Equalising your ears

You do not need to go deep for your ears to notice. Even at the bottom of an ordinary pool, water pressure pushes on your eardrums. Equalising lets air into the space behind them, so the pressure on both sides matches.

Done early and gently, it stops the ache before it starts. Ignored or forced, it can injure your ear. This guide explains what is happening and how to look after your ears.

What is inside your ear

Divers Alert Network (DAN) describes the ear in three parts:

• The outer ear: the part you can see, and the canal that leads to the eardrum.
• The middle ear: a small air-filled space behind the eardrum, holding three tiny bones that carry sound.
• The inner ear: the parts that handle hearing and balance.

The middle ear connects to the back of your nose and throat through a narrow passage called the Eustachian tube. Usually it stays closed. It opens briefly when you swallow or yawn, letting air in or out. You have felt it working whenever your ears "pop" on a plane.

Why your ears hurt underwater

Water is heavy. DAN explains that pressure rises steadily as you go down. In a 3 m pool, the pressure on your body is already almost a third higher than at the surface.

The air in your middle ear is trapped behind the eardrum. As the pressure outside rises, that air is squeezed into a smaller space, and the eardrum bows inwards. That is the feeling of fullness, and then pain.

Equalising pushes a little air up the Eustachian tubes into the middle ear. The air pressure inside rises to match the water outside, and the eardrum relaxes.

Why the first metre or two matter most

The change in pressure is biggest, compared with what you started with, near the surface. That means your ears need attention from the very start of a dive, not just when you are near the bottom. DAN's ear guidance asks divers to equalise every few feet over the first few metres of a descent.

How it feels

1. Fullness, like your ears are blocked or muffled.
2. Pressure, a growing push on the eardrum.
3. Pain, which means you have gone too far without equalising.

The aim is to equalise at the first hint of fullness, or before it.

Ways to equalise

DAN describes several methods. All of them do the same job: they open the bottom ends of the Eustachian tubes so air can get in. People differ, and the one that works best for you may not be the one that works for a friend.

The Valsalva is the one most people learn first. DAN cautions that it should always be gentle: do not blow hard, and do not hold the pressure for more than about five seconds. Blowing hard against a blocked nose can damage the delicate inner ear.

Aliyah will show you which suits you. Practising on land first, such as in front of a mirror, helps.

Tips from Divers Alert Network

DAN's ten tips for easy equalising, shared on the PADI blog, include:

• Check your ears on land. Swallow before you get in and listen for a click or pop in both ears.
• Start early. Equalising gently every few minutes in the hours before a dive may help.
• Equalise at the surface, gently, if it helps you.
• Go down feet first. DAN cites studies showing the Valsalva needs about 50% more force when you are head-down.
• Look up. Tilting your head back tends to open the tubes.
• Equalise often. Stay ahead of the pressure instead of catching up with it.
• Avoid smoking and alcohol, which irritate the lining of your nose and throat.
• Keep your mask clear. Water up the nose irritates it and makes more mucus.

Chewing gum between dives may also help some people.

When to stop

If it hurts, stop. Pain is a signal, not a challenge. DAN advises rising a little until the pain eases, then trying again gently.

• Do not push through pain. A pressure difference can lock the tubes shut, and forcing them only causes injury.
• Do not bob up and down trying to make it work.
• Tilting the blocked ear upwards can sometimes help.
• If you still cannot equalise, end the dive. Try again another day.

Signs to take seriously

DAN advises ending the dive at once for any of these:

• Dizziness or a spinning feeling during or after a dive
• Sudden loss of hearing
• Pain that does not go away

If symptoms carry on after you get out, do not dive again, and see a doctor. MedlinePlus, the US National Library of Medicine's health site, also advises medical help for severe ear pain, bleeding or fluid from the ear, fever, or pain that lasts more than a few hours.

What makes equalising harder

According to DAN, these all make it harder for air to pass:

• Colds, flu and chest or sinus infections
• Hay fever and other allergies
• Smoking
• A crooked septum, the wall inside the nose

MedlinePlus warns that diving with a blocked nose can make an ear injury worse. If you have a cold or a blocked nose, the safest choice is to skip breath-holds and diving until it clears.

A note on decongestants

Some divers use decongestant tablets or sprays. DAN cautions that they have side effects, and that repeated use of sprays can make congestion worse, and can even block the ears on the way back up. Do not try them for the first time before a swim. Speak to your doctor first. See Health checks before you start.

Common mistakes

• Waiting until it hurts. By then the tubes may already be squeezed shut.
• Blowing hard. Gentle and often beats one big push.
• Diving head-first when your ears are slow. Feet first is easier.
• Swimming with a cold. Your ears will tell you why that was a bad idea.
• Carrying on after pain or dizziness. Stop, and try another day.

Myths

"It's only a pool, so my ears don't matter." Pool depths are enough to hurt your ears and, if you force things, to injure them.

"Some people just can't equalise." Most people can learn with patience and the right method. If you truly cannot, see a doctor before you try again.

"A pop means I did it hard enough." A soft click is the goal. You should never need force.

In our lessons

Aliyah talks you through equalising before you go down, and watches for signs that your ears are struggling. You decide how far down you go, and you can come up at any time. If your ears are not happy on the day, we stay shallower. There is never pressure, of either kind, to go deeper.