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Inverted Equalization success

Thread Status: Hello , There was no answer in this thread for more than 60 days.
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New Member
Aug 19, 2002
I just thought I would give you an update on my status to equalize vertically. I thought I was doing the Frenzel Techigue, but just to make sure I put some water in my throat, held it there with the epiglottis and attempted to equalize. No problem. In fact, when inverted and attempting to equalize, I have been able to generate so much air pressure that I have blown my fingers of my nose several times and still not had my Eustachian tubes open. In an attempt to keep this from happening I have squeezed my nose until it was quiet painful, but still with no or limited ability to equalize vertically.

This lead me to the belief that there was more to overcoming my problem than pressure. It had to be something that was preventing the opening of the Eustachian tube in the Pharynx. Tissue apparently was blocking the entrance when vertical and air pressure alone was pushing the tissue against the opening making it even more difficult to open.

I searched my wife’s Human A&P book and the internet to find out more. Two main things came to view. One is physical problems with the opening of the Eustachian tubes. Tissue from the tube that sticks out into the pharynx is called torus tubarius. It sits besides the pharyngeal tonsil, which is called adenoids when they are swollen. A view of the Eustachian tube entrance into the Pharynx when adenoids are present can look like two lips pressed together. This can definitely cause Eustachian tube opening problems.

The second thing I discovered is there are two main muscles responsible for the opening of the Eustachian tubes. Let me first say, that it is the Pharynx end of the E-tubes that close and open, so when there are problems it is almost always at this end. These muscles are the Palatal Muscles group. Individually they are the Tensor veli palatini (TVP) and the Levelator veli palatini (LVP). Both muscles are activated from swallowing and jaw movements.

Unfortunately I could not find a good picture from the web I was able to post, but if you are interested go to http://www.brianpalmerdds.com/Otitis_media.pdf , page 8. This is the best picture I have found, but since it’s a pdf file, it can’t be put into this post. The picture is actually from a dissection, not a drawing.

The TVP muscle actually does almost a horseshoe around the E-tube. When it contracts its pull twists the E-tube from its closed position to an open position. The LVP muscle pulls up from the bottom of slit of the closed E-tube and helps open it that way. The picture at the above link is a cross dissection. What it doesn’t show is the depth of the TVP muscle. It is actually a ribbon shaped muscle with the wide part extending over the 1/3 Pharynx end of the E-tube. So it can help open the whole portion of the E-tube that is normally closed.

Now the medical lecture says these muscles are activated from swallowing and jaw movements. In reality, it’s not that exact, that’s just the best they can describe it. What I needed to do was to learn how to isolate these muscles. To do that I reason that since the TVP muscle surrounded the E-tube it was going to move when the E-tube opened and maybe I could learn the feel of that enough to isolate and activate it independent of air pressure. This belief came from another theory that in order to have success when inverted, I was going to open the E-tubes before I applied air pressure to them.

I started with the basic Frenzel in the upright position, which was easy for me, and then concentrated on the feeling around the Pharynx, ears, and upper jaw when the pop came. I experimented with swallowing and jaw movements at the same time. Then I tried to duplicate the same feeling without air pressure. It worked. So then I concentrated on getting the pop and then immediately adding air pressure.

Then I went to the inversion machine and start in a horizontal position. As I was able to do it I gradually lowered myself to vertical. For the first time in my life I was able to do it, but not for long. I would lose the feeling and or the timing and have to come up to at least a horizontal position again to get it back. I wanted to get the technique down, so I did it at least once a day, while it was still fresh. It became easier, but I found that after about 20 seconds in the complete vertical position, I was no longer able to do it. Mean while in the pool I developed a quick head up, equalize, then back down technique for when I lost the ability to do it completely vertical. This made s-curves in my descents and was not ideal, but it was livable.

I have trouble breathing through my nose and constant nasal drip so I went to see an ear & throat specialist. He said my nasal conchae were too big and it looked like it was due to allergies. He referred me to another ear & throat specialist who was a surgeon and an allergenic doctor. That doctor said the same thing, my conchae are too big, one of them is curved the wrong way, and they are blocking my nasal cavity. I tried to get both doctors to look at my E-tube opening, but they both said that there was obviously such a large problem in my nose, they didn’t feel it would be worth even looking at the E-tube opening until the nose problem was addressed.

I’m now on three different kinds of allergy medicine. He wants to evaluate my conchae problem, when he is sure the allergies are not affecting it. If I’m able to breath properly through the nose after being on the medicine then he will look further into what I’m allergic too and deal with that. If not, then there are surgery options. One good thing about this is that he said the medicine may help me E-tube problem. He is right, I’m now able to equalize with the open first then pressure technique for as long as I can hold my breath when vertical. I have only been able to try it on my inversion machine and in a 15’ deep pool as of yet, but I am quite happy with the improvement so far. I’m sure its going to help in deeper ascends when I get the opportunity.

