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.
Don
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.
Don