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- I cannot equalize my ears and feel pain
What is happening
You feel pressure or pain in one or both ears early in the descent and cannot descend calmly with the group. A reverse block may occur during ascent, while vertigo, hearing loss or tinnitus are separate warning signs.
Why it happens
Ordered from the most common cause down. Open one to see the mechanism behind it.
At the start of descent, gas volume in the middle ear shrinks quickly. If you wait for pain, the Eustachian tubes may already be blocked and equalization becomes harder.
- descending too quickly
- equalizing only once it hurts
- not equalizing before descent
Congestion, allergies or an upper respiratory infection can make it harder for air to pass to the middle ear. This makes familiar techniques less effective.
- a cold or congestion
- allergies
- frequent difficulty out of the water
With a blocked passage, prolonged forceful straining does not reliably open the ear and carries a risk of injury. The technique should be gentle and early, not forceful.
- blowing too hard
- prolonged straining
- repeating it despite pain
Your descent position can make equalization more difficult. DAN recommends descending feet first as part of the procedure.
- descending head first
- a rapid free descent
- no stable position
Different techniques work differently for different divers. If one does not work easily, dry practice and training with an instructor are more appropriate than forcing it underwater.
- Valsalva
- Frenzel
- Toynbee
What to try on your next dive
One thing, not ten. Give it a full dive before you judge it.
Early equalization on descent
- Agree with your buddy that you will descend slowly and feet first.
- Equalize before starting the descent.
- Continue to equalize early and often, before you feel pressure.
- At the first sign of pain, stop, ascend slightly and try again only without force.
- Practise your chosen technique on land, without force or pain.
- If you have frequent trouble, discuss it with an instructor or a physician knowledgeable in diving medicine.
How you will know it is working
| Published reference | Value | Source |
|---|---|---|
| Recommended interval | every 2 ft of descent | DAN — 6 Methods to Equalize Your Ears |
| Maximum Valsalva duration | no more than 5 seconds and without forceful blowing | DAN — 6 Methods to Equalize Your Ears |
After the dive, note whether you equalized before pressure developed, your position, and whether pain, a stop or a slight ascent was needed.
- Never force equalization. Do not blow hard or maintain pressure longer than the published limit.
- If you feel pain, stop and ascend slightly. If you cannot equalize, end the dive.
- If you suspect an inner-ear injury, or experience vertigo, hearing loss or tinnitus, end the dive and seek an ENT specialist. During a reverse block, ascend only as slowly as your gas supply allows.