Ear Equalization: Techniques, Tips, and Safety for Swimmers

How do you equalize swimming?

Equalizing in swimming, particularly when descending in water, refers to the essential process of balancing the pressure in your middle ear with the external water pressure to prevent discomfort, pain, or injury to the eardrum and inner ear structures.

Understanding Ear Equalization: Why It Matters

When you submerge yourself in water, especially as you descend, the surrounding water pressure increases significantly. This increased external pressure acts upon your eardrum (tympanic membrane). Inside your middle ear, there's an air-filled space. For comfort and safety, the pressure within this space must be equalized with the external pressure.

The Role of the Eustachian Tubes: Your middle ear is connected to the back of your throat by narrow passages called Eustachian tubes (also known as auditory tubes). These tubes are normally closed but can open to allow air to pass, equalizing the pressure between the middle ear and the outside environment. When you swallow, yawn, or perform certain maneuvers, these tubes can open.

Consequences of Unequalized Pressure: If the pressure is not equalized, the higher external water pressure will push the eardrum inward, causing pain, discomfort, and potentially leading to a condition called middle ear barotrauma. This can range from mild discomfort and temporary hearing loss to severe pain, eardrum rupture, and inner ear damage, which can result in permanent hearing loss or vertigo.

Common Equalization Techniques

Several techniques can be employed to equalize the pressure in your ears. The effectiveness of each varies among individuals, and some are more suitable for deeper or faster descents.

• Valsalva Maneuver: This is the most common and often the first technique taught.

  • How to: Pinch your nostrils shut, close your mouth, and gently try to exhale through your nose (as if blowing your nose). You should feel a "pop" or "click" in your ears as the Eustachian tubes open.
  • Considerations: This technique forces air into the Eustachian tubes and is effective for many. However, it can be less effective during rapid descents or if the tubes are already somewhat blocked, as it doesn't actively open the tubes but rather overpressurizes the nasopharynx.

• Frenzel Maneuver: Preferred by many experienced freedivers and scuba divers for its efficiency and control.

  • How to: Pinch your nostrils shut. Instead of using your chest and diaphragm, use your tongue as a piston to push air upwards into the back of your throat and into the Eustachian tubes. Imagine making a "k" or "g" sound while keeping your glottis (the opening between your vocal cords) closed.
  • Considerations: This technique is more controlled and uses less air, making it ideal for repeated equalization during a descent. It requires practice to master.

• Toynbee Maneuver:

  • How to: Pinch your nostrils shut and swallow. The act of swallowing helps to open the Eustachian tubes, and the pinched nose creates a slight vacuum that can help draw air in.
  • Considerations: Effective for some, particularly for minor pressure changes or during ascent.

• Lowry Technique: A combination of Valsalva and Toynbee.

  • How to: Pinch your nostrils, close your mouth, and gently try to exhale while simultaneously swallowing.
  • Considerations: Can be effective if one technique alone is insufficient.

• Edmonds Technique: Combines jaw movement with Valsalva.

  • How to: Pinch your nostrils and gently exhale through your nose while simultaneously pushing your jaw forward and wiggling it from side to side.
  • Considerations: The jaw movement can help to open the Eustachian tubes.

• Passive Equalization:

  • How to: Simply swallowing, yawning, or wiggling your jaw can sometimes be enough to open the Eustachian tubes and equalize pressure, especially during ascent or very shallow descents.
  • Considerations: Not reliable for significant descents.

When and How Often to Equalize

Proactive Equalization: The most important principle is to equalize before you feel discomfort or pain. Equalize early and often, especially during descent. As you descend, the pressure increases rapidly, so you should equalize every few feet or even continuously if you're descending quickly.

During Descent:

• Start equalizing as soon as your head goes underwater.
• Equalize frequently, ideally every few feet of descent.
• If you feel any pressure or discomfort, stop your descent, ascend slightly until the pressure eases, then try to equalize again before continuing down.
• Never force equalization if you feel pain.

During Ascent:

• Typically, equalization during ascent is passive, as the expanding air in your middle ear naturally pushes the Eustachian tubes open.
• If you experience a "reverse block" (pain or pressure during ascent), slow down your ascent and try swallowing or wiggling your jaw to aid the release of pressure.

Tips for Effective Equalization

• Descend Feet First: When diving or freediving, descending feet first can make equalization easier, as it may help prevent blood from pooling in the head and swelling the Eustachian tubes.
• Stay Hydrated: Good hydration helps keep mucus thin and prevents Eustachian tubes from becoming sticky or blocked.
• Avoid Diving with Congestion: If you have a cold, allergies, or nasal congestion, your Eustachian tubes may be swollen and difficult to equalize. Diving with congestion significantly increases the risk of barotrauma. Consider using a decongestant nasal spray before diving, but be aware that their effects can wear off underwater.
• Practice on Land: You can practice equalization techniques on land to get a feel for them. This helps you identify which method works best for you.
• Use a Nose Clip or Mask: Most equalization techniques require pinching your nose. A nose clip or the skirt of a dive mask makes this easy.
• Relax: Tension can make equalization more difficult. Try to relax your jaw and neck muscles.
• Listen to Your Body: Never push through pain. If you cannot equalize, ascend slowly until the pressure subsides. Forcing equalization can cause serious injury.

When to Seek Medical Advice

While ear equalization is a normal physiological process, persistent issues or symptoms after diving warrant medical attention. Consult a doctor, especially an Ear, Nose, and Throat (ENT) specialist, if you experience:

• Persistent ear pain or pressure after diving.
• Muffled hearing or hearing loss.
• Tinnitus (ringing in the ears).
• Dizziness or vertigo.
• Fluid discharge or bleeding from the ear.

Proper equalization is a fundamental skill for anyone engaging in aquatic activities that involve changes in depth. Mastering it ensures a safe, comfortable, and enjoyable experience in the water.