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Ear equalization myths (from scuba)

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donmoore

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I have done a lot of studying of ear mechanics and equalization the last few months, and this study has lead me to the belief that there are a couple of ear equalization myths in freediving. I welcome your disagreement, agreements, and thoughts.

First off, let me preface this with the argument that there are major physical differences between equalizing ears when freediving and scuba. I believe non-realization of these differences is the reason for the myths.

First myth: “To equalize ears all we need to do is open the Eustachian tubes. In fact we would all be better off if our Eustachian tubes stayed open all the time.” The last sentence above is almost word for word from a freediving hunting legend.

In reality the Eustachian tubes are designed to function as a valve between the middle ear and the pharynx. It would be undesirable to have them open all the time and it would actually be counter productive in freediving. As a valve they are to be open at times and closed at others.

The Eustachian tube has 3 functions: ventilation, protection, & drainage. First lets take protection. The closure of the tube is the protection feature. It protects the inter ear from reflux of nasopharyngeal secretions and bacterial flora. In otherwords things that cause middle ear infection. So if the Eustachian tube did not close, a person would suffer more ear infections than normal.

The second, and what us divers think about the most, is ventilation. Ventilation is allowing air to flow to or from the middle ear so that pressure can match ambient pressure on the other side of the eardrum. Okay, before you write me off for saying dum ass stuff you learned 20 years ago, go a little further with me.

What the difference between the pressure in the lungs & pharynx and the outer side of the eardrum, first for a scuba diver and then a freediver? Well a scuba diver is breathing from an ambient adjusting air device, a regulator. Therefore there is little difference in the pressure and thus if the Eustachian tubes stayed open all the time equalization would occur by itself.

In freediving there is a difference between the pressure in the lungs & pharynx and the outer side of the eardrum (assuming your not at the surface). The volume of air in the lungs does decrease some due to ambient water pressure, which would help to equalize it some, but I believe the volume in the middle air is mostly unaffected by ambient water pressure due to the fact it is protected by bone and cartridge. Therefore voluntary Eustachian tube opening equalization techniques may work a little in freediving, but they are not nearly as effective as in scuba.

It is the adding of air pressure to the middle ear to equalize the pressure to the ambient pressure on the outside of the eardrum, that causes equalization. The only way to do this in freediving is to increase the pressure by the exhaling in the Valsalva maneuver or by the tongue in the Frenzel technique. If the Eustachian tubes did not close after the equalization technique, then we would have to keep the pressure up from the lungs or tongue the whole time we were at depth. The fact that they close is what allows us to relax and enjoy ourselves for a while at a particular depth.

On a side note the reason we generally do not have equalization problems during ascent is that Eustachian tubes usually open by themselves with pressure from the middle ear. As air pressure builds in the middle air it bleeds off through the Eustachian tubes into the pharynx. It is the pharynx end of the tube that closes, so the air pushing from middle ear opens up the tube much easier than pressure from the pharyngeal.

The other related myth is Middle-Ear Barotrauma, aka Reverse Squeeze, in freediving due to blockage on in the outer ear. They say a tight fitting hood my cause this. Well tell me all you European, Canadian, and other cold water divers who dive with hoods, have you ever had this during freediving?

In scuba with air pressure in the pharynx being so much greater, this can be a problem. The middle air is an enclosed air filled cavity, therefore in freediving, if there was an enclosed air filled cavity on the outside of the eardrum, the pressure on both sides of the drum would be closer to each other and it would not suck the eardrum out. In scuba an opening of the Eustachian tubes with air pressure much higher from the pharynx than an enclosed air filled cavity on the outer eardrum side, would create an outward bending of the eardrum.

So how does these truths help in freediving. Well first, a clearer mental realization of what we are doing should help our technique. Our goal is not just to open up the Eustachian tubes, but through the use of muscles, push air into the middle ear and increase its pressure to the ambient pressure on the outside of the eardrum.

Second, this is the one that will probably cause the most constructive controversy! Outer ear blockage, aka air filled cavity on the outer eardrum side, is beneficial to freediving. Forget all that you have read about this in the past, it only applies to scuba. As long as you don’t block the ear with something that could be pushed into the eardrum itself from water pressure, than the more blockage, the more the pressure will equal the middle ear and less equalization you will have to do.

