Beat the Squeeze: The Ultimate Ear Equalization Guide for Scuba Divers

When you dive, the surrounding pressure increases rapidly with depth. Your middle ear — an air-filled cavity behind the eardrum — is connected to the outside world through the Eustachian tube. As you descend, the pressure outside rises and compresses the air inside your middle ear.

If you don’t equalize (add air) to match the pressure, the eardrum is forced inward — causing pain, discomfort, or even a middle ear barotrauma.
On ascent, the reverse can happen: trapped air expands and pushes outward, potentially leading to a reverse squeeze or ascent barotrauma.

According to DAN (Divers Alert Network), ear barotrauma is among the most common pressure-related injuries in diving. Learning how to equalize properly isn’t optional — it’s a fundamental safety skill for every diver.

In this post, we’ll break down how ear pressure works, the most effective equalization techniques, pre- and post-dive precautions, and what to do when equalizing becomes difficult.

 

How Ear Pressure Gets “Out of Balance”

The Physics: Pressure and Air Volume

Boyle’s Law states that at a constant temperature, the volume of a gas decreases as its pressure increases. As you descend, water pressure compresses the air in your middle ear. To balance the difference, you need to open the Eustachian tube to allow air to flow through.

During ascent, the opposite occurs — air expands and must escape to prevent over-pressure inside the ear.

The Role of the Eustachian Tube

The Eustachian tube connects the middle ear to the back of your throat and normally stays closed to block bacteria and debris. It opens briefly when you swallow, yawn, or move your jaw, allowing pressure to equalize — that little “pop” you sometimes hear.

However, during diving, pressure changes quickly. If you delay equalizing, the soft tissues around the tube can compress, making it hard — or even impossible — to open. Forcing air too strongly can cause it to lock shut or result in tissue damage.

When pressure imbalance becomes severe, it can result in bleeding, eardrum rupture, or inner ear injury — all of which can ruin a dive and require medical care.

 

6 Common Ear Equalization Techniques

DAN lists six proven ways to equalize. Each opens the Eustachian tube in a slightly different manner. Practice them on land before diving.

1. Valsalva Maneuver
   Pinch your nose, close your mouth, and gently blow air toward your nose. Done lightly, it’s effective; done forcefully, it can cause injury.
   
   
2. Toynbee Maneuver
   Pinch your nose and swallow at the same time. It uses throat muscles to open the Eustachian tube naturally — gentle and low risk.
   
   
3. Lowry Technique
   Combines the first two — blowing and swallowing simultaneously. It enhances airflow but requires coordination.
   
   
4. Edmonds Technique
   Pinch your nose, blow gently, and jut your jaw forward to help open the tube. Useful when equalizing gets tough.
   
   
5. Frenzel Maneuver
   A favorite among freedivers: with your nose pinched and glottis closed, use your tongue and throat muscles to push air upward (think of saying “K”). It’s gentle, precise, and safe.
   
   
6. Voluntary Tubal Opening
   Through practice, you can learn to open the Eustachian tubes at will — similar to “pretending to yawn.” Once mastered, it allows continuous equalization during descent.
   
   

Pro tip: Beginners should start with Valsalva and Toynbee, then progress to more advanced methods like Frenzel or voluntary opening for better control.

Above all, remember:

Equalize early, equalize often, and equalize gently.
Never wait until your ears hurt.

 

Pre-Dive Preparation and Safety Tips

Practice Before You Dive

• Gently practice equalization on land (Valsalva, swallowing, or yawning).
• Chew gum or suck on lozenges to stimulate swallowing.
• Avoid diving if you have nasal congestion, allergies, or a cold — these swell the Eustachian tube lining and block airflow.

Proper Descent and Body Position

• Descend slowly and keep your head slightly higher than your feet.
• Use a descent line to control speed.
• The first 10 feet (3 meters) are the most critical — equalize every 2–3 feet.
• If you feel any discomfort, stop, ascend slightly, and try again. Never push through pain.

Decongestants — Use with Caution

Some divers use nasal sprays or oral decongestants before diving. While they can help, they also wear off underwater and can cause rebound congestion, increasing the risk of a reverse block. Always consult a doctor first.

 

During the Dive: Key Equalization Habits

• Equalize before you feel pressure. Start even before descending.
• Stay proactive — equalize at the first hint of resistance.
• Be gentle. Over-pressurizing can injure the eardrum or inner ear.
• While ascending, air usually vents automatically, but if you feel fullness or dizziness, ascend more slowly or stop to re-equalize.

Extra tips:

• Combine swallowing, jaw movement, and neck extension to assist equalization.
• Sync equalization with your breathing rhythm.
• Practice micro-adjustments with subtle movements of the tongue or throat.
• Build “muscle memory” by practicing while driving downhill, on airplanes, or even in the shower.

Post-Dive Ear Care

Proper ear care after diving prevents infections and chronic irritation.

• Rinse ears with clean, fresh water.
• To remove residual moisture, you can use a 1:1 mix of white vinegar and rubbing alcohol (70%) — unless you suspect a perforated eardrum or have pain or discharge.
• Keep your ears dry and avoid polluted or dusty environments right after diving.
• If you experience pain, hearing loss, ringing, or dizziness, stop diving and seek medical evaluation.

Regularly exercise your Eustachian tubes by swallowing, yawning, or gentle jaw movements to maintain flexibility.

 

When Equalization Becomes Difficult

Even experienced divers occasionally struggle to equalize. Here’s what to do:

• Stop immediately if you feel pain or pressure.
• Ascend slightly until the discomfort eases, then try again slowly.
• Switch methods — sometimes Toynbee or Frenzel works better than Valsalva.
• Descend more slowly and take breaks to let your ears adjust.
• Avoid diving with congestion or cold symptoms.
• If problems persist or you notice bleeding, vertigo, or hearing changes, see an ENT specialist or dive medicine doctor.

 

Final Thoughts

Ear equalization may sound simple, but mastering it can make or break your dive experience.
To recap:

• Balance early, frequently, and gently.
• Learn multiple techniques and find what works best for you.
• Prepare before diving, practice regularly, and never force it.
• If something feels wrong, stop diving and get checked.

Your ears are delicate, and protecting them ensures you’ll keep enjoying the underwater world for years to come.