How to prevent ear injury when scuba diving

The ear is a vital organ that is responsible for your sense of hearing and balance. Have you ever dived headfirst down and suddenly developed a stabbing pain in your ears which forces you back to the surface? This kind of pain is associated with the increasing pressure on your eardrums as you dive which compresses the surface pressure air in your middle ear.

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Equalizing methods

The remedy for this pain is to equalize the pressure on both ears by opening the Eustachian tubes, which run from the back of your throat to the middle ear. The most common way of doing this is through the “Valsalva Maneuver” which involves pinching your nostrils and blowing gently through your nose. The overpressure in your throat will force the air through the Eustachian tubes.

Another method, known as the “Edmonds Technique” requires you to perform a Valsalva Maneuver while pushing your jaw forward and down.

You can also try the “Lowry Technique” wherein you need to pinch your nostrils close, blow, and swallow at the same time.

The “Voluntary Tubal Opening” method can be done by using the muscles of the soft palate and throat to push the jaw forward and down (mimicking a yawn).

Another way is by gently pinching your nostrils closed and swallowing which is referred to as the “Toynbee Maneuver”.

Last but not the least, you can give the “Frenzel Maneuver” a go by gently pinching your nostrils and making the sound of the letter “K”, causing the back of your tongue to compress air against the passageway of the Eustachian tubes.

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Equalizing tips

The ability to equalize pressure in the middle ear is introduced during the Basic Scuba Diving Course so that you could continue to practice and fine-tune the skill as you go along the other diving courses. Here are some easy techniques to open the airspace in the middle ear.

Equalize beforehand –  Start a good habit by equalizing your ears several hours before the dive or before stepping onboard the boat. Begin by gently equalizing your ears every few minutes to help reduce the chances of experiencing a block on your Eustachian tubes.  Wait for the “pop” or “click” sound to indicate that both Eustachian tubes are open. You can repeat the process just before submerging your head below the water and again when you’re barely below the water surface.

Equalize at the surface – If you’re new to diving or often have a difficult time equalizing, you can gently practice the technique even when you’re not in the water until you get the hang of it. This pre-pressurizing method at the surface can make your Eustachian tubes slightly wider but perform this only if it is helpful to you. During the actual dive, do it with every breath during your first 30 feet, without waiting to feel the pressure build-up.

Plunge feet first – Air moves up more readily to your Eustachian tubes when you descend feet first and fluid-like mucus has the tendency to drain downward.

Use a descent line – It is easier to control your descent rate when you pull yourself down using an anchor or mooring line. This way, you can avoid accelerating too fast and you can easily stop if you feel the pressure building up.

Stop when you feel pain – The rule of thumb is to stop diving when you experience throbbing pain in your ear because your Eustachian tubes are probably clogged by the pressure differential.  Pushing through the pain may only lead to ear barotrauma, an injury caused by pressure changes. When you experience discomfort or pain, it’s advisable to go back a few feet up and try equalizing again.

Avoid tobacco and alcohol – Avoid smoking tobacco and drinking alcohol which can both irritate your mucus membranes and promote the production of more mucus that might block your Eustachian tubes.

Practice makes perfect!

If you’re the type who often have problems equalizing, it might help if you practice several of the techniques mentioned above. Learning the different methods can help you determine which works best for you. Once you master a technique and feel confident about it then you can say goodbye to the ear pain the next time you go diving.

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