Remember I said these are my opinions and you are free to argue. Sharing my theory or prediction wouldn’t be fun if I didn’t go out on a limb a little! Speaking of prediction, I predict that within 10 years many freedivers will be using rigid sealing ear cups to create an air filled cavity on the outside of their ears.
Merry Christmas,
Don
 
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efattah

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Mar 2, 2001
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Ear Squeeze

A common problem in freediving is 'suit squeeze', where the hood of a stretchy wetsuit 'seals' around the outer ear, trapping air in the outer ear.

If you have suit squeeze, you are at first delighted to find that you don't have to equalize the ears as much as usual. However, as you descend deeper, the suit gets 'sucked' deeper into the out ear until it cannot get sucked any more. Then, the pressure on the outer ear drops below ambient. It continues to drop, until blood vessels in the outer ear explode to equalize the pressure in the outer ear. At that moment, the blood does equalize the pressure in the outer ear, causing a rapid increase in the pressure in the outer ear, and the rapid increase in pressure in the outer ear pushes the eardrum inward, causing ear pain, and this rapid pressure increase can blow your eardrum if you don't equalize fast and hard.

I had this happen to me two times. You have to dive deep for a full blood vessel rupture to occur in the out ear (while you have suit squeeze). It happened once on a 67m dive and again on a 75m dive a year later. Each time, the sudden bursting of blood vessels in my outer ear caused an instantaneous huge pain on my ear drum, but both times I was lucky, and my eardrum didn't break. I had to stop the descent, however.

Upon surfacing, I felt fine, but after taking my hood off, blood was pouring out of my outer ear, and once this led to a bad outer ear infection.

Normally, divers punch holes in their hood near their ears to allow the pressure to equalize. I also use short straws leading to my face, especially when I have two suits on (5mm and 3mm), in which case suit squeeze is terrible.


Eric Fattah
BC, Canada
 
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efattah

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Mar 2, 2001
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Nice quote

This topic reminds me of some accurate words Yasemin Dalkilic once said:

"If you have never had a problem down there, then you haven't dived deep enough times."
- Yasemin



Eric Fattah
BC, Canada
 

donmoore

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Eric,
Actually I had wondering what would happen when there was a large pressure difference creating a suction similar to mask squeeze. I had also wondered about a possible eardrum rupture due to a sudden increase to ambient pressure, but I never envisioned it due to blood vessel rupture in the outer ear. That must of looked terrible when you surfaced! Did you know the sudden increase in pressure was due to a blood vessel rupture at the time it happened? Thank God you were able to equal quickly.

Like you said, “You have to dive deep”. My freediving interest is mainly hunting. 67 and 75 meters is way deeper than I ever plan on going. At what depth do you feel it would be save to go to with suit squeeze?
Don
 

efattah

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Mar 2, 2001
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Suit Squeeze

The first time I suffered outer ear blood vessel rupture, I knew something 'weird' happened when I was down there, but I didn't know until I took my hood off. Even then, I didn't know until my friends told me blood was rushing out of my ear. The 2nd time, I realized as I was sinking towards the light at 80m that my left ear felt funny. Around 70m I realized I had suit squeeze. I considered opening my hood, but it was too late, and 'boom' suddenly my outer ear 'equalized itself' with blood. Then, on the ascent, I knew that there would be blood pouring out of my ear.

You could probably use suit squeeze down to about 20 metres without outer ear risks, but still, there is a danger, because if you move your head the wrong way, you could break the seal around your outer ear, causing water to rush in and suddenly increase the pressure, which could cause a drum rupture.

If you watch the videos of Loic Leferme's no-limits records, you'll see him open his hood around 20m to equalize the outer ear. Suit squeeze down to 160m+ probably isn't a good idea, as he no doubt found out the hard way.