Sorry for the length of this, but some people ask that I report back because, they, or students of theirs, had similar vertical equalization problems. I think the technique of open first and then pressure is good for people with this problem and maybe beneficial to most freedivers. I’m sure the other techniques such as: valvalsa, Toynbee Maneuver. Lowry Technique, Edmonds Technique, VTO, etc. are all using the Palatal Muscles to open the E-Tubes, but for me it helped to understand the anatomy of the muscles and E-tube to better visualize what I was trying to do and to combine it with the order of open and then pressure. When I say open first then pressure, it is so quick its almost simultaneously, but it’s the fraction of second that makes the difference. The air pressure is critical, but it has to come after the muscles are fired, or for me, the pressure hinders the opening of the E-tubes.
I'm glad you're on the mend. It sounds like you and the doctors are getting to the bottom of this and the good thing is that it seems fixable.
I'm glad for you.
I haven't even been able to master the frenzel yet:waterwork
You have read Eric F’s bible document http://www.ericfattah.com/frenzel.doc on the Frenzel technique? If you’re still unsure, try this. Put some water in your throat like your going to gurgle, close your mouth, pinch your nose, touch the tip of your tongue on the roof of your mouth right behind your front teeth, try to make pressure by thrusting the back of your tongue up and back. If your nostrils flare and your ears pop you did the Frenzel!

Sometimes concentrating on making the nostril flare helps to get the feel.
Thanks for the tip. I'm ganna try it and see what happens.
I've read the document and it's really self explanitory but I just haven't been able to master it yet. I can do all the "peices" of the frenzel , it's just when it comes to putting it all together that I have trouble. But I think the tip you gave me is going to help.
Much obliged ,
Modified Frenzel Technique for tight ears:

Do the frenzel while simultaneously moving your jaw (yawn). This generates the huge power of the frenzel while simultaneously loosing the eustachian tubes. I'd have problems believing that anyone mastering this modification wouldn't be able to equalize at will.

Eric Fattah
BC, Canada
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Eric Fattah
BC, Canada [/B][/QUOTE]
I'd have problems believing that anyone mastering this modification wouldn't be able to equalize at will.

Eric, you want to be a little more specific? Are you saying that someone who can master that technique in the head up position should be able to do it in any position, anytime?
If you open your tubes by moving your jaw, and then do the frenzel (simultaneously), the technique is so efficient that I doubt that anyone in the world would not be able to equalize with this method, assuming that you equalize early enough. However, doing both those techniques at once takes some major practice. If you find that doing both at once is easy, you're probably not doing them properly.

Eric Fattah
BC, Canada
“I'd have problems believing that anyone” and “doubt that anyone in the world would not be able to” is a little too simplistic of a view for me. It’s a well know fact that some people have more difficulty equalizing head down then others, which was the point of the thread.

A quote from Dr. Edmond Kay, “It is well known that the head-down position during descent can make middle ear equalization more difficult. Less well understood is the reason for this effect. There are soft tissues in the nasopharynx which surround the membranous Eustachian Tube, and no doubt gravity plays a role in there normal functioning. The most likely candidate for positional obstruction is this soft tissue.”

All people have different nasal and ear physical characteristics, especial when it comes to soft tissue. That is why some people need surgery on tonsils, adenoids, turbinates, deviated septum, etc and some don’t. Eustachian tubes are soft and pliable. If there is no blockage in the head up position and there is in the head down, then it only stands to reason that a particular technique that works well in the head up position, may not work in the head down position for everyone. Not all problems can be overcome by technique.

Also the two main muscles responsible for opening the Eustachian tubes are the Tensor veli palatini and the Levelator veli palatine. Both muscles are more directly by activated by swallowing then jaw movements.

What you forget is that I myself am the finest example of middle ear problems. I have tight ears to put it lightly. The valsalva technique, for me, will never work head-down, and it will barely work head up, if I blow as hard as possible even 2 or 3 feet below the surface.

In order to equalize with the frenzel, I have to squeeze my nose incredibly hard, and push incredibly hard with my tongue. It is harder head down than head up. If I dive while sick, sometimes my ears are so tight that standard frenzel doesn't do it. Then, I have to move my jaw while simultaneously doing the frenzel.

In order to write the equalizing document, I first had to learn all I could about equalizing, do experiments, develop new techniques, test them, and then learn enough physiology to actually teach the technique in the document. If I had 'easy ears', then would I have gone through all that trouble? Maybe the reason I went through all that trouble is because I myself am an example of the worst-case scenario, or close to it.

In that sense, I feel more justified to generalize. I once witnessed a freediver write to the freediver-UK magazine, complaining about tight ears. She said that valsalva didn't work head-down for her. She was immediately told to have surgery (and she did). I nearly cried. What a waste.

