting the dive and returning to the surface.
Air spaces in the sinuses and ear can expand if the ears do not properly equalize, causing an injury known as barotrauma. Mild symptoms of barotrauma include pain and pressure in the ear. More severe symptoms include ringing, hearing loss, nausea and dizziness. If you experience more severe symptoms of barotrauma, do not continue to dive. Consult a physician.
Children have small, flat Eustachian tubes that gradually open as they mature. Kids may find it difficult or impossible to equalize until their Eustachian tubes open fully
Uncontrolled nasal allergies:
Any allergy that causes congestion can make equalization difficult.
If you are having problems, try these tips to help you descend safely:
Start on the Surface
Before you even go under the water, start your equalization method. If you are using the Valsalva maneuver, gently blow through your nose while you are waiting to start your descent. This “pre-pressurizes” the ear and makes equalization easier upon descent.
Descend Feet First
If you are descend with your head first, it affects the Eustachian tube and makes it harder to equalize your ears.
Equalize Early and Often
Begin equalizing as soon as your head goes underwater and continue equalizing every few meters. This is probably the most important step to descending without ear problems. If you are having problems clearing one ear, tilt your head – with the blocked ear toward the surface.
Ascend if Not Clearing
If your ears are not clearing properly, ascend a few feet to reduce the pressure. Try clearing them again. If it still doesn’t work, ascend a few more feet and try again. Rinse and repeat until you have cleared your ears successfully.
Do Not Force It
If you have tried ascending and it is not working, abort the dive.
It’s better to forego a dive than have ear problems for the rest of your life.
This is probably the most important ear scuba diving tip to remember.