Eric Fattah
BC, Canada
 

Guss

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Sep 10, 2002
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Take care also at swallow waters

Eric,

I suffered an outer ear blood vessel ruptura because 'suit squeeze' in my left ear last summer while spearfishing at 12 m, and I’m not 100% sure but I think the rupture was moments after I started my ascent, at around 10 m. So everybody must take care of it also at swallow waters not only during deep dives as it happened with you Eric.

My ear was bleeding for 3 days. Happy enough there was no eardrum rupture only a very big dilatation of the drum. It took me 2 months to get my left ear completely recovered.

After this experience I did a small hole in my hood near the ears to allow the pressure to equalize but with the cold of the winter I suffered one otitis externa. So it was necessary to seal these holes. What I’m doing now and for the moment it’s working (at least waters from 0 to 30 m) is, after wearing my hood I introduce my hand on it to turn down the auricle of my ear (the pinna) covering the entrance of the ear canal. That protects my ear from this kind of problem not letting the neoprene of my hood squeezing the outer ear. As I told before this is working at swallow and medium waters, but in spring I want to go to 40 – 45 m. so If some of you have tried this method at deep waters and have had problems I would be very pleased to hear your advices.

Thanks in advance

Agustín Espinosa
 

donmoore

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Gus, I guess you are saying that the blood vessel rupture happened outside of the ear canal? Folding down the auricle is interesting. What you are apparently doing is trapping air inside of the external ear canal instead of the whole outer ear. The low pressure from reverse squeeze should still happen, but not on the outside of the external ear canal. So I guess the real question here is the external ear canal less subjectible to blood vessel rupture?

Here is an image that might help us view what we are talking about, if it turns out well enough.
Don
 

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donmoore

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Looks like I may have opened up some good discussion on outer ear blood vessel rupture, but I don’t think we should totally lose track of the main point post. It’s my fault though for stating too many points in the same post. Now granted Eric and Guss have probably killed my prediction about freedivers wearing rigid sealing ear cups, because I didn’t envision outer ear blood vessel rupture.

Middle-Ear Barotrauma, (aka Reverse Squeeze) is defined as an outward bulge of the eardrum. That’s why it’s called Middle-Ear Barotrauma. My theory was that this is not a problem in freediving because the breathing cavities of the diver are not at a high enough pressure to cause it. Outer ear blood vessel rupture actually supports this argument. The problem freedivers are having from reverse squeeze is blood vessel rupture in the outer ear, not the ear drum flexing outward. Once the blood vessel ruptures as Eric stated it filled the outer ear creating ambient pressure and with the low pressure in the middle ear, almost burst the drum by flexing it inward (not outward), until he was able to add air to middle ear by equalizing.

What is amazing to me is the complexity of Eustachian tube function and how much stuff has been written that really didn’t recognize it. The Eustachian tube is actually a combination of a one-way valve, and automatic regulating release valve. It’s a one-way valve in that you are able to add air through it on descent to increase the pressure in the middle ear and then it closes to hold the air pressure in. It’s an automatic regulating release valve in that it allows just the right amount of air to escape to equalize the middle ear to the ambient pressure on the outside of the ear drum. Now that’s quite a feat since the ambient pressure is constantly changing with depth.

In freediving this function ability is crucial, because the breathing cavities (pharynx, lungs, etc.) are at a lower then ambient pressure. Apparently the release is set for slightly higher pressure than ambient. When we equalize and stop, the middle ear pressure is just slightly higher than ambient so that there is a slight outward bulge in the eardrum. This is just enough for us to continue to descend a little further before we have to equalize again, but not enough that it is uncomfortable. This is also what is called over pressuring the ears at the surface. The ear can only be slightly over pressured unless we continue to pressure them through breathing cavity contraction.

Now imagine what it would be like if the E. tubes that stayed open all the time while freediving. Not only would it require constant air pressure from constant muscle contractions of the tongue or lungs (that would waste valuable energy), but it would be almost impossible to regulate it to the constantly changing ambient pressure. So one truth from this is that proper closure of the E. tubes is a crucial in freediving as them opening at the right time.