Eric Fattah
BC, Canada
I hope not to piss anyone off, but I have finally come to the point where I can equalise hands-free! I have tried many times, and started to get a handle on it in Egypt last year when I had 3 weeks to dive at leisure.
I just spent 6 days diving an island near Bali, and got to the point where I could easily dive with no nose-plugging at all, at a rate of about.6 metres per second. Any faster and I have to plug my nose, so it's not good enough for competition (too slow), but it's perfect for recreational diving.
I suspect that the warm water has something to do with this: cold water is usually harder to equalise in (jaw tension due to temperature) even for heads-up scubadivers. So I will have to spend some time in cold water again to see if I can improve it there too......NOT!
Actually I do miss the colder waters to be honest....that's where I learned to dive, and I miss that sensation, but I'll stick to warm water for now :)
Erik Y.

Erik dont worry I wont take it out on you :D Cos one of my mates can do that and every time I watch him dive I feel like beating him up in my Jealousy :D

Now i really feel lucky that equalisation for me does not represent much of a problem (i can't do "hands off" in cold waters).

I didn't realise that people have so much truble with equalisation.
But i am glad that there are techniques that can help.

Eric & Zipy,

Is there a special technique to equalizing without having to hold your nose, or are you just gifted with some abnormal anatomy? If there is a special technique, can you share it with us?

I agree that having surgery before exhausting efforts of technique and examination of the cause is not wise. The forums of hearing sufferers are filled with people with Patulous Eustachian Tube (PET), which is the inability to close one’s Eustachian tubes. Many of these people develop the problem after adenoid removal or surgery directly designed to correct the problem of Eustachian tubes that did not open properly. So in other words, surgery over-fixed the problem.

I kindly disagree that because you have “tight ears” you can generalize what will work for everyone. It is true that most people with “tight ears” have even more difficulty equalizing in the head down than head up, but it is not true that all people with difficulty equalizing head down, have “tight ears” when their head is not down. This phenomena has been experienced or witnessed by many.

I eventually came to realization that my problem was not “tight ears” in general, but blockage due to gravity. Earlier I had taken the advice of opening my E-tubes at the surface and holding them open with air pressure on the descent. I practiced this daily on an inversion machine with only limited success and then developed PET. When at rest I could hear my breath in my ears. Sometimes to get my tubes to close and to stop the noise (which is most annoying at night), I would invert myself off the side of the bed. With study, I learned that holding the tubes open with air pressure (extended overpressuring), was not good health advice.

There are several reasons for Eustachian tubes not opening properly. All the medical literature says to look for the cause and then treat the cause. Can certain equalization techniques help people with different causes of tight ears? I am sure of it. Can one technique work for everyone? I don't think so.
I'm defensive only because I have seen so many local students come to me and say that they 'tried the document' and still can't equalize; the common phrase is simply, 'it just doesn't work for me; I'm special; I have a special problem with my ears; I'm different than the others' (I've heard it so many times it's annoying by now).

So, in their mind they tried all options, and surgery looms near. Yet, I sit down with them for a few minutes, only to find that they didn't understand the techniques at all, and !voila!, no surgery needed.

So far I've yet to meet anyone whose equalizing problems I couldn't fix (except for one gentleman who refused to spend any time to learn any techniques).

In one particularly difficult case, I had to spend over 4 continuous hours with a gentleman before he could do the technique, and he suffered from such a bad inversion difficulty that even then he had to equalize very frequently when inverted.

Spending 4 hours in person is one thing, exchanging a few messages is much less effective.

It is possible that there is a problem out there which cannot be fixed; I have yet to encounter one, but if it does exist, it must be a very prominent genetic defect. I personally believe that if a person can equalize head up, then it proves that they can get air into their tubes, which means that it must somehow be possible to do so when inverted, without surgery.

Eric Fattah
BC, Canada
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Erik, I’m happy for you.
Erik, Zipy and other hand free equalizers, do you find there is a point in depth where the hand free technique no longer works for you? This seems to be what most freedivers say. I have a little theory about it. My theory is that, because the breathing cavities are not at ambient pressure, such as in the case of scuba, there will be some depth where the pressure at the entrance of the Eustachian Tube is too low to equalize the ear. Then nose blockage, become necessary to increase the pressure.

Compression of the lungs helps increase the pressure in the breathing cavities, but due to ribs and other hard structures, compression is not complete. This is why there is blood shift (blood being draw into the lungs, because of negative pressure) at extreme depth.

Just my theory. Like to hear your feelings and experiences. Maybe someday I will join you in the hand-free category.

yeah hands free equalisers are gifted, the ones that just have to wiggle there jaw etc, that sucks.

Hi Jason,
I use Frenzel with a jaw thrust and my head in "just right" position. I think relaxation is a huge factor here; I know it is for me. I need to be in dive mode and feel comfortable with the water....feeling very relaxed.
I can't do 1 constant Frenzel for 1 mouth full (this is what I do when using fingers on my nose); I need to pull the bottom of my mouth near my throat down (with my tongue), thereby opening the E tubes, then pump the air into them repeatedly as I descend. I should note that I have to have my mouth in this position before I dive, and already have started equalising at the surface, or I get blocked and must pinch my nose with my fingers.
I was diving to 40 metres with this method. I didn't try any deeper because I was alone.
I hope that helps a bit :)
Erik Y.
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