How this can be applied is to do short quick equalizations and then let the E. tubes do their thing. The military, where the Frenzel technique became popular, recommends that equalization should last no longer than 1½ seconds.
Don
 

Guss

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No Don, the blood vessel rupture happened to me inside the ear canal, the skin of the wall of my canal just broke, close to the drum. The neoprene is very flexible and because of the pressure it can adjust perfectly the surface of the outer ear and seal it. The auricle is not so flexible than the neoprene and his surface is more irregular so when Folding it down, the neoprene of the hood can not touch directly entrance of the ear canal and seal it.

What I´m afraid is, if I go deeper than 30 m and because of the pressure, can my folded auricle became as flexible as the neoprene is and having the same problem? If somebody has tried this before or have another solution I would be very pleased to receive some information.

Agustín Espinosa.
 

donmoore

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After further study and thinking, I’m correcting myself. Middle-ear barotrauma is not defined by the flexing of the eardrum. It is actually the damage done to the middle ear by negative pressure. Blood and mucus is sucked from surrounding tissues and begins to fill the middle ear. It just happens that in most cases it happens with painful flexing and sometimes tearing of the eardrum.

Therefore, an air cavity on the outside of eardrum in freediving, might help equalize the pressures (it would be negative on the outside drum and the middle ear), but damage to the middle ear would still occur at some point in depth and time. The only way to safely freedive at any significant depth is to have ambient pressure on the outside and fill the middle ear to the same pressure.

Agustín, Here is an idea. Fill the outer ear with warm water and then let the neoprene hold it in. Water is non-compressible so the water pressure on the outside should transmit through the neoprene and into the ear. The neoprene and body temperature should keep it warm. Just an idea.
Don
 

SpearSlinger1

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Not sure what you call it. But I learned a long time ago to just yawn keeping my mouth closed.

Works great for me and keeps my hands free.
 

haughki

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SEDATE

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What is the limit in meters to force the ears i mean sometimes i fell myself as half deaf if i go over +5m down i planed when i return home it happens?
 

DeepThought

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Sep 8, 2002
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SEDATE said:
What is the limit in meters to force the ears i mean sometimes i fell myself as half deaf if i go over +5m down i planed when i return home it happens?
If you ask me? 0 meters. I stop descending the instance I feel I missed an equalization, I don't even wait for a pressure signal from the ears. Why forcing it and risk an eardrum or unknown speculative cumulative hearing damage from overstretching it when I can just enjoy the depth I am at or go up and dive a billion other dives?
 

tylerz

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Jun 19, 2002
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It changes with depth. You would have to determine what change in pressure from the surface causes you to reach too much and then adjust it for your depth.
 

SEDATE

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Feb 6, 2005
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DeepThought said:
If you ask me? 0 meters. I stop descending the instance I feel I missed an equalization, I don't even wait for a pressure signal from the ears. Why forcing it and risk an eardrum or unknown speculative cumulative hearing damage from overstretching it when I can just enjoy the depth I am at or go up and dive a billion other dives?

Michael
Not talking about equlize..
To force i mean the ears itself and increase adaptation the ears to deep all parts of ears from outside getting presure ..if you force your limit you feel as a deaf for 2-3 days..later on you fell ok ..you start hearing very well..
 

harbour seal

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Aug 23, 2006
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Re: Ear Squeeze

efattah said:
Normally, divers punch holes in their hood near their ears to allow the pressure to equalize. I also use short straws leading to my face, especially when I have two suits on (5mm and 3mm), in which case suit squeeze is terrible.


Eric Fattah
BC, Canada

been working my way through the archives---great thread.

i experienced difficulties equalizing while wearing a hood.

my question:
what kind of straws do you use / where do you get them?

i imagine they need to be rigid and small diameter.

cheers,
sean
 

jome

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Jul 5, 2004
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That seems to work (holes). Another and IMO better solution is to put a shoelace or similar piece of string under your hood so that it runs over your ear and out of the hood.

Water the oozes slowly through the string, filling the ear, but it is first warmed by the head, so there is no shocking blast of cold water in the ear, like at least I experience with the holes.

If you do go with the holes, try to make them slighlty off, not directly above the ear canal...For the same reason.

Of course, the cold shock only hits you once...But it's nasty if it happens in the middle of a deep dive
 
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